Science in Christian Perspective

Some Implications of the New Reproductive Technologies*

Department of Anatomy
University of Otago
P.O. Box 913
Dunedin, New Zealand

From: PSCF 39 (March 1987): 31-39.
*The ideas expressed in this paper are discussed in greater detail in my book, Manufacturing Humans, recently published in the United States by Eerdmans. D. Gareth Jones (M.B.B.S. University of London; D.Sc., University of Western Australia) is Professor of Anatomy at Otago University in New Zealand. He has taught previously at University College of the University of London and at the University of Western Australia. Dr. Jones has published numerous books and articles in his field. He is the author of Our Fragile Brains (IVPI USA), Brave New People (IVPIUK), and Manufacturing Humans (to be published by IVPIUK in 1987).

In this paper I explore a range of implications of the new reproductive technologies, in areas that I consider to be crucial from the standpoint of Christian thinking and practice. In doing this I go beyond specific questions, such as the status of the fetus and the nature of personhood, and concentrate instead on broader issues, such as the value of human life, our approach to procreation and infertility, and the nature of the family. This is an exploration of broad themes which will, I hope, elicit a serious assessment of basic attitudes towards the new (and not-so-new) reproductive technologies.

Value of Human Life

The reproductive revolution has forced me to go back to biblical and theological principles, in an attempt to extract those principles of relevance to the questions raised by contemporary biotechnology. The following provide a hint as to the sort of issues I think we should be considering.

a. Human life, for each one of us, is on loan from God.1 It is a gift from God, and should never be viewed as primarily being of intrinsic biological value. Its value is derived from God, and is to be seen as coming from God and as being for his use. The value of human life can never, therefore, be isolated from its relation to God. Hence, in assessing how to deal with difficult ethical questions in the realm of bioethics, we must always work within this framework rather than view each human life in abstract absolute terms.

b. The wholeness of human beings implies that their biological-spiritual unity must be treated with seriousness. It also means that the biological aspect of human life cannot be subdivided into discrete genetic and environmental components. Consequently, human life cannot be defined solely in terms of its genetic uniqueness, any more than it can be defined only in environmental, social or spiritual terms. If this is true, it follows that the individuality of human beings derives not only from their genetic uniqueness, but also from the myriad environmental and spiritual factors essential for healthy personal development. Individuality is lost when there is no scope for growth and fulfillment as a being in one's own right, and when the opportunity to become oneself is denied or frustrated. What is of critical importance, therefore, is human value rather than the mere existence of human life in its barest essentials.

c. Human life should always be characterized by the potential to transcend what one is at present. For the individual this entails the potential to become more fully human in all aspects of one's life-in matters of health and culture, in family life, in the nature of one's employment, and in obedience to God's revelation and specific directives. It also implies that we are to assist and encourage others, so that they have the opportunity under God of realizing their potential. Potentiality, in these terms, applies with equal force to prenatal and postnatal life.

d. The quality of an individual's life is important. It is unfortunate that the term "quality of life" in bioethics has, in the eyes of some, become confined to the biological or medical quality of life. Equally unfortunate is the backlash this has entailed, so that for others 11 quality of life" is virtually a term of abuse. Nevertheless, the quality of life in a broad sense is seen to be an essential attribute of a Christian perspective on human life. The goal for the lives of individual human beings is an adequate physical existence, and a satisfactory day-to-day experience of family and social obligations, work, recreation, moral responsibility, and a whole range of challenges and expectations. It also incorporates spiritual experience, the service of God and one's fellow human beings, and interaction with other humans in love, forgiveness and hope.

It follows that any available technology may be used if it contributes to the richest possible life for the individual and for the enhancement of family life. Technologies, therefore, should cause us grave concern if they devalue the individual and his or her relationships. Conversely, and in terms of medical priorities, technologies should be positively encouraged if they bold out the possibility of enriching the life (or future life) of that person and of those closely related to him or her.

e. The undervaluing of human life may take many forms. It may certainly stem from the widescale destruction of fetal life for superficial reasons. But it may also be the result of the irresponsible creation of new life-within marriage or outside of it, in bed or in the laboratory. It may stem from pregnant women smoking or drinking alcohol, from unjust social or commercial practices, from an inequitable distribution of resources within our society or between societies, and from gross inequality of opportunities within a society.

