So far we have discussed the morality of different types of medical treatments, but we have not paused to consider whether it is ethically acceptable to use modern medical technology at all to manipulate our child-bearing. Are we playing God when we try to control when and how we have children?

There has always been a wide range of opinion and practice among Christians on this matter. Soon after his conversion, my physician husband was taken aback when a woman in his congregation explained she was not going to visit a doctor to treat a thigh abscess, but was instead going to pray according to the instructions of James:

Is anyone among you suffering? Let him pray. Is anyone cheerful? Let him sing praise. Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith will save the one who is sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven. (Jas 5:13-15)

She was waiting for God to heal her. Likewise, a friend of mine was devastated when a well-intentioned group of parishioners visited her to pray for her chronic back pain, and then accused her of having inadequate faith when she did not immediately improve.

There has always been a level of suspicion or unease among some Christians about medical technology. And it is not getting any easier. Healthcare is changing rapidly. The escalation in the number of ways we can manipulate the unborn human is regularly creating ethical dilemmas that we have never had to confront before. The developing scientific environment will demand a constant shift of focus and approach to the moral challenges, and new situations will require us to keep re-examining the subject. Rote answers won’t be enough.

What are Christians to do as we try to determine God’s will for us in this area of our lives? Is it legitimate for Christians to use medical treatments at all, or should we always depend on prayer? Are we trying to usurp God’s sovereignty when we visit a doctor, or does he work through the treatment? What is the relationship between divine healing and the practice of medicine? Is it okay to restore health so long as we don’t try to improve on nature? How should we respond to suffering as followers of a suffering God?

In order to address these challenging questions, I want to start by thinking more broadly about technology, for that is what medicine is—a particular form of human technology.

God and biotechnology

Good afternoon, ladies and gentlemen. This is your pilot speaking. We are flying at an altitude of 35,000 feet and a speed of 700 miles an hour. I have two pieces of news to report, one good and one bad. The bad news is that we are lost. The good news is that we are making very good time.

This anonymous quote is often used to introduce discussions of bioethics, expressing the common feeling that we humans often seem better at devising technology than knowing how to use it.

The word ‘technology’ is derived from the Greek techne, meaning art and craft, and logos, meaning discursive reason or rational discussion. Technology is the making or crafting of things using our reason. While the term itself was not used by the Greeks, the idea of technology was recognized by Aristotle when he described a productive state (as opposed to an action) involving true reason.[1]

The appropriate use of technology is an aspect of our stewardship of the earth, in obedience to God’s cultural mandate in Genesis 1:28, to “fill the earth and subdue it” (cf. Ps 8:4-8; Heb 2:5-8). Hebrews 2:8 clarifies the scope of our stewardship: “…in putting everything in subjection to [man], he left nothing outside his control”. We understand this to mean that the creation is subject to mankind’s benevolent rule under God.

The Bible gives us many examples of the high value given to man’s technological skill. Early technologists in the Bible are introduced in Genesis 4, with Jubal developing musical instruments (v. 21) and Tubal-Cain forging tools out of iron and bronze (v. 22). Taking the specifications God had given him, Noah built an impressive three-decker ark to ride out the flood (Gen 6:13-22). In the construction of the tabernacle, God chose Bezalel and “filled him with the Spirit of God, with ability and intelligence, with knowledge and all craftsmanship, to devise artistic designs, to work in gold, silver, and bronze, in cutting stones for setting, and in carving wood, to work in every craft” (Exod 31:3-5). The exquisite detail of Solomon’s temple displays the intricate beauty wrought with skill by the craftsman Hiram, thus making the temple fit for the Lord of hosts (1 Kgs 7:13-51). Christ himself was a carpenter’s son and presumably continued the family trade (Matt 13:55), and the apostle Paul made tents (Acts 18:3).

But from the earliest times, it was not only the godly who were given these gifts from God. After all, Cain (who murdered his brother, Abel) built the first city (Gen 4:17). And it is disappointing, if not surprising, that the description of Tubal-Cain’s ability to forge iron tools is immediately followed by his father Lamech boasting of killing a young man (vv. 23-24). Did the ‘tools’ quickly become weapons?

