by Scott B. Rae –

A few months ago, a woman in our church approached me excitedly to tell me about an unusual occurrence that was taking place in their family. Motivated by altruism alone, their daughter had agreed to be a surrogate mother for their daughter in law. The egg of the daughter in law and the sperm of her husband had been fertilized in vitro and successfully implanted in the uterus of the daughter, who was, at that time, two months pregnant. The fact that it was a case of gestational surrogacy, in which the surrogate has no direct genetic relation to the child she is carrying, made it morally permissible in the eyes of the woman who told me about the situation. In addition, the fact that it was done out of purely altruistic motives added to its moral acceptability. The idea that someone could think that such an act would be morally objectionable was preposterous to her. This was an example of Christ-like unconditional love at its best. Yet the response she received from others in the church was not so enthusiastic. There were significant questions raised about another person beside husband and wife contributing to reproduction, even though there was no new genetic material being introduced. and even though the surrogate was an extended family member. Many people in the community of God’s people are skeptical of any reproductive interventions, not to mention those which involve another person in collaborative reproduction.

The term “reproductive technologies” refers to a wide spectrum of “treatments” for infertility. These include fertility drugs, intrauterine insemination (IUI, both by husband IUI-H, and by donor, IUI-D), GIFT (gamete interfallopian transfer, where eggs are removed from the woman and reinserted in the fallopian tubes where fertilization can occur naturally), IVF (in vitro fertilization, where fertilization takes place “in vitro” or in glass, outside the body), egg donation, and surrogate motherhood. Both genetic (where the surrogate contributes the egg and uterus) and gestational surrogacy (where the surrogate contributes only the uterus, the egg coming from the wife in the contracting couple) are becoming more common. One group of these techniques involves medical intervention into natural reproductive processes (fertility drugs, IUI-H, GIFT, IVF). Others go further and require another person in order to achieve conception and/or birth (IUI-D, egg donation, and surrogate motherhood1). In some cases, the genetic material of the third party is required, and in others, such as gestational surrogacy, it is not.

Just how far should a couple go to have a child of their own? What are we to say to the couple who is infertile and wrestling with the ethics of these various technologies? These are important questions and should matter to couples considering them and to the loved ones who are counseling them. There is more to the decision about these technologies than simply the cost and success rate. Some techniques are problematic in the light of Scripture, and some that are within the boundaries of the Bible, may not be wise for a couple to enter into.

THEOLOGY OF THE FAMILY RELATED TO REPRODUCTION

In the light of Scripture, there does not seem to be any compelling reason to reject all technological interventions into procreation. If infertility is a result of the entrance of sin into the world, as is the case with other malfunctions of the body (most of which we would refer to as disease), then the use of medicine to treat infertility is no different than using medicine and medical technology to treat other conditions that involve failure of the systems of the body. Use of medical technology is no more “playing God” in infertility than it is in treating heart disease or kidney failure. This would suggest that in general, using technology to assist in conceiving a child, or even to replace some aspects of normal sex in procreation, is morally acceptable. That is, technologies that use the genetic materials of husband and wife are generally within the boundaries of Scripture. That is not to say that every aspect of those technologies is acceptable, and the normal practice of GIFT and IVF present moral complications.

The more difficult question concerns those technologies that require a third party in collaborative reproduction. Does the Biblical teaching on the structure of the family preclude any third party involvement? Or is the structure of the family a cultural construct that can change as social conditions change?

Though there has been a great deal written on the structure of the family, it is rare that the subject of reproduction is addressed in these works. Gender issues have driven most of the discussion of the structure of the family, and as a result, the bearing of family structure on reproduction has been neglected.2

Perhaps one of the principal reasons for this neglect is the lack of a developed notion of the family in the Scripture. The Bible assumes a great deal about the family’s structure without much of a systematic defense of it. However, we will argue that the family structure presented in Scripture is normative and is based on the intent of the creation account.

