Dienstag, 25. März 2014

Embryo and foetus as seen by Orthodox Church

Dr. Nikolaos Koios

The presentation of the opinion of the Orthodox Church about the value of the moral status of the embryo is based on the official statements of the local orthodox churches. Official statements about bioethical issues have been already released by the Orthodox Churches of Russia,Greece and Romania.
The official Church texts express the orthodox anthropology which is based on the christological doctrine which consists of all the events of divine economy, such as the Annunciation of the Theotokos (divine conception) and the birth of the Virgin Mary and the Nativity of Jesus Christ, which lead to significant anthropological conclusions.
Common guide line of all the Churches is that the embryo is regarded from the standpoint of having both a human beginning and a human perspective. From the very beginning of conception, the embryo is not considered simply as a fertilised egg but as perfect human being. From this standpoints emerge for the Orthodox Church about the embryo some of its inalienable rights: 
1. the right to human identity, 
2. the right to life, 
3. the right to eternity. From all this aforementioned perspective considers the Orthodox Church all the bioethical problems which have to do with the embryo.

A detailed presentation of the orthodox anthropology, which constitutes the essential basis for the evaluation of the embryo’s/fetus status, is practically impossible within the limits of a short article. Nevertheless I will try to present main points of the orthodox faith about the issue.
Regarding the official position of the local Orthodox Churches one should remark in advance that, official statements about bioethical issues have already been released by the Orthodox Churches of Russia, Greece and Romania. The rest of the local Orthodox Churches have assigned specialized scientists to the task of formulating their position on these issues. One should, however, stress the fact that these positions do not have the authority of an official ecclesiastical document. They are rather the suggestions and reflections, which usually constitutes the first background for the final official ecclesiastical formulation. What follows is an abridged presentation of the opinion of the orthodox theology about the value of the moral status of the embryo based on the aforementioned official statements of the local orthodox churches.

The embryo
The developments and progress of biotechnology not only caused fundamental changes to the process of human conception, but also revealed many secrets of the human development from the conception up to the birth. Each one of these “stages” (Fertilised Egg, Implantation, Zygote, Morula, Blastocyste, the emerging of the Ektoderms on the 13th Day, Foetus, on the twelfth week) has special characteristics that are of great importance to the medical science regarding the conception and development of the embryo, but also because it helps us to understand the function of the whole human organism. One can consider each of them as a “beginning”, as a beginning of a new phase of the biological development of the embryo.
These terms, which characterize each individual phase of the embryo’s and/or foetus’s life, are not at all problematic for the science of Medicine; on the contrary they prove to be useful, since they represent methodological and functional differentiations, which are helpful to science and research. Nevertheless, serious moral questions are raised, when these differentiations are used as basis for the evaluation of the moral status of the embryo. In other words: A completely peculiar and complicated issue of concern develops, if the protection of the life and the integrity of the embryo are dependent on the stage of its development.
For the orthodox theology, and, as we believe, for everyone, who has deep ethical concerns about bioethical questions, the moral status of the embryonic life, does not constitute a result of mental activity or scientific investigation but is a fruit of ethos[1]. From an ethical and anthropological point of view -in their theological and philosophical meaning-, all these terms referring to the embryonic life stages mentioned above, convey the same conclusion: they disconnect the event of the beginning of life from the very moment of the fusion of the egg and the sperm cell and the unique resulting genetic existence [2].
Throughout its tradition, the Orthodox Christian faith has in various ways expressed and formulated its experience and teaching regarding the nature of the embryo. The Orthodox Church positions and experience upon the nature and status of the embryo have been expressed through Canon Law, through the writings of the great theologian Church Fathers, through the christological doctrine wording – where a condensed body of the teachings on the mystery of God’s incarnation and the theanthropic person of Jesus Christ can be found. The christological doctrine consists of all the events of divine economy, such as the Annunciation of the Theotokos (divine conception) and the birth of the Virgin Mary and the Nativity of Jesus Christ, which lead to significant anthropological conclusions. Moreover, contemporary standpoints of the Synods of the Orthodox Churches often refer to the nature of the embryo and converge to the position described below.
Before we present the aspect of the Orthodox Church about the status of the embryo/foetus, it would be perhaps useful to mention shortly certain testimonies from biblical, liturgical, patristic and canonical texts, which support this opinion.

