The Sean McDowell Show - Is IVF Moral? A Christian Debate.

Episode Date: December 17, 2024

Is In Vitro Fertilization (IVF) ethical? Is there a pro-life way to practice IVF, or should it be entirely out of bounds for Christians (and others)? Dr. Scott Rae is one of the leading Christian ethicists today, he is the author of Moral Choices, and my co-host for the Think Biblically podcast. He makes the case for an ethical way of practicing IVF, and I push back. We certainly don't settle the issue, but invite you to consider what is at stake in the practice. READ: Moral Choices, by Scott Rae (https://amzn.to/4fj6Ev8) *Get a MASTERS IN APOLOGETICS or SCIENCE AND RELIGION at BIOLA (https://bit.ly/3LdNqKf) *USE Discount Code [SMDCERTDISC] for 25% off the BIOLA APOLOGETICS CERTIFICATE program (https://bit.ly/3AzfPFM) *See our fully online UNDERGRAD DEGREE in Bible, Theology, and Apologetics: (https://bit.ly/448STKK) FOLLOW ME ON SOCIAL MEDIA: Twitter: https://twitter.com/Sean_McDowell TikTok: @sean_mcdowell Instagram: https://www.instagram.com/seanmcdowell/ Website: https://seanmcdowell.org

Is in vitro fertilization ethical? Is there a morally permissible way for Christians to practice it? Today, my co-host and I, Scott Ray, are going to have a conversation about this. And Scott, one of the reasons I want to do this is I saw arguments for in vitro fertilization online. So arguments against it, but no one taking the time to walk through what is it, what are the concerns, and help people understand what's at stake from a biblical perspective. So we're going to make this a part of the Think Biblically podcast and dive in. You ready to go?

I am. And hopefully we can have some nuance and appreciate some of the complexities here, too. That would be the idea. Now, with that said, maybe a helpful place to start with is just what is in vitro fertilization? In vitro is simply Latin for in glass, and fertilization taking place in glass in a Petri dish. We'll assume here that it's gametes of husband and wife because you can have donors, you can have surrogates.

Fair enough. We'll keep them off the table for now for simplicity's sake. Okay. The woman is given high-powered hormones that enable her to release as many eggs as possible in one cycle. The average is, I say, normally somewhere between 8 and 15, although some women, it's a bust. Some women go way over that. Okay.

So it's just, but that's sort of the average. And a sperm sample is taken from the husband, and they put the eggs and sperm together in a Petri dish and see how many pick up a dance partner. And so usually there's a decent amount of attrition. Not every egg fertilizes successfully in the same way that not every egg fertilizes successfully in the body. So let's just say we get 10 eggs that we harvest and five successfully fertilized. Then they will, within a pretty short period of time, they have to implant the fertilized embryos. Now they will test them first. They will grade them to see what the likelihood of implanting successfully is and take the-grade embryos first and implant those, usually two, sometimes three, depending on a number of different factors.

And then they'll see if they get a successful pregnancy. They will freeze the rest and put them in storage so that if none of the initial implants take, and instead of having to start over again at the very beginning, which is much more costly, because the lion's share of the expense comes from the hormone treatments and the egg harvesting, and it's much more wear and tear on the woman's body, too,

to have to go through that again. So instead of starting over, they can just thaw out embryos and implant what's remaining. Okay, that's helpful. So ideally, it would be the father and the mother, the man's sperm, the woman's egg, and the woman carries it. But sometimes there's a surrogate. That's right.

Sometimes it's not the woman's egg. Sometimes it's not the man's sperm. There's all sorts of ways that this is practiced, which raises other ethical questions. Right. So people know a sense of- But those are not intrinsic to the process itself. Fair enough. And we would, yeah, we can let that set.

So this raises some of the questions we'll get to, not right now. But when you mentioned that some of them don't fertilize, like in vitro, as in the human body, some of the questions people are going to raise is like, is it okay for conception to take place in a glass as opposed to in the body? We'll come back to that. These are some of the issues that we will come and address and talk about. Are there effects on the unborn because of this, et cetera. Before we get there, what's the typical cost? I've heard it's about $20,000 for one cycle. And I know some women go through two, three, four, five, six plus cycles.

Is that roughly the cost? I think that's pretty close. When it started out, it was around 10. And it's increased significantly, but plus the, part of the reason it was so high is back in 1978, when it first started, the reason it was so high is because there are only a handful of clinics that were doing this.

Now, you know, supply and demand has taken effect and it's driven the price down, but it's still, you know, it's 40 years later. So it's, you know, it's 40 years later. So it's, you know, the cost of everything has gone up since then. But it could be much worse. Now, you get donors and surrogates involved. You know, if you have a surrogate involved, then you're probably another, you put another 50 grand on top of that. 50 at least, yeah. Fair enough.