Even though the extended family or clan was a major component of social life in Biblical times, the structure of the family has been remarkably consistent throughout Biblical history and up to the present day. Only with new ways of reproduction that do not require sexual intercourse has society been challenged to think of the family structure in different ways. This “nuclear” structure, consisting of a heterosexual couple producing children within the context of marriage has been the consistent pattern for the family throughout most of the history of civilization. But is it the divinely instituted norm, in such a way that any third party involvement in reproduction is precluded?

Perhaps a second reason for the paucity of Biblical material on the family structure is because it was made so clear at the creation mandate in Genesis 1-2. That is, the family structure was assumed in Scripture because it was grounded in creation. There is a normative family structure established by the creative word of God that expresses itself in the order of creation.3 The natural order of the family is established by the God of nature who embedded a specific structure for the family into the creation.

In Genesis 1-2, there is a critical link between the man and woman in the context of marriage and the procreation of children. Though the family is not the direct result of the command in Genesis 1:27 to “be fruitful and multiply,” the institution of the family is clearly related to it.

Though there are two creation accounts in Genesis 1-2, they are complementary and not contradictory. Genesis 1 provides the broad panorama overview of creation. Genesis 2 views the most important aspects of creation, the creation of man and woman, their relationship to each other and to God, in more detail. Thus the account of the creation of man and woman that is described in Genesis 2:18-25 actually fits into the broader overview of Genesis 1. To be specific, it occurs after the divine initiative in 1:26 to create mankind, and prior to the command to the newly formed couple in 1:27 to begin procreating and populating the earth. Thus, the creation of mankind is described generally in 1:26 and specifically in the male and female of the species in 2:18-25. The first command given to them that is recorded by Scripture is the command to reproduce in 1:27.

The key phrase in 2:24 is considered by most evangelicals to be the place where marriage is instituted. There are numerous reasons for this notion. First, the way that this text is quoted in other places in the New Testament makes it clear that it was originally intended for married couples (Matt. 19:5, Eph. 5:32).4 Second, the term “leave” is used to suggest that, against common ancient Near Eastern cultural practice in which the bride moved in with the groom and his family, a man and woman who will be intimately related (as the term “cleave” suggests) are to separate from their families of origin and begin a new family unit of their own. Third, the concept of one flesh clearly involves a sexual unity (though not limited to that), and throughout the Scripture it is evident that sexual relations are restricted to the setting of marriage. Thus it would appear that 2:24 is the place where marriage as a divine institution is begun.

Placing the more specific account of the creation of male and female and the subsequent institution of marriage back into the broader context of the creation in Genesis 1:26, the command to procreate is thus given to Adam and Eve in the context of their leaving, cleaving and becoming one flesh, that is, in the context of marriage. Though it is true that Adam and Eve are representative in a broader sense of the first male and female of the species, it is also true that this sets the precedent for heterosexual marriage and procreation within that setting. In other words, God has set up procreation to be restricted to heterosexual couples in marriage. There is continuity between God’s creation of the family in Genesis 1-2 and the command to procreate within that context.5 This structure of the family seems to be basic to God’s creative design, however extended the family became due to cultural and economic factors.

The use of the specific terms bone (etsem) and flesh (basar) in Genesis 2:23-24 are often used figuratively to indicate family relationships. When the two terms are used in combination (Gen. 29:14, Judges 9:2, 2 Sam. 5:1) or in parallel (I Chron. 11:1, 2 Sam. 19:12-13), or when flesh (basar) is used alone (Gen. 37:27, Lev. 18:6, 25:49, Neh. 5:5, Isa. 58:7), the notion of a blood family is normally present. It would appear, then, that the use of these terms in Genesis 2:23, when Adam declares that Eve is his bone and flesh, suggests that the normative family is in view in the creation account.

There is, then, continuity between the relationship between a couple in marriage and procreation (as well as parenthood, since Scripture assumes a similar continuity between the biological and social roles of parenthood). The teaching of the creation account is that procreation is to take place within the oneness of a total marriage relationship, not necessarily a specific instance of sexual intercourse.

