Is donating sperm and eggs an act of kindness to a stranger or a breach of our common humanity? Should wealthy women be able to hire surrogate mothers to bear their babies? What are the ethical questions surrounding adoption, in vitro fertilization (IVF), and prenatal genetic testing? These topics make the headlines, from Time magazine—which recently profiled a man who has sired at least 70 offspring via sperm donation—to The Atlantic, which recently commented on the problematic ethics of a society in which everything is up for sale, to Ann Patchett's recent novel State of Wonder, which explores the possibility of lifelong fertility.
From time eternal, men and women have been making babies, usually by choice, and usually in the old-fashioned way. But in recent years, making babies has become fraught with promises and possibilities never before imagined, whether the opportunity to conceive children later in life, identify genetic abnormalities in embryos, or hire surrogate mothers from halfway around the globe to carry an embryo to term. Ethical questions often get shoved to the side in the face of both rapid technological advancement and the emotions involved. Who wants to raise concerns about the production of millions of babies who bring great joy to millions of parents?
Thankfully, Ellen Painter Dollar has waded into the murky waters of reproductive technology in her new book No Easy Choice: A Story of Disability, Parenthood, and Faith in an Age of Advanced Reproduction (Westminster John Knox). Ellen begins with her own story as a woman with OI, osteogenesis imperfecta. She passed OI, a genetic disorder that causes frequent broken bones throughout childhood, to her first child, Leah, and wondered whether it was right for her to conceive other children who might inherit the same condition.
Ellen and her husband, Daniel, struggled with the practical and emotionally wrenching reality of caring for a toddler who could, say, break both of the bones in her left forearm, or break both her tibia and fibula, all during innocuous activities like climbing up on a sofa. They wanted more children, but they faced a 50 percent chance of passing along Ellen's defective gene. They considered preimplantation genetic diagnosis, in which they would create embryos via IVF and then test them for OI before implanting them in Ellen's womb.
But as Christians, the Dollars struggled with whether or not human embryos should be a matter of human control. They wondered whether participation in reproductive technology would contribute to a devaluing of human life or, alternately, demonstrate an act of stewardship over the gift of procreation they had been given. As Ellen writes, "If our desire for children comes from God, then how are Christians to view how to have children, particularly given the choices available to help people have babies even when they face challenges to natural conception?"
It is from this complicated personal drama that Ellen asks the questions that inform the book. Ellen weaves her own story into a narrative that prompts consideration about the desire to have children, the ethics of all forms of reproductive technology, and the role of suffering in the life of the believer. The combination of personal narrative, astute cultural analysis, vivid and clear prose, and Christian faith lead to a book filled with passages that challenge both Christian and secular assumptions about the topics at hand. For example, Ellen writes:
There are reasons why parents wish and hope and pray for healthy babies, and those reasons go beyond cultural biases toward achievement and health. Quite simply, it is hard to care for a fragile child, a child for whom the most routine activities—walking in socks on a bare floor, speeding up to keep up with her class in the school hallway—are dangerous. And it is likewise hard to be that child.
As I was reading, I wanted black and white ethical pronouncements about prenatal testing, abortion, in vitro fertilization, and the spectrum of other ethical issues that arise when Christians consider reproductive technology. I wanted clear theological instruction and biblical exegesis applied to every test case. I didn't get what I wanted. Scripture offers us clear affirmations of the value of human life, the reality of sin within the natural and moral order, and it gives us the mystery of the Cross in response to human suffering.
Ellen could have relied more heavily upon these narratives to guide her readers to particular conclusions. But Ellen refuses, wisely I suspect, to offer abstract answers, insisting that ethical and theological questions be asked in the context of particular stories. She writes:
As Christians we know that experience is not all that matters … On Sunday mornings, my experience is that I'm eating a tasteless wafer dipped in sweet wine, while my theological understanding tells me that I'm taking into myself the body and blood of my risen Savior. Truth is more than experience. But experience (that is, our stories) must count for something.
She goes on to explain, "In one story, OI is a basic brokenness in need of fixing. In another, OI is just one of many human limitations in need of acceptance." Ellen challenges the reader to hold these stories in their natural tension with each other rather than coming to quick resolution.
No Easy Choice comes with questions for discussion at the end of every chapter, and indeed: This is a book that ought to be read in conversation with others. Some readers will be frustrated by the lack of definitive conclusions about the ethics of reproductive technology. Others will be grateful for the freedom to ask questions. In either case, No Easy Choice goes beyond liberal and conservative arguments that tend to polarize true engagement and discussion and instead invites readers into an ongoing conversation surrounding some of the most pressing ethical issues of our day—a conversation readers will hopefully continue in their communities of faith, with wisdom from fellow Christians, Scripture, and the Holy Spirit.