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A Reply to Grudem on IVF - Issue #44

NB: This is a full essay (2300 words). I would apologize about violating my newsletter rules, except
The Path Before Us
A Reply to Grudem on IVF - Issue #44
By Matthew Lee Anderson • Issue #43 • View online
NB: This is a full essay (2300 words). I would apologize about violating my newsletter rules, except I don’t feel particularly bad about it given that this is all free, and therefore freely ignored…though my transgressions won’t continue!
TLDR: Wayne Grudem is wrong about IVF. Very, very wrong.
Within the pantheon of ‘difficult issues to disagree upon,’ nothing ranks higher than in vitro fertilization. Or so I have concluded recently, anyway. Opposing gay marriage means one will probably get tarred as a bigot, and dismissed and derided accordingly—which is certainly no fun. But at the end of the day, opposing the putative freedom of consenting adults to unite themselves seems trivial compared to arguing that people do something morally wrong in conceiving a child. With all due respect to all of us over the age of 18 months, there is no class of people so treasured, so valuable, in our culture as infants. (And for good reason! They’re great!) When those infants have been brought into the world out of the considerable  labor and time required for IVF, well, to oppose the practice makes one positively seem like a moral monster. I’m convinced that in forty years, Christians will be more hated for our anti-IVF position than we ever were for opposing gay unions.
I was reflecting on this as responses to the article I co-authored (with the estimable Andrew Walker) against IVF rolled in. People would have no reason to believe it from my Twitter feed, but I loathe disagreeing with everyone inside evangelicalism about this. Like most of the upper-middle-class world, I have several dear friends who have used IVF successfully against my objections—and I love them, and love their children. In those cases I have always sought to find a way to articulate my objections, while still conveying my willingness to love and live with them if they don’t ultimately agree. (I’ve failed at that in a myriad of ways, no doubt.) And their decisions to do otherwise than I advised have often made me question my own moral position: if people whom I love so deeply conclude otherwise, must not I be wrong?
There are only one of two directions we can go when people we love make moral choices: we can either waffle and change our own opinions about what’s right, or we can buttress the reasons we had for coming to the judgment in the first place. In that way, friends who walk a different moral path for too long, or in too many ways, really do risk dividing: in order to maintain the intelligibility and force of the life they have chosen, each side has to harden their views to offset the influence of the other. Or so it seems to me, anyway. But then, I’m not particularly good at living when I disagree with people whom I expect and want to have everything in common.
I don’t know Wayne Grudem, but I did find myself once again experiencing the odd feeling of being more assured of my arguments against in vitro while reading his attempt to explain why it is permissible. Grudem seems like a biblicist, like he’s only going to say what’s in the Bible and nothing but what’s in the Bible. But his Biblicism is merely on the surface, and therein lies its problem: the glitter and sparkles of Bible references that cover his essay obscure the entirely un-biblical assumptions he makes, which allows him to conclude IVF is permissible.
Consider the first two principles Grudem sets out, which by themselves establish the permissibility of IVF. Grudem’s first principle is that ‘overcoming infertility is pleasing to God.’ Infertility is “yet another result of the fall, one of the disabilities and diseases that entered the human race after Adam and Eve sinned.” God’s original plan is to bless humanity, and we ought to strive for that blessing through procreating. To this principle Grudem adds the notion that ‘modern medicine in general is a divine blessing that’s morally good.’ Medicine overcomes diseases. God isn’t neutral toward disabilities, but heals them—which means we should too. Grudem’s last two principles simply lay down constraints for how children should be conceived in a lab, namely, without committing them to a certain death and only from the ova of the married couple. But his first two make it clear that IVF should be permitted.
Only problems arise when we transpose those two principles into an arena that Scripture closely ties to infertility: death. (Yes, they are near to one another: Paul in Romans 4 writes that Abraham considered his own ‘dead’ body, and the ‘deadness’ of Sarah’s womb.) If we relocate Grudem’s principles into that realm, they would require us to accept, and even endorse, the project of pursuing indefinite life-extension through technological means. Death is a product of the Fall, and not part of God’s original creation—so we should resist it, with every means in our disposal. Jesus raised people from the dead—why shouldn’t we? The medicine that will overcome death is a ‘divine blessing that’s morally good.’ I suspect Grudem wouldn’t want this conclusion. I certainly don’t. But it’s impossible (for me) to see how he can avoid it.
