Oct 21 2024 51 mins 2
Darrell Bock:
Welcome to The Table where we discuss issues of God and culture to show the relevance of theology to everyday life. I'm Darrell Bock, executive director for cultural engagement at the Hendricks Center at Dallas Theological Seminary. And our topic today is IVF.
Now, if you don't know what those initials mean, in vitro fertilization, which has become a topic of discussion, especially since the Southern Baptist resolution on IVF that was passed earlier this summer in June. And with me is Scott Rae, who … Well, what is your current title, Scott? Because you've kind of shifted hats here.
Scott Rae:
It's dean of faculty and professor of christian ethics at Talbot School of Theology, Biola University.
Darrell Bock:
Very good. So, he's speaking to us from the wonderful place of California where they were shaking, rattling and rolling here recently.
Scott Rae:
Didn't feel a thing.
Darrell Bock:
I know. You're a veteran Californian, who goes, "Oh, that was just a little tickling of my toes."
Scott Rae:
Something like that.
Darrell Bock:
Yeah. So, Scott has done a lot of work in medical ethics and serves on, or did serve, I don't know if it's still current, on a couple of ethics commissions. I don't know what they're technically called in hospitals. And so, he brings expertise. He's author of a book on moral choices, which has gone through four editions. Anything that goes through four editions means it was either very, very good or needed lots of correction. I'm not sure which. And so-
Scott Rae:
Well, actually, I'm working on the fifth edition at the moment.
Darrell Bock:
Well, congratulations.
Scott Rae:
Basically what it means is that the field changes about every five years and the stuff needs updating.
Darrell Bock:
Yeah. Well, I was looking at the fourth edition today, and it's such a helpful resource that I would reccommend it to anyone who listens to us and says, "Ooh, I would like to know more."
So, let's turn our attention to IVF. We did a podcast on IVF in general earlier, so we're coming back to the topic. But for people who don't know what IVF is and perhaps why it's a moral challenge to people, let's just start there with the basic question and you can help us. So, what is IVF and why is it such a topic for discussion?
Scott Rae:
Well, it is the most common, I think, reproductive technology used today for couples who are wrestling with the terrible ordeal of infertility. And I think that's where you start on this is, if you're one of those couples who's listening to this in the throes of wrestling with infertility, we feel your pain. My wife and I dealt with this. We had about a four-year stretch of infertility. It was easily the most painful part of our 40 years of marriage, and nothing else has even come close to that.
So, it's the most common treatment used to deal with infertility, and it actually doesn't treat anything. It does an end run around it. And what they do is they use high-powered hormone treatments for the woman for about 30 days, that enable her to release as many eggs as possible in one cycle. Normally, she will release somewhere between five and 15 eggs. That's the norm. And then they are fertilized in vitro, in glass, literally, in a Petri dish. And you see how many eggs successfully fertilized. Usually, the attrition rate is about half. So, if they have 10 eggs, five will likely fertilize.
And then, they will implant some of those in the womb, usually not more than two, maybe three sometimes, but that depends on other factors. And they will freeze the rest. And then, if the first implantation is not successful, then they will go back and thaw out the remaining embryos and implant those. It greatly helps reduce the cost, but also creates one of the main ethical dilemmas, because if that first time is a win and they have twins or triplets, chances are that their childbearing days are basically over and they're left with the dilemma of what to do with these embryos that are in storage. And they have several options, none of which are considered ideal. They can discard them or they can donate them to research, or they can donate them to another infertile couple, or they can implant them themselves.
Darrell Bock:
Okay.
Scott Rae:
Anyway.
Darrell Bock:
So, was the quick sprint-through, walkthrough. Let me ask a couple of questions. Once the eggs are fertilized in vitro, in glass, are they able to, I don't know how to ask this exactly, grade the quality of what's been produced?
Scott Rae:
Yes, they do. They grade it on a scale of 1 to 3. 3 being excellent and 1 being unsuitable, for a variety of reasons. It could be genetic abnormalities, could be some other abnormality in the embryo. So yes, they grade them and they only implant the ones that are of top quality, and they will encourage the couple to discard the others.
Darrell Bock:
So, I mean, that adds a whole other dimension to this. Right?
Scott Rae:
Right. And the freezing of embryos, I think, is another ethical issue because if we believe that embryos are persons, I would never freeze my two-year-old, no matter what the reason is. We say that's something that we say is intrinsically immoral. That raises other questions.