Some biblical testimonies:
1. The encounter of the Theotokos with Elisabeth and the leaping of the embryo-St. John the Forerunner (Lk. 1:41), after recognizing the embryo Jesus. Through Mother Mary’s and Elisabeth’s narration and conversation the biological and spiritual status of embryo / foetus can be established.
2. As specified in the Church of Greece passage:
«…passages in the Old Testament texts speak about significant spiritual events that occurred in the lives of important persons (David, Isaiah, Jeremiah) “from the womb”, indicating that the embryonic status constitutes a stage of human evolution during which the grace of God acts upon man.[3] »
Liturgical testimonies
Conception is not only considered a major event but it also has a sacred character. That is underlined by the Orthodox Christian Church with the honour and the celebration of the conceptions of the persons involved in the divine economy: the mystery of Jesus Christ’s conception on the Day of Annunciation of the Theotokos (25th of March), the conception of Maria the Theotokos (9th of December) and, the conception of Saint John the Forerunner (23th of September).
Testimonies from the Church Fathers
The following passages represent the teaching of the Church from the [early] second century through to the fifth century. All converge on the opinion that the abortion is a sin that spiritually amounts to murder, no matter if it is attempted by surgical or chemical means, at an earlier or a later stage.
  1. From the Letter to Diognetus (speaking of what distinguishes Christians from pagans):
They marry, as do all others; they beget children but they do not destroy their offspring” [4].
  1. From the Didache
You shall not slay the child by abortions” [5].
  1. From the Letter of Barnabas
You shall not destroy your conceptions before they are brought forth; nor kill them after they are born” [6].
  1. From St. Basil the Great
A woman who aborts deliberately is liable to trial as a murderess. This is not a precise assertion of some figurative and inexpressible conception that passes current among us. For here there is involved the question of providing for the infants to be born, but also for the woman who has plotted against her own self. For in most cases the women die in the course of such operations. But besides this there is to be noted the fact that the destruction of the embryo constitutes another murder. It behoves us, however, not to extend their confessions to the extreme limit of death, but to admit them at the end of the moderate period of ten years, without specifying a definite time, but adjusting the cure to the manner of penitence [7].
  1. From St. John Chrysostom (Who considers abortion as a crime worse than murder)
…Where there is murder before birth? You do not even let a harlot remain only a harlot, but you make her a murderess as well. Indeed, it is something worse than murder and I do not know what to call it; for she does not kill what is formed but prevents its formation [8].”
Canons of the Orthodox Church regarding abortion:
  1. Canon 91 of the “Penthekti” Ecumenical Synod
As for women who furnish drugs for the purpose of procuring abortions, and those who take fetus-killing poisons, they are made subject to penalty for murderers [9].”
  1. Canon XXI of the Synod in Ankyra
Regarding women who become prostitutes and kill their babies, and who make it their business to concoct abortive means, the former rule barred them for life from communion, and they are left without resource. But having found a more philanthropic alternative, we have fixed the penalty at ten years, in accordance with the fixed degrees [10].