At a basic level, then, the skill and ability to use the materials of the created order to make things is one of God’s good gifts to us—whether the ability to make a chair, or to make music on the guitar, or to make a house that is beautiful and functional in its design. We do not somehow cease to trust God when we work or use our skills in this way—as if God’s provision for us can only operate when we are doing nothing! We work for our food, and at the same time we give thanks to God and pray for him to bless our labours. Medical technology is just another example of the skill, knowledge and ability that mankind has been able to develop because of how God has made us.

However, the Bible contains many warnings of what can go wrong when our God-given technological creativity is abused. The builders of the tower of Babel in Genesis 11 were skillful but fundamentally opposed to God. The technology the Israelites used to decorate the tabernacle was the same technology they had used to make the golden calf centuries before. Technology can be utilized for good or evil.

The same is true today. The technology we use to identify the genetic code for the purpose of curing disease is also being used to screen unborn children so they can be aborted. We should not be naïve about the risks that technology holds.

Since the Renaissance, technology and science have steadily assumed a more and more important place in Western society. Francis Bacon (1561-1626) mapped out a specifically Christian vision of using science for the welfare of human kind. In his New Atlantis (1627), he describes a society governed by the use of modern science and technology that could conquer nature for human benefit. Robert Boyle (1627-1692) and Isaac Newton (1642-1727) also saw the possibility of bringing glory to God through discovering the nature of his creation.

But it is not always a simple matter of man using technology. Technology also shapes and changes us. The Industrial Revolution (1750-1850) saw a drastic change in the profile of society—from a rural economy with families involved in cottage industries, to an urban economy built on manufacturing and commerce, in which women stayed home with the children while men went out to work. This changed social and family life enormously. The transformations of the past 50 years—many of them driven by technology—have brought yet more changes. With the rise of the service economy and the knowledge economy, there are now many more clean and safe jobs that women want. With the simultaneous development of reliable birth control, women now have an unprecedented level of biological and economic independence.[2] This has had a massive impact on the institution of the family, and not always in a way that nurtures the children involved.

The dangers inherent in technological progress have been voiced by Christians (e.g. CS Lewis) and non-Christians (e.g. Aldous Huxley). Huxley’s Brave New World (1932), a satirical portrayal of a scientific utopia, has been influential in the debate over the morality of technology in modern society. The novel warns of the power of technology to dehumanize mankind; it portrays a world where suffering has been eliminated, but at the expense of our real humanity and individuality. Lewis, on the other hand, in his The Abolition of Man (1943), acutely sees technology not so much as “Man’s power over Nature” but as “a power exercised by some men over other men with Nature as its instrument”.[3]

Theologian Oliver O’Donovan suggests that what makes ours in particular a technological culture is not so much what we can do, but how we think about it. He insightfully suggests that our culture is not technological because of the sophistication of our “instruments of making” so much as because we think of everything we do as a form of instrumental making: “Politics… is talked of as ‘making a better world’; love is ‘building a successful relationship’. There is no place for simply doing.”[4] O’Donovan continues:

The fate of a society which sees, wherever it looks, nothing but the products of the human will, is that it fails, when it does see some aspect of human activity which is not a matter of construction, to recognize the significance of what it sees and to think about it appropriately. This blindness in the realm of thought is the heart of what it is to be a technological culture.[5]

The result is that we then fail to recognize the inappropriateness of applying technology in certain situations: “When every activity is understood as making, then every situation into which we act is seen as a raw material, waiting to have something made out of it.”[6] It is not difficult to see how this ‘mechanization’ of human life can influence our attitude to pregnancy and child-bearing and the unfettered use of interventions such as ART.

Jean Bethke Elshtain points out that the human body is increasingly being thought of as the exclusive property of an individual, to do with exactly as he or she sees fit.[7] Encouraged by the biotech industry, we think of our bodies as malleable, as putty in our hands to be altered and re-shaped in pursuit of our needs and desires. She ponders the difficulty for Christians of arguing against the rush towards genetic and biological engineering when these things are offered to us in the name of progress, freedom and choice.

We can’t hide from the fact that technology does make many aspects of life easier, more comfortable, more pleasant. It makes us healthier, safer and richer. These are good things that all of us enjoy, and it is not wrong to desire them. Many lives have been saved as a result of medical technology. We can use radio to preach the gospel to nations whose borders are closed. Personally, I would hesitate to give up my washing machine. How can Christians challenge technology? Do we even want to?

