LCMS Convention Workbook St. Louis, Missouri — 1998, Page 355

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THEOLOGICAL DOCUMENTS.

Contrast to Adoption

Some may argue that contemporary procreative choices are simply a
variation on the morally praiseworthy practice of adoption. They would
contend, for example, that if we are prepared to welcome an adopted child
into the one-flesh unity of a marriage, then we should also accept procre-
ative choices that involve third-party intrusion into a marriage.

This argument overlooks a crucial moral difference between procre-
ative choices and adoption practices. As we have repeatedly emphasized,
an important principle in our evaluation of procreative choices involves
respecting the one-flesh union of marriage when procreating a child. The
Practice of adoption does not involve a choice to conceive a child outside
of the one-flesh relationship of marriage. Adoption responds to the
absence or disruption of a family context in a child’s life by welcoming the
already present child into a new home. Persons involved in adoption are
thus able to continue to respect the one-flesh unity of marriage as the only
appropriate context for conceiving a child.

Adoption is a choice that infertile couples often consider as they
prayerfully seek to serve God by caring for a child. Such a choice can be
made responsibly without disturbing the one-flesh unity of marriage
through third-party interventions into the conception of a child.” This is
one way for some infertile couples to serve God and the world by respond-
ing to the needs of a child through parenting.

Disagreement?

Discussion of these cases has perhaps led your group to experience
some difficult disagreements, and not everyone will be persuaded by the
reasoning offered here. We have noted several times along the way in this
study how faithful Christians might disagree with each other concerning
the proper guidance to be drawn from God's Word and concemning prac-
tical judgments about the likely outcome of a concrete decision in life.

If we are pledged together to strive to keep God's scriptural guidance cen-
tral in our deliberations and if we recognize that God's Spirit works in the body
of Christ to lead us into truth, then wrestling with disagreement can be a posi-
tive aspect of our life together in Christ. We acknowledge that determining
God's guidance is often a complex and difficuk matter, and we find that we are
ted once again to give thanks that God forgives us and then commends us
again to live with one another as those redeemed by grace through faith.

"In 1983 the Synod in convention adopted Resolution 3-04B, “To Reaffirm and imple
ment the Synod’s Pro-Life Position.” This resolution included a recommendation that the
synodical Board for Social Ministry Services encourage adoption as an alternative that
affirms life. Adoption is a significant way in which people can be guided by the Fifth Com-
mandment. It is a focused way of helping and supporting a'child “in every physical need”
(Luther's Small Catechism, 10).

c%)

Now, jot down some of the insights you would expect to find by tak-
ing some of the first steps you and we have listed. What possibilities for
good or ill seem to present themselves?

Many of the biblical passages relevant to decisions about in vitro fertil-
ization have been discussed in connection with the preceding cases. Some
background conceming current practices will be important to know.

For example, many versions of this technology include a conscious
intention not to nurture all of the fertilized eggs. Some practitioners
increase the efficiency of the technique by fertilizing more eggs than are
likely to be used and then choosing to implant only those that, upon
inspection, appear most promising.

When the technology is pursued in this way, the presence of so-called
“spare” embryos raises questions concerning their future. Should they sim-
Ply be discarded? Should they be frozen and stored for possible future
implantation? Should they be donated to other infertile couples for possi-
ble implantation? Might medical research profitably use some of these
embryos for research? All of these proposals have in fact been utilized in
the practice of one or another in vitro clinic.

Another dimension of this issue is illustrated in the following use of in
vitro technology:

In February of 1992, Chloe OBrien, a healthy child, was born to British
Parents who are carriers of cystic fibrosis. The 1 in 4 chance of producing a
child with CF was circumvented by using in vitro fertilization, genetically
screening the 8-cell embryos, and implanting only those determined not to
be affected with the disease. The screening technique was developed by sc
entists in Houston in cooperation with London’s Hammersmith Hospital”

This technique, known as Blastomere Analysis Before Implantation
(BABD), can be adapted to screen for a variety of potential genetic defects.
Some are beginning to argue that as such techniques become more refined
and widely available, people will be under a moral obligation to use them.

” Philip Elmer-Dewitt, “Catching a Bad Gene in the Tiniest of Embryos,” Time (October
5, 1992): 81-82; cf. interview by Jean-Yves Nau of Jacques Testart, “Dark side of genetic
screening.” Guardian Weekly (October 11, 1992): 13. For the full medical details referenced in
these articles, see A. H. Handyside, J. G. Lesko, J. J. Tavin, R. M. Winston, and M. R. Hughes,
“Birth of a normal girl after in ritro fertilization and preimplantation diagnostic testing for
cystic fibrosis,” The New England Journal of Medicine (September 24, 1992): 905.