Human life is tragically easily wasted, and all instances-whatever the motives-are an implicit denial that human life is precious to God. All forms of pointless human wastage are destructive of hope and question the value placed upon human life by God.

f. Although all human life has value and worth, choices between one human life and another are sometimes inevitable, or one group of humans is favoured above another group. Many such choices are invidious, and we should aim to ensure that, as far as possible, our social and economic systems do not precipitate these dilemmas with their overtones of injustice, exploitation and consequent despair. In the final analysis though, our world is a sinful one, and it is this that forms the basis of the ethical ambiguity, the moral imperfection and the errors of judgement with which we have to contend. Much as we might wish that all human life was of absolute value, in practice as well as in theory, this does not appear to be the case. Is it possible to argue that the lives of any particular groups of humans should be regarded as inviolate? If this is done on the grounds that the weak are entitled to the strongest protection, we may find that it fails to do justice to the overall challenge presented by the Christian imperative to value and enrich all human life.

g. Choosing between the lives of different human beings is a reflection of our responsibility as human beings under God. Such responsibility has, of course, many more ramifications than just this particular one. Our technological prowess has brought within our control our own potential as human beings. This is an extension of the God-given mandate to subdue the earth and bring it within our control. We are responsible therefore, both for ourselves and others as human beings, for nature in general and the human species in particular.

Human life cannot be defined solely in terms of its genetic uniqueness, any more than it can be defined only in environmental, social or spiritual terms.

Technology has possibilities for the good of human life, and it is appropriate that we, as created beings, should fulfill our God-given directive to utilize it in ways that will further human welfare. Choices are implicit in this, between one application of a technological development and an alternative application; between one individual who could benefit from a particular procedure and another individual who has to lose out because of a lack of resources; between children in one country who benefit from expensive medical care and children in another country for whom even the most basic of medical resources are unavailable. However complex some of these choices, they are nevertheless choices that individuals or societies are making repeatedly either deliberately or without thinking.2

The perspective which I believe emerges from the biblical teaching on human life is that our technological expertise is one of the riches bestowed upon us by God, and as such is to be employed wisely and responsibly. We are to be to be thankful for these riches, but we are also to realize the responsibility bestowed upon us to be faithful in our stewardship of such abundant resources. We are never to confuse these riches with faith. If we do, we confuse the creature with the Creator, and the difference between inordinate dependence upon human expertise and worshipful dependence upon God.

Procreation and Infertility

The "Brave New World" of reproductive technology has its roots in one of the most inauspicious of all longings-the desire for a child. It is not the desire for power or glory or even a perfect body, but the much humbler longing for progeny. There are, of course, additional elements and we would be unwise to downgrade these. Nevertheless, the drive behind much of the work in reproductive technology is the problem of infertility. It behooves us therefore, as we seek Christian directions for our bioethical thinking, to pay sufficient attention to both the place and importance of infertility in almost every aspect of this debate.

The desire for children stems from our creation as male and female, in other words, as sexual beings. The biblical concept of personhood is very closely related to sexuality, which fulfils several fundamental needs in human beings, including the need for companionship and intimacy and also the desire to procreate. While individuals may live fulfilled lives in the absence of one or more of these, they remain basic to human life as a whole.

The procreative urge is built into our biological, that is, our created, make-up. The desire on the part of a woman to be pregnant and to give birth to a child is an essentially human desire. The strength of the urge in many women reflects what a woman is in the image of God. A fetus, and subsequently a child, is part of the woman in a profound way, something it is perhaps impossible for a male to understand and which has biological, psychological and even spiritual implications for the woman herself. This underlines the gravity of induced abortion on the one hand, but it also underlines the gravity of giving up a baby for adoption on the other.

We should aim to ensure that ' as far as possible, our social and economic systems do not precipitate these dilemmas with their overtones Of injustice, exploitation and consequent despair.