There were places in the Old Testament Law that were designed to safeguard this creation ideal of the family. For example, the prohibitions against illicit sexual relations functioned to preserve the family from breakdown and assume the creation structure of the family as normative. In the sexual code in Leviticus 18, every sexual relationship except that between a heterosexual couple in marriage is prohibited. Incest, homosexuality, adultery (and specifically cultic prostitution), pre-marital sex and even bestiality are forbidden. Though there is no specific reason given for these prohibitions, it is clear that these violate the normative structure of the family that is rooted in creation. Keeping the creation ideal of the family intact and free from influences that would undermine it was considered central to the preservation of Israel as a society set apart as God’s holy nation (Ex. 19:6).

Even though the creation account does present a normative structure of the family that would appear to preclude third parties from being involved in collaborative reproduction, one should recognize that there are some novel reproductive arrangements that are used in the Old Testament. For example, levirate marriage (Deut. 25:5-10, Ruth 3-4) was employed to continue the lineage of a woman’s deceased husband should she be left childless at his death. Norman L. Geisler suggests this practice provides a Biblical precedent for third party involvement in a form such as artificial insemination by donor.6

However, levirate marriage is not analogous to other third party collaborative reproductive techniques for two reasons. First, there was technically no third party introduced into the reproductive matrix since the childless woman in view was a widow. Her husband was not only being replaced for purposes of reproduction, it was his death that made the entire levirate arrangement necessary. Second, this is not a case of simply inseminating the woman so that she could give birth, with the sperm donor taking no parenting responsibility. The near kinsman actually married her and took full responsibility for supporting her and the child that would be born out of their marriage. If anything, levirate marriage only supports the creation model by keeping reproduction within the context of marriage.7

A second novel reproductive arrangement that is found in the Old Testament is surrogate motherhood. This appears to have been a widely accepted cultural practice in the ancient Near East and was employed by both Abraham and Jacob in the patriarchal narratives (Gen. 16, 30). There does not appear to be any condemnation attached to the use of surrogates to alleviate female infertility. However, in Abraham’s case with Hagar, it could be argued that the consequences of his going in to Hagar were so negative that that is tantamount to a judgment on the practice. God could have simply let the consequences speak for themselves as an evaluation of the practice. In addition, in the Abraham and Hagar narrative, the issue at hand is not the use of a surrogate per se, but Abraham’s and Sarah’s lack of trust in God to keep His covenant promise. Thus it is not clear that with such a unique case as Abraham’s in his role as covenant mediator, that any normative Biblical teaching on third party collaborative reproduction can be deduced.

Though Jacob too is a patriarch who carries on the covenant, in his case there is no other issue of faith as was the case with Abraham. In Genesis 30, Rachel is childless and Leah has had a number of children. Rachel is so grieved that she instructs her maid to have sexual relations with Jacob and she finally ends up with a child, who she considers completely her own. The maid, acting as a surrogate, has no parental rights to the child she has borne. This would seem to be a case in which surrogacy is accepted as a normal practice, in which good results to all the parties involved.

However, one cannot assume that an accepted cultural practice is necessarily a moral norm that transcends culture. The Scripture is replete with cultural practices that are not considered normative for today. For example, polygamy appears to have been an accepted practice in the ancient world, yet it is not considered normative, particularly when viewed against the backdrop of the creation ideal of monogamy. Slavery was accepted in both testaments, yet no one can imagine a society today in which people actually own slaves. Simply because surrogacy existed as a practice that was utilized by the patriarchs says very little about its acceptability as a reproductive alternative today. For reasons that are not clear, God tolerated many practices that were not in accordance with his original design. Some of these were tolerated even though they were not consistent with his creation design for marriage and the family. The Mosaic legislation on divorce (Deut. 24:1-4, Matt. 19:3-9) is a clear example of this, and the pattern for marriage in Matthew 19 is clear that it was “from the beginning,” a clear reference to the creation account. Just because surrogacy was tolerated in the patriarchal era, it does not follow that its use today is legitimate, especially given the connection in the creation account between the context of heterosexual marriage and procreation.