Darrell Bock:
So, let me back up and let's do some biblical groundwork. I mean, the belief that many Christians have that God is responsible for the creation of life and that personhood begins with conception. And then, at the scientific level, everything that you need to have a child at a biological level comes with conception, which I think are the two base ideas that inform the ethics of this conversation.
The thing that strikes me in reading this, and this is not an area I'm very familiar with, so I'm coming in as a total novice, is the idea that an embryo by itself detached from a womb can be considered to be a life. Can you help us ethically sort through why that would be?
Scott Rae:
Yeah, because location does not make any philosophical difference to what kind of a thing an embryo is.
Darrell Bock:
Okay.
Scott Rae:
And so, whether it's in a Petri dish or in a womb is simply a change of location. And the fact that it can't flourish fully in a Petri dish is irrelevant to that, because if I decided to send you to the Moon, that's an environment that you can't flourish in, but that has nothing to do with your intrinsic value as a person. It's just simply a change of location and that location is morally neutral.
Darrell Bock:
I see. So, the idea of your being attached to a womb as being a basis for establishing at least the beginning of the nurturing of life isn't considered to be a moral factor in thinking through this?
Scott Rae:
No, because embryos, they are what they are based on what they are intrinsically. And you said it right just a second ago, that that single-cell embryo has all the capacities that it will ever need to mature into a full-grown adult.
Darrell Bock:
Yeah. I think one of the things that's confusing to people is the idea of you have everything that's intrinsic to life in that moment of conception, on the one hand. And yet, in one sense, you can't advance that potential, if I'll say it that way, without the sustenance of the mother to bring that child to gestation. Fair enough?
Scott Rae:
I would put it a little differently.
Darrell Bock:
Okay.
Scott Rae:
I would say that if it's not in the proper environment, there are certain capacities that are inherent to the embryo that are unable to be actualized. And so, it can mature to a certain point, but not beyond that. And all that means is that the capacities that are inherent in the embryo cannot come to fruition. But the fact that capacities can't come to fruition, that's no ontological comment on what kind of a thing the embryo is. Just because you can't bring capacities to actualization doesn't mean that you don't have them in the first place. It just means you're not in the right environment for those to come to fruition.
Darrell Bock:
And it is the case that if you left an embryo in a Petri dish to grow on its own, I don't know how else to say this, that it might exist for a time, but it would never go beyond that?
Scott Rae:
That's correct.
Darrell Bock:
Okay.
Scott Rae:
But that's the same thing … I mean, if you left the newborn alone, you could say the same thing about the newborn. In fact, I would say that the degree of dependence on the womb is only slightly different between a nine-month-old fetus and a newborn child.
Darrell Bock:
Okay. And the reason I'm walking through these various scenarios is because I think they raise some of the ethical distinctions that you have to think about in order to deal with the way people might raise responses to the circumstances that IVF generates.
Scott Rae:
Yeah. Agreed. And this is not a black and white issue. It requires a lot of nuance. In fact, I think some of the statements say, that the Catholic Church has made, that completely rule it out, I don't think give it the kind of nuance that it needs. And I think the Southern Baptist statement that you referred to a little earlier, that's better, I think, at providing some of that nuance. But I think there's still room for some conversation about how that applies.
Darrell Bock:
Okay. This is a nice setup for, before we get to the details of the Southern Baptist resolution, which has generated our conversation, let me go through and ask a question this way. If you were to list the outstanding ethical issues or buckets that one would have to think about in thinking about IVF, what would that list look like?
Scott Rae:
All right. Number one, is it immoral to conceive a child outside the womb?
Darrell Bock:
Okay.
Scott Rae:
So, that's sort of basic, because if the answer to that is yes, then this is a short conversation.
Darrell Bock:
And that's the position of the Catholic Church. Correct?
Scott Rae:
That is the Catholic view.
Darrell Bock:
Okay.
Scott Rae:
Now, I will say some of our evangelical brothers and sisters are becoming more Catholic with regards to IVF and other reproductive technologies, but that's the intrinsic one.
The other issues have to do with the procedure that's being used in IVF. Excuse me. So, the second one would be the disposition of leftover embryos, if there are. The third one would be selective termination, if more pregnancies result than the woman is prepared to carry safely or desires to raise. The fourth one has to do with the freezing of embryos. Then the fifth one might have to do with if donor eggs or sperm are being brought into the arrangement or surrogates are being brought into it, then that raises questions about bringing third parties into the matrix of marriage for procreative purposes.
