I recently wrote a long, in-depth review about the book, “Walking Through Infertility: Biblical, Theological, and Moral Counsel for Those Who Are Struggling,” by Matthew Arbo. I think this is an excellent book, despite the fact that I strongly disagree with several of the arguments that Arbo makes. He walks readers through the moral and ethical issues surrounding IVF that many couples may be unaware of, and I think that reading this book would potentially save many couples from being caught off-guard by these issues and decisions. You can read my full review here.
I felt so strongly about the book that I decided to ask the author for an interview. He graciously agreed, even though he had been sent my review and knew I disagreed with him on many points. I sent him a few questions and his written responses are below.
Q. What led you to write a book about infertility?
Experience, mainly. Several close family and friends have experienced infertility. Bearing with them in that difficulty in what ways I could impressed on me just how unique and isolating the experience of infertility can be for couples, and likewise how those close to infertile couples often do not know what to say or do. I also began having more frequent conversations about infertility with couples in our church, and when they asked for resources to point them toward I didn’t have much confidence in what was out there, not from a thoroughly biblical or theological viewpoint, anyway. Suddenly, writing a book seemed like something I really needed to take on.
Q. I love your idea that infertile couples can submit to their calling (even if it’s only a temporary calling) of childlessness, and still actively petition God for a child. Can you elaborate a little bit on how this would look in the daily, practical lives of couples?
Our callings are what God invites us do with him. All Christians are called to discipleship in general; not all Christians are called narrowly to engineering or marriage or, in this case, childlessness. A childless couple waits upon the Lord with open ears and receptive hearts. This waiting isn’t passive, but active, and this seems to imply a tension: on the one hand, the couple accepts with faith the calling God has given, and yet at the same time the couple beseeches God for a child. Perhaps something like “hopeful waiting” captures the thought. What does this look like In the daily, practical lives of couples? I think it looks like the faithful, consistent practice of ordinary disciplines. Included in these disciplines is prayer, of course, but so are other disciplines like fasting, solitude, and study. With prayer in particular, it is important that prayers for children are also accompanied by prayers for patience, contentment, and joy; that is, couples ask for what they need to sustain them for what God has given them now to do.
[Side note from Lisa: If you want to practice praying for patience, contentment, and joy, as Matthew suggests, check out my “31 Days of Prayer During Infertility” blog series and the free downloadable prayer calendar].
Q. What advice would you give to churches that want to find ways to serve infertile and childless couples in their congregation?
I think there are at least two things every church can do to serve infertile couples. The first is to foster an ecclesial culture in which everyone—single and married, those with children and those without—are equipped and encouraged to participate fully in the faith community. To foster that sort of culture will involve corresponding deflation of familial hierarchy. A second piece of advice is more cautionary: infertile couples deserve your presence not your platitudes. What infertile couples most need (and want) is for others simply to be there for them, to company with them in their suffering or grief. Thats the harder, more sacrificial thing to do. Don’t over-promise and under-commit. Another final bit of advice would be for churches (especially pastoral staff) to talk more openly about the experience, when appropriate, helping de-stigmatize infertility and open opportunities for communication and sharing.
Q. Part of your book talks about the importance of remaining committed to the church during infertility. How would you counsel an infertile or childless couple that finds it particularly painful to attend a church that has a heavy focus on family life and children’s ministry?
Let me say right from the outset that I empathize deeply with couples who find it painful to attend churches that place a heavy emphasis on children and family. That sort of pain is natural and entirely understandable. So, please understand, the counsel I offer comes in the gentlest possible spirit. I suppose I would encourage couples first of all to resist the urge to withdraw from your community. Withdraw is often the first, self-protective impulse. I invite you to reflect upon, and also to pray about, an alternative, perhaps even on some appearances contradictory approach: rather than withdraw from the faith community, step more deeply into it. God has so established his church that, when serving his people and exercising our gifts as extensions of his grace, we actually become increasingly conformed to the image of Jesus. I fully acknowledge this won’t be easy. In fact, sometimes it will feel defeating. But there is really no other way to participate in the life of the church than by service and reciprocity. It may happen that contributing in this way gradually renews both the affections and the practices of the church.
Q. The biggest struggle I had with the book’s section on the morality of IVF was your counsel that couples with more embryos than they can raise should not place the embryos for adoption, unless there is an extreme situation as a hysterectomy or the death of the wife. Instead, you advise them to eventually transfer all embryos into the wife, have her give birth, and then place the resulting child up for adoption.