For those of us living in this fast-paced, youth-oriented culture, the ongoing quest of biotechnology to perfect the human body can be difficult to assess, because it comes to us in the dominant language of our culture—the language of freedom, and of avoiding pain and suffering. We all feel the pull of these things. They promise an escape from the uncertainties of the human condition into a realm of near-mastery. With God supposedly removed as a brake on human self-sovereignty, we see no limit to what human power may accomplish. And if someone objects that it is sinful pride to take the place of God, this is taken as a piece of antiquated superstition. Anyone voicing concerns about the rush towards genetic and biological engineering is seen as either anti-science or callous towards those who may benefit.

Elshtain sees the ever more radical manipulations of the human body as a cultural “flight from finitude”. It undermines recognition of the complexities and limitations and joys of embodiment—the givens of what it means to be human, to be a creature. As creatures we are dependent upon our creator. And it follows that we are not absolutely free, but free only within the limits set by our sovereign God. There is a difference between those projects where we pursue God-likeness for ourselves, and those where we act as co-creators respectful of the limits of our creatureliness. Christians grasp this distinction, and therein lies our real freedom.[8] In Romans 12:2, the apostle Paul encourages us: “Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect”.

George Grant questions whether technology really makes society as ‘free’ as we think it does. While the basic knowledge (the science) that underlies technology is itself morally neutral, each technology is inevitably accompanied by an ethic of how it should be used, because each technology is designed for a specific task. We may think it is up to us to decide how to use a computer, but we can only do so within the boundaries of its design. So technology is not neutral, and the ‘freedom’ it gives us is limited to selecting between the options available, rather than expressing our full creativity in search of alternatives. In the example of procreation, for instance, what was once an exercise in receiving and caring for the gift of a child becomes a reproductive project of obtaining a child of one’s own, choosing the best route through existing treatment pathways. “And in doing so, it is difficult to see how such a child cannot be regarded as something other than a commodity.”[9]

Paradoxically, this presumed ‘freedom without limits’ is achieved for the individual through a loss of freedom for others. Parents achieve freedom from caring for a disabled child through prenatal screening, which gives them the information needed to make sure all pregnancies brought to term are normal. As a result, pressure is already being brought to bear on parents who hesitate to screen or refuse to abort: “How could you choose to burden society in this way?” Is this freedom? Elshtain worries not only about the elimination of a whole category of persons, but also about the prospects for those who are born damaged from any cause. There are already moves to screen every pregnancy for Down syndrome. And so, in the name of expanding individual choice, we are narrowing our definition of what it means to be human.[10]

Technology is now harnessed not just for the restoration of normal human function but also to provide options that our ancestors never dreamed of. ART has expanded its market to provide services not only for infertile heterosexual couples but also for single parents, homosexual parents, menopausal parents and now even fetal parents.[11] Some people hope to live forever.[12] What is now possible has created a perceived need that did not previously exist. Who would ever have thought that 60-year-old women would seek children of their own? Supply now drives demand, not vice versa, because we are using medicine not only to overcome disease, but also to overcome and supersede normal human functioning. And the financial rewards are enormous.

In recent years, new medical technologies are increasingly used to create wealth for small groups of individuals, rather than primarily as tools for the improvement of human health. While most scientists aim to better the human experience, the use of patents and confidentiality agreements are slowly dissolving the community of mutual cooperation that previously existed between international scientists. Previously scientists would work together and share results to enable progress to be made more rapidly, but now results are often kept secret until a lucrative application can be patented.

The power of commercial interests in scientific research has also meant that ethical boundaries have been challenged by the push for profits. Laws have been overturned to clear the way for destructive research on human embryos, as well as the creation of human embryos with three genetic parents.[13] Human cloning is now legal in several countries. These are worrying developments. When the focus of research moves from healing to profit-making, ethical considerations are unlikely to receive much consideration.