Status and nature of the embryo
According to contemporary official Church texts the embryo is regarded from the standpoint of having both a human beginning and a human perspective. Its cells, genetic material, morphology and physiology are entirely human. Moreover, its potential to develop solely into a perfect human being, and nothing else, confirms its human existence. Additionally, the remark that the fertilisation is a final and irreversible fact is very substantial. The fertilised egg cannot revert to its former non-fertilized status and be fertilized again by another sperm. Following the fertilisation the characteristics of a new human life have been irrevocably determined.
Furthermore, the perfect human identity pertains to a human being in all stages of his/her ή their development through the zygote and blastocyst ones (stages), to the old age. As characteristically put forth: “From the very beginning of conception, the embryo is not simply a fertilised egg; it is a perfect human being as far as its identity is concerned, and is constantly being perfected during its phenotypic expression and development” [11].
Spiritual status of the embryo
All the above lead to the conclusion that the beginning of man’s biological life is identical to a unique event of the utmost importance: the creation of psychosomatic inherence. In every embryo, from the very moment of conception, along with the cellular multiplication, the birth and development of its soul is carried out. Both these inseparable elements, the birth and growth of body and soul constitute the human person-hypostasis, which is the fundamental way in which the orthodox theology regards man. As a psychosomatic being the embryo will pass from time to eternity, from decay to incorruptibility, from the physical resemblance to its parents to the spiritual likeness to God.
The ethical rights of the embryo
In the teachings of the Orthodox Church about the embryo some of its inalienable rights emerge, which (the church) through its passages brings forth and maintains. First and foremost, the rights of an embryo emanate from the fact that the embryo is a person under development; it is an entity, which depends on and results from the will of third persons and is unable to take care of and defend itself.
According to the Greek Orthodox Church passage, with which,as far as the content is concerned, the passages of both the Churches of Russia and Rumania accord, the rights of an embryo are as follows:
1. Τhe right to human identity. The embryo has the ethically indisputable right to show its own identity and develop its personality. We should not be the ones to decide about its nature and status; instead, we ought to give the embryo itself the opportunity to reveal it to us; to prove that it is a human being and display the traits of its body and soul, which differentiate and distinguish it from any other human being. Science and society must protect this right.
2. The right to life. The embryo’s natural course of development is the same as that of every human being. We should acknowledge its right to life, and protect and care for the embryo itself. The embryo should reach its own status of autonomous life under the best possible circumstances. The sole aim of its existence should be its life, not the experiment (experimental embryos), or surplus embryos (spare embryos), or waiting under freezing conditions (frozen embryos). The fact that for thousands of embryos the warm maternal womb has been replaced by the frozen environment of a freezer, and the potential for life by the prospect of experiments and death, undermines human value and violates the right to life.
3. The right to eternity. The embryo has the prospect for immortality. Since the moment of its conception it is destined to pass to the life of eternity. This reveals the right of God to repeat His image in man [12].
Bioethical Issues
  1. Abortion and moral responsibility
In accordance with the aforementioned, as it can easily be understood, under no circumstances can the Orthodox Church accept abortion. The Russian church passage, as for abortion and moral responsibility for it, states that without rejecting the women who had an abortion, the Church calls upon them to repent and to overcome the destructive consequences of the sin through prayer and penance followed by participation in the Sacraments [13].
A more lenient stance is observed by the Romanian text in case the mother’s life is in imminent danger should pregnancy be continued and especially in case the woman in danger is already mother to other children [14]. In this case it is the spiritual father to spiritual child relationship that judjement is dependent upon. As a more general ecclesiastic stance it is maintained that the woman who interrupted pregnancy in this situation shall not be excluded from the Eucharistic communion.
Responsibility for the sin of the abortion of the unborn child should be borne, along with the mother, by the father if he gave his consent.
Sin also lies with the doctor who performed the abortion. The Church calls upon the state to recognise the right of medics to refuse to procure abortion for the reasons of conscience [15].
2. Problems of in vitro fertilisation
The application of new reproduction technologies to the field of assisted reproduction raises a host of ethical questions for the Orthodox Church. Of these, the ones having to do with the status of the embryo itself and not with the whole procedure of in vitro fertilization (e.g. the moral issues of taking sperm or ova, etc) will be mentioned thereinafter.
Τhe frozen-surplus embryos question: Based upon the hitherto medical data the eggs cannot be easily frozen. Therefore, the regular practices facilitate the retrieval of eggs, the fertilisation of which leads to the problem of surplus embryos and frozen embryos.
For the Church the term “surplus embryos” is particularly problematic, because it cannot be accepted that there are surplus human beings whose fate is determined by third parties. Each human being –and therefore each embryo– possesses the uniqueness of personhood, the sacredness of God’s image and the need to be in communion with other persons.
Orthodox Christian anthropology and theology cannot justify the existence of embryos that are independent of the pregnancy procedure. Each embryo constitutes the image of God and should be given the chance to become like Him. That means that it cannot accept any of the uses for which the current practice of assisted reproduction designates the so-called “surplus embryos”, such as their future or potential use by the natural parents, the donation to other parents, experimentation, or their being used for organogenesis so as to cover transplant need, or anything else that could lead to their being destroyed. Thus, the official Orthodox Church refuses to acquiesce to any of the above[16].
Τhe multiple pregnancies question: The transfer of extra embryos in the womb so as to increase the success ratio, often results to multiple pregnancies. In these cases, when a “selective reduction of the number of embryos” is suggested for the success of the pregnancy, that means actually the destruction of living embryos; in other words a situation to which the church is opposed.
The prenatal testing question: Prenatal testing is connected with the application of in vitro fertilisation. When prenatal testing aims at a therapeutic or preventive operation and implantation thereafter, then it is compatible with classic medical perception. However, at present, not only are these cases very few, but they also carry all related IVF consequences. That means that in the case of preimplantation and prenatal diagnosis the Orthodox theological position is clear. The Church respects and protects fetal life from the moment of conception, defined as the union of ovum and sperm. Since it is not possible to cure genetic disorders at the preimplantation or prenatal stages, there is no real reason to accept prenatal or preimplantation diagnosis. The rejection of a fertilised ovum outside the womb is just as morally reprehensible as the deliberate termination of a pregnancy, which can never be considered ‘therapeutic’.
Apart from that, the church holds strong reservations as for the potential use of prenatal testing with the view to selecting specific characteristics or rejecting embryos with undesirable characteristics. This could lead to a eugenic perception of life, which the Orthodox Church rejects.
The use of contraceptive methods question is a parameter of the issue, which the passage of the Russian church mostly addresses: Some contraceptives have an abortive effect, artificially interrupting the life of the embryo at the very first stages of his life. Therefore, the same judgements are applicable to their use as for abortion. But other means, which do not involve interrupting an already conceived life, cannot be equated with abortion in the least[17].

