ASSISTED REPRODUCTION - A CHRISTIAN CLINICIAN'S VIEW
By:
Elvonne Whitney, M.D.The struggle many infertile Christian couples face in their quest for a child is one that God is certainly sensitive to. Many Biblical examples, including that of Hannah (ISam. 1), attest to His caring, concern, and at times, intervention for those who desire an offspring. Many more couples than previously now have the opportunity to have their desired child using assisted reproduction technologies. However, these technologies raise important ethical and moral questions, and Christian couples and the health care providers assisting them do well to seek God's will in these areas. The church can also seek to assist such individuals in their understanding of God's will.
While most of this discussion will apply to any infertile couple, some of the issues discussed apply most specifically to those considering in vitro fertilization, egg or sperm donation, or the use of a surrogate mother.
First of all, let us remember how important individual freedom of choice is to God. I have seen many couples who struggle with much pain because of other family members' or church members' behavior and comments regarding their decision to use various assisted reproductive technologies. Some choose not to share their struggle or decisions with others because of such hurtful behavior, and as a result often feel very isolated. Some struggle with guilt, feeling that their difficulty conceiving a child is a result of past sins, and God is punishing them. Our God is a forgiving God, and whatever past acts may have been done, He views His children with compassion and forgiveness. The church should be a place where all such couples can receive support and compassion in their struggle.
The decision to use or not use such technologies is a deeply personal one, to be settled between a couple and God. The church family should value and protect each couple's individual privacy and decision in these matters, while offering comfort, understanding, and careful support in their seeking of God's will for those who choose to share their struggle.
For issues where no clear Biblical instructions exist, we must support individuals in their personal interpretation and application of the principles involved. We must tread very carefully in this area. God can speak to individuals just as easily, and perhaps more so, than He can speak to organizations in areas of such personal concern. This is not to negate the role of the community of faith in assisting couples in their struggle with these questions, or to limit the importance of the principles involved. But perhaps we do best to outline the issues and principles, and support individuals in their own application of them. Any creation of a "rule book" would go against the way God deals with His people in these personal areas.
Now let us consider some specific points. There certainly is clear scriptural support for a child having the benefits of a stable family. This is helpful in making a decision to limit the application of assisted reproductive technologies to married couples. A number of European countries have outlawed assisted reproduction for unmarried individuals on purely secular grounds.
However, there is a vast difference between using these technologies on unmarried individuals, and in applying such technologies to couples where one or both partners is unable to either produce eggs or sperm, or carry a pregnancy. Let us consider that heritage is composed of multiple factors. Genetic heritage is important, but not necessarily the most important. Social and spiritual heritage are vital as well. This is illustrated in several scriptural examples. Among these is the Old Testament Levirate rule, whereby if a man died with no heirs, his brother was to, in today's terms, inseminate his wife "so his name may not be blotted out of Israel" (Deut. 25:6). In essence, this was God's direction for the use of sperm donation to carry on the family line if an individual had no children.
Another example: both Rachel and Leah had sons for Jacob using their maids Bilhah and Zilpah (Gen. 30:3-12). This has many similarities to today's surrogate mothers. Also, Abraham used Hagar to produce an offspring because of Sarah's infertility. Though this caused problems later because of rivalry, etc. between the two women, God did not forbid it. While the specifics in these examples may be said to relate to the Hebrew culture, and other principles are illustrated here also, it does indicate God's appreciation for man's need to pass his social and spiritual heritage on to his offspring even if he cannot pass on his genetic heritage. God has created within human beings a desire to procreate and fulfill His original mandate to "Be fruitful and multiply" (Gen. 2:28). There may be instances where social and spiritual heritage are more important than genetic heritage.
There is no doubt that the use of assisted reproductive technologies raises difficult ethical questions. However, shouldn't Christians be in a better position than others to speak to these questions in the light of scripture and the Holy Spirit's guidance? We would do well to expend effort in understanding the issues the use of donor sperm or oocytes and surrogacy raise, and in developing effective ways to assist couples in dealing with these issues if they so choose, rather then summarily recommending avoiding them.