Darrell Bock:
Okay. So, no wonder you need nuance. You got five different issues that you got to deal with.
Scott Rae:
Yeah. Some of them are not that tough.
Darrell Bock:
Okay.
Scott Rae:
So, for example, with the selective termination possibility, the couple can easily take that one off the table just by limiting the number of embryos implanted to the number that she could safely carry.
Darrell Bock:
Okay. So, basically what you're saying there is, there are no excess embryos on the other end of the process? Is that what you're saying?
Scott Rae:
No. No, not really. This would happen if the thing's too successful and say, you implant four embryos and all of them take.
Darrell Bock:
Ah, I see what you're saying.
Scott Rae:
So, not many women can carry four embryos to term safely.
Darrell Bock:
Right.
Scott Rae:
But the couple can dispense with that quickly by just telling the clinic, "No, we're only implanting two max."
Darrell Bock:
I see. So, that's the decision that's made on the front end, basically.
Scott Rae:
Yes.
Darrell Bock:
Yeah. Okay.
Scott Rae:
And this is all stuff … Darrell, what's so important about this conversation is that I think the average person in the church, they never hear about this.
Darrell Bock:
Right. Exactly.
Scott Rae:
They're grossly undereducated in our churches on this.
Darrell Bock:
Yeah. Yeah. Well, that's why that's doing this is to walk through the scenario. So, let's go through the five one at a time. And let's do it this way because we're trying to respect how people view the judgments that have to be made as we walk through this. So, let's go one at a time and lay out the options that exist with each one, and then I'll let you express what you think the ethical preference is for each one as we go. So, let's go one at a time.
Scott Rae:
Okay. The first one, I think is the most basic one. And in my view there is nothing intrinsically morally problematic about conceiving a child outside the womb. And the reason for that is that infertility … This is where I think the Southern Baptist statement could use a little bit more theological oomph to it in this area. They acknowledge that infertility is painful and it affects couples who have good desires to bring kids into the world. But what they don't say is that infertility is the result of the general entrance of sin into the world. It was not the way God intended it to be. So, as a result, it would seem that one of the legitimate goals of medicine would be to help alleviate the general effects of the entrance of sin, which I think some of the primary effects are disease, decay, and the dying process.
So, infertility is, I think, a result of the general entrance of sin, which I think makes it a legitimate arena for medicine to be involved in. So, I don't think there's anything necessarily problematic about the technological fix for infertility. And even though somebody might come back and say, "Well, nothing's being fixed here. You're just doing an end run around the problem." But I would say that's not problematic either, because if that is, then we got lots of treatments and technologies that go out the window. Kidney dialysis doesn't fix anything. It just does a complete end run around diseased kidneys. So, I think that by itself, that's not a deal-breaker on that.
Darrell Bock:
And does the discussion we had earlier about location also not come into this to some degree? The issue is the embryo is the embryo, and whether it's in the womb or outside the womb, that is an entity. I mean, I get that you have an additional action that has produced the embryo, but still.
Scott Rae:
Yeah, the location makes no ontological difference as to what kind of a thing an embryo actually is. Now, here's what the Catholic teaching will say … Because they ground it differently. They don't go from what kind of a thing an embryo is. They go from what kind of a thing's sexual relations are. And their view is that the unitive … The unitive, which we would call the one flesh aspect of sex, and the procreative aspect always have to go together, and they can't be separated, which explains in my view why Catholics are just as adamant about birth control as they are about abortion because they're two sides of the same coin.
Darrell Bock:
I see.
Scott Rae:
But I don't think the scripture always mandates that those two things be separated. I think there are other ends for sexual relations besides procreation, and that's a key one, but it's not the only one. And so, I think take for example, in the Song of Solomon. Song of Solomon celebrates just the beauty and the joy and sort of the innate goodness of sexual relations in marriage. And there's not a word about procreation in there. It's simply a celebration of the goodness and beauty of sex.
And I think what Paul's teaching in 1 Corinthians 7, at the beginning, about how married couples should have regular sexual relations so they're not tempted to fulfill those desires outside of marriage, has nothing to do with procreation. It has to do with the value of sexual relations for marriage. And so, to put it, I think, in short, I don't think the scripture mandates that the unitive and procreative aspects of sex always have to go together. In fact, I think there's a time in which what I would call a God-ordained separation of those two things, and that is when a woman hits menopause, because you can have all the procreative intention that you want, but unless we see a virgin birth equivalent, women are not going to get pregnant after menopause.