And these problems run throughout Grudem’s essay. For instance, Grudem rejects the language of ‘natural’ on the basis of a facile description of what its use in moral theology means. Appealing to ‘nature,’ Grudem suggests, “must assume a definition of ‘natural’ that arbitrarily excludes modern medical means from what we consider part of nature.” Having drawn his caricature, Grudem follows it with a number of fatuous counterexamples meant to show the constructed process of in vitro in fact counts as ‘natural’: ‘look, the lab equipment in IVF is made from nature!’ If we took this sort of argument seriously, we’d have to endorse on similar grounds the entirely artificial creation of human life without any kind of assistance of the parents’ action whatsoever. “Look, all the organisms and microbes we’re combining to create a parentless human are ‘natural.’ So what’s the problem?” The use of ‘natural’ in moral theology is complicated, to be sure: but Grudem’s strategy functionally eviscerates it, which candidly makes me wonder precisely how he understands St. Paul’s claim that same-sex unions are ‘contrary to nature.’
These errors in Grudem’s reasoning pervade his essay. He writes, for instance, that “IVF did not separate sex from conception because, for this couple, there was no connection between sex and conception.” Their inability to conceive through intercourse means intercourse has no relation whatsoever to conception. Now: it might be true that conception by them is impossible. But that’s a distinct claim from saying that their act of intercourse has no relation to conception. Let’s say a couple knows they are infertile: the wife is missing ovaries. Even for such a couple, every act of intercourse has something to do with conception—even if by way of their knowledge of its absence. It lingers in the background of every choice, and if they want children will doubtlessly emerge into the foreground. The entire texture of their sexual lives will be different from one in which conception is possible: they will be free to approach intercourse with a cheerful disregard of their bodily rhythms or lives, should they want, like no fertile couple could. But that difference does not mean that there is no intrinsic connection between their intercourse and conception. Even the young man engaging in ‘solo sexuality’ alone in his room is engaging in acts that have a relation to conception. The act they pursue is intrinsically ordered toward conception; and their failure to respect that intrinsic order partially explains its badness.
None of this even starts to address the fact that IVF is a practice, which commits its participants to certain understandings of themselves and the world regardless of what their intentions are for pursuing it. Nor does it address whether we should even theorize infertility as a “disease,” as Grudem assumes, nor does it get at the inherently systemic problems created by treating IVF as “medicine” in the first place. On the last, I’m coming to suspect that a large percentage of people who pursue IVF do so because they are hurried into it by doctors who are ignorant of the kinds of diagnoses and treatments available for assisting male reproductive systems. As long as IVF is the default option, research into medical efforts to enable natural conception are going to lag (and that is, I hasten to add, the technical medical term for it).
But the problems with Grudem’s approach are not limited to his non-exegetical arguments: they are founded within how he understands Scripture itself. Consider his reading of Genesis 1:28, and the ‘command’ (it isn’t, but set that aside) to be fruitful and multiply: “This verse by itself does not say that no other means of producing children would be pleasing to God, but it is the foundational pattern for marriage in the entire Bible, and it is the first instance of the command to be fruitful.” Grudem doubles down on this principle later, reminding us that there is “no biblical command that says ‘conception must only be the result of sexual intercourse.’” On Grudem’s view, without any “clear moral teachings,” we shouldn’t rule out “modern inventions simply because they didn’t exist in biblical times”.
Well, that’s true. It also would allow for cryogenically preserving ourselves for, say, 800 years if we so decide. There is no negative command against it in Scripture, after all. And it would allow creating human life without any genetic material from existing individuals whatsoever: after all, the only negative commands are against conceiving children outside of marriage. There’s no prohibition on conceiving children within marriage, though without any help from anyone else! There’s no prohibition on adding four more limbs to our bodies, or blending our DNA with a lions, or turning ourselves into cyborgs. Modernity’s awesome, baby, and the only limits are our imaginations, and the explicit prohibitions within Scripture.
