Sources for Christian Bioethics: The Orthodox Discourse on Sin

Abstract

The article discusses ways of developing bioethical guidance in the Orthodox Christian discourse. Here, “ethical” refers to what contributes to holiness, “un-ethical” refers to sin as what hinders man’s foundational calling to holiness. To explore the development of guidance for emerging bioethical issues, we use the “therapeutic” understanding of treatment for sin in two senses. (1) It refers to the spiritual means provided by the “hospital” of the Orthodox Church for healing the fallenness of human nature in general; and (2) it helps identify in particular cases both what counts as transgression of unconditional boundaries (defining what is illicit for everyone) and what is advisable in order to help particular persons to choose rightly within the area of the “more or less licit” (or “permissible”). Sources of the Orthodox faith that frame the general understanding of the boundaries between the permissible and the impermissible reflect the work of the Holy Spirit in the Church framing her Sacred (Holy) Tradition. In Holy Tradition, prayers, as communion with God, occupy a central position. This is why Orthodox moral reasoning, and thus also Orthodox bioethics, takes the form of liturgical bioethics. Penalties of excommunication determine hard boundaries that believers should not overstep: when crossing such boundaries, they enter on a spiritually dangerous path that completely distracts them away from God. Many minor sins, by contrast, have not been codified in Canons. They are not taken to remove the sinner completely from contact with the Lord. Within this realm of actions, it depends on a person’s spiritual maturity whether such actions are classified as sinful. Thus, an act can be counted merely as a small offense if committed by a beginner, while that same act can become a grave sin for an advanced believer. Due to acceleration of the technological progress, Orthodox recourse to Holy Tradition encounters ever-new challenges. There are bioethical issues that had not surfaced at the time of the Fathers of the Church. Today, Bishops gathered at a local council can supply the guidance lacking on a newly emerging bioethical problem. Even if ratified only by such local councils, the resulting decrees can also be regarded as the expression of the Holy Spirit working within a local Church and conveying His guidance. The article illustrates this source of Christian bioethics by reference to how the Russian Orthodox Church orients and develops its position on the ethics of reproductive technologies.

I. INTRODUCTION

The rapid development of biomedical knowledge has forced the Orthodox Church to seek answers to new bioethical questions. In what sense does medicine’s secular commitment to do more “good” than “harm”¹ translate into the Orthodox commitment to promoting holiness? How does the Orthodox pursuit of holiness square with the use of new medical technologies? What sources should be invoked as sources for Christian bioethics in Orthodoxy?

Our considerations proceed in two steps. The first section explores the Orthodox understanding of what counts as “ethical” and “unethical” in bio-medicine, as distinguished from secular understandings. Here the argument plays on two levels, one regarding the theological background for the general moral evaluation of human action and the other concerning particular considerations informing pastoral care. On the former level, the issue is whether this or that medical intervention is permissible or not, and if permissible, under what circumstances or constraints, and to what extent. It is on this level that the Orthodox Church is able to offer general moral guidance both for believers and also for law- and policymaking in traditionally Orthodox countries. On the latter level, the issue is how, in particular situations, the application of permissible procedures will likely affect the spiritual development of the persons involved. It is this latter sense that places particular emphasis on the Orthodox discourse on the treatment for sin as “therapeutic.” Here the Orthodox Church must interpret this or that medical procedure in view of the pastoral guidance sought by those persons.

The next section illustrates the moral and pastoral interplay framing the therapeutic focus of the Orthodox discourse on sin, and thus of what counts as “ethical” or “unethical” in Orthodox bioethics, by a practical example: a draft document “Ethical Issues Associated with In Vitro Fertilization,” published for general church discussion in Russia since the beginning of 2021 (Intercouncil Presence of Russian Orthodox Church, 2021). In assessing this document, helpful guidance can be derived from the late H. T. Engelhardt, Jr.’s groundbreaking book The Foundations of Christian Bioethics (Engelhardt, 2000) for the bioethical puzzles involved in the technology of assisted reproduction. Still, to develop guidance (both moral and pastoral) for believers on the use of the newer medical technologies, more theological input is needed. We need to take another careful look at the sources for Orthodox bioethics. Only in this way can we gain firmer ground for addressing the more recent challenges of medical progress.