Darrell Bock:
Yeah. It ain't happening.
Scott Rae:
No. And I think, most of us, at our age are deeply grateful that that's not happening. So, I think what I would say to my Catholic brothers and sisters is that's a natural law, God-ordained way of actually separating the unitive and procreative aspects of sex. But anyway, I think the first one, I think, I don't see a problem with that per se.
Darrell Bock:
Okay. So, that moves us to the second category that you mentioned. I don't remember the order that you mentioned them in. I don't necessarily think we have to presume in the order you originally mentioned them in, but let's go to number two.
Scott Rae:
And number two is the disposition of embryos that are left over.
Darrell Bock:
Okay.
Scott Rae:
And I think what we need to distinguish is between the standard of practice in IVF clinics and other options that might be available to the couple if the clinic's willing to play ball with them.
So, the standard of practice is to create as many embryos as possible and store the rest. And the reason for that is almost strictly financial, because the beginning process of the hormone treatment for the woman to release as many eggs as possible in one cycle is the costliest part of IVF.
Darrell Bock:
I see.
Scott Rae:
And so, what they're trying to avoid is if they don't get enough embryos, then you got to start over, and it's the cost plus this is not easy on the woman's body either. So, it just throws her system all out of whack to do this. In fact, the record that I've heard, the most eggs retrieved in one cycle was 60. That's 6-0. I think that's five years worth in one cycle. So, it's no wonder that this takes a huge toll on the woman's body.
Now, what couples have to be committed to at the beginning to deal with this, is they have to be committed to the notion that every embryo they create in the lab deserves implantation in the womb.
Darrell Bock:
And again, it's because the embryo is seen as a genuine person.
Scott Rae:
As a full person. Yeah. Now, the people who really get this are the people who have had children through IVF and have embryos left over, because they know that there's continuity between those embryos in the Petri dish and the bouncing children that they're holding in their arms. They know that they're not two fundamentally different things. They're the same thing at this different stage of maturity. And so, that's why we actually, we don't use the terms that they develop into fetuses or they become fetuses. They mature into something that they already are. It's not like metamorphosis where they become something different than what they already are.
So, if couples are willing to make that commitment to implant all the embryos created, either themselves or putting them up for adoption to another infertile couple, I think you can be okay with this. Okay? Now, I'm still not thrilled about freezing embryos, and that's a hurdle still you have to get over. But couples can … There are clinics that will taper back the hormone treatments that they do at the very beginning, so they don't release as many eggs as they could. And I've even heard of some clinic, this is not the norm at all, but who will do this one at a time. Now, you're taking huge financial risks here to do that.
Darrell Bock:
Because your odds are about what, 50/50 on a embryo being produced from the egg?
Scott Rae:
An embryo successfully fertilizing. That's about right. But I mean, some couples actually, they'll go through all this and get nothing, and then some hit the jackpot. But to take the average, that's about right.
So, that's the hard one. And I can't tell you, Darrell, how many couples I've talked to who don't think about this until they've got embryos in storage. And then they realize, "Yikes, I'm in a world of trouble here." Because say they've had twins or triplets, they're probably done. The woman may not be able to carry them again, but they don't like the idea of giving them up for adoption, because that's different than putting one baby up for adoption. That's potentially 4, 5, 6 of your children that you're putting up for adoption. And a lot of people don't have the stomach for that. And understandably so.
Darrell Bock:
And so, the issue is because the alternative is, and I take it this is what sometimes happens is, once you have the number of children that you want, the remaining embryos are destroyed?
Scott Rae:
That's one of the options, and that does happen fairly often. Actually, the most common thing that happens is couples will pay the storage fee.
Darrell Bock:
Interesting.
Scott Rae:
And they'll keep paying it until one day they stop. And that puts the clinic in a major quandary.
Darrell Bock:
As to what they do?
Scott Rae:
As to what they do then.
Darrell Bock:
Yeah. Okay.
Scott Rae:
What it reflects is that the couple, they're rightly, I think, totally ambivalent about destroying the embryos that they know are their children.
Darrell Bock:
Right.
Scott Rae:
That's a hard one to ask them to do.
Darrell Bock:
Right. Yeah. And just to be clear on this, what we're saying is the people who are concerned about this are people who have, for lack of a better description, a theological view of conception, right?
Scott Rae:
Correct.