By itself, of course, the desire to bear a child does not bypass the need to make ethical decisions. Such decisions still have to be made when confronted by abortion or adoption, both of which have to be decided on other grounds. Neither does it suggest that a single woman or a lesbian couple should bear children. What it does is direct our attention to what for many women is a very powerful and very understandable desire. This, in turn, stresses the gravity of the choices that are repeatedly being made in the reproductive area, and these are accentuated by the ever-increasing choices being held out by modern reproductive technology and also by the influence of social pressures.

In the Old Testament we find certain patterns for circumventing childlessness, such as the patriarchal pattern and levirite marriage.3 Whatever may be made of these particular devices, they certainly appear to illustrate God's concern for the infertile. It may well be legitimate therefore, to search for remedies to overcome it. What does come through in the Old Testament is that the goal of these procedures was to strengthen the family unit, even if some of the attempts were misguided. What we have to decide is whether these Old Testament devices have any relevance for our quite different form of society, and if so, whether they provide us with guidelines for practices of gamete donation and surrogate motherhood.

This [profound human desire] underlines the gravity of induced abortion on the one hand, but it also underlines the gravity of giving up a baby for adoption on the other.

There appears to be no suggestion that we actually employ these Old Testament practices today, especially in view of the involvement of sexual intercourse by a third party and the possible involvement of polygamy. Can we learn anything though, from the importance to one society of providing a family with an heir, when the demand in our society is to provide a husband and wife with a child? This raises the issue of the nature and extent of the family, to which far too little attention has been paid by theologians.

We are still left with the question of how far we should go in attempting to alleviate infertility. Regardless of any specific answers we provide, we need to remember that the availability of a technological procedure is never sufficient reason for using it. Somehow or other we are going to have to put together biblical principles and directives, and the intertwined threads of infertility, technological expertise and the challenges of procedures such as gamete donation and human embryo research.

Another issue I should like to raise is perhaps an unexpected one in this context, and it is that of adoption. I shall not go into the theological dimensions of adoption,4 except to say that it appears to have two prominent emphases-the openness of God in accepting into his family those who are undeserving, and the obligation placed on the followers of Christ to assist children and others in need. From here it is but a short step to the establishment of orphanages and acceptance of the practice of adoption. The issue confronting us is whether adoption as we. know it today is simply concerned with the welfare of the adopted child.

Most adoptive parents have traditionally been infertile couples, or alternatively, couples who for some medical reason have decided against having children (or further children) of their own. For as long as there was an ample supply of babies awaiting adoption within the community concerned, the desire of couples for a child (or children) and the needs of the babies available for adoption converged. Although the desire to avert childlessness would probably have been uppermost in the motives of the couples concerned, this fitted in very well with the welfare of the adoptive children who were accepted into families rather than left to face a future of institutional life. There were, of course, difficulties since certain children-notably those with mental or physical handicaps, and those with a different cultural or ethnic background-were not readily accepted for adoption. In this regard, the social practice of adoption has generally fallen short of adoption in biblical terms.

These problems with adoption have been markedly accentuated over recent years as the number of "acceptable" babies available for adoption has dropped dramatically in countries with liberal abortion practices and where single parents are accepted. The result has been an increasing emphasis on one particular motive for adoption, namely, the overcoming of childlessness. There is no longer any problem in finding suitable adoptive families for "acceptable" babies; the social problem of meeting the needs of these children has, therefore, all but disappeared. With this trend, the face of adoption has changed: its role in overcoming childlessness has come to the fore, as has the plight of the "unacceptable" babies.5

Not infrequently, it is argued that pregnant single women (very often teenagers) seeking an abortion should be counselled to continue with the pregnancy, and make the child available for adoption. In this way the fetus' life will be saved, and a childless couple will be provided with a child. While I accept that there is considerable merit in both these consequences, we need to be aware that this view of adoption is quite different from the traditional one. Instead of the needs of an existing child being met by being made part of a family, a child is now being brought into the world in order to meet the needs of a childless couple.

I am well aware that this is only part of the issue, since a fetus' life is also, being saved; nevertheless the way in which the argument is expressed is putting the spotlight on the couple longing for a child. In general social terms this may be quite acceptable. We need to realize, however, what it is that we are doing: we are providing a couple with a child which is not genetically theirs, and we are doing this for the sole reason that they desire a child. In moving in this direction we are accepting the notion that the nuclear family need not be a enetically homogeneous unit. This is being done with only limited regard for humanitarian reasons stemming from concern for the welfare of the child.