II. SIN IN ORTHODOXY

The crux of the difference between Christian bioethics and secular bioethics is that the former rests its moral judgments on the authority of Divinely sanctioned moral teachings. In a Christian context, it is God Who created man and gave human life the purpose of getting closer to God, and He also gave people a moral law to help them fulfill that purpose. Sin is understood as breaking a person’s relationship with God. It distances that person from God’s Realm and salvation.

Regarding the Orthodox stance on sin in bioethics, Engelhardt shows the ways in which what is bioethically permissible and impermissible must be extrapolated from a whole array of sources: first and foremost, from the authority of the words of the Lord Himself, second, from the accounts written by His disciples, along with their canons and decrees (as summarized in the Rudder by Nicodemos Hagiorites (1957)), and third, from the commentaries authored by the spirit-bearing fathers of all ages who formed (and continue to form) what is recognized by the Church as “Holy Tradition.” (Engelhardt, 2000). Summarizing that body of information, Engelhardt defines sin as an obstacle to holiness, to communion with God. He repeatedly uses the image of “missing the mark” in order to establish certain medical procedures as unacceptable. “Missing the mark” comes in degrees: some courses of action are absolutely impermissible because they tend to lead persons far away from God. Others, while not conducive to “hitting the mark,” but instead tending to distract a person from his advance in holiness, still do not have to be prohibited, insofar as they are at least not altogether incompatible with that person’s continued struggle toward holiness. In a sense, that likens Orthodox pastoral care itself to medicine, Engelhardt emphasizes a “therapeutic” understanding of treatment for sin.

In this essay, we engage that “therapeutic” understanding of treatment for sin in two senses: (1) it refers to the spiritual means provided by the “hospital” of the Orthodox Church for healing the fallenness of human nature in general; and (2) it helps to identify in particular cases both what counts as transgression of unconditional boundaries (defining what is illicit for everyone) and what is advisable in order to help particular persons to choose rightly within the area of the “more or less licit” (or “permissible”). Thus, even in this latter case (i.e., # 2.), the “therapeutic” aspect of the Church’s approach to sin, while circumscribed by unconditionally illicit “grave sins,” is not reduced to a legal framework that holds unconditionally, or offers universal guidance for every Christian under all circumstances. Rather, that approach also envisions the need to consider a particular person’s spiritual maturity. Every Christian, in seeking to commit himself to God according to his abilities, needs specific “therapy.”

The concept of sin in Orthodoxy thus has a therapeutic focus. It takes its bearings from the fact that after humanity’s fall from grace, human nature is inherently corrupt. This corruption encompasses not only vulnerability to illness and death but also a so-called propensity-for-sin². It is due to this characteristic of human nature that it is so hard for human beings to do the good they intend to do, un-adulterated by sin. St. Macarius of Egypt notes that a Christian, called to fight sin, can never win on his own: “To wrestle against it, to fight against it, to give and receive blows, is thine; to uproot is God’s” (Mayson, 1921, 18). Therefore, the distortion of human nature is effectively healed only with the help of the Divine mercy, and, most of all through his participation in the Sacraments of the Church: partaking of Holy Communion, if one is properly prepared for it, helps the believer to change himself and to come closer to God.

The Christian path to holiness thus also implies his avoiding engagements that would alienate him from God, and thus avoiding sin in this wider sense of the term. Such an orientation imposes boundaries, or points of bearing a Christian must not overstep. To emphasize it once again: such boundaries are to be reflected through a therapeutic prism in two senses: What is generally permissible and not permissible in general depends on an assessment of what courses of action would altogether alienate anyone from his path to holiness, and what is permissible or advisable in particular cases depends on an assessment of what it would mean for a particular person, given his spiritual maturity, to optimally pursue that very path. For more experienced Christians, thus, the range of what is permissible-qua-advisable is significantly narrowed down. For example, doubts about the faith can be a grave sin for a spiritual ascetic, while for the novice it is an integral part of his spiritual wrestling with evil thoughts.

At this point one may wonder: if Orthodoxy’s complex therapeutic approach to sin, and thus also to what is ethical and unethical, does not offer any general and precise definitions, how is it possible to make use of the concept of sin in Orthodox bioethics? What is there to say about boundaries if they fluctuate, depending on particular individuals?

