Essay Feedback

I love getting essay feedback.

This was the final line of my Church History 2 essay marker comments:

"This was a weakness in the essay - not enough critical engagement, especially with the secondary sources. Nevertheless, it was an 'above average' answer and was worth reading." [Emphasis mine]

It's always good to know that the best thing the marker can say about your essay is that is wasn't a complete waste of their time.

Some reflections on Assisted Reproductive Technology

I had a really great evening at the Moore College Centre for Christian Living on Monday night, lots of thought provoking stuff which I just posted about here. I strongly encourage you to read that post first to put these thoughts in context.

Some random thoughts:
My personal conviction is that Christian couples should all discuss ART during pre-marital counselling. These decisions need to be made before they become an issue, and not in the emotion of the situation.

It is too simplistic for people to say, "I'm against IVF". It does not reflect a Christian understanding of intervention which seeks to minimise suffering and pain, not as an absolute, but as an expression of God giving us knowledge and understanding of his created world, and as a reflection of the hope of things being put right when Jesus returns. In its simplest form IVF is the combining of a single egg and single sperm brought together outside the body ('in vitro' is literally 'in glass' or 'in a test tube') and then transferred back. It is the bypassing of the fallopian tubes. We have heart bypasses, we have fallopian tube bypasses.

Often driving an aversion to all ART is that unnatural is wrong. But what is unnatural? It is unnatural to put a broken arm in a cast as that is providing an external support. But it is also unnatural to have a radius and ulna which aren't straight. In a very basic sense, ART is in the same category as fixing a broken arm, or dentistry. Sure, there is more to it, but the theological understanding driving all forms of medical intervention is the same. Though, clearly ART is different in that it involves human life.

People seem to forget that God is in control of all of life. There is no guarantees that ART will produce children. The success rate is still very small, but God is just as involved in the science lab as in the bedroom. This will affect how Christians go about ART, not if they will. Some forms of assistance have very few moral issues. Furthermore, a couple will only fall pregnant if God chooses for it to occur. An infertile couple will not have children at any cost, but children to the glory of God.

A recent objection I have come across with ART is its history of development. Embryos have, and continue to be destroyed as part of the research and development in the field. Is a Christian using some forms of ART implicitly condoning and supporting these ungodly actions by paying for their services, even if they follow a biblical approach (as outlined in the previous post), in good conscience? This is a hard one, and I would want to offer a few things in response.
1. God has put us in a world where right and wrong are often not black and white, but shades of grey. The history of many medicines and especially vaccinations has involved testing (oftentimes bad) on human subjects. Does this mean we shouldn't use the Rubella vaccine because it was originally created from a cell line of an aborted foetus? The history of development, though we wouldn't condone it, does not mean Christians are unable to receive the benefit of it.

2. But again, ART is a little different, for it is also the ongoing research which continues to trouble Christians, and which in theory, as infertile Christians use ART they are supporting this process. This again is a difficult issue. However, as Christian couples would not be supplying the embryos for research, their support is a byproduct of the cost of their treatment. The answer to these questions are complex. For the reality is that as our government pays for aspects of ART through Medicare, every taxpayer also contributes to the field. No doubt much of the money for research similarly comes from government grants. But I don't think we should stop paying our taxes.

3. It is really a deeper issue of supply as well. We need to make sure if we have an objection based on both
a. Supporting a flawed system, and
b. Having the profits of a business used for immoral purposes,
then we need to make sure we don't stop with ART. If we applied the same standards to our food and clothing of not being willing to financially enable people to continue to exploit other humans then we probably wouldn't own an iPhone or MacBook. We almost certainly wouldn't wear anything from Nike. We wouldn't eat any chocolate products (not just chocolate bars, but all chocolate) or drink any coffee (unless its fairtrade). My point isn't to excuse the use of ART if in using the treatment financial advantage is given which allows further morally corruptible research. But I'm saying the fact that we all wear clothing and eat food and use technology which often props up corrupt and exploitative practices shows that our ethical approach must be more nuanced. The morally neutral product is difficult to find. It might be that somehow ART research crosses a particular line for some people, but don't pretend it's some unique area where you are financing the 'killing of people' anymore than owning your iPhone does.

