Guest: Dr. Ken Magnuson | Dr. Arnold interviews Dr. Magnuson about the ethics of current reproductive technologies.
Topics of conversation include:
Dr. Ken Magnuson serves as the executive director of the Evangelical Theological Society. He is professor of Christian Ethics at Southwestern Baptist Theological Seminary, as well as at Phoenix Seminary. He is the author of Invitation to Christian Ethics: Moral Reasoning and Contemporary Issues (Kregel Academic, 2020).
Welcome to Faith Seeking Understanding, a podcast from Phoenix Seminary—helping Christians grow in their understanding of the faith, hosted by Dr. Brian Arnold, president of Phoenix Seminary.
Brian Arnold (00:19):
We often say we live in unprecedented times, and sometimes it's true. Technology has revolutionized the world in ways that cannot compare to previous times. It's impressive that we can hop on a plane and be halfway around the world in a day. News travels around the globe immediately. We have satellites in outer space that can read the license plate on your car. But most significant of all, we can manipulate the way that life comes to be. Reproductive technologies have had a greater consequence in the world than any other technological advance. Contraception has changed the amount and timing of many pregnancies, as people put off having children until later in life. In vitro fertilization, or IVF, has allowed infertile couples to have children. Men can donate sperm and never even know if they have sons and daughters. Anytime we are talking about the creation of life, we have an ethical duty as Christians to pause and reflect on Scripture.
Brian Arnold (01:11):
We should not just adopt practices because we can. But we should also excitedly inhabit a world in which innovation exists, because that's a gift from God as well. But how are we to think Christianly about reproductive technology? Well, to help us understand that question today, we have with us Dr. Ken Magnuson. Dr. Magnuson is the executive director of the Evangelical Theological Society, and he is professor of Christian Ethics at Southwestern Seminary. And he also teaches Christian Ethics with us at Phoenix Seminary. Dr. Magnuson has published numerous articles and essays in the field of ethics, writing on topics like teleology, virtue ethics, divine commands, and he's the author of Invitation to Christian Ethics: Moral Reasoning and Contemporary Issues as part of the Invitation to Theological Study series. Dr. Magnuson, welcome to the podcast.
Ken Magnuson (01:59):
Thank you, Brian. It's good to be with you.
Brian Arnold (02:01):
So, as you know, we ask our guests one big question, today that question is—what do Christians need to know about reproductive technologies? And we could ask that in a number of ways. We could say, are some of these reproductive technologies Christian? Or, how do we put on our spectacles of Scripture in order to understand these things from the biblical worldview kind of perspective? But before we do a lot of that, let's just get a lay of the land, and sketch out some of the reproductive technologies that are available today.
Ken Magnuson (02:31):
Yeah, sure. There's a lot of things out there. Assisted reproductive technologies, by the way, refer to treatments involving human eggs, sperm, and embryos, in order to assist an infertile couple to have a child. So these will include artificial insemination, which can be used with a husband or a donor's sperm. It includes in vitro fertilization, which has a number of variations, as well as very specific things like intracytoplasmic sperm injection, or ICSI. The most common form of reproductive technology is in vitro fertilization or IVF. And with IVF, a woman's eggs are surgically extracted, placed with sperm in the laboratory in a petri dish to facilitate fertilization, and then, if there are any resulting embryos, one or two of those will be transferred to the woman's uterus with the hope that implantation will occur. Now, what's fascinating—your introduction was great here—I mean, the first human being born as a result of IVF was Louise Brown in England in 1978, and it has taken off. And, so the CDC reports close to somewhere between one and a half to 2% of all births in the United States. So that's around 75 to 80,000 of the 4 million births in the US.
Brian Arnold (04:03):
So as we will get into this even a little bit more, out of that one to 2%, how many of those are unsuccessful, I wonder? Do we have any idea?
Ken Magnuson (04:16):
So, yeah. So that's one and a half to 2% success. IVF...the success rates range greatly, and it depends on how you count them. So if you take a healthy 35 year old woman or under, using their own eggs, they'll advertise that the success rate is 55%, or somewhere between 50 and 55%. But that's for each cycle of egg retrieval, which means embryos are frozen, and if the first time around is unsuccessful, they'll go back to that. So if you were to rate the first embryo attempt at implantation, that's about 41%, and that drops as you go, with older women using their own eggs. So by the time you're working with a woman over 40, that rate drops to about 7%.