The Sources of Ethical Guidance Within Orthodox Bioethics

This sub-section explores those sources of the Orthodox faith which frame the general understanding of the boundaries between the permissible and the impermissible in terms of what brings persons closer to God or alienates them from Him. These sources reflect the work of the Holy Spirit in the Church framing her Holy Tradition. That work manifests itself in the noetic³ experience of God gained by saints who, supported by Divine grace, have succeeded in purifying and healing their hearts. In order to help less perfect Christians, such experience is articulated in the writings of such saints, who are also called Fathers of the Church, and in the decrees of the Church councils that were recognized as “ecumenical.”

The general teaching of the Church on sin contained in such writings and decrees can also be experienced by and applied to the life of, each individual believer through his participation in the worship of the Church, where her prayers (the lex orandi) correspond to her dogmatic teachings (the lex credendi). To the extent that such participation also involves the sacrament of confession, the therapeutic nature of sin becomes especially prominent: the judgment of the father confessor will interpret what a particular believer should pursue or avoid (as sinful) given the latter’s situation and degree of spiritual maturity. Such personalized guidance is offered by a believer’s spiritual father, or by the priest who receives his confession on a regular basis. The role of such spiritual guidance is to orient human persons’ life toward God.

Old Testament Sources

All sources of Orthodox doctrine of sin derive from the Divine Self-revelation to His chosen people. Here, the boundaries are set that human beings may not cross, lest they lose the path of return into God’s life-sustaining grace. God’s prophets made His will known, along with the strictures of the law. The most famous commandments were given to Moses at Sinai. They include (along with rules for proper worship) the most elementary moral guidelines. For example, it is forbidden to commit murder, fornicate, steal, and disrespect parents. Such prohibitions on specific actions are accompanied by additional spiritual prohibitions, which are more fully developed in the New Testament; for example, the ban on jealousy (“You shall not covet your neighbor’s house”—Ex. 20:17).

Further Divine commandments are scattered across other prophetic and legal books: such as respect for elders, concern for the welfare of widows and orphans, leniency toward insolvent debtors, support of the poor, kindness to slaves, generosity to enemies, etc. (Proverbs 25:21), as well as the prohibition of homosexual acts (Lev. 20:13). Still, the moral law of the Old Testament does not offer the full extent of the Divine teaching. After all, its primary purpose was to educate and prepare the nation of Israel to receive the ultimate Divine revelation in Christ.

New Testament Sources

With His coming in the flesh, the Lord Jesus Christ did not abrogate the moral prescriptions of the Old Testament but completed them: “I have not come to abolish them but to fulfill them” (Matt. 5:17). This fulfillment raised Christians’ moral standards to an unprecedented height. The comparison of the Sermon on the Mount and Moses’s commandments makes this clear. Whereas Moses forbids physical murder, Christ teaches that there is also verbal murder (Matt. 5:22). Similarly, Christ specifies what is implied in the sin of adultery, declaring not only the physical act but also the corrupt disposition of the heart illicit: “Anyone who looks at a woman lustfully has already committed adultery with her in his heart” (Matt. 5:28). Thus, Jesus Christ places greater emphasis on the correction and healing of the human heart as the inner focus of the spiritual life (Matt. 15:19).

During His earthly life, Jesus Christ did not reveal some of His teachings to all, because not all could understand them (Matt. 13:11). Even His chosen disciples were not mature enough to comprehend everything He said. In His farewell discourse, the Lord, therefore, promised to send the Holy Spirit, who “will teach you all things and will remind you of everything I have said to you” (John 14:26). After His Resurrection, Jesus Christ revealed the mysteries of His Kingdom (Acts 1:3) to the apostles. By sending the Holy Spirit upon them on the Day of Pentecost (Acts 2:1–47), He qualified them to be teachers of the Divine Kingdom, and that also included His—as it were—“moral law.” This is why we find the major bulk of the Orthodox teachings on sin (both moral and spiritual) in the apostolic corpus of the New Testament. Thus, for example, we find a listing of the grievous sins that prevent a person from inheriting the Kingdom of God in Paul’s writings. He calls them the works of the flesh: “The acts of the flesh include: sexual immorality, impurity and debauchery; idolatry and witchcraft; hatred, discord, jealousy, fits of rage, selfish ambition, dissensions, factions and envy” (Gal. 5:19–21). Those who persist in committing such sins, that is, the unrepentant sinners, will not inherit the kingdom of God, they will not attain their God-given goal of holiness (Gal. 5:21).