One could object to this connection between marriage and procreation by citing the widely accepted practice of adoption as a violation of it. However, adoption is widely recognized as an exception to the general rule, or an emergency solution to the tragic situation of an unwanted pregnancy. Just because a discontinuity between procreation and parenthood is occasionally permitted in cases of adoption, it does not follow that any such intentional separation of the biological and social roles of parenthood is allowed. Emergency solutions such as adoption usually make for poor operating norms, and just because the exceptional case is allowed, that does not justify it as the norm.

In general then, reproductive technologies that do not introduce third parties into the reproductive matrix can be considered consistent with the Biblical theology of the family.8 However, someone might object that we have merely assumed without argument that what is biblically or creationally normative is also morally obligatory and that to act contrary to a norm is to do what is morally prohibited. That is, we can imagine an objection which insists that an act may be contrary to what is morally normative and at the same time be morally permissible. Case in point, the examples of Abraham and Jacob are arguably illustrations of third-party reproductive arrangements which, though not normative are nevertheless morally permissible. It is reasonable to take it that appeal to the creation norm closes the case. In the New Testament, when “family” issues are addressed (divorce and women’s roles) appeal to the creation norm was considered to end the argument. However, in the absence of direct prohibitions of third party collaboration, it may be arguing too much to say that they are prohibited in every case. Thus, we say that we are morally skeptical about third party reproduction.

APPLICATION TO REPRODUCTIVE TECHNOLOGIES
Intrauterine Insemination (IUI)

When the woman’s husband’s sperm simply needs help in fertilizing the egg, intrauterine insemination by husband (IUI-H) is performed. Within the theology of the family developed here there does not seem to be any morally significant differences between IUI-H and procreation by intercourse. However, a couple considering IUI-H should be aware that it is often performed in conjunction with potent fertility drugs, similar to those used in GIFT and IVF. As a result, the couple should be prepared for multiple pregnancies if these drugs are used. However, there are many cases in which the woman’s husband’s sperm needs more than some assistance in reaching the egg. In these cases, intrauterine insemination by donor (IUI-D) is used.

IUI-D raises ethical questions that are not raised by IUI-H. Since IUI-H takes place between husband and wife, the integrity of the family is maintained, and there is continuity between procreation and parenthood. But IUI-D introduces a third party into the reproductive matrix, and someone who donates sperm to be used for IUI-D is now contributing genetic material without the intent to parent the child that will be produced through the use of his genes. Procreation and parenthood have been separated and a third party has been introduced into the family by contributing his genetic material to a child that he will never see. We are thus morally skeptical about IUI-D since it violates the creation model that sets up continuity between partners in marriage and procreation.

In Vitro Fertilization (IVF)

In general, as long as in vitro fertilization does not utilize a third party who provides genetic material, as in cases of egg donation, or who provides the womb, as in cases of gestational surrogacy, it would be morally permissible for an infertile couple to use IVF. Though this involves fertilization outside the womb and extensive medical intervention in the woman’s reproductive cycle, it would fall within the range of technological innovations that are a part of common grace. Only when third parties contribute gametes or the gestational environment would its use violate the Biblical continuity between marriage and procreation.

However, that is not to say that IVF is entirely free of moral concerns for the Christian. Both of the above possibilities (embryos in storage and too many embryos implanting in the womb) raise significant legal and moral issues about IVF. What to do with frozen embryos if they are not needed raises significant questions about the moral status of the embryo. Most people recognize that with its potential to become a fully developed baby, the embryo cannot be seen as morally neutral and regarded as a piece of tissue, something that it inherently is not. The alternatives would appear to be to keep the embryos in storage, destroy them, to allow the couple to donate them to another infertile couple, or to use them for experimental purposes.