Okay, so some of the other questions this raises is just the process itself. And I know we're going to make a distinction between what might be considered an ethical Christian practice and what all Christians should agree is out of bounds. But when you fertilize, when the eggs are fertilized in a glass, in a beaker, et cetera, then they are judged whether they are suitable for life. And some are discarded that are not. Obviously you would say Christians should do this, but that's an area that some would say, timeout, this process itself is problematic, practiced in certain ways. We'll come back to that. Just highlighting for people, some of the issues at play. Is it ever okay to freeze a human being? That's a question we need to talk about. But as

far as I could tell, correct me if I'm wrong in this, that 2.3% of babies are now born through IVF. That's the most recent stat I could find. So this is growing from 1978, the first 46 years ago, now 2.3%. And it's getting more common. And it's getting cheaper, that's probably only going to increase. But with that, I also found interestingly enough that from embryos that are created, only 2.3% actually result in life births. Once they go through the entire process from screening out, damage from thawing, a miscarriage, et cetera. So if 100 embryos are made, 2.3% result in life with IVF as a whole. Do both those sound right to you? That sounds about right. Another way to look at this, which is typically the way the couple would look at this, is they

evaluate success on the number of live births you have per clinic. And so roughly, I mean, we're dealing with major cases of infertility. These are problem pregnancies from the start. And so you wouldn't expect a significantly high success rate. So roughly, and this has held pretty steady over the years, roughly 25 to 30% of all couples who come into an infertility clinic for IVF will emerge with a healthy baby, which means that somewhere, you know, two-thirds to three-quarters of the couples who invest in this procedure will walk, at the end of it, will walk away with nothing. And I think what's particularly challenging about this is that with each successive attempt

that you try, the success rate goes down. Because we've got, we're just dealing with, you know, we're just dealing with really tough fertility challenges. And even sometimes doing an end run around them like IVF does doesn't solve anything. So that's, I think, couples need to be aware of that. And it breaks my heart to see couples taking out second and third mortgages on their homes to pay for the latest round of this when the success rate is going to be less than what they did with the first try. It raises interesting questions that we don't have to spend time on, but the money and the cost in doing this is a factor that's a part of the moral equation as well. No doubt. And it favors those with more resources

and people handle it irresponsibly. That's a piece that's often ignored and having that child becomes the highest good within itself in a way. Yes, not only having that child, but it's having our own child. That's fair enough. And the genetic connection to that.

When it seems to me in the scriptures, the emphasis on parenting is not so much on the transmission of genetics, though in the Old Testament that was important for property distribution and things like that. But the more important emphasis is on the transmission of values and spirituality to the next generation, more so, I think, than the transmission of genes in that regard. Which makes sense. In a modern scientific-focused worldview, we would see things a little bit differently. Now, it's pretty obvious why a couple would choose to have IVF. You just explained it, your own biologically connected child.

That is a natural yearning God has given us that is good. Part of our procreative constitution. I have friends who have told me they've used IVF. I have not. I probably have a lot of friends who have, who haven't even told me that will watch this and maybe they'll let me know afterwards. But like apologists and writers

that do the same kind of thing that I do. And I found it's hard, not always, I don't want to generalize too much, but it's so personal for people. If you raise moral questions about IVF, it's as if you're questioning the legitimacy of the kids themselves. And I understand why somebody would feel that way. But you and I firmly agree at the beginning. Number one, we just recognize the pain of infertility. You dealt with that for years. You've talked about publicly in a way I didn't. We had a miscarriage and that was incredibly painful,

but have not dealt with infertility. And also we want to affirm that every single human being, regardless of how they are conceived, has value. So I made the point, separate issue, that my own sister who went to Biola has been public about being conceived in date rape. IVF, date rape, whatever the conception is, doesn't take away human value.

Is there anything you want to add before we kind of jump into this about that? Well, I think it is, you know, it is personal for my wife and me. We never had to go down the road of IVF. We did go, go down the road of some less expensive, less technologically intrusive, you know, things to try and, you know, to get through this. And ours had a happy ending in ways that were entirely providential. That's the only

way I can explain it. Because the things that my wife's obstetrician would never have discovered. So there's a long, long story behind that. But that was pure providence that other doctors discovered this in ways that we never would have figured out. But the pain of this was real and it was deep.

And it was magnified by the number of clueless friends we had who were offering what they thought was helpful, well-meaning advice, which turned out to be incredibly counterproductive. So we stopped, you know, we stopped going to church on Mother's Day and Father's Day, those were the two worst days of the year. Family, you know, quote, family holidays, like Thanksgiving and Christmas, very tough. So, you know, but ours, you know,

ours had a good ending. We're very grateful for that. And we see, you know, we see our kids as the gifts that they are. Well said, that's helpful. Two questions. Let's just quickly talk about this and then jump to the ethics of it itself.

In my estimation, probably no or almost no churches are talking about this topic at all. Maybe people don't feel equipped to talk about it. They don't understand the nuances of it. Is that your sense? I mean, like 10%, if I had to guess, are even addressing this in any substantive way.

I think, yeah, our churches are, they're drastically undereducated about this. And here's the thing. Most couples who go into IVF are not going to hear about the moral issues from the infertility clinic. And if they're not hearing them there

and not hearing them in our churches, where else are they going to get it? They're not. On the Think Biblically podcast. Well, I mean, bless our hearts for that. But, you know, for people who aren't listening to this, they're probably not going to get it anywhere unless they seek out somebody who they know and trust. And there are other people.

You've written on it. We have other friends who've written on it and done videos. Not downplaying that, but as a whole, people just are just are not informed hence that's why we're having this and i think churches i think churches just don't want they just don't want to deal with it because they know that they've got lots of people who have had kids with ivf and they don't want to fall out from that fair enough now we could go into some depth like why are we talking about this now? Because it started in 1978. But recently, there's been like the accident in the clinic in Alabama, where somebody sued rightful death where their embryos were destroyed. And some people are like, wait a minute, Christians are pro IVF and pro family, but they're not treating this unborn like it's really a human being.