So there is a profit motive but also a technological imperative, which is the idea that progress is always good and that what can be done should be done. But as Christians we do not endorse progress at any cost. We may be willing to forego some treatments, despite the material benefits, because we deem them unethical. This is not only because some biblical prohibitions are absolute, but also because of the biblical understanding that there can be meaning in suffering. We can learn from suffering; it can have a purpose.

Suffering

The Christian world view has a distinctive view of suffering. We do not see suffering as illusory or unreal (as a Buddhist would), nor as the ultimately meaningless result of different sets of evolved molecules interacting with each other (as a consistent atheist would). For the Christian, suffering lies within the sphere of God’s sovereign rule as the creator and governor of our world. Indeed, the presence of sickness, decay and death is the result of his judgement on our rebellious world.

In other words, although (like nearly everyone) Christians do not wish to suffer and do not enjoy suffering, we know that we experience suffering under the sovereign rule of God.

Thus, suffering can function as God’s loving discipline designed to correct our ways (Heb 12:5-11). Suffering can test us, prove us and purify us (Ps 66:10; Jas 1:3; 1 Pet 1:7; Rom 5:3-5). Christians will also suffer because of persecution (Mark 10:29-30; 2 Cor 12:10; 2 Thess 1:4-5).

Sometimes suffering is a direct consequence of our sin. Consider the Corinthians who participated in the Lord’s Supper “in an unworthy manner” (1 Cor 11:27-30). We can see other examples in 2 Kings 5:20-27, Psalm 32, John 5:14 and Acts 5:1-10 and 12:19-23. Sometimes suffering is unrelated to our sin. Consider the blind man in John 9, as well as the example of Christ, who suffered though being without sin (2 Cor 5:21; Heb 4:15; 1 Pet 2:22; 1 John 3:5). In the same way, we see around us some people becoming sick as a direct result of their actions (smokers come to mind), while other people who have taken great care of themselves appear to have been randomly struck down with disease.

Yet these ‘random’ events may still have meaning. In John 9, Jesus said the man was born blind in order that God’s work could be displayed in his life (v. 3). We are told that suffering can be for our good even when we don’t understand it (Rom 8:28ff.). Job never understood the reason for his suffering, and doggedly refused his friends’ ‘rational’ explanations. After an overwhelming experience of God himself, he was able to triumph nonetheless.

In other words, although we naturally and rightly want to minimize suffering where we can, we do so under the rule of God. We accept the ethical boundaries he has put in place, and acknowledge that if suffering is to be our experience then good will also emerge from it within the plans of God. We also know that suffering will be temporary and, from an eternal perspective, brief. As Paul says:

Though our outer self is wasting away, our inner self is being renewed day by day. For this light momentary affliction is preparing for us an eternal weight of glory beyond all comparison, as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal. (2 Cor 4:16-18)

But the individualistic, secular public isn’t interested in the spiritual benefits of suffering, or in considering whether there might be a higher good than simply avoiding suffering at all costs. I remember hearing a parent at my child’s school talking about prenatal genetic screening: “Of course, it’s normal to want the best for our children; why would we ever hesitate to take full advantage of such opportunities to rule out the possibility of disease?” But in pursuing ‘the best’ for some children, we are prepared to terminate the lives of other children who might experience disease.

In our world of instant gratification, the public would rather just get results. This attitude is not new. Especially since the 17^th and 18^th centuries, suffering has been considered pointless, and man has sought to eliminate it by the instrumental control of nature. With suffering being thought to hold no meaning, the willingness to endure it has, understandably, been reduced. We find ourselves, then, at an impasse. Christians accept that some degree of illness and disability is inevitable in a fallen world, while the secular community is determined to conquer illness and disability at any cost.

We live in difficult times. The kingdom of God has come in Christ but will not be fully revealed until Jesus returns. We may not be able to control the technological pretensions of those who seek to build their biotechnological towers up to heaven, but the people of God can still bring glory to God as we practise wise stewardship of all the good things he has made. In our personal choices, we can still make practical decisions to ensure our own use of biotechnology reflects the values of God’s kingdom, because in the end we know that our physical bodies, complete with genome, will pass away. In our public and social interactions, we can argue and lobby for healthcare policies that protect and nourish life.