For those who view personhood as beginning at conception, the disposition of these embryos presents a knotty moral dilemma. If the right to life is acquired at conception, then destroying embryos or using them in experiments is problematic. Destroying embryos outside the body or passively allowing them to be kept in storage until they could not be successfully thawed, would appear to be the moral equivalent of abortion, and science cannot experiment on someone with basic human rights without his consent, particularly since most experimentation on the embryo would result in its destruction. That leaves donation of the embryos as the only viable alternative. Yet this is problematic since it introduces not only a third but also a fourth person into the reproductive matrix. But if the couple is not capable of implanting the remaining embryos themselves, this is clearly a preferable option to destroying them.

A second problem arises not from the failures of implantation, but from its successes. Routinely more embryos are usually implanted than will survive in the uterus. But occasionally a woman is left with more developing embryos than she can carry to term without risk to her health and life. In these cases, the woman and her husband and her doctor have very difficult decisions to make. When this happens the doctor will normally recommend selective termination of one or more of the developing embryos. This is done sometimes for convenience’s sake, but out of a genuine concern for the life of the mother. Not only does this involve trading one life or more (the developing fetus(es)), but also the doctor is faced with the decision of which one(s) to terminate and how to make that decision. If the mother’s life is clearly at significant risk in carrying all the fetuses to term, then it would appear justified to terminate one or more of the fetuses in order to save the life of the mother. This is analogous to cases in which abortion is justifiable when carrying the pregnancy to term would put the mother’s life at grave risk. But even for people who do not fit into the pro-life camp, the agony of making such painful decisions must surely be considered prior to utilizing IVF to alleviate infertility.

To avoid these dilemmas, a couple using IVF should limit the number of eggs being fertilized. This is a bit tricky, since no one can predict how many eggs will be successfully fertilized. The general principle at work here is that every embryo created in the lab has the right to a chance at developing in the womb, preferably with the couple who provided the gametes. It would be acceptable to put some additional embryos up for adoption, though the couple should be aware that if they follow the normal practice in IVF, they might end up with numerous embryos to deal with, anywhere from 1-10. Putting one embryo up for adoption is much easier emotionally than putting up 8-10. That is a very different matter for the couple.

In addition, the couple should request that only the number of embryos be implanted that the woman could carry safely should all of them be successfully implanted. This may increase the cost of IVF, but will avoid serious moral problems for those Christians who employ it.

GIFT (Gamete Intrafallopian Transfer)

GIFT is a variation on IVF in which fertilization takes place in the body, not in the lab. The same procedure is used for harvesting eggs, but they are placed back in the body with sperm so that conception occurs in the body. Normally, 3-4 eggs are placed in the woman’s body and the rest are fertilized in vitro and held in storage for later use. One can avoid the potential for leftover embryos more easily with GIFT, since the couple can simply forego having additional eggs fertilized in vitro. The eggs, rather than the leftover embryos, would be discarded. The drawback to this is, of course, that the couple only gets one chance at achieving a pregnancy. If that fails, they would have to start over. Issues concerning leftover embryos in both GIFT and IVF would be solved if eggs could be frozen and successfully thawed out, but that practice is still in the experimental stage and not offered in most infertility clinics yet.

 

Surrogate Motherhood

Undoubtedly, surrogate motherhood is the most controversial of the new reproductive technologies. However, it is not new, and does not necessarily involve sophisticated technology. What is new is the place of contracts and brokers in the process of procreation. Clearly in every case of surrogacy, a third party is introduced into the reproductive process. Even if third parties were allowed into reproduction by the Biblical teaching, there are other moral reasons to be concerned about surrogacy. They are as follows:

Surrogacy Involves the Sale of Children. Certainly the most serious objection to commercial surrogacy9 is that it reduces children to objects of barter by putting a price on them. Most of the arguments in favor of surrogacy are attempts to avoid this problem. Opponents of surrogacy insist that any attempt to deny or minimize the charge of baby-selling fails, and thus surrogacy involves the sale of children. This violates the thirteenth amendment that outlawed slavery because it constituted the sale of human beings. It violates commonly and widely held moral principles that safeguard human rights and the dignity of human persons, namely that human beings are made in God’s image and are His unique creations. Persons are not fundamentally things that can be purchased and sold for a price. The fact that proponents of surrogacy try so hard to get around the charge of baby-selling indicates their acceptance of these moral principles as well. The debate is not whether human beings should be bought and sold.

