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The passage from the book of Genesis, second book of Genesis, verses 15-17. Listen for the word of God. The Lord God took the man and put him in the garden of Eden to till it and keep it. And the Lord God commanded the man, you shall freely eat of every tree of the garden.

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But of the tree of the knowledge of good and evil, you shall not eat. For in the day that you eat of it, you shall die. Let us meditate in this passage for a couple of minutes, please. The word of the Lord.

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Thanks be to God. It is my pleasure and privilege this morning to introduce our E.C. Westervelt lecturer, Dr. James F.

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Childress. Dr. Childress is a native of Mount Airy, North Carolina. He is a graduate from Yale Divinity School, where he completed both his Master in Arts and Doctorate in the Department of Religious Studies.

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His careful and thought-provoking scholarship has made him the recipient of numerous awards and fellowships. Just to mention a few, the Yale University Fellowship, Fellowship in Law and Religion, Harvard Law School, Fellowship of the Woodrow Wilson International Center, the Guggenheim Fellowship, and Fellowship of the Institute of Medicine of the National Academy of Sciences. His contributions to scholarship in the field of ethics go hand in hand with his passion and talent as a teacher, as witnessed by the prestigious institutions that have required his services.

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Among them, the University of Chicago, Hastings Center, Kennedy Institute, Princeton University, Columbia University, and Georgetown University. Dr. Childress is the author of numerous publications and articles. He has written seminal works in the area of social ethics, leading with such topics as war,

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non-violence, civil disobedience. He is co-author of the Dictionary of Christian Ethics, published by Winminster Press, a resource that every seminary student and every church library should have. So when you walk out the door, make a left turn, the bookstore is in the corner. His text on biomedical ethics, principles of biomedical ethics, is the definite work one must have mastery of.

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in the area of biomedic ethics today. This book, which he co-authored with Tom L. Beauchamp, is now in his fourth edition. I just heard he finished his fifth edition of that text, so that's soon to come out.

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And it has been published in several foreign languages. On a more personal note, I have the privilege of attending two of Dr. Children's classes at the University of Chicago in 1977. and was honored and highly instructed by his comments during my own doctoral examinations.

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I don't know if you still remember that, James. Ever since, I have carefully and gratefully followed and kept up to date with his work. It might be of interest to you, James, to know that Austin Presbyterian Seminary students are quite familiar with your work, and so are the hospitals and medical ethics committees in town. And now back to our topic.

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Without a shadow of a doubt, the moral dilemmas all of us confront today in the area of medical services are the result not of the limitations and impotence of medical technologies and procedures, but rather of their amazing success. Ours is the problem of discerning whether or not we are doing more than what seems we ought to do and afford to do economically, politically, and humanly speaking. Discerning how to choose responsibly as individuals, family members, citizens, and members of faith communities is indeed a challenge few of us will be spared from making.

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We are indeed fortunate today to have Dr. James Childress, Kyle Professor of Religious Studies and Professor of Medical Education of the University of Virginia at Richmond, Virginia, who will address us on the topic of the intersection of theology and bioethics, responsible choices about biomedical technologies in the 21st century. His first lecture is entitled Life's Beginning.

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Dr. Childress. Thank you very much for that generous introduction. I do remember it's a wonderful examination.

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It is a privilege and an honor for me to be invited to deliver the E.C. Westervelt Lectures during the Midwinter Lecture Series. There is a story, possibly apocryphal, about Henry Ford visiting a small Midwestern town. Shortly after he had arrived at the hotel, a committee of key officials from the town

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called upon him to ask him to make a donation to help build a new hospital in the community. And Ford promptly agreed to contribute $5,000 toward the new hospital. You can tell this is a very old story. The next morning, Ford was startled to see the headline in the local newspaper, Ford to contribute $50,000 to the new hospital.

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About that time, the committee of town officials returned, apologized profusely for the mistake, and assured Ford that it would be corrected in the next edition of the newspaper. And he thought about that for a moment, imagining the headline, Ford to contribute only $5,000. And he said that he would contribute the full $50,000 if he could determine the inscription for the plaque on the new hospital. They said for that amount, he could put almost anything he wanted to on the plaque.