It is my contention that contemporary adoption enshrines a range of awkward ethical dilemmas, many of which are also encountered (sometimes in more extreme forms) in the new reproductive technologies. For the couple seeking a child for adoption, various choices confront them: between a healthy child and one with some form of handicap. between a child with their own racial characteristics as against one with different racial characteristics. between a child unrelated to them genetically (the adopted child), as opposed to one completely or partially their own in genetic terms but conceived using some artificial means. The couple also needs to consider the motives behind whatever choice they make.

Adoption also involves another party, and this is the woman whose child it is-the biological mother. While it is easy to advocate that a woman (frequently single and frequently a teenager with an "unwanted" baby should give up the baby to a couple longing for one, the biological and psychok~gical bonds between the biological mother and the child are still broken. We should be aware that the arguments used to justify this will have relevance for arguments used in favour of surrogate motherhood. While there are immense differences between the two situations. there are also areas of overlap that we would be foolish to ignore.

Nature of the Family

For me, one of the great implications of the new reproductive technologies is to sort out the boundaries of the family as a unit. This issue is raised by the whole area of gamete donations and also by surrogacy in its many forms.

The control which can now be exerted over reproduction means that the production of children can be divorced more and more readily from the context of the "familv" and from the marriage relationship. A major difficulty, however, is that discussions rarely get beyond the conjugal or nuclear family, with the result that unrealistic expectations are placed on the nuclear family. This is particularly evident when infertility and childlessness are threatening the stability of this family unit. A general principle to emerge from the biblical teaching is that there is a mutuality of relationships within the "family," whether this be the nuclear family, the extended family or the church family.6 To expect a husband and wife to cope in isolation with the trauma of infertility, or with bringing up a handicapped child (or incidentally with many other social pressures) is to place upon them a burden totally alien to Hebraic and Christian precepts.

In sociological terms, the concepts of family and marriage crop up repeatedly within society, and so they have to be tackled from this perspective as well as from the Hebraic-Christian one. Unfortunately, there are no ready definitions, especially of the family. It may refer to a married couple alone, a married couple with children, three generations of related people, an unmarried couple with children, a married couple with adopted or foster children, a married (or unmarried) couple whose children have grown up and are living away from home, a solo (divorced, widowed or single) parent with children, and so on. From this range of possibilities it is clear that, while marriage frequently has a great deal to do with the family, this is not always the case.

Contemporary adoption enshrines a range of awkward ethical dilemmas, many of which are also encountered (sometimes in more extreme forms) in the new reproductive technologies.

Robert Snowden and collaborators at the University of Exeter7 recognize two essential ingredients in family life. These are: (1) an exclusive sexual relationship, and (2) the birth, nurturing and upbringing of children. For them, family and marriage are concerned primarily with issues surrounding procreation. Taking this further, they argue that familial relationships normally imply a shared genetic background. The genetic link is a direct one in the case of children and their parents, and an indirect one where the birth of children unites previously unrelated sets of kin. In this way, direct and indirect genetic links are important in establishing "family" relationships, although such relationships are possible in the case of childless couples and their respective in-law kin. Within "normal" family situations, there are a number of assumptions. These include recognition of the mother and father, their respective roles in being the biological (genetic) parents of the children as well as their social parents, and the exclusivity of their sexual relationship. These assumptions are shattered by artificial interventions into the reproductive process, and they are also shattered by adultery and adoption. Doubts arise over recognition of the parents, when the genetic link between the two parents and their children are broken, or when all stages in the reproductive process are not carried out in the same woman.

While genetic continuity within a family may be the simplest situation to deal with, the lack of such continuity can be handled in the context of loving, accepting relationships.

Under normal circumstances the genetic and nurturing functions of parents are difficult to separate. Once a division is created between these functions, difficulties in recognition may well ensue. This is because a division has been created between the child's past, in terms of family history, and its present, in terms of current family relationships. The crucial role of nurturing the child after its birth (the obvious f ace of parenting) may be carried out by those who have had no involvement in the child's past. This is when doubts are expressed about the child's real parentage or about the father's status as the real father (as in artificial insemination by donor, AID).