Rather it is over whether commercial surrogacy constitutes such a sale of children. It is clearly more than the rental of a womb since the surrogate is paid at least half of the fee conditioned on her surrender of parental rights to the child she bears. Such surrender of parental rights is clearly an indispensable part of the arrangement being successfully completed. Thus it is more than simply a service rendered, it is the transfer of rights to a child for money, or baby-selling.10 As the New Jersey Supreme Court put it in the Baby M case, “There are, in a civilized society, some things that money cannot buy. . . , There are values. . . , that society deems more important than granting to wealth whatever it can buy, be it labor, love or life.”11 The sale of children, which normally results from a surrogacy transaction (the only exception being cases of altruistic surrogacy), is inherently problematic, irrespective of the other good consequences that the arrangement produces, in the same way that slavery is inherently troubling, because human being are not objects for sale.

Surrogacy Involves Potential for Exploitation of the Surrogate. Most agree about the potential for commercial surrogacy to be exploitative. The combination of desperate infertile couples, low income surrogates, and surrogacy brokers with varying degrees of moral scruples raises the prospect that the entire commercial enterprise can be exploitative. Should surrogacy become more socially acceptable and states pass laws making it legal, it is not difficult to imagine the various ways in which surrogacy brokers would attempt to hold costs down in order to maximize their profit. One of the most attractive ways in which this could be done would be to recruit surrogate mothers more actively from among the poor in this country and particularly from the third world. For example, some are suggesting that those with financial need actually make the best candidates for surrogates since they are the least inclined to keep the child produced by the arrangement.12 Others are making plans to actively recruit women from the third world to be brought to the United States to serve as surrogates. The advantage to using these women is that it dramatically reduces the cost of doing the surrogacy business. John Stehura of the Bionetics Foundation stated that the surrogates from these countries would only receive the basic necessities and travel expenses for their services. Revealing a strong bias toward exploitation of the surrogates, he stated,

Often they (the potential surrogates) are looking for a survival situation—something to do to pay for the rent and food. They come from underdeveloped countries where food is a serious issue.” But he also added that they make good candidates for surrogacy when he stated, “they know how to take care of children. . . , it’s obviously a perfect match.13

Stehura further speculates that perhaps one tenth of the normal fee could be paid these women and it would not even matter if they had some other health problems, as long as they had an adequate diet and no problems that would affect the developing child.14 It is not difficult to see the potential for crass exploitation of poor women in desperate circumstances, a potential that is already being seriously considered by brokers in the industry. It is not clear the degree to which these statements are representative of the entire industry, but with the profit motive being a primary factor it does not take much imagination to see the potential for taking advantage of vulnerable women.

Surrogacy Involves Detachment from the Child In Utero. One of the most serious objections to surrogacy applies to both commercial and altruistic surrogacy. In screening women to select the most ideal surrogates, one looks for the woman’s ability to give up the child she is carrying easily. Normally, the less attached the woman is to the child, the easier it is to complete the arrangement. But this is hardly an ideal setting for a pregnancy. Surrogacy sanctions female detachment from the child in the womb, a situation that one would never want in any other pregnancy. This detachment is something that would be strongly discouraged in a traditional pregnancy, but is strongly encouraged in surrogacy. Thus surrogacy actually turns a vice, the ability to detach from the child in utero, into a virtue. Should surrogacy be widely practiced, bioethicist Daniel Callahan of the Hastings Center describes what one of the results would be. He states,