Brian Arnold (05:14):
That's stunning. To think if 1% to 2% of births are produced through IVF in the United States. And of those, you know, the successful ones, those are only 7% of the total number. You know, like...as you mentioned, you can get to that math a couple different ways. But the point I think stands, that it is likely that it's not going to work in many circumstances.
Ken Magnuson (05:39):
I think it's safe to say that if you're dealing with a healthy woman under 35, you're talking about each time you try about 40%. And overall numbers probably in the low to mid thirties average across the board. So, yeah. And that's each time you try, you know—you try again, and you have the same percentage chance, but you're talking about three or four attempts...well, let's say two or three attempts at least, before you're successful.
Brian Arnold (06:13):
So let's even just say this pretty close to the front side of this episode—this is a live issue for a lot of people. I think most of us know somebody who's done IVF. I've got a family member who had triplets from using IVF, many maybe listening who have tried it unsuccessfully, and haven't really thought about all the ethical components related to it. So I know you have a pastor's heart, and you want to be sensitive around this topic, but it's important. And I think a lot of people just haven't thought through some of those ramifications of something like IVF. So how do you, as a Christian ethicist, sit down with people and start to explain what reproductive technologies mean for a marriage? Which ones can be pursued in terms of the Christian ethic? Which ones should maybe be avoided? I know these are a lot of questions, and a lot of big ones, but where do you even start on a topic like this?
Ken Magnuson (07:12):
Yeah, I mean, I think it's important, Brian...I appreciate you mentioning, you know, I think we need to approach this both from an ethics standpoint, but also pastorally. And those two things are very comfortable with each other, I think. But there are some distinctions. And so, if we're going to counsel a couple well, we're not going to just start by, you know, sort of an ethics lecture with them. Like, you know—do this, don't do this, avoid this at all costs. But we're going to hear just what they're going through, and recognize that infertility is a very painful reality, and this is reflected in Scripture. So much so, like, you see this picture in Genesis 30 when Rachel, Jacob's wife, is experiencing infertility, and she comes to Jacob and says—give me children, or I'll die.
Ken Magnuson (08:10):
And that captures something of the distress felt. And we see that elsewhere in Scripture. So I think it's important to recognize that. To hear them. To listen to them And at the right moment, share, you know, what might be...hopefully they're inquisitive and interested in hearing what might be appropriate in pursuing, if anything. And I would just say, you know, even to begin with, to say—you really need to weigh the cost, because the percentage chance that you'll be successful isn't a hundred percent, right? It's well below that. So you can pursue all of this, which takes a lot of energy, and it can be burdensome and things, and still not be successful. So part of pastoral counsel is going to be using wisdom to prepare a couple to—how will they finish on the end of this attempt if they still don't have children?
Ken Magnuson (09:10):
Now, if we get to the ethical questions, I think we ought to be very cautious. And where they violate the sanctity of human life, or the one-flesh covenant of marriage, or where they employ sex selection or eugenics—that's often not going to be the case for the kind of couples that we might counsel, but it is out there—they're very morally problematic. And then in some cases, where it assists a couple in having a child without these serious problems, it may be acceptable, but remembering that it's expensive, it can be very burdensome, and it has a rather modest success rate.
Brian Arnold (09:53):
So let's begin with some of those principles you laid out about the sanctity of human life, and the one covenant kind of bond between a husband and a wife, and how that is implicated in that. Because, you know, thinking about something like Psalm 139, where David says, "you knit me together in my mother's womb." Like, there's this active process that God has in the creation of a human life, and this is why things like abortion is wrong in the Christian worldview, right? Because we believe that God is...from the moment that there is conception, that there's a human life there. So how do you work through it from that vantage point, of just saying why this matters so much? And what is IVF, maybe in particular...how does that cross over into the discussion of the sanctity of human life?
Ken Magnuson (10:48):
Yeah. So Christians are very familiar with these conversations when it comes to abortion, less so, I think, when it comes to reproductive technology. And sometimes, out of desperation for a child, the couple will perhaps ignore some of those issues. But where it comes into play—and it's rather frequent—is with in vitro fertilization. The laboratory, or the clinic, is interested in success, right? So...and they may not have—well, normally don't have—qualms about the treatment of an embryo. And so excess embryos are created. And that's, again, in order to have greater chance of success. But what happens with those excess embryos is some are destroyed, and often they are frozen. In both cases—certainly with the destruction of embryos, but I would argue also with the freezing of embryos—we are not respecting the sanctity human life.
Brian Arnold (11:55):
So what would you even say...I knew a couple when I was back in Kentucky, that did an embryo adoption. So they actually secured an IVF created child, and she actually bore the child. How do we think through those kind of issues?