Whatever the child's genetic status, and whatever genetic links there may or may not be with the (social) parents, a successful family environment is one in which the relationships are based on respect and trust. Relationships of this calibre are crucial to the well-being and healthy development of children. Without them family life disintegrates and is rapidly undermined. In general, important support is provided by society's recognition of marriage and the family (including non-genetic relationships such as in adoption). If society were to conclude that family relationships were no longer worth supporting, the implications for family life could be far-reaching.

From what I have said a number of points emerge. First, monogamy is the ideal pattern in marriage. If this is so, it follows that the ideal family pattern is one in which there is genetic continuity between the parents and children.

Second, the extended family has a great deal to recommend it. In our contemporary societies it may encompass not simply different generations of the one genetic family, but a nuclear (genetic) family together with one or more unrelated individuals such as single people, infertile couples, foster children and young people. Although extended families may take many different forms, a central feature of them should be a welcoming atmosphere with trusting relationships. It is this mutuality of support and care that is important. In this way, the loneliness and isolation of the single person or the childless couple may-to some degreebe overcome, while the excessive demands made by children on the parents of a large family or on a solo parent may be alleviated.

The quality of the relationships existing within the nuclear or extended family is the critical element in the nurturing of children. It is this that provides an appropriate context within which a child may begin to realize its potential. Once this is established, it can be seen how lack of genetic continuity can be accommodated. While genetic continuity within a family (in its narrow context) may be the simplest situation to deal with, the lack of such continuity can be handled in the context of loving, accepting relationships. It is within this framework that the adopted or fostered child can flourish, as can the child born out of wedlock, or reared by a step-parent, or conceived and born with the aid of a diverse range of reproductive technologies. The fundamental) questions from a Christian perspective can then be seen to center not so much on the technology per se, but on the context in which it is used and the family environment in which the offspring will be reared.

Significance of Fertilization

Some of the most difficult implications of the new reproductive technologies for us to cope with are those revolving around the event of fertilization. For one group of people, those who are desperately longing for a child, fertilization has been elevated to the status of an idol. It is the one thing they want more than anything, and, for some, virtually anything may be sacrificed to attain it. Hence, the willingness to cross previously uncrossable marriage boundaries. Paradoxically this is not the only group who may be in this position. At the other end of the spectrum, those who appear to place more value on embryonic life than on any other form of human life have also made it an idol. For them, once new human life has been conceived, nothing whatsoever should come between that nascent life and its realization in the birth of a child. All the weight of the 11 sanctity of human life" has to be borne by the event of fertilization, so that idol status has, in effect, been bestowed upon fertilization.

I realize this is a provocative statement. It is made, however, in an effort to make us ask how adequate (or otherwise) is this particular traditional view of fertilization at coping with the challenges of the new reproductive technologies. In saying this, I am not prejudging these technologies; I am not arguing that they have to be accepted and that traditional views of fertilization have to be altered. Rather, I am asking whether the weight many Christians have placed on fertilization is not too much for it to bear.

Perhaps I can illustrate this, and related points, by reference to three groups of issues. The first of these concerns contraception. Let us imagine four couples: A, B, C and D. Not one of them wishes to conceive. Couple A decide not to have intercourse; thereby preventing a possible future child' from coming into existence. Couple B have intercourse; since they are using an oral contraceptive. fertilization does not occur, and no child results. Couple C have intercourse, and the wife is using an intra-uterine contraceptive device (IUCD); fertilization does occur, but the embryo is prevented from implanting: no child results. Couple D have intercourse, but no contraceptive is being employed since they think they are infertile and have no reason to expect to conceive. Fertilization, however, occurs on this occasion; a child is not wanted on account of the wife's chronic ill-health; a first trimester abortion is carried out, and no child results.

All the weight of the "sanctity of human life" has to be borne by the event of fertilization ' so that idol status has, in effect, been bestowed upon fertilization.