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So when the hospital was completed and the day of dedication arrived, Ford returned to unveil two facing plaques which read, I came among ye, and ye took me in. I'm delighted to have come among you at Austin Seminary, for my wife Marcia and I have been taken in, but only in the best sense of that phrase. So thank you very much for your hospitality. the very beginning, Christians have encouraged and provided health care, an activity featured in Jesus' Healing and in the famous parable of the Good Samaritan.

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And over the centuries, the Christian traditions have provided guidance to physicians and other health care providers, family caregivers, and patients. While often distinctive, This Christian guidance in medical ethics sometimes overlapped with and at other times incorporated with modifications, guidance available in professional oaths and codes. And the same holds for other religious traditions, too.

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But in the 1960s and early 1970s, a new movement emerged called bioethics as an attempt to deal with new technologies that were developing at a very rapid pace. For instance, technologies that could prolong life far beyond previous possibilities, transplant organs from one person, living or dead, to another, detect fetal defects in utero, and offer new reproductive opportunities. Bioethics involves an interdisciplinary interprofessional

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exploration of the ethical issues that arise in the biological sciences, medicine, and health care, especially in response to technological developments. Now, those involved in early bioethics, that is, late 1960s, early '70s, whatever their professional backgrounds, whether they were physicians or theologians or philosophers, tended to appreciate and even appeal to religious convictions. to religious perspectives and frameworks. But then secular bioethics became quite common and even dominant.

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In the last few years, however, a religion has returned to center stage in bioethics, because many recognize that Christians, Jews, Muslims, and others have imported insights into the human condition in light of their fundamental religious beliefs. And that those insights can help us evaluate these new technologies, perhaps even providing the resources where appropriate for resisting those technologies. Since quite often, secular bioethics tends to take a gee whiz or wow

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approach to the new technologies, often blessing them without providing the kind of critical perspective that is needed, the kind of prophetic perspective that Christianity might provide. Now, this first lecture will examine several issues that arise, ethical issues that arise in reproductive technologies, raising the fundamental question, does God care how we make babies? Can we be in partnership with God in making babies through reproductive technologies, or must we view those technologies as a form of rebellion, of domination, rather than responsible stewardship? Now, I'll offer a brief introduction to reproductive technologies, then ask about the significance of the desire to have a child of one's own,

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Turn to question about the connections between sexual intercourse and procreation, whether what is normal should also be seen as what is normative. And then turn to questions about the impact of these technologies on the family, when we're talking about the artificial family, and the impact of those technologies on children so conceived. Now, one problem that these technologies address is infertility, which is defined as the inability of a couple to conceive after 12 months of intercourse without contraception. Infertility is a major problem in the United States.

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It affects about 2.4 million married couples. But many who are not married may also have problems if they want to have children. Why not adoption? Well, as you know, there are not as many children available now because of the loss of the stigma for single mothers, the availability of contraception and abortion, and the reduction of adverse consequences of being illegitimate.

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Furthermore, the process of adoption itself is fraught with difficulties and uncertainties. as is evident in the current international scandal about the twins who were born in the United States and now reside in the UK. And courts are trying to determine which laws will govern where they reside and who their adoptive parents will be. Now, various reproductive technologies are used not only to deal with infertility, but also in some cases to avoid passing on a genetic disease, a problem to offspring.

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And they're used in other cases for non-medical reasons. For example, a single person wanting to have a child. But reproductive technologies are not likely to replace the traditional method of making babies because, as one philosopher has noted, the traditional method is inexpensive, can be performed at home, takes little time, training, or skill, and is certainly more enjoyable. Now, it probably didn't take philosophical analysis to reach that conclusion.

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Now our actual situation in the use of these technologies is that if we look at artificial insemination, a low-tech procedure that's been around for a long, long time with the first reported case of artificial insemination by donor occurring over 100 years ago. That was not revealed publicly until the person was 25 years old. Now we're up to about 30,000, 30 to 35,000 born by artificial insemination by husband and the same number by artificial insemination by donor.

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In vitro fertilization and its various spin-offs, those are more recent developments. Louise Brown was born in the UK in 1978, Elizabeth Carr in Virginia in 1981. So we're just over 20 years into the revolution in reproductive technology brought by in vitro fertilization, and techniques continue to develop not only to improve procedures already exist, but to provide even newer possibilities.