Human life must be treated with respect at all stages of development. This is Biblical. Any Christian couple should carefully consider ahead of time the moral issues regarding such things as the number of ova to be fertilized with in vitro fertilization, and the disposition of remaining pre-embryos. Simply discarding "unused" embryos does not follow Biblical principles regarding the sacredness of human life. The availability of cryo-preservation, or freezing, of such embryos is one alternative available. This can allow the couple to have further attempts at conception if the initial attempt fails. It may also allow the possibility of having more than one child, or the opportunity to donate such pre-embryos to another infertile couple who may be unable to have a child any other way. It is hoped that soon technology will allow us to freeze unfertilized oocytes, and this will make some of these decisions easier, in that only very few oocytes need be inseminated at one time and any remaining oocytes frozen for possible later use.
Another issue is that of multiple pregnancy. Some of the current technologies including in vitro fertilization significantly increase the chance for twins, triplets, and other multiple births. Because of the very high risk of severe prematurity and non-survival of babies from pregnancies with four or more fetuses, selective termination of one or more fetuses is available. This obviously raises important moral issues. Is it right to intentionally terminate one or more fetus so that the remaining ones will have a significantly better chance for survival? Is it right to allow the pregnancy to continue with several fetuses, with the likelihood that no babies may survive? Many see the Biblical imperative against voluntarily taking human life as an answer to this issue. Any decision is sure to be agonizing. Therefore, when using such technologies it is imperative to use every medical effort to minimize the possibility of multiple pregnancy so that such a decision will rarely need to be made. Thankfully, we can now control that risk to a large degree.
There are some other issues that any couple considering sperm or egg donation, or surrogacy, should prayerfully consider. These include the feelings of the wife and husband about a third party being involved in the conception of their child. There is also the question of whether and when to tell the child the details of his or her conception, and whether to tell family and friends. The couple will want to be sure all legal and medical questions are fully addressed. Also, many of these technologies are very expensive, and couples will want to be sure that they are using their financial resources wisely and in a way that God would approve.
There are many things that medical technology can do with our current understanding of God's laws. There are also many things that we cannot do. A major example of this is that once embryos, eggs, or sperm are replaced in the uterus, we have no more control over their further development. Whether or not pregnancy occurs, and how many embryos continue to develop, is out of our hands. God is still in control, and every conception is a miracle. In a sense it is as though God has said, "This far you may come, and no farther".
Let me point to one more Biblical example of God's view of infertility. Throughout his walk with God, Abraham was repeatedly promised a son (Gen. 15:4 and others). This son would begin a line of descendants that would outnumber the stars of the heavens (Gen. 22:17) and eventually lead to Jesus Himself. God fulfilled His promise to Abraham in a miraculous way (Gen. 21:1-7). While God may not choose to intervene miraculously in the lives of every infertile couple, He can certainly bless the efforts of Christian couples to have children using the technologies that our growing understanding of His wondrous ways allows. At times God has chosen to heal numerous physical diseases miraculously. However, He can also greatly bless the efforts of health care providers in applying our constantly growing knowledge to help heal disease and relieve suffering.
Should there be any fundamental difference between our view of other medical treatment and of Christian's search to fulfill one of their most basic God-given desires, that of having offspring? God is ultimately the Great Physician. I never cease to be amazed at His wondrous works each time conception occurs with or without assistance. As with any technology or power, we must use our growing understanding of human reproduction responsibly and under His guidance. And in doing so we can be partners with God in the joy of the recurring miracle of new life.
Every morning Rich & I talk on my drive in to work. He travels with his job, so he is gone for two weeks and then home for the weekend. We use this time to touch base and catch up. Nights around here are pretty crazy, and so we don't always get a chance to chat in the evenings. So this morning, we were having our morning chat and discussing our adoption plans. Rich expressed a lot of the same thoughts that I had posted last night on the blog, but not all of the same thoughts. He is leaning toward embryo adoption. I feel like my heart is in Africa.
He had some valid points, some of the same points I addressed in my post last night. Embryo adoption would be so much easier. Less time, less money, easier on the child to adjust to a new life. And he feels that we are still doing God's work because we are choosing a child that may otherwise have been destroyed. We are honoring their parent's decision to choose life.
I wish that babies just came easy :)