In addition to the negative dimension of Orthodox teachings on sin, the New Testament places a strong emphasis on positive teachings. Thus, the apostle Paul contrasts the works of the flesh with the works of the spirit, as if thereby wishing to offer a perspective for struggling believers: “love, joy, peace, forbearance, kindness, goodness, faithfulness, gentleness and self-control” (Gal. 5:22–23). A similar indication of the framework within which one can draw near to God can also be found in other apostolic epistles (2 Tim. 3:1–5; Jude 1:17–19; 2 Peter 3:3).

As to the relationship between the Old and the New Testament’s—as it were—“moral” teachings, Christians prioritize the latter. Moreover, Old Testament provisions are accepted within Orthodoxy only if they have some parallels with, and are confirmed by the New Testament: Thus, for example, many of the Old Testament doctrines on cleanness and uncleanness are considered no longer necessary or even advisable in the New Testament: these prescriptions were merely temporary, necessary for protecting the Jews as the chosen people of God against seductive contacts with foreigners. For example, in the New Testament, the rules pertaining to clean and unclean food are abolished: “What God has cleansed, you do not consider unclean” (Acts 10:15). On the other hand, the Holy Scriptures of the Old Testament and the teachings of the Church unequivocally condemn homosexual intercourse as a vicious distortion of the God-created nature of man. Here the Old Testament norm “If someone lies with a man as with a woman, then both of them have done an abomination” (Lev. 20:13) is confirmed by a parallel in New Testament. In particular, Paul the Apostle unequivocally condemns same-sex relationships: “those who practice such things deserve to die” (Rom. 1:26–32).

The Orthodox Sense of Tradition

Since, obviously, not every bioethical question of today can be resolved by referring to the Holy Scriptures, it is often necessary to turn to Holy Tradition in the wider sense, as referring to the life of the Holy Spirit in the Church.

The Holy Spirit, Who has been living and working in the Church since the descent on the apostles at Pentecost, defines the boundaries between what is permitted and what is not, i.e., what is sinful and what is not sinful. His action in the early Church enabled people to determine the way in which they could pursue salvation as they approached God. Even though the Old Testament commandments remained in effect in the early Church, new questions arose that were not answered in the existing Scriptures. That is why the early Christians looked to God to determine the right solution to the new questions. We could say that in the life of the early Church, we see the beginning formation of Holy Tradition: although clear guidance on sin had been provided, the inclusion of converts in the people of God required proper extrapolation not only in view of the requirements of ritual cleanness but also in view of morals: Thus, the Apostolic Council in Jerusalem had to decide whether to impose all Jewish rules on them or not. It decreed: “It seemed good to the Holy Spirit and to us not to burden you with anything beyond the following requirements: You are to abstain from food sacrificed to idols, from blood, from the meat of strangled animals and from sexual immorality. You will do well to avoid these things” (Acts 15:28–29). Through the unanimous decision of such councils, the Holy Spirit manifests His works and presence within the Church. This is why that first decree starts with the words “It has seemed good to the Holy Spirit and to us” (Acts 15:28). Since that time, these words of Acts 15:28 have become a constant formula introducing all further Councils. It means that the whole Church recognizes the Holy Spirit’s guidance whenever all bishops convene and express unanimously a dogma or a moral canon.