Christians have an advantage in considering these issues because we are under no illusions regarding this fallen world. Even if our community acknowledges there is a risk of misuse with any technology, the usual response is that regulations and prohibitions will control use of new techniques. As Christians, we know better, because we know that all people everywhere are predisposed to sin (Rom 3:23). Regulations don’t work. People break them. This understanding will prompt Christians to lobby against the development of technologies such as cloning. At times, all we may be able to do is encourage the enforcement of prohibitions that already exist. We do this for the sake of those who will be harmed by biotechnology’s excesses.

However, we also need to remember that we are dealing with real people’s problems. We need to extend compassion even when we are morally opposed to what other people want. When I am arguing against the abortion of disabled children, I am very conscious of the burden a mother takes on when she brings a disabled child to term. Of course all babies are beautiful, but we should not underestimate the toll of caring for one of these little ones. I am conscious that I also need to argue for better community support for these families, and I need to encourage fellow Christians to do likewise. Christian ethics are not just about saying ‘No’ to particular technologies, but about practical love and care for our neighbour (Jas 2:14-17).

My final comment is that, regardless of its problems, we as Christians should not turn our backs on technology. I applaud the efforts of bioethicist Nigel Cameron, who promotes the role of Christians in hosting debates on the challenges of technology:

The key need is to mainstream this discussion, and get it out of the hands of transhumanists on the one hand and Luddites, if there really are any, on the other. Our embrace of the technologies of the 21st century depends vitally on our understanding of their implications and our ability to take responsibility for their development.[14]

Those of us who are pro-tech and pro-human need to shape the future…[15]

Out of love, we need to keep engaging with our society on these issues, giving specific attention to the urgent need for moral leadership as we encounter the difficult challenges posed by biotechnology.[16]

Healing

Where does healing fit in? If sickness and death are the results of God’s judgement on human sin, are our medical problems done away with by the victory over sin that Christ has won? And if so, does this render medical treatment and technology a problem for Christians?

This has been a controversial issue among Christians, and it’s not within our scope here to conduct a full investigation of the subject. However, the outlines of an answer would be as follows.

The Old Testament word that comes closest to ‘health’ is shalom. It is usually translated as ‘peace’, but its meaning is much richer. Shalom represents salvation, wholeness, integrity, community, righteousness, justice and wellbeing.[17] This helps us to see health as God sees it. It is a holistic experience that extends beyond the physical and is grounded in our relationships.[18]

There are many Old Testament examples of God as healer. Following the exodus from Egypt, God reassures Israel that he is not only the judge who can afflict them with disease, but also the healer who restores them: “If you will diligently listen to the voice of the Lord your God, and do that which is right in his eyes, and give ear to his commandments and keep all his statutes, I will put none of the diseases on you that I put on the Egyptians, for I am the Lord, your healer” (Exod 15:26). His healing is manifested in physical wellbeing, such as when he used Elisha to restore the Shunammite’s son to life (2 Kgs 4:32-35), or when he restored Job’s fortunes following his time of trial (Job 42:10-17); but it is also connected with spiritual wellbeing and forgiveness (2 Chr 30:18-22).

Sometimes ‘healing’ takes place quite apart from any normal activity or agency, such as when Moses’ hand suddenly becomes leprous and is just as suddenly healed (Exod 4:6-7). Sometimes symbolic actions are undertaken that precede the healing—such as when Elisha instructed the rather sceptical Naaman to wash 7 times in the Jordan River as a cure for his leprosy (2 Kgs 5:1-14). At other times the Lord uses medical means, such as when God heals Hezekiah by getting Isaiah to prescribe him a fig poultice (2 Kgs 20:4-7).