So I would hope at the least that any arrogant dismissal of using ART would be replaced with a humble acknowledgment that there is great complexity in the moral landscape God has placed modern day Christians in. However, as always we must reflect upon our ability to do good to our neighbour, even the unborn ones.

I'm really looking forward to reading Dr Megan Best's book when it is released. It has a clever title: 'Fearfully and wonderfully made'.

Dr Megan Best on 'A Christian Approach to Assisted Reproductive Technology'

Dr Megan Best is a palliative care specialist but has been seeking to research and promote a Christian understanding of Assisted Reproductive Technology having been approached a number of years ago to work with the ethics advisory committee for Sydney Anglicans. She has a book coming out on the topic but here are my notes from a lecture Dr Best gave at the Moore College 'Centre for Christian Living' lecture earlier this week.

Dr Megan Best - 'A Christian Approach to ART'
ART - Assisted Reproductive Technology. Medical intervention which assists in the production of children. Most common is IVF. How should we think about the making of "test tube babies"?

Gen 1:28 "Be fruitful and increase in number; fill the earth" Is this reproduce at all costs? Are there limits?

• We are free to act within limits of God's design
• Free to pursue healing of our bodies which makes child-bearing difficult.
• But not "at any cost"

Goal: Framework for thinking, then application to common procedures.

1. Biblical view of marriage
Children created through sexual relationship within marriage between man and woman.
Christian marriage - Gen 2:24. Marriage is a new creative act of God.

• Unitive (Gen 2:24)
• Procreative (Gen 1:28)

What is the link to sex in marriage? RC says they must be combined, that only sex that is unitive AND procreative is right. Protestants recognise importance of both, and say both apply in marriage.

The command is repeated in Gen 9, so to fill and subdue continues. Not all couples can procreate (as recognised throughout the Bible), but it is the norm. Through children Gen 5 the image of God is perpetuated, and the blessing of God achieved.

Scripture teaches that the family is subordinate to the marriage. Emphasis in Gen 2 is on man and woman, and thus marriage is a valid end in itself. Desire to have children should not destroy marriage, as they aren't promised. Children should be extended same love and hospitality we have been shown, but conviction is to stand as couple no matter what.

Christians see children as opportunity to raise godly children to witness to next generation, not just perpetuating gene pool, and so need to think of responsibilies not rights.

2. Responsibilities of parenthood

• To be Godly example to their children and witness to the next generation (Gen 18:19, Deut 6:7)
• To nurture (1 Jn 3:11-16)
• Material provision (1 Tim 5:8)
• Kinship (OT genealogies, Joshua 4:4-7, 20-24) Our very existence is dependent on family line e.g. shown in adopted chilren knowing their parents.

Infertility is painful and often unexpected. It is only as infertility occurs that Christians understand just how much they have no control. Pain increased as infertility a taboo subject. The bible validates the pain of childbirth by comparing it to natural disasters Prov 30:15–16. In a funny way ART has increased anxiety, as there is now another big stress for Christians regarding intervention.

Lots of reasons to procreate. As a blessing of God, it is good to desire children. To those to whom it is denied, there is pain of loss. Difficult to understand why God would withold children from those who desire it (though not the focus of tonight). The desire for this good blessing is what makes the pull of ART so strong and increases anxiety.

3. Moral status of the human embryo
Does it matter how we treat an embryo? Firstly we need a biology lesson

Embryo is 1-8 weeks, then called a foetus. If a baby is a human, when did it start being a human? As everything is available in the first cell, and it is self-directing from that point, at that point life begins. We are dealing with a human being from the time of fertilisation. All professionals accept the self-directing and unique structure of the embryo from fertilisation. It is unified whole, not just collection of cells.

What does Bible tell us about development in the womb?

• Conception linked to birth - Gen 4:1; Isa 46:3; Matt 1:18
• Relationship with God while in the womb - Ps 139; Job 10; Ps 51:3
• The incarnation of Jesus - Jesus' human existence began at conception - Phil 2:7-8
• All humans bear the image of God - Gen 1:26-27, 9:6
• Do not kill - Ex 20:13
• Legal recognition of unborn child - Ex 21:22-25

To get involved in ART, need to have conviction to protect life from beginning.