We will be forced to cultivate the services of women with the hardly desirable trait of being willing to gestate and then give up their own children, especially if paid enough to do so. . . , There would still be the need to find women with the capacity to dissociate and distance themselves from their own child. This is not a psychological trait we should want to foster, even in the name of altruism.15

CONCLUSION

How far should we go to have children? We have argued that the Biblical teaching on the family allows for some technological interventions in reproduction but is morally suspicious of those that introduce a third party into the process. In general, artificial insemination by husband, GIFT and in vitro fertilization can be used, assuming that the other moral difficulties involved with in vitro fertilization (embryo storage and selective termination) are addressed. But artificial insemination by donor, egg donation and surrogate motherhood cannot be used without violating the divinely ordained continuity between the context of marriage and procreation.

Furthermore, though we hinted that perhaps use of these third parties in collaborative reproduction is morally questionable, we do not pretend to have argued adequately that every violation of a biblical/creation norm is morally prohibited or sinful. Rather, for argument’s sake, we assumed that third-party reproductive technologies may be morally permissible even though they are a violation of what is normative in creation. Nevertheless, we stressed that moral deliberation concerning the employment of these reproductive technologies should not be limited to determining what is morally permissible and prohibited (sinful). Good moral reasoning should also account for considerations of virtue and human character, which are complex and extremely relevant to obtaining the good life. AJ

Scott B. Rae is Associate Professor of Biblical Studies and Christian Ethics at Talbot School of Theology. He is the author of Brave New Families: Bibilical Ethics and Reproductive Technologies (Baker).

NOTES

1 Much of the debate over surrogacy is over gestational surrogacy, in which there is no genetic link between the surrogate and the child. This is often viewed as a “rent-a-womb” arrangement and since it does not introduce a third person’s genetic material into the child, it is treated differently than genetic surrogacy, where the surrogate contributes both egg and uterus.

2 There are a handful of exceptions to this trend. They include Helmut Thielicke, The Ethics of Sex; Ray S. Anderson and Dennis B. Guernsey, On Being Family, Eerdmans, 1985; and Oscar E. Feucht, Family Relationships and the Church, Concordia, 1970. In general, Protestant works on the ethics of reproductive technologies have been scarce and the field has been dominated by Roman Catholic moral theologians.

3 Anderson and Guernsey, 17.
4 The exception to this is in I Cor. 6:12-20, where Paul argues against sexual promiscuity on the basis of Gen. 2:24. He is not speaking to married couples here, but his point is limited to the one flesh relationship that is associated with sexual intercourse, thus making promiscuity wholly inappropriate for the believer. This is magnified by the indwelling Christ in the believer, so that Christ is actually joined to the person with whom one has had an affair.
5 This is not to say that single parent families are any less genuine families in the sight of God, only that procreation cannot occur in that setting. Single parent families usually began as two parent families and procreation occurred in the proper context. Divorce, however tragic, does not prevent the resulting single parent and children from being a legitimate family.
6 Norman Geisler, Christian Ethics, Baker, 1990, p. 187. 7 Levirate marraige does introduce the issue of polygamy, but that is a separate issue from third party collaborative reproduction.
8 See the discussion of in vitro fertilization below, which on the surface would be consistent with the Biblical notion of the family, but has other moral concerns that are addressed.
9 Most of the surrogacy cases are of the commercial kind, involving a fee paid to the surrogate above normal expenses incurred in the course of the pregnancy. There are a few cases of altruistic surrogacy, in which a close friend or family member carries a child for another out of altruism alone. 10 Exchange of consideration for the transfer of parental rights in adoption cases is against the law in most states in the United States.
11 In the matter of Baby M, 537 A. 2d, 1249 (1988).
12 Statement of staff psychologist Howard Adelman of Surrogate Mothering Ltd. in Philadelphia, cited in Gena Corea, The Mother Machine (New York: Harper and Row, 1985), 229.
13 Cited in Corea, 245.
14 Cited in Corea, 214-215.
15 Daniel Callahan, “Surrogate Motherhood: A Bad Idea,” New York Times (20 January 1987): B21.