Bioethics Again

One of the assignments in my doctoral classwork is to "counsel" in hypothetical situations after investigating the ethical issues in certain cases. Here's an example:

The question: A young couple has been working in your church as youth leaders. They would love to have a family of their own, but have not been able to conceive after several years of trying. Recently, a friend of theirs from work suggested going to a local fertility clinic to try artificial insemination. They have come to you for guidance. What would you advise?

My answer:

The facts of the situation are as follows:
· The couple has been happily married and have not been able to conceive a child.
· They are (we assume) believers and want to honor God with their decision.
· They yearn for children and feel this yearning is a God-given desire.
· Artificial insemination is no longer an experimental procedure. It has been proven and tested for generations.
· Artificial insemination comes in several varieties: AIH, insemination by husband, and AID, insemination by donor.
· Artificial insemination outside the body (IVF) can result in the fertilization of several eggs, resulting in more than one living embryo.
· More than one living embryo may be implanted in the woman’s womb. One or more may not survive implantation. Or several may survive, requiring that one or more unborn babies be destroyed in order to preserve the mother’s health and the lives of the others.

The ethical issues involved are the rights of the parents to procreate and the right of an embryo to life.

The alternatives: the couple could choose adoption instead of exploring AI or IVF in any form. Many children wait now for parents, and adopting one of them could fulfill two sets of dreams with one action. Sacrifice would be involved—the parents’ dream of biological children, the experience of pregnancy, some months of babyhood—and challenges would be present. But God often uses and blesses adoption.

The couple could choose AIH, insemination by husband. This would maintain the sanctity of the marital bond and give the couple the biological child they want. If conception is to occur in vitro, they could stipulate that only one egg be removed and one embryo created. This limitation, however, would result in far greater trouble and expense for the family and the medical personnel.

The couple could choose AID, insemination by donor. This might violate the sanctity of the marital bond and could result in the father’s being “detached” from the resulting child. The mother could also feel “attached” in a way the father cannot understand. In effect, he would be adopting another man’s child borne by his wife.

The consequences are rife with the potential for problems. Adoption holds its own unique challenges, but the parents would be facing them equally since the child would not be biologically related to either of them. Furthermore, if they felt the clear leading of God in this direction, they could rest in the knowledge that God has brought them to this place in his sovereign will.

AIH offers far fewer problems than AID or adoption. The resulting child would be related to mother and father, so the method of conception becomes a moot point. If any form of in vitro fertilization is chosen, the experience, particularly if limited to one egg/one embryo at a time, may take longer and create financial hardship for the family.

AID, for reasons discussed above, could result in deep mixed feelings for mother and father: guilt for the mother because she is related to this child while the husband is not, and resentment on the part of the father because he is raising someone else’s son. If the child learns of that his father is not his biological parent, he might likewise feel unattached and even experience a sense of loss and yearning for his “missing piece.” Even if he is not told, he may notice that he is not much like his father and wonder about his origins . . . and even his mother’s fidelity.

My decision would be to counsel the family to prayerfully consider either adoption, AIH, or simply to wait. All three options present unique challenges, but by the time most couples reach this degree of desperation, they are willing to forge ahead and do what must be done. They must have a clear sense of God’s leading in a particular direction, or they will spend the rest of their lives wondering if they’ve done the wrong thing.

Heavy stuff, isn't it? (Note: I'm not sure that artificial insemination by donor would "violate the marriage bond," but the author of my textbook views it as a violation of the "be one flesh" mandate in Genesis 2. Personally, I haven't been able to reconcile that view to the idea of "raising up sons to one's brother" (Levirate marriage) that was practiced in the Old Testament.

~~Angie, certain that something like this will pop up in the WIP

P.S. Thanks, Lisa, for the clarification. You're right, so I edited. :-)