4. Morality of individual ART procedures
ART is lucrative business, and not all providers are altruistic.
It is not wrong for Christians to seek medical intervention to fix things that are broken. But not ALL methods are acceptable if we want to protect life from its beginning. But reason for infertility will determine what form of ART is used and thus acceptable. Egg/sperm on their own not human, don't need protecting.

IUI - simple remedy to get sperm/egg to unite. Simply bypasses fallopian tubes - though an otherwise intimate activity now involves others. Still two week wait to know if there is a pregnancy. The only issue here is in how the sperm is actually collected - whether with pornography by masturbation or not. Some Christians have problem with masturbation, but most don't. Lust for other than spouse is a problem. Alternatives won't be offered, so need to be forceful. Many clinics allow those who live close by to collect at home. There are alternatives available regarding collection, so ask.

IVF - First and most common form of ART. Basic IVF involves single egg and thus no destruction of embryos. Again, fallopian tubes are just bypassed, and so no huge ethical concerns. But more commonly, IVF is combined with ovarian stimulation to produce more eggs, so that more than one can be harvested. Best case is 25% success for someone who walks into an ART centre. Ovarian stimulation can be used for those not doing IVF, but who can't naturally ovulate. Some dangers involved in this procedure. No ethical reasons per se for hormone use, but if all eggs fertilise, the problems of freezing embryos arises.

Freezing came about to increase success rates for patients and to avoid danger of ovarian stimulation. It is not expected all fertilised eggs will produce to live birth. Generally only 80% even fertilise. In most countries embryos not allowed to exist outside body after 14 days and must be destroyed or cryopreserved. 50-90% don't survive defrosting, depending on clinic (Note: This percentage is questioned later in question time as not in line with what people have been told). There is no formula that x number of embryos lead to x live births. You could have 12 embryos and none lead to live birth, or to 12. They usually look for those that look best, but there is no definite criteria for which ones will go best just by looking at them. Those that look best have no definite link to which will develop. Last year a baby was born from an egg which had been frozen for 20 years time. Only allowed to freeze for 5 years in most states (Note: this is also addressed later in questions).

Is it morally permissible to freeze humans if embryos are humans? This is the most difficult question in the whole business. The basis of Christian ethics is love for God and our neighbour. If we believe an embryo is human, a Christian will give each embryo the best chance at life. Every embryo that is fertilised should be transferred to a womb at some stage. A completely healthy couple having children naturally will have 50-70% of women who have embryos that fertilise but not implant. So for whatever reason God has chosen in the creation of children to build into the process some form of fertilsation which does not lead to a baby being born. The only reason for not transferring embryo is that it is dead. Easier to tell this at blastocyst (5 days) rather than at day 3. Arguments against freezing is that it is unnatural - that unnatural is immoral, but natural theology is based on human reason of what is natural/unnatural, and being after fall this ethic is confusing and not necessarily biblical. Slippery slope is a non-argument as we are down bottom of slope anyway. Further questions for freezing: What if couple gets divorced or one partner dies?

ICSI - Discovered by accident when needle slipped. Sperm injected directly into egg, rather than simply placed together. Used when sperm aren't mobile. Male offspring from ICSI tend to have genetic issues and higher infertility, probably arising from the scientist choosing sperm not the strongest.

Donor Gametes (Sperm and Eggs) - Can't buy human tissue in Australia so need to advertise. Big problem in terms of the family, as third or fourth person are added into the marriage relationship. A common problems with lack of equality in marriage, and husbands can find it difficult, creating tension. Problem also with offspring not knowing their heritage.

Embryo Biopsy
Genetic screening is problematic as it is making judgment on value of life. This does not protect embryos. (Note: Rob Forsyth was interviewed on 702ABC in Sydney that a friend at Bible study was talking about and apparently he had a great line on choosing the sex of your child something like 'A child is created from the parents, not for the parents')

Surrogacy - Lots of problems!!

Summary: Even if ethically okay, might not be okay for you. Lots of costs involved in treatment, physical risks primarily for women. Brings strangers into procreation and not the intimate activity its meant to be. Many find the process dehumanising. Emotionally traumatic. Time consuming. Will doctor help me overcome my ethical concerns, will I be happy to put my foot down. Success rate is still very small ~20% even in the best clinics. Need to set a stop time before you start. Is it worth the cost to your marriage?

