What about the Ethics of In Vitro Fertilization for Christians?

This week's article for the newspaper answers a follow-up from last edition's contraceptive explanation, extending the question to in vitro fertilization and other fertility treatments:

Q:  If there are concerns among Christians around the ethics of contraception, are there also similar issues raised in connection with In Vitro Fertilization and other fertility measures in light of Biblical ethics?

The inability to conceive or carry children to term has been a source of great heartache from the beginning of recorded history.  Women from ancient times like Sarah, Rachel, and Hannah were troubled by this problem and we have their stories recorded in the Bible, along with the Lord’s intervention in response to their prayers. 

One of the consequences when sin entered the world through our first parents was that our bodies and the world around them were thrown into general disarray.  We see this in natural disasters and our struggle to keep up with the assaults of the natural world.  We also see it in disease and dysfunction in our bodies – of which infertility is an example. 

Unlike Sarah, Rachel, and Hannah, many do not conceive naturally in answer to their prayers, but today, we have medical knowledge and treatments which could not have been imagined the ancient times in which those women lived.  While these have the potential to be a great blessing for couples seeking children, they also raise moral concerns for some Christians. 

There are a number of interventions which are not a subject of concern among Christians.  These include:  examination of reproductive health, medically correcting hormonal irregularities, and surgically correcting anatomical irregularities. 

The Roman Catholic Church raises the greatest number of concerns regarding responses to infertility.  Among these are concerns regarding the methods of obtaining samples for diagnosis, whether treatments interrupt the couple’s marital intimacy, and whether third parties become involved in the act of conception. 

Other concerns are shared by both Roman Catholics and other denominations of Christians.  For example, there is significant debate concerning the appropriateness of using genetic material from a third party in the process of conceiving a child.  For some, this raises both moral concerns about whether such a treatment constitutes adultery as well as social concerns about the impact on the family by the lack of biological connection to one of the parents. 

Likewise, surrogacy is a topic of debate among some Christians, because even though the genetic material came entirely from the married couple, a third party is carrying and birthing the child, raising similar concerns to those involved with using donor genetic material. 

In Vitro Fertilization requires probably the most complex examination among fertility measures. Some discourage this method based on the assertion that it is an unnatural interference between the married couple or involves a third party in conception, but the majority of consideration revolves around other factors.  The most prominent of these are questions concerning proper respect for human life. 

Because In Vitro fertilization is such a costly process, it is most practical to create numerous embryos at one time and freeze them until they are needed.  In most cases, numerous embryos are implanted into the mother in hopes that one or two will implant and grow to term.  However, when a large number of embryos survive, the mother is left to face the high-risk scenario of carrying all of them to term or the decision to abort several of them to reduce their number, which would be considered immoral by a majority of Christian traditions. 

It also leaves the question of what to do with excess embryos that were created during the process.  Many Christian traditions would consider most of the available options (which include removing them from cold storage to die, leaving them perpetually frozen, or making them the subjects of medical research) as immoral treatments of a living person. 

As a result, many Christians who choose to use In Vitro fertilization choose to take several measures to ensure proper respect for human life.  These include creating only as many embryos as can be used (even though this may incur additional cost) and implanting only as many embryos as can be safely carried.  In the event a Christian couple inadvertently finds themselves with embryos they are not able to use (which can happen due to unforeseen circumstances, in spite of attempts to avoid doing so), many are now choosing to offer those embryos for adoption so that they can be given life by another couple who is willing and able to carry them to term. 

Explaining Christian Positions on Contraception

For this week's newspapers, I (very briefly) explain the differences between different types of Christians on contraception and how this relates to Hobby Lobby and other recent Supreme Court and Affordable Care Act issues:

Q:  I am having difficulty understanding the religious convictions which led to the recent Supreme Court cases about health care and contraceptive coverage.  Can you explain why the parties to the case object to providing certain medications or treatments to their employees?

While this story that has received considerable attention and raised some intense emotional responses, the religious elements of the story have, unfortunately, been poorly explained or largely ignored in the majority of news coverage.  This missing element would reveal that rather than a two-position issue (contraception vs. no contraception) there is a vast diversity of approaches to this question among the various branches of Christianity plays a significant role in understanding the convictions represented in these cases. 

For one group of denominations, there would be no prohibitions whatsoever regarding contraception.  It would be viewed as a matter of unrestricted individual opinion, and no further inquiry regarding the method of contraception, nor regarding the mechanisms by which they function would be necessary.  The list of denominations with this approach would largely align with those with accepting stances toward abortion and approving positions toward same-sex relationships.  In some cases, members of this segment of denominations may even provide or promote contraceptive products as a matter of human care or social justice. 

On the opposite end of the spectrum would be those traditions which disapprove of contraception as a matter of principle.  Most notable among this segment would be the Roman Catholic Church, which approves of only complete abstinence or the natural timing of cycles as methods of avoiding or delaying pregnancy.  Additionally, there is an understanding among a small, yet broad, portion of the conservative evangelical community which encourages couples to be open to receive as many children as God would grant them.  Proponents of this end of the spectrum typically point to verses where God commands Adam and Eve, as well as Noah’s Family to “Be Fruitful and Multiply,” and the many Psalms and Proverbs which speak highly of numerous children as a blessing from the Lord.  They may also employ an argument from nature – that it is unethical to interfere with nature by the use of chemical or barrier contraceptive methods. 

The remainder the Christian spectrum falls between these two bookends.  For these Christians, children are acknowledged as a blessing, and openness to children is typically encouraged.  At the same time, it is also recognized that each family’s situation is unique, and some may find it necessary to provide a longer break between pregnancies or that medical, economic, or other reasons make limiting family size the wisest course of action. 

While they trust the conscience of each husband and wife to guide this choice, they place one firm boundary – that it is not permissible to take actions which have the potential to end the life of an already-conceived child.  In most cases, this would allow a husband and wife to use barrier methods of contraception as well as surgical sterilization, without concern, as dictated by their circumstances. 

Many would also be open to the use of traditional contraceptive pills, patches, and shots, although this is less universal due to questions about the potential of these methods to prevent a fertilized egg from implanting. 

IUDs are often seen even less favorably because of their potential to prevent implantation.  Those who observe this boundary would always exclude such methods as “morning after” pills, which intend to prevent ovulation, but have a secondary mechanism of preventing implantation of a fertilized egg.  They would also exclude “week after” pills or any method which exclusively prevents implantation after fertilization. 

It is this final category of contraceptives that were at the center of the most prominent of these cases.  In fact, the most prominent plaintiff in this series of cases actually provides 16 out of the 20 contraceptives specified by the Affordable Care Act, and only objected to providing those methods which have the intention or potential to end already-conceived life, for the reason that they believe they would be contributing to an act of murder by funding such methods in their insurance coverage.