Are there some inconsistencies there? We've seen some political parties promising support from the government. So it's kind of launched into the public conversation where I think we need to have this. Maybe let's start with, I think there's going to be some areas where you and I maybe differ on this. Let's talk about areas where we see it similarly. So what are some ways IVF is practiced that probably a lot of clinics will not say that we can or at least should all agree are unethical? Well, I'd put it like this, Sean, that the, I'd say the standard of practice in IVF contains a plethora of ethical

dilemmas for couples to face. One is, what do you do with leftover embryos? And the general rule that I think is not negotiable is that every embryo created in the lab deserves to be implanted. No discarding embryos, no giving them off to experimentation, which will result in them being discarded. I think it's okay for couples to put them up for adoption

to another infertile couple. That may be an area where we differ on. Sure. But destroying embryos is one. Selective termination is a second. Even if I was pro-choice, Sean, I would think this is just a callous disregard for life. You go to these lengths to create life in the lab, and then you destroy it because you don't like what you've created. And so that's a problem. lengths to create life in the lab, and then you destroy it because you don't like what you've created.

And so that's a problem. And that can easily be fixed with just, you just don't implant the number that you can't safely carry. That's easy to fix. I think selecting for gender is a huge problem. And although it's, IVF is one of the technologies required to select for gender. You can screen for it,

you can screen for other disabilities, but I think discarding embryos regardless of the reason, I think is morally very problematic. And then I think, you know, I think part of the reason that its use has increased is we have a lot of same-sex couples who are using this. And we have single mothers by choice who will do this in some cases. Not normally, but you do have single adults who are doing this. And I think, you know, donors, I think, are off the table. I think donors, I think, are off the table. Surrogates, I think, are off the table.

There may be a rare exception to surrogacy. I've consulted on a couple of cases that we can talk about. Sure. I think that's an exception. Generally, it's a rule. But generally, I say that's off. And then I think the other one that is an issue that I think we don't often think about is related to the guy. Because usually what happens is you go into the clinic and for the guy to give a sperm sample, you got your choice of magazines and movies to get you aroused.

And if I were a woman married to a guy who was going to be the father of my child, I would not want him attaining a sperm sample like that. So we can talk more about that. But I think there are lots of things in the standard of practice that are very problematic. Now, I think you can probably also make an argument for freezing embryos per se is a problem. I have one physician who I trust on this has said that usually the reason embryos don't thaw out successfully is because there's some sort of abnormality that would prevent them from implanting successfully. Now, I don't have the expertise to evaluate whether that's true or not. Sure. If that's true or not. Sure. If that's the case, then I might look at freezing embryos a little differently.

But we do know there is attrition in that. Now, whether that would be attrition, where that would take place, I think that may change how I regard that. That's helpful. I didn't know what list you were going to come up with. And I agree with almost all of these. There are a couple that I see differently. So destroying embryos out.

We're seeing gender selection now. Interestingly, for the first time I'm aware of in like world history, choosing girls over boys, interestingly enough. Let me suggest. I think there is an exception to that. Okay. Because there are genetic diseases that are sex-linked. There are about 300 of them. And I think that's the one case where selecting for sex would be okay, to do an end run around

a clear genetic abnormality that you're at serious risk of inheriting. Okay. So let's hold some of those exceptions aside. But fair enough. Donors, surrogacy. There is nuance and complexity here. I know, you're a philosopher. That's what I want.

That's helpful. Porn use, like you said, for the production of the sperm. Gay couples doing so, in part because that intentionally creates a child and denies them a father and a mother. That is violating the rights of this child. Single couples, I agree with you.

Now, this is a separate issue. There's a difference between a single adopting someone than creating somebody through the process of IVF. I think where I would start to differ on is, is it ethical at all to freeze embryos? And we'll come to that. And is it ethical at all to freeze embryos? And we'll come to that. And is it ethical at all to make embryos in a lab? That's where I would start to take issue. And we can, we can unpack that one. I think we'll, we'll get to it. As far as I understand, some estimates say there's about

1.5 million frozen embryos. And so let me ask- That's just in the United States. Thank you. Yes, just in the United States. Correct. I'm not sure anybody really knows what that number is. That's just the estimates I've seen. Do you think, given that many Christians and evangelicals have uncritically utilized IVF, Catholic Church obviously has not, and it's enabled all of these kinds of technologies to go forward. So we've counseled people to do so in churches. We haven't preached against it. We haven't educated people on it.

And there's so many drastic stories we could give, dramatic stories of people that are affected by IVF. Do you think there's any responsibility within evangelical Christians, even if there is an ethical way to practice IVF? We haven't even gotten there yet. I think the church as a whole needs to step back and say, you know what? We uncritically jumped into this. We've contributed to some harm. This is on us or no. I think it's been more what I would call benign neglect on behalf of lots of churches. It's just not being addressed. And I think we are, I think the church does bear some responsibility for that.

And I think in part, it's schools like Talbot that also bear some responsibility too. Now, we have courses where we're educating the next generation of pastors and church leaders to do this better. And I tell my students, say, look, the measure of which I've succeeded in the class is when people in your church call you instead of me for advice about these issues. Because I want you to be the ones who are addressing this with the people that you're going through life with. You know them, you know their values, and you should be the one walking with them through this. But I've had to chide my students, my graduates sometimes, who still call me and say, would you meet with this couple?