In the New Testament, holistic healing is an integral part of Jesus’ ministry as he announces the coming of the kingdom of God: “And he went throughout all Galilee, teaching in their synagogues and proclaiming the gospel of the kingdom and healing every disease and every affliction among the people” (Matt 4:23). The Greek verbs used to describe Jesus’ healings include therapeuo (to care for the sick, treat, cure, heal), iaomai (physical treatment, to make whole, spiritual healing), sozo (to save, make whole, save from the effects of disease), and diasozo (to save thoroughly).[19] Jesus didn’t just apply a bandaid; he completely restored his patients to full flourishing, whether they suffered from blindness (Mark 8:22-25, 10:46-52; John 9:1-11), deafness and dumbness (Matt 9:32-33; Mark 7:32-37, 9:17-27), or paralysis (Mark 2:3-12). He healed those suffering from demon possession (Mark 1:23-26, 34; 5:2-13; Luke 4:40-41), and could even overcome death (Luke 7:11-15; 8:41-42, 49-55; John 11:1-44). Indeed, healing of the sick was to be the sign that the Messiah had come (Isa 35:5-6; cf. Luke 7:18-23). Jesus also sent out his disciples to heal the sick as a demonstration of the coming of the kingdom (Matt 10:5-8; cf. Luke 10:9). We also know that when the kingdom comes in all its fullness, in the new creation there will be no more evil and death and crying and pain (Rev 21:4).

All this has led some Christians to the view that it is God’s will for all sickness to be cured here and now through miraculous means. This is an understandable desire, and it is certainly true that God can and does heal people now in his kindness and grace—often through medical means, but also in ways that we cannot explain.

However, the idea that God will heal all our diseases now—if we have faith—has two serious flaws. The first is a problem of timing. One of the benefits of Christ’s victory and kingdom is that all death and disease will be done away with—but not until the new creation. In this present age, the whole creation is still groaning, Paul says, and waiting for that day (Rom 8:18-25). Suffering is still a reality, including sickness and death. In fact, it is quite clear from the New Testament that Christians should still expect to sicken and die (if Jesus doesn’t come first). Nearly all human death is a result of what we would call ‘sickness’. No-one dies of ‘old age’. They die because of some medical problem that we can’t cure. In God’s timing and plans, sickness is still an unavoidable reality of our fallen world, and he will not ‘cure’ it until the Last Day.

However, the second flaw in the ‘everything healed now’ view is that it restricts ‘healing’ to the physical. God is interested not just in our physical wellbeing but also in our spiritual, emotional and psychological wellbeing. No illness is beyond his ability to heal, but his intentions towards us are holistic. He wants to see all areas of our lives flourishing. We need to keep this in mind when we pray for resolution of the physical problems that afflict us. It could be that, as for the apostle Paul, God will choose not to relieve our physical suffering for non-physical reasons—for example, to keep us from becoming conceited, or to demonstrate his power in our weakness (2 Cor 12:7-10). ‘No’ is just as much an answer to prayer as ‘Yes’. We pray requests, not answers.

If God does choose to heal one of our physical ailments, he can do so directly and without any human intervention. However, he very often uses some kind of intermediary, such as a doctor—and this makes it no less an example of his kindness and grace. In the example I mentioned at the beginning of this chapter, my husband’s urging led the woman to get medical help and to have her problem subsequently resolved.

Medicine, world views and ethics

Let’s tie these thoughts together. When we go to a doctor or utilize some form of biotechnology, we should not check God in at the door. There is no such thing as a purely ‘medical’ decision that lies outside the context of a world view. We all have a world view that shapes our thinking, our values and our ethics—even your doctor has one!

Secular or scientific neutrality is a myth. When a difficult decision arises in medicine there will often be an ethical aspect that is not recognized for what it is. It may be cast as a completely ‘medical’ decision when in fact it involves issues of morality. For example, should we undergo genetic testing or screening? Should we try an expensive experimental treatment if there is little chance of it working? Should we utilize medical treatments that were discovered and developed by morally questionable means? If we wish to honour God in all areas of our lives, we will bring all these questions before him.

Very often, medical decisions are made on utilitarian grounds—that is, within a world view that sees the ends as justifying the means. Doctors are taught to use the most cost-effective treatment, or the therapy with the best success rate, but they may not stop to think: is this treatment morally permissible? Doctors will often not raise these ethical questions; we will need to do that ourselves. We will then need to use a biblical approach to decision-making,[20] taking into consideration the advice given.

Each decision we make during treatment needs to be approached with prayerful requests for wisdom, and held up to God’s word to make sure it does not breach biblical ethics. But beware—this may make you unpopular in some treatment centres! You may be viewed as difficult and unreasonable by those who do not value human life as you do. You may be considered disruptive if you ask for more time to consider your preferences and get more advice. But in the end we will all have to account for our own decisions before God. The Bible teaches us that we must take responsibility for our actions (2 Cor 5:10), and it is not enough to say, “The doctor made me do it”.