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I will not mention cloning in this lecture. I will do that in the third lecture when I try to talk about what our public policies, based on in part on religious responses, ought to be regarding some of these technologies. So let me start then with the question of the moral significance of the desire for a child of one's own. Clearly what

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pushes and sustains the impressive system of reproductive technology in the U.S. is the felt need or strong desire for a child of one's own. This system rests on what one commentator describes as the age-old urge to control the beginning of human life. What do we

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to make of this desire. Recall Rachel's lament to Jacob in Genesis. Give me children or I shall die. A modern version of this appears in the Coen brothers film Raising Arizona, where some of you, I hear some laughter, some of you have seen that wonderful, I recommend that film.

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Edwina is infertile and she and Hi are turned down by all the adoption agencies because Hi is an ex-con. So they kidnap a quintuplet. figuring that with four others, the parents won't miss this one. Now, some critics would lump reproductive technologies together with kidnapping as morally unjustified ways to deal with this frustrated desire to have a child of one's own.

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Whether that desire is frustrated because of infertility or other factors that preclude children, for example, a non-traditional family or woman's post-menopausal state. Now, social and cultural factors, social and cultural ideals and pressures, certainly stimulate and deepen this desire for a child of one's own. And these include biblical texts, such as the blessing following the divine creation, to be fruitful and multiply, to fill the earth and subdue it.

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Recall other biblical stories, including one of Abraham, Sarah, who was infertile for a period, and Hagar, Sarah's maid. Sarah said to Abraham, Behold now, the Lord has prevented me from bearing children. Go in to my maid. It may be that I shall obtain a child by her.

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This effort to deal with childlessness was non-technological. But this story has a powerful warning for technological as well as non-technological efforts. Conflicts erupted because Sarah and Hagar, who bore a son named Ishmael, those conflicts erupted and continued after Sarah later had a son of her own, Isaac. And finally, given these conflicts, Abraham sent Hagar and Ishmael out into the wilderness,

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where they almost died before the Lord rescued them. Now, obviously, there are major differences between that story and modern stories of efforts to have children. Beyond the fact that the modern stories often involve low-tech or high-tech procedures, such as IVF, most modern people do not feel that they can count on divine intervention to pick up the pieces. the way God intervened in the biblical story.

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In the widespread contemporary pursuit of children of one's own through high-tech interventions, there are both successes and failures. One recent book is entitled Wanting a Child, and then there's a very long subtitle, the sort of thing one would have found in 17th century literature. 22 writers on their difficult but mostly successful quest for parenthood in a high-tech age. Mostly successful.

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But if one looks at the statistics involving high-tech procedures, there are many failures. And users of technology, this technology, in their eager quest for parenthood, may not receive accurate and adequate information about the rate of failure or may not hear it when it is given to them. And they may not appreciate, on a cost-benefit analysis, the significance of comparing the rate of success with the cost that will be expended, especially in procedures like in vitro fertilization.

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A second concern is that this system of reproductive technologies may itself create or deepen desires for greater use of the technologies, even in the wake of low success rates. And they may create or deepen desires for trying just one more time or trying the latest technique. As a result, some Christian and other commentators stress that reproductive technologies may be enslaving rather than liberating.

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They may be oppressive. rather than creating freedom. Now, the technologies have often been praised as ways to enable those who desire children to get around some natural biological limits and constraints. For example, blocked fallopian tubes.

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But the options themselves are felt, in many cases, to be coercive. So many participants indicate when they bemoan the tyranny of reproductive technologies. Now, early in the development of these technologies, some feminists viewed them as potentially liberating.

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But given the developments over the last several years, many feminists now view these technologies as at least potentially, if not actually, oppressive. these technologies seem to extend patriarchal control over women in the process of reproduction, because after all, women's eggs and women's wombs are still necessary. And the system of reproductive technology is still largely under male control. At the very least, then, when we think about these reproductive technologies in relation to freedom and oppression,

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They are morally ambiguous. But the system is morally ambiguous in other ways, too. Not only is there an interest from a justice standpoint in having all the voices, for example, those of women, in the discussion about these technologies, but also there's an interest from the standpoint of justice in whether the extensive use of these costly technologies to address frustrated desires to have children is really an appropriate societal expenditure of funds.

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To some, no matter how strong the desire, we should redirect or direct society's resources on grounds of justice to technologies to prevent and cure disease, illness, and trauma, especially where the risk is premature death. So the first set of comments focused on the significance of the desire to have a child of one's own. Another general question arises about natural procreation over against artificial reproduction.