I say, no, you meet with them. You should know how to do this. And I've got stuff for you to reread if you need help. So I'd say more, it's just more been, I'd just say benign neglect. I might be a little stronger on that. I think there's sins of commission and sins of omission. I think there's things we failed to do and think about reflectively that we should have known differently and need to take some ownership in that. And that's what it means to be a Christian and say, I got something wrong and I repent and here's what

we need to do differently. I think that's a sign of strength, not weakness. Well, here's, I think part of the reason for that is just from our experience, I think it's really hard to identify with what infertile couples go through if you hadn't been down that road yourself. And, you know, the pastors we know who have been down that road are much more sensitive to this and I think tend to do a better job of educating their churches on it. But I think there are a lot of folks who, you know, they just, you know, they had no trouble having children and they can relate to infertile couples from a distance, but it just doesn't resonate quite the same way. That's fair. I do remember the first time you mentioned in, I think it was ethics one I had with you, four years of infertility, and I was just newly married. It's the first time it ever crossed my mind as a grad student

about the pain and difficulty of that. I never even thought about it. Wasn't in your premarital counseling? No, it wasn't. I don't think that's one of my suggestions is this needs to be a piece of it and done well, and it's not at all. Okay, let's keep going. Maybe this would help. Some consider IVF a way that we can work with God to remedy the brokenness that exists in our imperfect world. Do you see it that way?

That's maybe where we start to view things a little bit differently. You go ahead first. Yeah, and Sean, we have to distinguish between the standard of practice in most clinics and other ways that IVF could be done, in my view, acceptably. So the question is, I think, more basic than that, is there anything intrinsically wrong with conceiving a child outside the womb, outside normal sexual relations? Because in my view, that's at the heart of this. Now, in general, I think most medical technology are ways that we can work with God, like the

way you put that, to remedy the brokenness that exists in our imperfect world. Medical technology, I think, is God's good gift to human beings that through general revelation and common grace, we are able to alleviate the effects of the general inference of sin, primarily disease, decay, and death. I know there's lots of others, but those are the ones that affect medical technology, I think, most. And I would make the argument that infertility is a result of the general inference of sin into the world, not the way God intended it to be. Make sure our viewers hear this correctly. I'm not saying personal sin. It's the general entrance of sin into the world,

the general brokenness of the world. And just the number of couples, one in six couples of childbearing age are technically infertile. That's a lot of folks. And that's a lot of brokenness that people are dealing with. So I don't think there's anything problematic with using medical technology in general to alleviate infertility. And the fact that IVF doesn't cure anything is irrelevant to this because it's doing an end run around the problem much the same way that kidney dialysis

doesn't end run around kidneys. It doesn't fix anything. It just averts the problem. Dialysis doesn't fix a broken kidney. There might be some differences between the process of what a kidney does and the process. Keep going. I'm coming to that.

Okay. Now, the question is, is there anything morally, biblically problematic about conceiving a child outside the womb? I think that's the central question. And my answer to that is no. I don't see anything problematic about that, assuming that we're not doing the standard of practice. Just that question. And the reason for that is that what the Bible indicates is that procreation has to take place within the general sphere of heterosexual marriage. I don't believe the Bible teaches that procreation has to take place within the sphere of always normal sexual relations. Now, I think the reason people think that is because in biblical times,

that was the only way available for people to procreate anything. I mean, surrogates had to be, that had to be done the old fashioned way, right? And so, you know, in fact, I have a question about that for my Old Testament friends, why surrogacy didn't also constitute adultery in the scriptures. And so, and I don't believe, contrary to our Catholic brothers and sisters, that the unitive and procreative aspects of sex always have to go together. I don't think that's true. I don't think the scripture requires that. I don't even think the natural law requires that. We have, I think, several instances where the unitive aspect, which we would call, us Protestants would call that the one flesh aspect of sex, is considered, I think, a sufficient end in itself. Things like the Song of Solomon, for example, that celebrate just the beauty and the enjoyment of sexual relations without any mention of procreation. And I think in 1 Corinthians 7, when Paul says husbands and wives are to give each other regularly to sexual relations

so that the temptation to have those desires satisfied wouldn't extend outside the realm of marriage, without any mention of procreation. And I think there's even a natural law argument to this, because I think there's a God-ordained separation of the unitive and procreative aspects of sex, and we refer to that as menopause. And I think even having a procreative intention after menopause, I think is a somewhat meaningless concept. Because unless we're hoping for miracles or virgin births or anything like that, I think the concept of having— and that's why our Catholic brothers and sisters come back and say, well, you don't have to have a procreative intention. You just have to be open to procreation.

But even, I think, openness to procreation after menopause, you know, I think is a meaningless concept. Some women after menopause, you know, their ovaries removed, they have hysterectomies for health reasons. And to even have an openness to procreation, I think is a meaningless concept. So I would say that is a God-ordained natural law separation of the unitive and procreative aspects of sex, which means that the requirement for those always have to go together can't be an absolute. And the fact that God ordained it and that human beings are separating those through IVF and other types of things, I think is a distinction without a difference, because if God ordained that separation, then it can't be intrinsically problematic.