Suppose, in fact, that we became vastly more successful at conceiving without embryo death through in vitro fertilization than we are through natural conception. On Grudem’s view, this might actually make attempting to conceive through ordinary intercourse—morally bad! If that seems counterintuitive, consider what resources Grudem can appeal to in order to avoid it. He thinks there is nothing inherently morally binding about the link between sex and conception, after all. And he is very worried about embryo death. If it is permissible to create outside the womb because of infertility, on what grounds is it not morally responsible to do so to avoid embryo wastage?
Moreover, if it really is true that in vitro is permissible and there is a command to be fruitful and multiply—it might be presumptively obligatory upon infertile couples, all things otherwise being equal, to do their bounden duty and undertake IVF in order to generate life. I’ve not read Grudem’s book, so I don’t know whether he says anything about voluntary childlessness. I’m skeptical of the practice, myself. But it’s pretty easy to see how Grudem’s view could in practice eviscerate the freedom of couples to embrace their involuntary childlessness as a way of bearing witness to the reality that children come from God. What begins as optional soon becomes compulsory: that is the logic of modernity, and it is a logic that Grudem has embraced—or at least left himself defenseless against.
May I suggest, then, that Grudem’s biblicism is not merely superficial, but that it is deeply—unbiblical? Scripture shows us what is good and right for humanity. Sometimes it clarifies that with prohibitions: but sometimes, it allows us to infer those prohibitions from the goods it treats as normative for us (and not simply normal). The absence of any prohibition on conceiving children outside of the womb is not permission to do so. Where Grudem looks at Scripture and sees the absence of any explicit command to not separate sex and conception, I look at Scripture and see everywhere the affirmation of the importance of holding marital intercourse and conception together. Grudem wants biblicism: but then, not finding guidance within the Bible, leaves us without a map or rudder.
Why do I protest so much? Because the heart of Grudem’s moral vision  undermines the power of the Gospel of Jesus Christ for those who are infertile. (Yes, I just said that.) Suppose Grudem is right, and sex and conception only come apart because we live in a fallen world: affirming the licitness of in vitro fertilization in response lends our endorsement to that division. Those who are infertile are not suddenly fertile when in vitro is successful: they have not been brought by medicine into a state in which their bodies are more likely to conceive, because of those interventions. They are not nearer to having their reproductive powers restored than they were before. A child exists who bears their imprint and visage, yes: but the ‘disease’ of infertility still structures their bodies, and their sexual lives together. In this way, IVF makes its peace with a fallen world: it accepts its terms, and does so for the benefits it offers. It has nothing in common with the Gospel, which promises us that in the consummation of the Kingdom it is the barren, those who never bore a child, that shall burst in to joy because “more are the children of the desolate than the children of the married wife, saieth the Lord” (Isaiah 54:1). Like the ‘promise’ of indefinite life extension, in vitro attempts to mimic this eschatological reality by working against the grain of our created limits, in order to satisfy our deepest desires here and now, without delay and at our own hands. In vitro fertilization does not, in any meaningful sense, ‘overcome’ infertility, so much as enable us to escape it. Like the gnosticism of old, IVF does not restore creation so much as empty it.
Grudem’s essay is bad work, bad theology, and affirms bad practices. And we shouldn’t hesitate or equivocate in saying so. Evangelicalism’s acceptance of making life outside the womb should scandalize our conscience. That a figure so widely esteemed among evangelicals is so willing to defend IVF is, to me, a sign of how embedded the practice is within evangelicalism’s ethos—and of how decadent our movement has become.

On Unrelated Matters
The Scruton tapes: an anatomy of a modern hit job
The Penultimate Word
“If…we agree that in the conceivable future the development of cloning techniques may give the fantasy of human parthenogenesis an entrée into actuality, that will be a demonstration, if it occurs, that mankind does have the awesome technical power to exchange the humanity God has given him for something else, to treat natural humanity itself as a raw material for constructing a form of life that is not natural humanity but is an artificial development out of humanity. The sheer difficulty of comprehending this staggering power which man can deploy may make us incline to minimize the significance of this, as of any other, technical innovation, projected or realized. The great intellectual challenge that faces our age in view of these innovations is not to understand that this or that may or may not be done, but to understand what it is that would be done, if it were to be done. And it would be mere intellectual evasiveness to pretend that the human mode of reproduction was a contingency that chanced upon our human race, and might as well not have done.” – Oliver O'Donovan
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Matthew Lee Anderson

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