™ Barbara Rothman is an opponent of this development, but she sketches the following
scenario to illustrate how the argument might be made: “Of course, Helen, you can go ahead
and get pregnant with Frank any old way. But is that sensible, mature? Let’s run you
through three cycles over the next few months, extracting eggs, fertilizing them with Frank's
sperm and freezing them. We'll grow the embryos for a bit, test them and use only the very
best. This is the most important decision of your life. You wouldn't have accepted any hus-
band by chance—why should you accept any embryo?” (Barbara Rothman, “Reproductrve
Technologies Offer False Hope and Serious Risk” in Biomedical Ethics: Opposing Viewpoints,
ed. Terry O'Neill {San Diego: Greenhaven Press, Inc., 1994], 168).

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CASE 4:
IN VirRO FERTILIZATION WITHIN A MARRIAGE

Beth and Zachary have been advised that their best hope for having a
child involves the technique of in vitro fertilization. In vitro fertilization
brings together the couple's eggs and sperm for fertilization outside of the
woman's body. Fertilized eggs are reintroduced in one of several different
ways into the mother’s reproductive system. Lf one or more embryos suc-
cessfully implants in the mother’s womb, then pregnancy can proceed in
the usual way. Beth and Zachary wonder whether this proposed method
can be an appropriate approach to parenting for a Christian couple.

DISCIPLINED CHAOS
As in the previous cases, spend some time writing down and commu-
nicating to each other a list of steps that might be taken to help the group
enrich its thinking about this case. Perhaps someone in your group is
knowledgeable about this technology, either as a health care professional
or as a person who has some experience with it. As always, group mem-
bers will want to be sensitive in discussing these matters with each other.

What did you come up with? Here are some of the steps we have
drawn up:

° Praying together for God’s guidance.

© Seeking to learn more about the details of in vitro technology.

* Seeking biblical materials that may be relevant to the case.

° Asking if other Lutheran congregations or our Synod or its theolo-
gians have offered any advice about in vitro fertilization.
Looking for relevant discussions of this matter among Christians
in other confessional communities.
Examining discussions of this technology found in other literature.

Asking about similarities and differences between this case and
the cases we have already discussed.

w

Advocacy for such techniques is based on the premise that fertilized eggs
afflicted with a known genetic disease should simply be denied nurture in
the mother’s womb.

Some proponents of this kind of embryo screening argue that this
Practice simply brings more precision to what nature already does. They
note that as many as half or more natural conceptions end in natural loss
of the fetus, and much of this loss is related to elimination of severely com-
Promised fetuses.”>

Others point out that in the earliest stage of embryonic life none of the
cells have differentiated or specialized. They point to the phenomenon of
twinning: if the embryo is divided in its early moments, two complete indi-
viduals sharing identical genetic patterns can grow from the division. They
then argue that at this earliest stage of development no one distinct person
is yet to be reckoned with. The indeterminate personhood of the embryo is
said to indicate that the embryo is not of the same status as that of a fetus
in which cell differentiation has begun. Thus, disposal of the embryo and
perhaps even research upon it at this earliest stage is defensible both
morally and spiritually.

A different set of questions involves the practice of introducing mul-
tiple embryos into the woman’s reproductive system in order to increase
the likelihood of a successful implantation. If too many implant, the
response is selectively to “reduce” the pregnancy to a safe number of
fetuses.

Our Synod has not previously commented directly on in vitro technol-
ogy. We note, however, that synodical representatives participated in dis-
cussions that led in 1985 to the preparation of a report on in vitro fertiliza-
tion by the Division of Theological Studies of the Lutheran Council of the
U.S.A. In this report those representing The Lutheran Church—Missouri
Synod in these discussions suggested that in vitro technology would need
to be subject to the following limitations:

a. Because the biblical injunction to be fruitful and multiply was given by

God to a man and a woman united in the one-flesh union of marriage
(Gen. 1:28; 2:21-25), only the sperm and egg of a man and woman unit-
ed in marriage may be employed. Any use of donor sperm or eggs.

™ Although addressing a somewhat different problem (the treatment of extracorporeal
embryos when using i rite fertilization to treat infertility), Leon Kass suggests that “no dis-
respect is intended or practiced by the mere fact that several eggs are removed to increase
the chance of success.” He continues, “The demise of the unimplanted embryos would be
analogous to the loss of numerous embryos wasted in the normal int vivo attempts to generate
a child. St is estimated that over 50 percent of eggs successhully fertilized during unprotected
sexual intercourse fail to implant, or do not remain implanted, in the uterine wall, and are
shed soon thereafter, before a diagnosis of pregnancy could be made. Any couple attempting
to conceive a child tacitly accepts such embryonic wastage as the perfectly acceptable price
to be paid for the birth of a (usually) healthy child” (Leon Kass, Toward a More Natural Science:
Bintogy and Human Affairs [New York: Free Press, 1985], 107).

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