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A Theology of Reproductive Technology

For the last few decades, Oliver O’Donovan’s Begotten or Made? has been difficult to find and expensive to buy. Thanks to the foresight of the Davenant Institute, an organization aimed at renewing the intellectual life of contemporary Protestantism, that’s no longer the case.

This “New Edition for the 21st Century,” published some 38 years after the original, is now both readily available and affordable—at least on Kindle, and also in paperback for those in the U.S. and Canada. What’s more, it comes with a new introduction by Matthew Lee Anderson, which helpfully highlights the significance of the work, and a fresh afterword from O’Donovan himself.

Lectures on Reproduction

Begotten or Made? is the published version of the London Lectures in Contemporary Christianity delivered by O’Donovan in 1983. As he explains in the 1984 preface, he’d been invited to tackle a bioethical theme and, as IVF was still a novel technology, “it was not difficult to settle on the area of artificial human fertilization” (xiii). Importantly, however, he was less concerned about dealing with the technique of artificial reproduction than he was with the theology behind it.

Reproductive technology has developed considerably since that time. But by penetrating through the mechanisms of IVF to the ideas that enable it, O’Donovan produced a theoethical treatise that remains highly relevant today.

As Matthew Lee Anderson writes in his introduction, “O’Donovan’s work is both timeless and timely because he digs beneath the concrete practical questions into the manner of thinking embedded within the new technologies of ‘making’ human life” (iii).

Ethics, Theology, and Technology

In chapter 1, O’Donovan both explains and contrasts his use of the terms “begetting” (by which he means the natural generation of a being like ourselves) and “making” (the artificial creation of a being unlike ourselves) to prepare for later discussions of “particular technical undertakings which promise to transform our human begetting into making” (6). This leads to a consideration of the purpose of medicine and medical technique, which traditionally wasn’t thought to be that of “interfering in a healthy body” but of “curing a sick one” (8).

For Christians, the recognition of “limits to the appropriateness of our ‘making’” is a necessary entailment of our “faith in the natural order as the good creation of God” (15). This is important because it helps us differentiate the process of repairing that which God has created from attempts to alter or overcome his design. Much of the technology around artificial reproduction was devised to circumvent nature rather than to restore it.

Much of the technology around artificial reproduction was devised to circumvent nature rather than to restore it.

In chapter 2, “Sex by Artifice,” O’Donovan deals with what he calls “transsexual surgery” (now termed “sex reassignment surgery” or “gender confirmation surgery”). This, as he sees it, is another form of technology primarily oriented toward thwarting or changing nature rather than healing or restoring it. As such, it cannot be regarded as a form of medicine in any meaningful sense.

His discussion of this subject was primarily intended to show where divorcing reproduction from intercourse between a male and a female would lead and how, conversely, “the general program of artificializing procreation is furthered by the artificializing of sex” (22). However, O’Donovan’s analysis of the “philosophical decision” to collapse “the distinction between the physical sex and the psychological sex” of a person can now be seen as prophetic (27). Forty years on, his treatment of the subject remains one of the clearest and most penetrating yet written. Anderson agrees, describing it as “the single most incisive theological treatment of the subject to date” (iii). The book is worth reading for this chapter alone.

Chapter 3 explains why donor involvement in the procreative process is inherently unethical. O’Donovan outlines the moral deficiencies of replacing one of the parents within the family with (potentially) a stranger.

In making his case, he deals carefully with possible objections raised by the Old Testament practice of levirate marriage, which he argues is significantly different from the contemporary practice of AID—i.e., “artificial insemination by donor” (37). An analogy with adoption likewise fails. He writes, “To take another’s child into one’s family is a totally different kind of act from taking another’s gamete into one’s act of procreation” (45).

One aspect of this chapter that needs further development (due to the practice’s increasing popularity today, rather than any lack in O’Donovan’s reasoning) is the renting of wombs through surrogacy. But even here, he has provided the necessary groundwork for an ethical evaluation (and rejection) of this practice.

Chapter 4 wrestles with the meaning of personhood (in general) and the personhood of the embryo (in particular). Contemporary medical ethics requires the subject’s consent for experimentation, which an embryo obviously cannot give. And yet so much reproductive technology—from freezing embryos to genetically modifying them—is experimental and has at least some risk of damage or death.

Therefore, even if (contrary to the scientific evidence) one concludes the personhood of an embryo is ambiguous, the logic of Roman Catholic thought should prevail: “Declare ignorance about the beginnings of personal existence and then protect the child from conception on” (69). But instead, our generation has committed “the new and subtle crime of making babies to be ambiguously human, of presenting to us members of our own species who are doubtfully proper objects of compassion and love.”

In O’Donovan’s mind, this is “the clearest possible demonstration of the principle that when we start making human beings we necessarily stop loving them.” Why so? Because “that which is made rather than begotten becomes something that we have at our disposal, not someone with whom we can engage in brotherly fellowship” (79).

Contemporary medical ethics requires the subject’s consent for experimentation, which an embryo obviously cannot give.

The final chapter wraps up the book’s larger argument, making the case for nature and against artifice by means of an imaginative but highly instructive fairy tale. One of the most significant aspects of moral reasoning about artificial reproductive technologies arising from O’Donovan’s discussion is that many who participate in such techniques likely don’t consider the moral implications of their actions.

The clinical nature of IVF, for example, eliminates the mutual relationship and cooperation normally required for natural conception. It also seeks to overcome the element of “randomness,” which is “one of the factors which most distinguish the act of begetting from the act of technique” (87). While this may not invalidate all uses of IVF technology, it is, on the whole, something significantly different from natural procreation.

Compact and Cogent

Begotten or Made? is slender, with its five main chapters coming to a little over a hundred pages. But while compact, it is carefully and cogently argued, even if those not familiar with O’Donovan’s style of moral reasoning may find it dense and difficult at points. It’s a book that should be read slowly and pondered deeply. But it’s well worth the time it takes to read it and, as we’d recommend, reread it.

In producing a second edition of this increasingly important work, the Davenant Institute has performed a valuable service for the body of Christ. This is indeed, as Carl Trueman writes in his commendation, a book that “deserves to be widely read by a new generation of theologians, philosophers, and pastors.”

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