Darrell Bock:
I mean, if you're a religious nun who doesn't have a theological … The way I describe a religious nun, they don't have a theological bone in their body. They're not thinking about this, they're not concerned about it.
Scott Rae:
No.
Darrell Bock:
But someone who has a Christian commitment sees God involved in the creation of life, et cetera, it becomes a very important, and even central, one of the most basic questions you can answer.
Scott Rae:
It is, it's a crucial question. I mean, the average couple who goes through IVF goes in without having their eyes open to this.
Darrell Bock:
Flying blind.
Scott Rae:
Because the clinic's not going to tell them. And if the clinic's not going to tell them, and our churches are not talking, well, where are they going to hear this? They're not.
Darrell Bock:
Yeah. Okay. Number three.
Scott Rae:
Selective termination. That one we've already fixed, because you just limit the number of embryos implanted to the number that you can safely carry.
Darrell Bock:
Okay.
Scott Rae:
I mean, even if I were pro-choice, I would still think it'd be really callous to go to this length to create all these embryos and then selectively terminate some just because you got pregnant with more than you wanted.
Darrell Bock:
Yeah.
Scott Rae:
And that just strikes me as really callous toward life.
Darrell Bock:
Yeah. So, start off on the right foot, is that what we're saying?
Scott Rae:
Well, yeah, come in with your eyes open. And if you don't have the stomach to do it the right way, then don't do it. But yeah, Darrell, you'd be surprised how many couples I talked to who I will tell them about the ethical issue, and they will look me right in the eye and say, "I don't care about those, because all we want is a child, and the ends justify the means."
Darrell Bock:
Yeah. Yeah. Well, there's a lot of ends justifies the means in the world.
Scott Rae:
Yeah. And we say, unfortunately, they don't.
Darrell Bock:
Yeah. Okay. So, number four.
Scott Rae:
Freezing embryos. I'm really uncomfortable with this, and I think because that's just … That is where I think the Southern Baptist statement is right and our Catholic friends are right, that freezing embryos is intrinsically dehumanizing, because it treats them as a product and not a person. That's not something we would ever do to a person, regardless … I mean, to a person outside the womb, regardless of what the reasons are. We would just say that's just something you don't do, but that is the standard of practice in infertility clinics.
Darrell Bock:
So, let me ask this question, comes to mind as we're talking about this particular example, and that is, I think about people who get an operation who are put to sleep so they don't feel the pain, the kind of alteration. So, isn't part of the ethical dilemma the decision about what you do, if I can say it this way, coming out of the freezing as much as the freezing itself? Or, not?
Scott Rae:
It is. No, it is, because there's some debate over the likelihood of attrition in thawing out embryos.
Darrell Bock:
I see.
Scott Rae:
Because clearly, well, some don't make it.
Darrell Bock:
Yeah.
Scott Rae:
The reason they don't make it is what's up for debate, is whether there's something intrinsic to freezing and thawing or the reason they don't make it … My obstetrician told us some time ago that the reason frozen embryos don't thaw out successfully is usually because there's some sort of genetic abnormality. And if they don't thaw successfully, then they won't implant successfully.
Darrell Bock:
Interesting.
Scott Rae:
I'm not so sure about that.
Darrell Bock:
Yeah, I mean, that's convenient in some ways.
Scott Rae:
Yeah. I mean, I have great respect for our OB, but I think there's probably something that's intrinsic to freezing and thawing. That's not what's intended to happen. And it doesn't kill the embryo, it just dramatically slows down all of the metabolic processes that the embryo is going through in order to have cells divide and to grow and mature.
Darrell Bock:
Right. Right. Okay. So, that's-
Scott Rae:
That's a problem.
Darrell Bock:
That's the challenging one, if I can say it that way.
Scott Rae:
It is. And I think the only way out of it is to tell the clinic from the start, "No leftover embryos." And that either involves one at a time or what's called minimal stimulation IVF, where they only stimulate the ovaries enough to produce a handful of eggs. That's the only way around that. Financial risk to that is off the charts, and the clinic will look at you like you've lost your mind.
But I think for the couple, you have to tell the clinic what your values are upfront. And if this is really important to the couple, which it ought to be, they've got to tell the clinic. And this is where we tell couples that, "You need to keep in mind that these infertility clinics, sometimes they advertise themselves as giving people the gift of life, which is an overblown claim to begin with-"
Darrell Bock:
Yeah. Right.
