Why the Church Needs Bioethics

A Guide to Wise Engagement with Life’s Challenges

Zondervan, John F. Kilner

• Publisher: Zondervan Academic
• Year: 2011
• Print ISBN: 9780310328520
• eBook ISBN: 9780310493051
• Topic: Theology & Religion
• Subtopic: Christian Ministry

In a world where incredible medical technologies are possible … does “can do” mean “should do”? Why the Church Needs Bioethics helps you understand and constructively engage bioethical challenges with the resources of Christian wisdom and ministry. Three rich and true-to-life case studies illustrate the urgency of such bioethical issues as reproductive and genetic technologies, abortion, forgoing treatment, assisted suicide, stem cell research, and human enhancement technologies. Leading Christian voices bring biblical and theological perspective to bear on the incredible medical technologies available today; mobilize useful insights from health care, law, and business; and demonstrate the powerful ways the church can make a difference through counseling, pastoral care, intercultural ministry, preaching, and education. This book equips students, church and lay leaders, and people in health-related fields with the knowledge to make faithful bioethical decisions and to help foster a world where human beings are shown respect as people created in the image of God. Contributors to Why the Church Needs Bioethics include leading Bible and theology scholars, such as D. A. Carson and Kevin Vanhoozer; leaders in the areas of preaching (Greg Scharf) and ethics (Scott Rae); and 15 other experts in the fields of biblical-theological studies, ministry, communication, business, law, healthcare, and bioethics.

Part One
BETTER BIRTH

CASE STUDY

HAVING A BABY THE NEW-FASHIONED WAY

Betty (43) and Tom (45) have been married for ten years. As a couple, Tom and Betty are requesting an in vitro fertilization (IVF) team at a nearby infertility clinic to assist them in achieving a pregnancy using Betty’s sister’s eggs and Tom’s sperm. In this process, Betty’s sister, Laura, will undergo a superovulation process to increase the number of eggs she can contribute. Just before ovulation, her eggs will be removed from her body and fertilized in the laboratory. Some of the resultant embryos will be transferred into Betty’s uterus two days after fertilization. The medical risks are small but real.

As a couple, these college-educated professionals are financially secure. Betty is a buyer for a major retail chain. Tom does accounting in a county office. Building a fine house while advancing in their careers had pushed childbearing interests into the background. Betty began to raise the idea of having children about five to six years into the marriage. As she approached forty, Betty noticed that she had the house she always wanted but no children. Following intense discussion, Tom and Betty decided to have children. After being off birth control for a year with no pregnancy, Betty became concerned. She became meticulous about tracking her cycle and having sex. What surprised them both was a heightened interest in spirituality. They began to attend an active Christian church with a contemporary-style service. Later they accepted a cordial invitation to join a small home fellowship group, and they participated whenever it was convenient.

As cycle after cycle passed without her becoming pregnant, Betty could no longer let the matter rest. The couple began to seek out medical advice. In the meantime, Betty was finding it difficult socially to be around children and couples who had children. She was progressively feeling more isolated and “on the outside.” This increasingly affected the couple’s social life, which added tension to their relationship with each other as well.

Tom and Betty have since received extensive unsuccessful treatment for infertility. Betty has responded poorly in her IVF cycles, and despite six attempts has never reached the stage of egg retrieval. Her age is thought to be a significant factor in her inability to produce mature eggs. Prior to their marriage, Betty became pregnant by Tom; however, the couple chose to terminate the pregnancy because they felt they were neither emotionally nor financially ready for parenthood. Adoption is not an option for them. Their desire is for either a genetically related child or none at all. Tom seems to be more ambivalent than Betty about parenthood at this season in his life, but “wants to make his wife happy.” The relationship and marriage have been stormy at times but are currently stable. Tom is concerned that Betty is putting all of her energy into becoming pregnant. Consequently, being together is far more stressful and less enjoyable.

Betty has asked her sister, Laura, age thirty-eight, to donate her eggs so that Betty and Tom can have a child. Laura is on the other side of a contentious and costly divorce. Her marriage was troubled from the start by out-of-control spending and a husband who had trouble remaining faithful. His business bankruptcy left her in desperate straits financially. She finds comfort in raising her two children, ages three and five. She states that she has finished her family and desires no more children. She expresses delight in being able to help her sister. She lives 150 miles away, however, and will have to accept the inconvenience of staying with Betty and Tom for several weeks while preparing for the procedure. Her children will come to stay also.