I felt the book lacked an explanation of why you feel that separating a child from its genetic mother AFTER birth is morally preferable to allowing the woman who will ultimately parent the child to give birth to it. This is basically advising the genetic mother to become the surrogate for the adoptive mother, since after all, the adoptive mother will ultimately raise the child. You yourself question whether a surrogate can “‘care’ for her developing baby with only her head and without her heart, to simply do her contractual duty, dispassionate to the new one drawing upon her very life and breath?The answer clearly is no, and indeed she shouldn’t have to” (p. 92). Your counsel would result in a lot of trauma for both the child and the genetic mother. Wouldn’t it be better for the adoptive mother to create the maternal bonds that results from carrying, delivering, and nursing the child, instead of breaking the physical and emotional bonds a genetic mother will create?
There are several overlapping questions here, so let me try to take these in turn. In the book, I do counsel couples with embryos to have them implanted, unless there are extreme mitigating circumstances. I do not advise couples to separate newborn children from mothers. I think if read carefully in context, what I am suggesting in the book is that couples who have stored embryos and who do not want more children should nevertheless have the embryos implanted. The couple may ultimately elect to place the child for adoption; it is the couple’s decision. I doubt many couples will eventually elect to place children for adoption. I do not in any way mean to suggest that mother and child should be separated. Doing so against the mother’s will would be illegal, in any case, unless social services were forced to intervene for requisite reasons.
With that important clarification in place, I think the concern raised about the genetic mother becoming a de facto surrogate is relieved. Parents with embryos bear a moral responsibility to have their embryos implanted. The mother of the child carries the child to term. I’m not suggesting the genetic mother serves as a surrogate for the adoptive mother. Rather, I’m suggesting that the genetic mother should carry her children to term and, if at all possible, rear them. The bond between mother and child is deep and intimate. God created that bond. So, I want to be absolutely clear: never would I suggest that mother and child should be separated (save in extreme circumstances when the life of the child could be at risk (i.e., mother is an addict or self-harming).
Q. You also caution against IVF due to it’s ethically murky history and the number of embryos that have been destroyed in the process of refining the technique in the last few decades. This is a valid point, but if we apply this to IVF, mustn’t we also apply this to our usage of other medical technologies (both life-saving and elective) that have questionable histories? Examples include the exploitation of mentally handicapped children to help create vaccines for hepatitis and the infamous U.S. Public Health Service Syphilis Study at Tuskegee. Both studies (and numerous more) resulted in the deaths of innocent people.
A great question. The short answer yes, we should also apply the moral principle to other medical technologies. What I am critiquing in the book is Utilitarianism, the now prevailing viewpoint in much medical experimentation. The utilitarian wishes to argue that it is the value associated with the consequences of our actions that is morally decisive. So, in other words, if we have some aim—say, a particular medical discovery—and that aim seems to maximize advantages for the most people, then that action should be performed, and is indeed good to perform. The utilitarian therefore accepts that evils may be involved in pursuit of these aims. The Tuskegee experiments you mention are a classic example of this logic: destroy individual lives on the mere prospect of discovery. I emphasize “prospect” here because no experiment can guarantee achieving the desired results. That represents a huge weakness and liability of utilitarianism: doing evil on the mere prospect of achieving a desired aim cannot be intrinsically justified because the aims may not even be achieved, and even if they were, the ends would not justify use of evil means. Another example here, drawn from a different domain, is use of nuclear weapons in war. Nuclear weapons are indiscriminate and disproportionate and are categorically evil. There are no circumstances in which they are justified. They’re wrong even if a nation were confident it might help conclude hostilities. Not using nuclear weapons may mean prolonging the war, or it may not; thats just the provisional nature of moral prospection. The only way for the utilitarian theory to get traction is for it to presume upon the future, when the fact is our actions, particularly our collective actions, carry all sorts of unintended consequences.
I could say more about the weaknesses of utilitarianism, but in drawing the connection to the question posed, IVF is not a “treatment” in the strictly medical sense of the term. Destroying embryos to refine techniques was not and is not morally justified. In fact, it was and is morally wrong. Now, none of this is to suggest that medical research shouldn’t seek noble aims. I am very much pro-science and pro-medicine. What medicine has achieved over the last half century is breathtaking. But it is essential that medical research is guided by moral principles more substantive and coherent than utilitarianism.
Many thanks to Matthew Arbo for giving this interview. I appreciate his willingness to engage in a dialogue with me, even though I wrote a partially-critical review of his book. For those of you who are considering IVF in the future, I hope you found this to be enlightening and helpful.
For Further Reading
Christians and IVF: Can I Honor God and Still Do IVF?
Leftover Embryos- The part of IVF I hate talking about
Leftover Embryos: A Family Member’s Concern
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