Scott Rae:
… "but they are fundamentally a business. And if they're not respecting your values," I said, "take your ball and go home. Go somewhere else."
Darrell Bock:
Yeah. Okay. So, number five.
Scott Rae:
This is embryo adoption, which I think is a good option both for couples trying to get pregnant and for couples with leftover embryos. So, we'll take the latter of those first. I would have your viewers and listeners google the Snowflake Program, which is the first and largest embryo adoption agency in the world. It's headquartered just a few minutes from where Biola is in Southern California. And they've facilitated hundreds of embryo adoptions, and they do it the right way. It's actually an adoption procedure that's recognized by law.
Sometimes the clinics will sell you the embryos and not bother with the adoption process. And although that's probably pretty safe because the couples who put the embryos up for adoption probably are not going to come back and reclaim their children like traditional adoptive mothers sometimes do. And I think it's a good option for couples who are considering adoption, because it gives you a number of things that are normally really important to the couple and can be important to the child. For one, the woman gets the experience of pregnancy and childbirth, which is really important to a lot of women, but it's also, there's continuity between the mother who gestates the child and the mother who rears the child. There's no break in the relationship that happens in traditional adoption.
So, I think there's a lot of merit to embryo adoption. There are over a million embryos in storage in clinics around the country today. And to rescue some of those, I think is … I would call that, it's not procreation, adoption is a rescue operation. That is different from procreation. I would distinguish between those two.
Darrell Bock:
And so, it's a good alternative to what has to be the remaining option, which is destroying the embryo.
Scott Rae:
Yeah. Or donating to research, which does the same thing.
Darrell Bock:
Okay. So, well, actually, we haven't raised that dimension of this yet at all. So, that's probably worth noting now, which is what happens with the remaining embryos is either they terminate, right? Or, they're used for research, or they find another home, if I can say it that way.
Scott Rae:
Basically. That's right. And so, the research will either kill the embryo or they'll be discarded after the research is done.
Darrell Bock:
Right. Which has always been another element that's made some of the discussion of IVF controversial because you still have this problem of what happens with an embryo that doesn't end up becoming a child.
Scott Rae:
That's correct. And most of the options are really problematic. The easy options are morally really challenging, and this is why couples, they got to know what they're getting into before they get into it.
Darrell Bock:
By easy option, you mean, just simply for lack of not caring about the result? Or, is that what you mean?
Scott Rae:
Basically, yeah.
Darrell Bock:
Yeah.
Scott Rae:
It doesn't cost anything. You kind of forget about it and move on. Quote, unquote, "Move on." I'm not quite sure how you move on from that entirely, but it's a much easier decision than the decision to implant them yourself or to donate them to another couple.
So yeah, I mean, I had a couple in my office not too long ago that they'd had two different rounds of IVF and had twins both times and had embryos left over. And they did not want any more children, but they were really torn about what to do because they thought implanting them themselves, "We're able to implant them ourselves. It's the right thing to do." And so, they did. And they had another set of twins.
Darrell Bock:
Oh, wow.
Scott Rae:
And so, at the time I talked to them, they were looking at the option of having six kids under the age of five running around their house, which is a wild and crazy environment, but I'm convinced they did the right thing, and so are they.
The only thing challenging about embryo adoption, and some of the Catholic critics have mentioned this, is that sometimes if that functions as a safety net for couples to produce as many embryos as they can, to get the best success rate for themselves, it sometimes fosters what I think is a cavalier attitude toward creating embryos in the lab. That's a problem. We should be much more judicious about how we do this because having … I mean, I'm delighted that embryo adoption is available, but using it as a safety net and going on with a standard of practice, I still think is problematic.
Darrell Bock:
Okay. Well, that walks us through the territory and the options-
Scott Rae:
Is that clear as mud?
Darrell Bock:
Yeah. No, that's good. And it shows the complexity and why nuance is important. So, let's turn our attention to the Southern Baptist resolution, per se. You say you have a copy, so why don't you read that to people?
Scott Rae:
I do.
Darrell Bock:
Hopefully it'll make more sense having walked through our options.
Scott Rae:
Yeah, it's actually too long to read on the air like this.
Darrell Bock:
Okay.
Scott Rae:
I would encourage your listeners to get access to it. Just google, "SBC IVF." Will get you there.
Darrell Bock:
Okay.
Scott Rae:
I'll highlight a couple of things.
Darrell Bock:
Yeah. The key components.