These four, couples pose immense challenges to our ethical decision-making, and demonstrate clearly the stress we place on fertilization. The intention of all four couples is the same-none of them wishes to conceive and bring a new human being into existence. The result in all four cases is the same, and yet in two of them fertilization occurs. Are couples C and D acting unethically, or is there no dif f erence between all four couples? In terms of the principles outlined previously, there is a difference ethically between the actions of A and B on the one hand, and those of C and D on the other. The principles dealt with earlier do not rule out the actions of C and D under every circumstance. They do, however, see them in hierarchical terms, with the actions of both C and D being less acceptable than those of A and B-and D being more objectionable than those of C. In both instances, they should only be resorted to in situations where all other contraceptive procedures have failed, and where there is conflict between two courses of action both regarded as evil. If, however, fertilization is used as an absolute landmark, the actions of C and D become unethical.

A second illustration refers to couples E, F, G, H and I. In this case the couples wish to conceive. Couple E are fertile; they have intercourse and fertilization occurs. Each time they want to conceive they know they will be successful within two to three months. Couple F are fertile but there are certain sexual problems requiring counselling. With help, however, they overcome these problems and are able to conceive. With couple G, the male partner has an infertility problem. However, the use of artificial insemination by the husband (AIH) helps to circumvent this problem, and fertilization occurs using AIH. In the case of couple H, there is an infertility problem on the female side. This is solved by microsurgery on her uterine tubes, and fertilization subsequently occurs. A similar problem exists with couple 1; surgery is unsuccessful in this instance, although fertilization is brought about using in vitro fertilization (IVF). 

In each of these cases the couple wish to have a child of their own, derived from their own genetic materials. They do not want to introduce a third party into their marriage relationship. Each of them is successful, although different avenues are used. Each of them would, ideally, have wanted a child in the simplest, easiest and most natural fashion-just like couple E and yet they are unable to do so. The question is, Have couples F to I acted less ethically than couple E? Is there any distinction between the actions of couples F and G, both of whom have received therapy and yet only couple G have had artificial assistance in the reproductive process itself? Is there any distinction between couples H and I, both of whom have the same problem (blockage in the female partner's uterine tubes) and resort to the same initial treatment (microsurgery to repair the blocked tubes); and yet couple I had to go further and employ IVF?

Yet again, there is ethical uncertainty. The goal of all five couples is the same-the production of a child from their own bodies, a child who is the outcome of their marital love. in none of these instances has there been any abrogation of the marriage bond or any desire to do so. In each case the desire has been to raise a family of their own, to care for and to bring up any resulting children within the confines of the love and warmth of a couple committed to each other and also to others for whom they have responsibility. Any differences between these couples stem from the extent of their fertility, and the intrusion of therapy into the reproductive process. On the basis of the principles outlined previously, there are no ethical differences between the actions of any of these couples. When undue emphasis is placed on fertilization, however, AIH may be regarded as unethical, and IVF almost definitely will be viewed as such.

A third set of illustrations concerns couples J, K, L and M in an IVF program. Couple J conceive using the simplest form of IVF, with the husband's sperm and the wife's ovum; no freezing of embryos is involved. In the case of couple K six embryos are produced. Two are transferred to the wife's uterus on each of three successive months; she becomes pregnant on the third attempt. Although four embryos were initially frozen, none remain at the end of the treatment period. With couple L six embryos are again produced; in this case, however, the wife becomes pregnant on the first treatment, leaving four spare embryos. All these are used a couple of years later to provide the couple with a second child, so that no spare embryos remain. In the case of couple M, six embryos are produced and pregnancy occurs after four have been used. The two spare embryos are not required by this couple, and are discarded. Once again, there are ethical uncertainties which have nothing to do with transgressing the bounds of the marital relationship. They do, however, raise once more the question of the artificial assistance of, reproduction, and the production of an excess number of embryos, their freezing, and their fate. When stress is laid on fertilization, none of these procedures will be ethically acceptable. However, the principles I have discussed open the way to the actions of couple J. The actions of couples K through M are, however, more problematic since the freezing of embryos is undertaken knowing that there may be surplus ones to the couples' requirements. There is no way of knowing whether this will or will not be the case in any individual instance. The matter can only be resolved in terms of the status ascribed to the embryos under these circumstances.