The spiritual approach to life
The word of the Church is first and foremost theological. The cornerstone of every judjement uttered is its word about God. The Church expresses this truth through the spiritual life of its members, as stated in the Holy Bible and Holy Deliverance. The theology of the Church apart from being word about God is being word about man. God’s revelation to the world testifies the uttermost expression of the Holy Trinity’s love and is materialized for the sake of man. In this sense in Church’s theology its anthropology is included as well, its truth about man. This anthropology is where the Church Ethos emanates from. The truth about man, especially as it is formulated in the Christ Himself and expressed by evangelic commands, the religious doctrine, the Church Fathers’ teachings, comprises its members’ life index at the same time. In other words, every moral problem or question is faced by the Church according to its perception about man and their relationship to God. Therefore, the Church has not yet evolved any autonomous system of ethics or bioethics other than the relationship of Uncreated God and His creature, man. Given this viewpoint the Orthodox Church confronts bioethical issues as well.
What must be accentuated when everything is considered is the intent eschatological character of the orthodox teaching. For the Orthodox Church what is of greater importance is not what we are or how we are born but what we can become. Potentiality is what makes our life move, not reality.  We are more what we can become than what we now are.  “The future as a potential bears more weight than present time as a reality; for the kingdom of God, the eschaton, is closer to the truth than the tangible and visible world of the present.  Respectively, the embryo is more what it can become; a human being with a living soul, and less what it appears to be; a developing cellular organism”


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