There are several areas of potential conflict:

1. Disagreement over the issue of secrecy. Laura believes the entire family should know about the procedure and that the child should be told, in Laura’s words, “about my contribution to its genetic heritage.” Betty is adamant that the donation be a closely held secret with no one else knowing. On this matter, Tom and Betty speak with one voice.

2. The use of preimplantation genetic diagnosis (PGD) and amniocentesis. Laura wants to be sure that any child she is partly responsible for bringing into the world is healthy, whereas Betty does not think she wants to know about problems. She is certain she could not go through an abortion if genetic abnormalities were discovered by using amniocentesis to test the genetic health of the developing fetus. Tom agrees with Laura’s commitment to doing whatever it takes to ensure that only a healthy child is born. But he suggests that abortion could likely be avoided by genetically screening the embryos using PGD before any are implanted, so that only healthy embryos are implanted.

3. Plans for unwanted healthy embryos. Tom, Betty, and Laura learn that the embryos not transferred to Betty’s uterus will be frozen for future use, but may never be needed by Betty and Tom if all goes well the first time. So Betty suggests that any extra embryos be made available to other couples who, like her and Tom, cannot conceive and do not have a sister such as Laura to provide the eggs. Tom and Laura indicate they would prefer to sell the embryos for stem cell research, since they have heard about dozens of ways that sick people are already being helped by stem cell treatments.

4. Superovulation versus surrogacy. There is a level of uncertainty about whether Betty can successfully become pregnant and carry a child through to birth, even if healthy embryos are produced. So Betty and Tom have also asked Laura if she would be willing to serve as a surrogate mother and handle the pregnancy stage for her sister. They have pointed out to her that she could simply be inseminated with Tom’s sperm and not have to risk the dangers of drug-induced superovulation. Laura replied that pregnancy would require a much greater effort on her part, and that Betty and Tom would need to pay her for that. In fact, she has added, all this talk of the risks of superovulation has made her think that she should also be paid something even if she provides only her eggs and not her uterus.

5. The complex relationship among them. Betty denies any concerns about her relationship with Laura. She and Tom stood by her sister during her tumultuous marriage. She feels that her sister owes her this help. As Betty puts it, “Laura got all the good eggs.” Laura and Tom have always gotten along well. Laura says she has the best brother-in-law in the world and would love to help him have a child. So Betty encourages Tom to try to negotiate favorable terms with Laura.

CHAPTER 1

WISDOM FROM THE OLD TESTAMENT

Richard E. Averbeck

The situation of Betty and Tom, on which this chapter is based, is reminiscent of millions of similar situations today and throughout human history. It is part of our human groaning: “We know that the whole creation has been groaning as in the pains of childbirth right up to the present time. Not only so, but we ourselves, who have the firstfruits of the Spirit, groan inwardly as we wait eagerly for our adoption as sons, the redemption of our bodies” (Rom. 8:22–23).¹

For a woman, the anguish of not being able to have a child can far exceed “the pains of childbirth.” We live as fallen people in the midst of a fallen world, all of which are in “bondage to decay” (v. 21). For some couples, this particular kind of groaning becomes an all-consuming part of their lives, at least for a time, if not permanently. It spoils everything, so to speak. Once they encounter this obstacle, no part of their marriage relationship or any family or other social relationship escapes its dark shadow. They will do almost anything to overcome it, no matter what tactics may be involved. Some handle it better than others, but the pain involved in not being able to have a baby is very real and can be overwhelming.

After long-term disappointing failure at trying to have a child naturally, Betty and Tom try in vitro fertilization (IVF) with Betty’s eggs, but without success. As a result, they now intend to use eggs provided by Betty’s sister, Laura, or perhaps even have her serve as a surrogate mother for them by being artificially inseminated with Tom’s sperm. Meanwhile, a considerable amount of marital and social distance and conflict have arisen between them and with others. So they are trying to manage the complications of both the infertility itself and the ways they have been handling it. It is not a happy situation and, realistically, there is a great deal of potential for serious ongoing problems even if they should manage to find a way to have a baby “in the new-fashioned way.” As noted above, this is not a new story. Each instance of it, however, has different people involved and, therefore, its own peculiarities.