Qns:
Egg collection? Early stage of technology. Once this process is improved it will decrease many of the issues, but big loss of eggs, and very very expensive, especially if clinic knows you are doing it for ethical reasons (as opposed to say having cancer treatment which will make a woman infertile).

Qn: Loss of eggs from defrosting? Freezing blastocysts (Day 5) has better defrosting rate than those frozen at day 3, and it's because less survive and growing them to this stage is picking the strongest. Interestingly, recent research suggests that even those that don't survive freezing stage would never have made it. (Note: I was wondering how this research would be possible, but I assume they are saying that eggs implanted which survive freezing have a much higher percentage chance of implantation compared to those which are transferred before freezing.)

What happens to Christian couples who want to continue having embryos transferred after the five year limit on holding eggs expires? Many people delay making the decision on what to do with remaining embryos, so many just refused to make a decision and then stopped paying their fees. The five year limit on holding eggs is so clinics could cease having to pay the storage cost for those who refused to make a decision on their embryos, and had ceased to have any contact with the fertility specialist. The 5 years starts after a clinic loses track and a couple are no longer actively involved in fertility treatment. There is actually no limit on how long an embryo can be stored for, and companies will not destroy embryos of those who are still actively involved in treatment and/or continue to pay for storage.

Embryo adoption? In early stage. Better than gamete adoption. Shows love for the embryo. Generally a good thing. Interestingly, and sadly, most parents would prefer their embryos used for research rather than donated to a couple.

Research on ART offspring? No long term studies, but it is generally known children want to know thier origins. Donor offspring see that the whole industry is about the parents rather than the children. The anonymity makes them upset. Many children are pleased to know the lengths their parents went to, to have them. However, anonymity and where it comes out later in life is a problem.

I think lecturers should have a style guide for lecture notes

I'm not being facetious. I reckon all lecture notes should submit to a style guide.

The college could provide a document which has all the styles embedded in a style guide so it's relatively simple to update all existing files.

It would need to include

• a header with 'Moore College' and the subject name on two lines justified to the left, and the lecturer's name and year on the top right on two lines in size 10 font.
• The footer would contain a single number centred.
• Set reading would be contained in a box at the beginning of the document. Any 'Further Reading' would be in smaller italisised font at the end of the lecture notes.
• Each lecture needs to be clearly numbered. Bigger sections would be marked by a centred larger font, possibly in bold. Sub-headings could be aligned to the left but clearly marked.
• All paragraphs and sections would need a single line between them.
• A font would be specified for all English writing but preferably would have the option to work with Hebrew and Greek. However, Hebrew and Greek should be up to the discretion of the lecturer, as not all of the markings of a language are easily displayed with a font.
• All Hebrew and Greek (and Aramaic for those playing at home) would need to be in Unicode (I think that's the fancy word for where you can copy and paste it in another document and it will keep the correct characters).
• The document type would be required for all lecture notes, both in .pdf and .docx (though I still prefer .doc I recognise times have changed.)
• Furthermore, just as students can only upload assignments with a specified file name, all lecture notes can only be uploaded with the filename '01_Title' and all supplementary files must similarly be attached to the particular lecture with which they come including '01-1_Title'

On a similar note, all subjects would come with a simple sheet explaining in appropriate columns
'Date, Lecture title, Lecturer, Set Readings.'

Any suggestions on the best font for lecture notes? Gentium, perhaps?

Download this Trevor Hodge EP

Then once you've enjoyed it, go back and tip him. But don't forget to go back!



Trevor is the music pastor (read: worship pastor if you're looking for an argument) at Kirkplace in Sydney. Most of the tunes I've heard sung at College chapel or at the Oxygen conference, and they worked well in a congregational setting.

I dig it.

Aha! And you thought it was impossible to over-emphasise the bodily nature of the resurrection

From Herman Bavinck on the result of a belief called totalitas materiae or 'the resurrection of the totality of matter'.

"... it leads to a variety of subtle and curious inquiries that are of no value for the doctrine of the resurrection. The question that is then pursued is whether the hair and the nails, the blood and the gall, the semen and the urine, the intestines and the genitals will all rise again and be composed of the same–in number and kind–atoms of which they were composed in this life."

No.

And eww.

Is this proof that everything can just as easily be over-emphasised as under-emphasised? My assessment of higher level theology is that the most comfortable location to engage in it is sitting on the fence.