Ken Magnuson (12:15):
Yeah, I get that question a lot. And my short answer would be that I think this is a worthy thing to do. There are...the exact number is not known, but there's somewhere around a million embryos in frozen storage in the United States, and many of those will never be given a chance at life. Because what happens is a couple may in the process early on, think—well, we'll have two or three children by this means, and freeze, you know, six or eight embryos, or something like that, and try again. But then they decide, you know, one was enough, or two was enough, and those embryos remain frozen. So a couple coming along and taking one of those embryos and giving it a chance at life, I think is a worthy thing to do. There's a lot of other considerations, you know, adopting children that have been born already, things like that. But I think this is rescuing a child that already exists, in such a strange world, is existing frozen.
Brian Arnold (13:23):
So I want to go back to even the counseling kind of question. And I know when I was pastoring, this feels a lot like the discussion of suffering. And people are suffering—if they're using any kind of reproductive technology, there is embedded in that this idea of suffering, that they were not able to have a child through normal means. Right? And so, I know when I was pastoring, I recognize how important it is to get people to have a theology of suffering before they were suffering. But the problem with that is every time you preach about suffering, there's somebody who's suffering. And then that can sound unkind in that moment to them, when you're trying to give that base. I feel like the same thing is here, right? The ideal is—how do you get people who are not in this situation to think through this? But oftentimes we get the questions when somebody is in this situation, and it's harder to have the conversation, I feel like. So what would you say if a couple wants to move forward with IVF? What advice do you give them?
Ken Magnuson (14:21):
Yeah. Again, you know, I would want to caution them in the sense that this may not be successful. It may be successful, but may not be. But also, if they are serious about moving forward, I would encourage them very much to proceed with caution, and not to create excess embryos. The problem with this is some clinics won't serve a couple if they are unwilling to create excess embryos, so you have to find those clinics that would do so. It also lowers the success rate in any given cycle of egg retrieval. And so that's a downside. But if a couple is wanting to do this in a morally unproblematic—some would argue just less problematic—way, then I think that we need to honor the sanctity of human life and not create excess embryos. And then proceed again. One other thing I'd want to say, Brian, is that the stress of doing this is so great that it really puts a lot of stress on the marriage. And so I'd want to counsel a couple, and pray for them, that they would attend carefully to their marriage during this time.
Brian Arnold (15:43):
And one of the things that bridges this—I've heard you say this before, and I thought it was so helpful—is that there's not such thing as an infertile wife or an infertile husband. There's an infertile couple. How have you been able to see that kind of turn some lights on for people? I think when they hear that...when I heard that, I thought—what a helpful way to communicate that.
Ken Magnuson (16:04):
Yeah. Yeah. Because, you know, what happens a lot is we refer to the infertile spouse. And, you know, I've looked at this issue for a long time, and I see the impact of that is that if you have, for instance, an infertile wife, she may feel like—I'm holding something back from my husband, and therefore if we need to use a donor for eggs, or a surrogate, I don't want to deprive my husband of the opportunity to have a child, or for us to be able to have a child. And I can understand that way of thinking. But, you know, when we enter into a marriage covenant, we become one flesh and we make vows that our relationship is exclusive and lifelong—for better or for worse, in sickness and in health. And so that's why, just as you say, I think we shouldn't speak of an infertile husband or wife, but an infertile couple. And one spouse should not circumvent their marriage to have a child of their own, even if it seems that the spouse who is unable to have a child wants that. And I've read some studies. I know that this can be something a couple enters into, but then there's a feeling of regret. There's challenges, and I think rightly so, because it's going outside of the one-flesh nature of marriage.
Brian Arnold (17:33):
Well, and let's talk about a couple of these more specifically. Things like sperm or egg donation. Or even like surrogacy. So those seem like other common types of reproductive technology. So how do we think through those? I like the lens of thinking through the one-flesh union as a guiding principle.
Ken Magnuson (17:54):
Yeah. Yeah. Which is why I think that the use of donor sperm, or egg, or surrogacy is problematic and should be avoided. Even the use of "donor" is a bit deceptive, because we're really talking about the sale of eggs and sperm, and the hiring of a surrogate, if you will. But yeah, it's unknown, even, how many children are born from sperm donors. A number that I see often is 30 to 60,000 in the US. That might be underestimated. But this happens sometimes in the marriage where either the husband or the wife is unable to provide the necessary gamete, or sperm or egg. And so a donor is brought in. Or a surrogate is brought in, because a woman is unable to carry a child. Often though, with sperm donation, it happens outside of the marriage relationship entirely, where a single woman who wants to have a child, but either doesn't want or is not ready for marriage, pursues this in order to have a child of her own.