So, and therefore, that requirement that the unitive and procreative aspects of sex always go together can't be an absolute absolute. I think that's the root of it. Well, I think there's two questions. I think can we, the way it's often framed is can we create human beings by science rather than sex? That's the root of it, one of the questions. The other one is are there— Clearly we can.

The question is should we? Well, morally can we? Should we? Agreed. Sorry. And are there effects in doing this to the child, which is more consequential? I think there's some harms that have been raised. That's a follow-up question, but you're right. The root principle is, do the unitive and procreative elements go together? Now, this could open a huge can of worms, but I think there's a difference between like Paul and the Song of Solomon talking about the duties that we have, husbands to wives, and the beauty of pleasurable sex, and saying that means we can separate it, therefore, from its procreative function.

It's one thing to highlight it, talk about that purpose. It's another thing to say we have this purpose, but it can be severed from the other purpose. That's one pushback I would have on that piece. You're right that the heart is a connection. Can we separate? Is it okay to have sex without babies and babies without sex?

Now, technology has enabled us to do both. Obviously, IVF on one end, birth control, or of course, abortion on the other, which are different. I recognize that. You made a point about, I think when it comes to the God-ordained end of menopause, there's arguably a difference between God ordaining that for reasons that God has

and us choosing to do an end run around that through technology. I think those are very, very different things. One is natural. It's built in, doesn't seem to be the result of the fall, as far as we can tell. And then using technology to do an end run around that in things like IVF. But don't miss the point I was making, because I do think that's an important distinction, but I think for the question that we're raising, it's a distinction without a difference.

Because again, if God has ordained it, what that means is that that mandate that the unitive and procreative aspects always have to go together is not an absolute. And whether a human being separated or not, or God separates it, if God has separated it through menopause, then it can't be intrinsically wrong. And whether human beings separate or not is beside the point. So I don't see why that's beside the point. If God has built into our bodies a certain separation, then what we learn is there comes a time where a man and woman who are married can have sex and be married, and it's not going to naturally result in a child. Does that mean we can turn around before that God-instituted season and say, oh, since God did it, therefore we can separate it in other ways?

I don't think that follows. Maybe that's where we— I mean, that's going to be a point where we differ. Maybe that's just the point that we differ on. I think it does follow from that because what that means is that there's nothing intrinsically wrong about that separation. Now, I think we can agree that human beings separating it has caused effects. I would acknowledge that. And I think, you know, we talk about this with birth control

a lot. But that's another conversation here. But I think, well, let's go on. I can see the nuances in your mind. There's so much to do here. Okay.

I want to read something and then you just respond in terms of what you think. I think you'll disagree, but I don't know how to phrase it better myself than Stephanie Gray Connors. Her book, Conceived by Science, she's Catholic. And so obviously understand where she's coming from. We're not going to find chapter in verse, a Bible passage that says, because the technology wasn't available.

So in some ways, it's a theology, the body and biblical principles that we have to play off and see if it works. So here's kind of the case that she makes. she's talking about how at the moment of one, so she's contrasting conception in IVF with conception in God's design inside the woman. And she says in IVF, it enlists a third party to do so at the moment of conception, which is interesting. You bring a third party in at the moment of conception, which is interesting. You bring a third party in at the moment of conception.

And then she walks through some of the differences between how IVF conceives and how it naturally conceives inside. So she says, for example, if a woman shows signs of ovulation on Tuesday, but her egg is not released until Thursday, and she and her husband have sex each day, Monday to Friday, the semen from which these five acts of sex will contain the winning sperm. Which one? We don't know. In other words, there's a built-in contingency there that we cannot control. There's something about God's design for a couple's ability to be fruitful and multiply

that is hands-on, but also hands-off. We can't force somebody into existence. They're receiving someone whom God brings into existence. So her argument is that IVF in contrast is making someone. It's literally manufacturing a human person. So the parents aren't receiving new life as fruit. Rather, instead, a new human is beginning at the hands of a stranger. So her argument, and I think I'm inclined towards it, is that IVF does not actually mimic what happens naturally. It actually changes it. So God designed the body that sex is necessary, whereas IVF makes sex unnecessary.

You don't buy it, but tell us why. I don't, because the physician, calling a physician, an infertility specialist, a third party, I think is completely different than the other third parties that we rule off the table. Like a surrogate or a donor. Like donors or surrogates. Completely different. And the reason is because the physician makes no soulish contribution to the child like a donor does. The donor or surrogate contributes, and it contributes not just physically but soulishly as well.

That's a big intrusion to the matrix of marriage. The infertility specialist is simply a physician who is helping alleviate one of the general effects of the inference of sin. And I think calling that a third party, I think, is misleading. And I don't think that's true. Any more than a lawyer who prepares adoption papers is a third party in adoption agreement. I just don't think that's true. I don't see this as the uncertainties about whether conception is going to occur and the hands-off approach that's needed with natural conception is exactly the same with IVF. You don't have control over how many embryos are successfully fertilized.

After the sperm and egg come together, it's hands off and you trust God in the same way that a couple does when they're trying to conceive naturally. So I don't see that as being relevant. And I don't see this as manufacturing a child. Now, if you are doing gene editing and choosing the traits of your child based on your desires, or if you're choosing the sex of your child, that's moving us much more down in that direction.