Holy Tradition is an expression of the life of the Holy Spirit in the Church, of the action of God among people who are seeking to attain holiness. Saint Silouan the Athonite says:

The life of the Church means life in the Holy Spirit, and Sacred Tradition the unceasing action of the Holy Spirit in her. Sacred Tradition, as the eternal and immutable dwelling of the Holy Spirit in the Church, lies at the very root of her being, and so encompasses her life that even the very Scriptures come to be but one of its forms. (Sophrony, 1973, 54)

This is why the Church, led by the Holy Spirit, accepts Holy Tradition as a teaching every believer can recognize, and thus be united with, all other believers. As St. Vincent of Lerins summarizes: “we hold that faith which has been believed everywhere, always, by all” (1995, 132). Such faithful preservation of Holy Tradition in the Church has been safeguarded in the Orthodox Church throughout two millennia now, because that Tradition has been transmitted through the experience of life in the Church. Archpriest John Meyendorff says, “The inner continuity between both the Old and New Testaments and subsequent theology is what is called tradition” (1969, viii). In the Russian translation, his words sound even stronger, disclosing the true meaning of Holy Tradition:

Tradition is a continuous sequence not only of ideas but also of experience. It presupposes not only intellectual coherence but also lived communication on the ways of comprehending the truth. (Meyendorff, 2000, 11)

From the very beginning of the life of the Church, Holy Tradition even determined what should be included in the Holy Scriptures. In the early Church, there were many gospels. In time, led by the Holy Spirit, people who had purified their hearts decided that only four Gospels (Matthew, Mark, Luke, and John) express the universal faith in Christ. Thus, the Orthodox Church, unlike many of the Protestant religions, recognizes that the Holy Scriptures themselves are determined by Holy Tradition.

Another manifestation of the Holy Spirit acting in the Orthodox Church and revealing His presence consists in the enlightenment of saints whose words contribute to the Holy Tradition they represent: To quote St. Gregory the Theologian:

Not to every one, my friends, does it belong to philosophize about God… Philosophizing about God does not belong to all persons, because it is permitted only to those who have been examined and have a solid footing in contemplation [theoria], and who have been previously purified in soul and body, or at the very least are being purified. For the impure to touch the pure is, we may safely say, not safe, just as it is unsafe to fix weak eyes upon the sun’s rays. (2011, 3)

The Orthodox Church derives additional dogmatic and moral orientation from such theologically grounded knowledge in the proper sense of the term. Now even that knowledge also needs to be extracted and articulated or interpreted (cf. the glossolalia discussed by Paul in1 Cor 14: 5, 12–14), so that other Christians, who are either less qualified to receive first-hand revelatory experience, or less educated to profit intellectually from the primary written accounts, can benefit. This is why a discursive explanation of moral norms in Orthodoxy is both necessary and possible, even though such explanations are never fully sufficient. They offer general guidelines and important guidance regarding moral and spiritual norms. They must be supplemented by a regard for the lived witness of people who have attained holiness in communion with God and who thereby have become “moral” role models, properly understood in terms of holiness. By emulating such models, believers come to enhance their grasp of what God wants from them in each situation, and thus also in issues arising in biomedicine.

The Orthodox Liturgical Tradition as Basis for the Canonical Rules

Orthodox bioethics, as framed in terms of the twofold teaching on sin (i.e., (1) of falling short of humans’ divine vocation and (2) of transgressing moral boundaries or choosing improperly) has its roots in the Holy Scriptures and the Holy Tradition of the Orthodox Church. Given that Holy Tradition reveals itself through the bearers of Holy Spirit, Orthodox bioethics must also be based on noetically empirical knowledge (Engelhardt, 1995) obtained from the experience of personal encounters of holy people with God. Their contact with God allows them to see the direction that persons, both generally and in particular cases, should take toward their meeting with God. Holy men and women in their experience of God realize from what is necessary to refrain and what to pursue in order to get closer God. This is why St. Gregory of Nazianzus says that theologizing of God is not permitted to everyone and is not possible every time and before every audience (2011, 3–4). The encounter with God makes a person a theologian in the strict sense. Conversely, a theologian in a broader, academic, sense can refer to a person who studies or researches a theological subject at a university. The latter one interprets and explains discursively what is already revealed in noetic knowledge. Such academic theologians know about God whereas theologians in the proper sense know God noetically. They do not speak “about” God but prayerfully “with God.”