Brian Arnold (19:13):
And on that one we can say, I think pretty authoritatively—you should not as a believer pursue that. Right? The gift of children really seems to belong inside the marital union, right? The command to be fruitful and multiply. And I can think of some scenarios where maybe we would say—okay, that's a little bit of a different situation. And maybe it wouldn't be. I'm curious to get your thoughts, actually. If you've got a missionary, single woman out on the field, there's a child who has no parents, and she adopts the child—that seems like a different type of question that we'd be talking about than this.
Ken Magnuson (19:51):
I think it is a different question. Again, it's rescuing a child. And I think it's...you know, most of us, I think, would recognize that it's not ideal to bring a child into a one-parent household, even in that situation. But it may well be better for the child than any other existing alternatives. But when we're talking...yeah, so I agree with you on, you know, that's a clear problem with pursuing a sperm donation or something for a single woman. But I think, to me, it's a pretty clear problem to use sperm or egg donation as well. I think it's circumventing the one-flesh nature of marriage to do that.
Brian Arnold (20:39):
And you said something before that I think is really pertinent for this conversation, and that is—some of these approaches that people take to reproduction have an immediacy of "we want to have the child." But really, those decisions then last for 30 years. And the way that that can enter into some marital questions down the road. I'm thinking in the case of a couple who says—he's infertile, she's not, they get a sperm donor—he may not ever fully feel like the child's father. How does that drive a wedge in that one-flesh union, in marital strife that could happen in decades to come?
Ken Magnuson (21:21):
Yeah, it's interesting to hear. Some people seem to manage those minefields okay. But there's a lot of, you know, people who will testify that...you know, that they always feel like there's a third parent there, even though the donor was anonymous. That their child represents the union of their spouse and somebody else. Right? And that doesn't go away.
Brian Arnold (21:51):
Well, yeah. Exactly. And I think even...again, maybe in terms of analogy, like abortion. Like how often we hear the stories—and not every woman, some of them are shouting their abortion we see, and I still wonder what the conscience is really like underneath—but, you know, they have these lingering just anxieties and depression and concern of the decision that they made, no matter how long ago it was, to seek an abortion. So these reproductive technology questions have some serious, lifelong, and eternal considerations as we think through these. And I appreciate you spending your career thinking through these carefully. I...my biggest concern is when people just say, "well, hey, it's available, so we should be able to avail ourselves of it." And that is not the best approach. I love how you even think back through Genesis and creation, and what is God doing in creating men and women and putting them together in a bond of marriage? And then what is being fruitful and multiplying look like? But also your willingness to have the conversations, and recognize that some of these are better options than others. So it's not a complete no. But there are just some things to think through before a couple would pursue these. Well, you've done a lot of reading on these topics, obviously. You've written on them some. What are some of the best resources that we could point our listeners to if they're thinking through these issues?
Ken Magnuson (23:16):
Yeah. It's a good question. One of the most influential books written in this area, for me, is Oliver O'Donovan's book, Begotten or Made? It's just a little book, although it's pretty dense reading. First published in 1984, and it still has much to teach us. There's another one, actually, interestingly, one of O'Donovan's students, Brent Waters, who is an ethicist, wrote a book called Reproductive Technology, subtitle is Toward a Theology of Procreative Stewardship. And I love that. And it's a helpful book. I would also say, Ben Mitchell is an ethicist and together with Joy Riley, they wrote a book called Christian Bioethics. And in there you see a discussion of reproductive technology, among other things. I have a chapter in my text where I just try to, you know, address the most, you know, relevant issues. I don't have time to go into great depth, but I try to highlight the important issues in there.
Brian Arnold (24:22):
And I want to commend your book on many levels to our listeners. You were my Ethics professor, actually, back in spring of 2005. And I found you to be a very clear communicator, and when your book came out, that was true of the book as well, of just really helping people see the issues, and clearly get that information. So appreciate your labor on that, both in the classroom and in your writing ministry. And again, just for taking the time over the last few decades to really consider these issues. I think it's touching more and more families and homes and churches, and we want to be thinking Christians who do things in a way that pleases and honors the Lord and gives a witness and testimony to the watching world, like you said, as, as we are stewards of procreation in this day and age. Dr. Magnuson, thanks so much for joining me today.
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