I don't think this is it because I think what we're trying to do here is not to manufacture a child. We're trying to alleviate the effects of infertility. So a few thoughts in this that maybe would help is I think you're unmistakably correct that there's not a soulish contribution in the way a donor would be, for sure.

Of course, that's still two individuals coming together. That's not like a third soul that's being a part of it. So it's still two individuals, whether it's a donor or not. We would take issue with donor for separate reasons and concerns, not in principle the soulish contribution. So it's a third party, but not in the same way I agree with that. I think the question is, and maybe this,

we just leave it out there for our viewers to think about and look at, is it okay to have an outside party intervene and try to control and direct the process of conception removed outside of the human body, which is God's original design for it, into a beaker? That's the question. Seems like you don't have moral issues with it.

Fine. I don't. I would take some issue with that. And the reason for that is because, you know, God's design is affected by the general entrance of sin and has caused that brokenness. So I think maybe this is a helpful point we could draw out is how far technology can go to alleviate original design to function the way the eye or the hand or the body originally functioned. So in infertility, I would draw a distinction between saying somebody can take a drug to increase the number of eggs, surgery to fix the body, which restores it to God's original design, how it's supposed to take place.

In vitro fertilization, in my view, goes outside of that and is doing, that's not just fixing the process. I think it's changing it in a fashion. What say you? Then I think there are other medical technologies that you have to reject. Such as? Dialysis. Because dialysis doesn't cure anything.

It doesn't end run around kidney disease. It filters the blood independently of the kidney and puts it back in the system. And there are probably a handful of others that I think you're going to have to reject too. That's interesting. So I guess I would maybe make a distinction between a technology that is keeping somebody alive, right, versus a technology that is changing a process in itself of conception. That seems to me a different thing with dialysis.

The person is literally dying. How do we keep them going? Maybe a heart transplant, you could make the same kind of thing versus let's use the technology to intentionally end run around a process. Strikes me as there might be a difference there. I think they're both, think they're both in runs.

And what you're doing is you're enabling, as best you can, you're enabling a person to live, to restore other natural functions by bypassing the one that has failed. And I think you're doing exactly the same with IVF. It's just that the difference is that the kidney is designed to filter impurities out of the blood, whereas the reproductive system is designed to produce a child. So you're just allowing the system which has been broken by the entrance of sin to be restored, to function, to produce what it was originally designed to produce.

But I'll grant you it's not fixing anything. But there are other technologies that don't do that either. Yeah, I don't know. I have to think about this. That's a fair point. If bringing a second person into the process is the same, and if we can make dialysis comparable to procreation, I'm not sure that I would fully accept that as being comparable in terms of medical care.

But fair point. Let our audience wrestle with that, see which one they find compelling. Okay, let's keep going. We're pushing back on the time here, but hopefully I think we're just, our goal is what's at stake, what's for and against,

let people see and reason through it. That's the whole goal. So hopefully we're doing that. Is it ever okay to freeze an embryo? So I would take some issue with this. I would too. And let me lay out why in principle, and then you can tell me. Like, I think sometimes we talk about embryos, like donating embryos, the way we wouldn't talk about donating an adopted child, which even our language amongst Christians seems to indicate that we don't really believe at conception. You have a distinct living human being.

It becomes like, I don't know that we Christians have thought that through really well. So is it okay to freeze a full human being against their will, I don't know that that's okay. Without their consent. Exactly, without consent. And we know that a lot of them will not survive it. Now, it seems to me there's a difference between somebody who's in a medical condition and the only way we can help them is to potentially freeze them. And not that that ever happens.

But that's different than creating a human being. This is not for the embryo's benefit. Exactly. That's the point. And they're created knowing many will be frozen. And many of those will die and damage thawing out. And the other thing I'll throw in there is like if we freeze a human being, does a human being have a right to grow and develop along a certain timeline? And it's like we're doing an injustice to that embryo, which is a human being, by freezing them and literally freezing in time and physically freezing them.

It's problematic to me. Yeah. Some people say, look, these are the frozen and unchosen and there's something to that. But all freezing does is it just temporarily stops the embryo's metabolic processes and puts them,

puts them on, you know, on hold. So, I think the attrition rate, I think, is very troubling to me. And, but the reason for the attrition rate, I think, is very troubling to me. But the reason for the attrition is also important.

Now, that's why freezing embryos, freezing eggs is two completely different things. Agreed. I agree with that. Thawing eggs is a lot harder to do. And the attrition rate on thawing a woman's eggs is off the charts. Because an egg is not a human being. Right. And there are other reasons. Sure.

I think if my physician friend is right that the reason for the attrition is because there's some sort of defect in the embryo that is incompatible with life and it will miscarry, then that removes some of the moral tension for me. But if that's not true and there are other reasons for embryos not being able to thaw out successfully, then that raises my level of moral discomfort with freezing embryos. Okay. So you have reservation discomfort. I say serious reservations about that. So some people that will have IVF have said things like, if there's extra embryos, I promise

they'll be donated even if they're frozen for a period of time. That's one way some have told me. Maybe not everybody has to do that if they insert each one. But that seems to invite a certain level of, okay, wait a minute. You've created human beings in this contingent state that can be harmed. That in itself is problematic to me if IVF leads to that, even if you have the intention of adopting it out. Right. And I think this is part of it.