It will certainly help if you can think things through before you go for treatment, so that you can anticipate some of the issues that may arise. You may benefit from asking around and finding a doctor sympathetic to Christian values. God has given us a Christian community for support in difficult times of our lives, and this may be a good time to call on it.

Given all that we have said so far, it is ethical to use medical treatments that respect human life and respect biblical models of marriage and family. It is consistent with biblical teaching to restore malfunctioning body systems to the way they were intended to be, and to facilitate the act of procreation as it is normally performed. Note that I am not saying here that childlessness is a disease that needs a medical remedy. I am pointing to the underlying pathology that may prevent normal marital intercourse from resulting in pregnancy.

From God’s perspective, our health includes our spiritual, emotional and psychological wellbeing, so it is also appropriate to seek help for treatment if any of these are damaged. Accordingly, it would be appropriate to ask for counselling to help cope with the psychological and emotional challenges of infertility if you find it difficult to work through the issues on your own. You might decide to speak to your minister, or you may go to a professional counsellor. Good professional counsellors don’t tell you what to do so much as help you understand your own thoughts and feelings. Some Christians find it easier with a Christian counsellor, although (as with doctors) many counsellors are happy to take your belief system into account even if they don’t share it themselves.

It would also be appropriate for a married couple with medical infertility to seek assistance in treating medical and surgical problems that are a barrier to normal procreation. This might include hormonal supplements to correct deficiencies, surgery to unblock a fallopian tube, or treatment for endometriosis. If these sorts of problems cannot be overcome, bringing the sperm and egg of a husband and wife together to make an embryo by IVF is, I believe, permissible if no unethical practices (such as embryo destruction) are involved. These treatments or interventions all work to facilitate normal conception. However, it would not be consistent with biblical ethics for a single woman to use assisted reproduction to have a baby, since the Bible teaches that procreation is intended to occur within a marriage between a man and a woman, and a family is intended to consist of two parents of the opposite gender. Sometimes, of course, this intention isn’t fulfilled in our fallen world. Single women have children; marriages split up. But these sad realities aren’t justification for arranging it that way intentionally.

What about the next step, where a couple cannot conceive and tests reveal that the husband has no sperm? The standard medical treatment would be to substitute donor sperm to make the embryo, usually by donor insemination. Here the medical intervention is going beyond ‘restoring what is broken’, in that it is not the man’s ability to make sperm that will be mended. Instead, another man’s sperm will be substituted. In this instance, there will be three people involved in making the embryo, thus moving outside the biblical model of two parents per family. Again, I am talking about what we are aiming for. I realize that some families may lose a parent, or gain a step-parent, but God’s intention in creation was for children to be raised by two married biological parents.[21]

In the same way, deciding whether babies may live or die according to their genetic makeup or physical wholeness is outside biblical norms. The Bible teaches that all human beings have value, regardless of their individual characteristics, because we are all made in the image of God (Gen 1:27) and should not be killed (Gen 9:6).

Use of controversial treatments for alternative purposes

What about employing unethical or controversial treatments for purposes other than their original design? For example, if you decide that using the oral contraceptive pill for prevention of pregnancy is wrong, is it also wrong to take an oral contraceptive pill for an unrelated purpose? The hormones in oral contraceptives work on several different mechanisms in the body and may be prescribed to treat problems as diverse as severe acne or abnormal hair growth. I would suggest that such use is permissible for that person. As we have already noted in chapter 5, it is not only the action itself that we need to consider, but also our motives. In this instance, so long as: (a) our intention is to treat the alternative problem, not contraception, even if the action of the pill is contraceptive at the same time; and (b) you do not achieve the treatment effect through preventing a pregnancy; then you have not contravened your ethical opposition to using oral contraception. Even the leaders of the Catholic Church, who traditionally have opposed the use of hormonal contraceptives, allow them for such purposes.[22] This pattern of reasoning is technically called the ‘principle of double effect’.

Having said all of this, there is no instruction in the Bible that makes taking advantage of modern healthcare a moral requirement in itself. Life itself is not the ultimate good. We are not obliged to seek life and health at all costs. In fact, to do so would be to make it an idol.