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And that is whether the usual pattern of a connection between sexual intercourse and procreation is more than normal, whether it's also normative. Now, Contraception has broken this connection so that it's possible to have sexual intercourse without much concern about procreation. The reproductive technologies now make possible procreation without sexual intercourse.

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Sex without babies, babies without sex. Is the latter development morally problematic? Now the Roman Catholic tradition has been most emphatic in its rejection of virtually all of the reproductive technologies, except, as I will note in just a moment, those that could be viewed as assisting nature rather than dominating nature.

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And part of the, one of the grounds for this rejection in Roman Catholicism is the view that the unitive and procreative meanings of sexual relations within marriage must be connected. So you shouldn't pursue the unitive without keeping open the possibility of procreation, you shouldn't pursue procreation, without that occurring in the context of the unity of relation. At one point in a declaration, the Vatican says, Marriage does not confer upon the spouses the right to have a child, but only the right to perform those natural acts which are, per se, ordered to procreation.

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This statement calls on infertile couples, infertile spouses, to find in their sad situation an opportunity for sharing in a particular way in the Lord's cross the source of spiritual fruitfulness. Now, I suggested that there is a possibility to use some technologies if those can be viewed as assisting nature rather than dominating it. But as a matter of fact, most of the reproductive technologies fall under the condemnation that they are matters or modes of domination rather than assistance.

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Some within the Roman Catholic context, for example, the late Richard McCormick and Lisa Cahill, respond that a child should be the result or should issue from a loving act. But that doesn't necessarily mean sexual intercourse. There are other loving acts within marriage that express and maintain mutual love, even, in many cases, in the use of reproductive technologies. McCormick, Cahill, and other critics within the Roman Catholic context of the official position note that the drafters of the Vatican's statement failed to consult couples who are struggling with these issues or with women for their perspective.

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Now, some Protestants also discern the divine will, intention, or purpose in natural biological limits on procreation. Examples include the late Paul Ramsey, Oliver Donovan, Gilbert Meinlander, Albert Mueller, and others. These critics often draw a distinction between gifts and products, containing that children should be gifts, not products, and that children become products. when some reproductive technologies are used.

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Human reproduction becomes a technological product as a matter of human will and technological prowess, rather than, as Albert Mohler puts it, a divine gift, mystery, and stewardship. Humans should be begotten, not merely made. Now, by contrast, some other Protestants contend that The divine gift of children can come through divine partnership with couples using reproductive technologies, just as it can in divine partnership with couples engaged in sexual intercourse with the possibility of procreation being kept open.

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The third set of concerns center on the impact of these technologies on the family, on parenthood. What happens when we have artificial families? Now, some view reproductive technologies as a threat to the family.

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And at first glance, this appears to be an odd view. I mean, after all, people use these technologies to create or enlarge families. But the concern, often unstated, or perhaps the concern often unstated, is that Some may use these reproductive technologies to create non-traditional families.

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It's not possible, I believe, to define the essence of family or parenthood and then derive judgments about particular reproductive technologies. Carol Levine offers a good starting point for thinking about families in relation to reproductive technologies. She says, Family members are individuals who, by virtue of birth, adoption, or declared commitment, share deep personal connections and are mutually entitled to receive and obligated to provide support.

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Support of various kinds, to the extent possible, especially in times of need. The key features of that statement include that in a family, individuals are related by birth, adoption, or declared commitment. There are deep personal connections, often but not necessarily involving warm affection.

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And there are mutual obligations and rights involving various kinds of support. Now, some uses of reproductive technology do raise profound questions about the boundaries of families. Who's in and who's outside of family?

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Especially who's in a parent-child relationship? Consider the following case of a young girl, JC, who was for a time considered to be parentless, that is, a legal orphan, even though five people had contributed to her conception and birth. Luann and John Bazanca, wife and husband, arranged for in vitro fertilization involving donor sperm and donor egg, and for the resulting embryo to be implanted in a surrogate who agreed to carry and give birth to the child for them.

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Problems erupted when Luann and John broke up after fertilization, implantation, and pregnancy, but prior to the child's birth. John later refused to accept any responsibility for the child. While Luanne filed a petition with the court to establish herself as J.C.'s mother.