I think in a fallen, broken world. We may not have all the moral purity that we want for this. And the reason I say that is because I think I would support, and I call it embryo adoption. I don't use the term embryo donation for that. I call it putting embryos up for adoption. I think that's a more acceptable option for couples. What troubles me about that, I think it does contribute to a cavalier attitude toward creating embryos in the lab.

But I think we have a lot of excess embryos that are going to be destroyed. That's right. And the best option, I think, in a fallen, broken world is that those be put up for adoption much better than them being destroyed and much better than them being subject to experimentation. So I would be very supportive of the embryo adoption program.

You know, we interviewed the first snowflake baby ever that's right is a Biola grad so that I think I don't have a problem with that

per se although freezing embryos for that purpose I think is still troubling to me okay can I circle back

it's been in the back of my mind because I've been thinking about that dialysis thing and throw out one more distinction for you. You can tell me if you don't buy it or not. So is there a difference between a right to life and a right to having children? We do have a right to life. And so a technology such as dialysis to preserve a right to life is different than a right to having children. I would phrase it differently. And I'd say the answer is no. Okay. Tell me why. I would say we don't have a right to have children.

We have a right to attempt to have children. Those are two different things. You do not have a right to a child. Okay. You have a right to attempt to have a child. And IVF, I think is among other reproductive technologies, giving couples a chance to exercise that right within moral parameters that we've only briefly touched on. Sure, we have. Okay, so fair enough.

And I would agree with that. That goes back to is IVF within the realms of the right that somebody has in a God-ordained way of having a child or does it go beyond it? That's maybe where we differ. That's where we differ. But there seems to me there is a distinction between, would you, maybe concede is not the right word,

but a technology when it comes to- Concede to you, nothing. Not the best the right word, but a technology when it comes to- Concede to you, nothing. Not the best word. Whatever, you get the point. Now I lost my train of thought. I'm sorry. Between a technology that does an end run and dialysis to save life is different than one that I have a right to try to be a parent, to have a child.

That seems very, very different. Like we make moral distinctions when we can take life and when we can't. I think trying to have a child is different than keeping somebody alive and what technology we use for one doesn't necessarily translate to the other. But it's enabling the system to produce the product that it was designed to produce. It's enabling the body to be free of toxins. It's enabling the reproductive system to produce a child. I don't see a difference between those. Okay, so if life is at stake or not, doesn't change the equation for you. Fair enough. Okay, let's keep going.

People can wrestle with that one. All right, so one of the questions, I'm curious your take on this, is some of the harms that have come up to children that are conceived through IVF. And I guess you could reject this, you could embrace it, say it's worth it. One of our friends, Katie Faust,

has put together just a whole document on some of the data coming out of the effects. And for example, she draws out the very nature of like conceiving in a beaker outside of the body at the most fragile state of a human being outside of the womb. It's intended environment invites some of these potential harms. I think there's a point to that. But she says, for example, this is an article on our site, Them Before Us.

Let me see. So risk to kids. The IVF process consists of multiple steps from hyper ovulation and extraction of eggs to manipulation, fertilizing embryos in a petri dish. At the time, they're most vulnerable. So, increased risks for disease with children conceived through artificial reproductive technology, more susceptible to fetal growth restrictions. She cites specific cases here of cardiovascular factors that are elevated for children conceived through IVF, higher fasting blood glucose levels, higher risk of type 2 diabetes, premature birth.

A study from Michigan State University talks about children born. This is kids with birth defects through IVF, so not all kids. Birth defects through IVF had approximately seven times the cancer risk as opposed to children with birth defects conceived naturally. 2019 Danish study of more than a million children found that babies conceived through assisted reproduction via frozen embryo transfer were more than twice as likely to develop childhood cancer, particularly leukemia and neuroblastoma. A World Journal of Clinical Pediatrics found that children conceived through IVF have a

higher rate of brain damage, often associated. You don't need the details. Males tend to develop typically, but females show less advanced breast development and more bone age. I mean, the studies go on and on, even some on the level of like cognitive development and intellectual development they cite. So is this a risk? What do you make of that data? And does that make you rethink at all IVF? Well, I think what I'd like to know is, how elevated is the risk? Is it slight?

Is it significant? And I think I just compare that with the overwhelming number of children born of IVF who are completely healthy and have no obvious health risks that you and I wouldn't be subject to just as a result of normally living life. I mean, the vast majority of kids born of IVF are perfectly healthy kids. Now that's not to say that the utilitarian outcome determines the morality of it. Sure.

But I think, you know, might there be some additional risks? You know, maybe, and I know it'd be helpful to know if there's how, how much is that risk elevated, uh, as opposed to normal conception. So I wouldn't, I wouldn't lose a lot of sleep over that myself. Um, given, you know, what the overwhelming majority of IVF kids exhibit. So I guess it's hard to give a number, but you're willing to tolerate some level of risk and just have to assess what is that risk,

how significant it is, how are they affected. That would be the assessment for you. And we just have to look at the data and maybe compare it to other procedures. I'd want to dig a little deeper into that. Okay, fair enough. Are you going to do that for your update on moral choices? Does that concern you enough?

It will be mentioned. It will be mentioned. Okay. All right, fair enough. We are totally pushing the time on this one. We've gone way longer than I think we normally do. Did I miss anything? Let's hope our listeners think this is as fun as we did.