Scott Rae:
Yeah. Where they start is they start with the personhood of the embryo. So, "Whereas every human being is made in God's image, and it is thus to be respected and protected from the moment of fertilization until natural death without regard to developmental stage or location." I think they've said that exactly right.
And it says, "Whereas human beings possess an inherent right to life, an opportunity to reach their full developmental maturity." And then, here's the part that I'm just not so sure how to read, "Whereas biblical creation order portrays the embodied union of husband and wife as the singular normative expression for procreation." And that sounds like a really Catholic view of this.
Darrell Bock:
Yeah.
Scott Rae:
And I think what I'd want to make sure people understood is that there's a reason why the creation order portrayed that embodied union as the norm for procreation. That's because it was the only option on the planet at the time. All right? There was no opportunity to do anything else. The only option was the embodied union of the husband and a surrogate, but procreation, it was not possible in biblical time for procreation to happen outside of normal sexual relations.
Darrell Bock:
In other words, IVF couldn't happen.
Scott Rae:
Well, yeah, it was not even … I mean, on nobody's radar screen at that time. And I'm leery of reading too much into an argument from silence, like that. So, that's the part that I'm not so sure about because they say a little bit later on that, "Resolved, we affirm that all children, no matter the circumstances of their conception, are gifts from God and loved by him." Which sounds like there may be nothing intrinsically problematic about where a child is conceived. And I mean, if that's the way I want to read that, then I think that's fine. But I'm not convinced that the Catholic requirement that all procreation take place within normal sexual relations in marriage is biblically required.
Darrell Bock:
Okay.
Scott Rae:
I do think it's required that procreation takes place within the general sphere of marriage. That's true. And the Bible's really clear about that. But there's clear continuity between marriage, procreation, and parenting, that those are all supposed to go together. Unless, of course, that one of the parents is unfit, or there are a handful of other exceptions to that.
But I think they get a lot of things right. It says, "Whereas the IVF process routinely generates more embryos than could be safely implanted, thus resulting in continued freezing, stockpiling, and ultimate destruction of human embryos." I think that's true. I mean, I think there's a lot of good in this. They resolve to continue to promote adoption. They resolve to grieve alongside couples. They resolve to commend couples to do this in ways consistent with the dignity of the embryo. That's all. I think that's right. Those are all good things. I think, what I hope is helpful to your listeners is we've tried to spell out a little bit more what that involves in more detail.
Darrell Bock:
Right. So, that spills over into, for lack of a better description, the debate about legally how to think about this. And of course, it was an Alabama Supreme Court decision, I guess, recognizing the viability and the humanity of the embryo on its own terms that triggered all this.
Scott Rae:
Correct.
Darrell Bock:
And by everything that we've set up to that point, that decision, at least viewed theologically, makes sense.
Scott Rae:
I think, yeah, I would be supportive of that decision, because we recognize the right to life of full persons. The 14th Amendment to the Constitution recognizes that human beings can't be bought and sold. And we've extended that to newborns. We've extended that to adoptable children. We've extended that to fetuses, because we don't buy and sell their body parts as a norm. And theologically, there's no good reason not to extend that to embryos.
Darrell Bock:
Okay. And that comes from where we started, which is that when you have an embryo, you have everything necessary to mature to life.
Scott Rae:
I'd say to adulthood, because it already is life.
Darrell Bock:
Life. Fair enough.
Scott Rae:
And this is where, I mean, embryologists will tell you that from conception it's a living human being.
Darrell Bock:
Yeah. Yeah. I remember when we were … As you know, I serve on the board of Wheaton, and we were part of a litigation in this regard, trying to seek protections for the theological way we see this space in relationship to healthcare provisions and that kind of thing. And I remember-
Scott Rae:
We were a party to that lawsuit too.
Darrell Bock:
Okay. And we actually were in conversations with our scientists about this, and that's where I first heard the principle that everything that's necessary for growth to adulthood resides in the embryo from the moment of conception.
Scott Rae:
That's correct. There's an argument to be made that the very first cell, in some respects, could be the most complicated cell in the whole body.
Darrell Bock:
Yeah. Yeah. Because of all the potential that resides within it?
Scott Rae:
That's all the capacities that have yet to be actualized.
Darrell Bock:
Yeah. So, all this is interesting. This is the hard part of this. The hard part of this is we function in an environment where not everyone has and possesses the same worldview. And so, that's where our tensions come from. And I tell people that if someone doesn't have a theological orientation and a category for this, then what we are contending for in the public square is hard for them to process, because they don't have the categories for it.