These illustrations highlight some of the uncertainties surrounding the event of fertilization. These include a reassessment of the acceptability of contraception (both natural and artificial), they introduce conflict between giving "life" to the pre-implantation embryo and the legitimacy of embryo donation, and they bring to the fore the competing claims of the pre-implantation embryo, the later fetus, and postnatal human life.

Undue emphasis on fertilization does not eliminate conflict and uncertainty. In fact, it increases both conflict and uncertainty. The nature of the uncertainties has, however, been changed, and the repercussions are enormous for almost every facet of reproductive bioethics, and even for our views of marriage and the family.

Concluding Remarks

The implications of the new reproductive technologies are diverse. Some are specific, and bring us face-to-face with specific decisions-approval or disapproval of AID, IVF, the freezing of human embryos, et cetera. Others, however, are of a much more general nature, touching as they do on our attitudes towards infertility, adoption, and the family. Above all, these technologies should be forcing us to question the way in which we make ethical decisions in many "non-technological" (as well as "technological") areas of our lives. Perhaps some of our widely accepted attitudes are not as firmly based in theological realities as we might like to think.


1. For a fuller discussion of some of these points see J. Robert Nelson, Human Life: A Biblical Perspective for Bioethics, Fortress Press, Philadelphia, 1984.

2. The making of choices such as these is a salutary reminder that there can be no escape from such decision-making, which frequently has to be undertaken on financial grounds. This occurs not only in the medical area, but also in, for instance, the planning of road systems where costs and safety factors are integral facets of planning. These general considerations are relevant to the IVF debate, since one of the reasons sometimes given for rejecting IVF on moral grounds is that choices have to be made between one embryo and another. This is considered by some to be unethical, entailing as it does the choice of one "human life" at the expense of another. Quite apart from the observation that this is a constant occurrence in natural fertilization, it is also placing demands on our ethical system that we do not make in other areas.

3. For biblical references to these patterns, see Genesis 16:1-15, 30:1-13; Deuteronomy Z5:5-10; Genesis 38. For a New Testament reference to one of these illustrations, see Galatians 4:22-27.

4. For an outline of the theological dimensions of adoption see, for example, J. I. Packer, Knowing God, Hodder and Stoughton, London, 1973.

5. The human side of infertility and adoption, as well as the plight of unacceptable babies, is brought out in joy Cooke's book, Why Us, Lord?, Pickering Paperbacks, Basingstoke, 1985. Perhaps the most controversial and unsatisfactory aspect of this personal account of the trauma of infertility comes with the Cooke's rejection of a mentally retarded baby, suffering from galactosaernia, who was offered to them for adoption. While the pathos of this choice is self-evident, the rejection of the child is interpreted as God's will for them. Since the author was strongly opposed to abortion, one is left wondering what is God's will for those who have no choice about caring for a mentally retarded child. This incident also throws a great deal of light on contemporary attitudes (even on the part of some Christians who would resolutely deny such attitudes) implicit in the emphasis upon adoption as a means of overcoming childlessness rather than of caring for a child in desperate need of a loving family, the importance attached to an adequate 1. quality of life" (defined in strictly biological terms), and the assumption that children are an essential part of marriage.

6. For an analysis of the "family" in the Old Testament see, for example, a paper by Michael Schluter and Roy Clements entitled "Family Policy in Old Testament Israel: Some Lessons for British Social Policy in the 1980s," published by the Universities and Colleges Christian Fellowship (UCCF), Leicester, 1984. Further aspects of the concept of the family are to be found in F. J. Kline, "Family," in Baker's Dictionary of Christian Ethics, Baker Book House, Grand Rapids, 1973, pp. 237-242; in T. C. Mitchell and D. W. B. Robinson, "Family," "Household," in J. D. Douglas (ed.), The Illustrated Bible Dictionary, Part 1, Inter-Varsity Press, Leicester, 1980, pp. 500-502; in J. 1. Packer, M. C. Tenney and W. White (eds.), articles on "Family Relationships" and "Birth and Death," The Bible Almanac, Nelson, Nashville, 1980, pp. 411-419 and pp. 440-449.

7. R. Snowden, G. D. Mitchell and E. M. Snowden. Artificial Reproduction: A Social Investigation, Allen and Unwin, London, 1983.