I hope they're still with us. There's so many more angles we could go with this. Let me ask you this. One more question, then you tell me. What do you make of the Southern Baptists have come out pretty strongly against all forms of IVF? Every human being is made in God's image. Human beings possess an inherent right to life and the opportunity to reach their full development. Governments are ordained to protect this.

And I thought this actually stood out to me. They said biblical creation or portrays the embodied union of husband and wife as the singular normative expression for procreation. That sounds kind of Catholic in the Southern Baptist resolution, which interested me. And they make the distinction, all children are to be fully respected and protected, but not all technological means of assisting human reproduction are equally God-honoring or morally justified. So Southern Baptists seemingly have shifted against this.

And because of the apparent consequences they see it and God's design for sex as embodied, they've rejected it. What do you make of that? And do you see, because I know you're studying this, do you see other trends going that way or do you think this is an issue Christians are just going to kind of agree to disagree on moving forward? I think Christians are going to be divided on this for a long time to come. Oh, I do see some folks who, in my view, are becoming more Catholic in their view of this.

And I think that's what the Southern Baptists have done, is they've essentially adopted a Catholic view, but without the specific Catholic theology that undergirds the Catholic rejection of IVF. Theirs is based on the moral status of embryos. Now, the Catholic view is based on that unit of procreative connection that always has to be in place. And minimal stimulation IVF is where they dial back the hormones that enable the woman to release all these eggs, and she releases fewer rather than more. And so in both of these, you're betting on one round of implants, especially with the one. If the one egg doesn't fertilize, then you got to start over again. But you don't do all the expensive hormone treatments that enable multiple ovulations.

That make sense? So I think that'd be a condition, and I think you don't, you know, ever implant more embryos than you can safely carry. So no selective termination, no, you know, no biopsying of embryos to test for genetic diseases, things like that that are eventually discarded if they're not, if they have a genetic problem. So those would be some of the conditions. Now, to be fair, the clinic will look at the couple and look like they've lost their minds. And financially speaking, they probably have. But I think it can be done in this way. And my caution to couples considering IVF

is to go in with your eyes open about what the standard of practice is and know that they're going to assume that embryos are just clumps of cells. They're going to assume that however many you create is irrelevant. They will assume that freezing and thawing them out is okay and the nutrition from thawing is okay. They will assume that freezing and thawing them out is okay

and that attrition from thawing is okay. They will assume that selective termination is okay. All those things. And I would suggest if you tell them what your values are up front and if they can't live with your values, then go to the next place. It's a business like anything else.

Fair enough. Let me give a couple of qualifications and then you wrap it up. I think you're right that there's some theological differences between the Southern Baptist and between the Catholic Church. I don't know how far they take it.

I do find it interesting because they said biblical creation portrays the embodied union of husband and wife as the normative expression for procreation. So it seems to be a sense, maybe I'm misreading it, that going outside of the embodied union is outside of God's design for procreation. It seems that the Southern Baptists are moving that direction, even though probably not fully into a Catholic theology of the body. It's different. Fair enough. I think I would say I,

I appreciate the reservation against freezing. Part of my caution would be if we're engaging in any process and it's going to result by the nature with some unborn human beings being frozen without them giving consent and some being harmed by the process, we shouldn't engage in that process. That would be a caution for me because this is going to happen as a result of it. I guess I would also say, yes, the majority of children born with IVF won't have the kinds of medical concerns, the brain cancer, the elevated diabetes to risk, but

some do. And it seems to me one child brought into the world through IVF and then has brain cancer and suffers unnecessarily because of it is one child too many when we're introducing in a technology outside of God's created design. On top of that, as far as I understand, there are other infertility clinics as effective or more effective, not as expensive, they get to the root of the issue, why there's infertility. Now, they can't promise, like you said, most cannot have children, that I would strongly tell Christians to exhaust all of those before they consider IVF. Obviously, I have concern about IVF. I've expressed those, but try all of those

at least first. Right. IVF is not the default position. Yeah. Anything you want to add to that from my final points? Are you able to express what, from my final points, are you able to express what? No, I've said what I needed to.

I think maybe the one, just the one thing I would add is that I do think that sexual relations are ordered toward procreation. That's the difference between, you know, heterosexual couples and same-sex couples. Okay. But I don't think that procreation is the sole end of sexual relations.

I agree. There are other aspects of sexual relations that are equally appropriate and can be legitimate ends in and of themselves, which I think is another reason why I don't take that separation of that union and procreate to be intrinsically problematic. Fair enough. So I think even Catholics and myself in this issue would say there are other valuable means and purposes of sex. Can they be severed? Is that the root of where some of the differences is that procreative element? Fair enough. We could come back to this at some point. I appreciate this. I mean, like I had not gone through bouts of infertility. I am somewhat working through this, to be honest

with you. And part of this conversation was to push back and get some clarity on it. That's the goal for people watching. So minimally, I hope you watch this, share with somebody, talk it through, and at least you've been informed on some of the issues and concerns that people raise and where the differences are. I'm exhausted, but this was about as fun of a conversation as I've had in a long time. It's good stuff. Don't forget to hit, oh, sorry, go ahead. Well, and, you know know that we can disagree on things without raising our voice or calling each other idiots exactly it's a good thing fair enough make

sure you hit subscribe to the podcast if you're listening or if you watch this on youtube hit subscribe more conversation like this yet to come we'll see you next time