Scott Rae:
Right.
Darrell Bock:
That doesn't make their perception right, but it is worth being aware of why you have the kind of conversations that you do.
Scott Rae:
Well, and I think what it means is that we have to be able to craft an argument that is consistent with our theological convictions, but not explicitly dependent on them. And make sense of this in the public square.
Darrell Bock:
Yeah. No, this is something I talk about all the time because you want to talk about why life ought to function this way almost regardless-
Scott Rae:
That's correct.
Darrell Bock:
… of your view. And what the nature of this thing is, which is why the science part of it is important, because the science part is telling you what you're actually dealing with.
Scott Rae:
That's correct. Although, the science needs to be supplemented by philosophy and theology, because not everybody identifies a human being and a human person as the same thing. And it's very common for people to say that fetuses are human beings, but they're not yet persons. And at the end of life, it's very common to say people, they are still human beings, but they are no longer persons. And those categories that define a person are things like rationality, self-consciousness, capacity for relationships, the things that give life its texture and a lot of its meaning.
The problem with those categories is that there are a number of counterexamples that I think lay waste to that distinction, because someone under general anesthesia has the ability to exhibit none of those capacities, at least if the anesthesia is being done correctly. But when they wake up, it's all gone.
Darrell Bock:
Voila. It's back again.
Scott Rae:
I'm back. Yeah. And so, for someone to say, "Well, that's just an exception to the general rule. Of course, while they're under anesthesia, they're still a person." But what they're doing there, is they're obviously appealing to something else besides those capacities to say that that person under anesthesia is still a full person. And so, you can't have it both ways on that.
And so, I think we would say that because embryos and fetuses and newborns and adults, because human beings are a certain kind of thing, they exhibit certain traits, but the traits don't make you a person. Right? The traits fall out of who we are as human persons, but they don't determine … That's a really important distinction to make sure we don't get the philosophical cart before the horse.
Darrell Bock:
Yeah. And so, you're speaking philosophically now. And then, of course, theologically what we do is we say what makes a person a person, I think, in part is they're made in the image of God.
Scott Rae:
True. But that sort of begs the question of who should be included in that category of being made in the image of God? And I think some of, say, the Gospel accounts in Luke 1 and 2, I think suggest that fetuses from the very earliest stage of maturity were considered there image of God-bearing persons.
Darrell Bock:
And I think it's interesting you brought this up. I find the passage where John the Baptist leaps in the womb when Mary shows up, as being an example of what you just described.
Scott Rae:
I think that's right. And I think some translations in Psalm 139, where it talks about having been fashioned in the secret place, the womb being reserved as a place of protection. There are places where sometimes that term for the unborn, the unformed substance is the way I think the NIV renders it. There are some that translate that as embryo. I wouldn't go to the stake for that, but I think that's not an unreasonable translation of that. And the point I think they're making is from the earliest stages of pregnancy, you have someone who is being fashioned and molded and formed intricately by God in the womb and has all of the marks of being a full person.
Darrell Bock:
And the psalmist is seeing that as part of his personal history.
Scott Rae:
Yes. And again, continuity between those different time periods.
Darrell Bock:
Right. Yep. Well, Scott, I want to thank you for taking the time to walk us through all this and allow us to take a second look at IVF together and with these particular questions in mind. I think we've not only talked about what it is, but the implications of it both in terms of the way the church sees it and then in its legal context. So, I really appreciate you taking the time to do this with us.
Scott Rae:
Yeah, my pleasure. Just, I think, a final word to, if you have pastors or church leaders who are listening-
Darrell Bock:
Yeah. Sure.
Scott Rae:
… be sure that you are doing something to help educate the people in your congregations about some of the things that they will face, decisions they'll have to make when contemplating IVF, because 1 in 6, Darrell, couples of childbearing age are technically infertile. And there are a lot of folks out there, and they are in our pews Sunday after Sunday.
Darrell Bock:
Wow.
Scott Rae:
And they need to hear what they are considering. And for pastors and church leaders to be helpful guides along the way.
Darrell Bock:
Well, thank you for the time. Really do appreciate it. And I want to thank you, our listeners, for being with us. If you like the show, please leave a rating or a review so that others can find out about us. And we hope you'll be with us again the next time when we discuss issues of God and culture to show the relevance of theology to everyday life. Thank you for being a part of The Table today.