The goal of this chapter is to look at the issues Betty and Tom face from the perspective of Old Testament Scripture. First, we will consider passages that deal directly with barrenness (i.e., infertility). According to the Bible, this was just as serious and difficult a problem in ancient Israel as it is today — perhaps even worse. Some of the ways and means available to deal with it were different, but not all of them were. Moreover, the harsh personal, marital, relational, and social repercussions were much the same as today. It is not difficult to find biblical correspondences with this case study. Second, after working through the infertility accounts, we will focus our attention on Genesis 1–4 and its implications for dealing with infertility from a biblically based bioethical point of view. Our purpose will be to discover what biblical framework of thinking and acting is available to guide Tom, Betty, and Laura through such a troubling dilemma in a way that is pleasing to God.

We cannot escape groaning in life, even if we are among the redeemed (Rom. 8:23). It comes with the condition and circumstances of being fallen people in a fallen world. Yes, God can and sometimes does step in supernaturally to change people’s situations. Praise him! As harsh and painful as it may be to face, however, God is generally more interested in changing people than he is in changing their circumstances. This is a reality that all need to grasp no matter what their circumstances may be. The Lord wants people to walk faithfully and prayerfully with him in the midst of their life situations, whatever they may be. This is the only route to “the peace of God, which transcends all understanding” (Phil. 4:7).

INFERTILITY AND BARRENNESS IN THE OLD TESTAMENT

It is a good and natural God-given desire for a man and woman, committed to one another in a loving marriage, to want to have a baby together. That God’s original and perfect design welcomes reproduction needs to be affirmed with gentle care amid the difficulties faced by a couple struggling with infertility. Psalm 127:3–5 makes the point from a man’s point of view: “Sons are a heritage from the Lord, children a reward from him. Like arrows in the hands of a warrior are sons born in one’s youth. Blessed is the man whose quiver is full of them. They will not be put to shame when they contend with their enemies in the gate.” From the woman’s point of view, Psalm 113:9 praises the Lord for his grace when “he settles the barren woman in her home as a happy mother of children.”

One of God’s covenant promises to the ancient Israelites as a nation was that if they remained faithful to their covenant with him, he would bless them with fertility (Exod. 23:26; Deut. 7:14). Fertility was a sign of God’s favor toward them as part of his plan to prosper his covenant people, who were the especially blessed nation in the midst of all the other nations. Conversely, there are instances in which infertility is portrayed as a judgment from God, whether within Israel (e.g., 2 Sam. 6:23, regarding the barrenness of David’s wife Michal) or among other peoples (e.g., Gen. 20:17–18, regarding Abimelech’s entire household).

In the case of Betty and Tom, all that has gone wrong flows ultimately from the corruption of God’s original design physically, relationally, and spiritually as seen in Genesis 3–4 and the rest of the Bible. We will come back to all this later, but it is important to note here that, on the one hand, some elements of the case are not necessarily a direct result of the people’s personal corruption. The physical reality of infertility, for example, is a medical problem that can occur beyond people’s control. On the other hand, the case study suggests that they may have contributed to the problem by waiting so long. Betty’s “clock” has been “ticking” for a long time. The previous pregnancy and abortion shows that she was fertile earlier in life. It also shows, however, that something has gone terribly wrong in their thinking about having a baby in the first place. The disregard for the life of the earlier baby and the self-centered pragmatic reasons for the abortion are not the focus of this chapter, but they are emblematic of the underlying corruption that is in full view in the case study.²

BARRENNESS AND INHERITANCE IN THE OLD TESTAMENT WORLD

There are a number of cases of barrenness in the Old Testament, beginning with Israel’s three main ancestral women: (1) Sarai, Abram’s wife (Gen. 11:30; they were later renamed Sarah and Abraham, respectively, Gen. 17:5, 15–16), (2) Rebekah, Isaac’s wife (Gen. 25:21), and (3) Rachel, Jacob’s wife (Gen. 29:31; Jacob was given a second name, Israel, in Gen. 32:28).³ In some ways, infertility was even worse in the Old Testament world than today because of the legalities associated with inheritance rights in the patricentric tribal clan culture of that day.

Consider, for example, the case of the daughters of Zelophehad (Num. 27:1–11; cf. also 26:33 and chap. 36). Their father had no male heirs, which meant that his line of descent would vanish from his tr...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Team of Authors and Critiquers
• Introduction: Wisdom for Life’s Challenges
• Part One: Better Birth
• Part Two: Better Life
• Part Three: Better Death
• Part Four: Better Learning
• Conclusion: Connecting the Church and Bioethics
• About the Publisher