The necessity of prayers for meeting and communication with God is confirmed by Evagrius Ponticus who states “If you are a theologian, you truly pray. If you truly pray, you are a theologian” (1981, 65). Such prayer is embedded in the liturgical life of the Church. Hence Orthodox moral reasoning, and also Orthodox bioethics, takes the form of a liturgical bioethics. Only the Orthodox Church, as the Church of the Apostles from its beginning till today, has preserved the fullness of liturgical resources undergirding our knowledge about salvation as the attainment of holiness through communion with the living God (Engelhardt, 2005). The Holy Liturgy represents the culmination of the Holy Tradition. Only what was recognized by the Church as an expression of Truth, as dogma, was integrated into the Divine service. As the holy martyr Irenaeus of Lyons said:

Our opinion is in accordance with the Eucharist, and the Eucharist in turn establishes our opinion. For we offer to Him His own, announcing consistently the fellowship and union of the flesh and Spirit. (1995, 486).

And Basil the Great wrote:

My present creed is not different from the former; it has remained ever one and the same. As we received from the Lord, so are we baptized; as we are baptized, so we make profession of our faith; as we make profession of our faith, so do we offer our doxology. (1995b, 291–2)

Grave sins, as mentioned above, are defined as what altogether obstructs communion with the Lord. Since during this earthly life, a person’s beginning of experienced communion with God primarily happens through participation in the Holy Eucharist, it is his ability to receive communion, rather than being ex-communicated (i.e., excluded from that sacrament), which determines the severity of a particular sin. Thus, the severity of sin correlates with the length of the sinner’s excommunication from the Holy Sacraments. This is why we can range sins in accordance with canonical penances imposed on a sinner.

For our example of technology-assisted reproduction (to be discussed in the next section), two of those sins will be crucial: the sin of murder, as implied in the destruction of excess embryos which often accompanies in vitro fertilization, and the sin of adultery or fornication, as involved in heterologous insemination or egg donation. The destruction of embryos is tantamount to an abortion, or murder. Here either ex-communication until the end of life is imposed or re-admission for Holy Communion is postponed to the person’s deathbed⁴. At the very least, the penalty of ex-communication lasts 27 years (Agapius and Nicodemus, 1957, 874–5). This shows how the Holy Tradition considers murder, even the murder of an unborn human being, to be a grave sin. Likewise, for adultery, there is a 15-year deprivation of the sacrament, while fornication imposes 7 years (Agapius and Nicodemus, 1957, 828). The greater gravity of adultery derives from the fact that it involves not only the desecration of one’s own body but also the betrayal of one’s spouse. Here the spouse’s consent is irrelevant, and thus the practice of heterologous insemination or egg donation is equally sanctioned. In this way, canonical penalties indicate at least in part how Liturgical Tradition determines boundaries that believers should not overstep. Crossing that line, and disobeying the canonical rules which impose some extent of excommunication (i.e., avoiding to confess such crossing), would render their participation in the Holy Gifts “unworthy” and expose them to the “judgment and condemnation” invoked by the Prayers before Holy Communion (Antiochian Orthodox Christian Archdiocese of North America, n. d.). On the other hand, such penances become a bitter therapeutic medicine for a sinner, helping him to recover and return to the path toward holiness. These boundaries also extend to the use of medicine.

It must be kept in mind, of course, that the severity of the rules of penance does not aim to satisfy Divine anger or Divine justice. Instead, that severity is meant to heal the sinner, train him in repentance, and thereby return him onto the path toward God. Not every sin requires a codified penalty of ex-communication but rather only grave sins that distort a person’s spiritual integrity and estrange him from God. Only grave sins—as a rule—keep a Christian from being able to partake of Holy Communion, therefore, representing hard boundaries, and imposing powerful medicine. In the case of IVF, our chosen example for Orthodox bioethics, the relevant serious sins involve abortions (i.e., killing innocent human life), adultery, and fornication. These are always sinful and forbidden, even though, as we see below, the penalties might be smaller for some than for others. Many minor sins, by contrast, have not been codified in Canons. They are not taken to remove the sinner completely from contact with the Lord. Within this realm of actions not clearly classified as sinful, it depends on a person’s spiritual maturity if their choices are counted as sinful. Here actions are generally considered permissible, but for particular persons, who have attained a higher place on the “ladder of divine ascent,” they are considered illicit and must be repented. The next subsection will offer greater details about such different judgments.

The Principles of Oikonomia and Akribia

Orthodoxy’s therapeutic understanding of sin differentiates between moral knowledge, as codified in canons and general laws or rules, and the application of what is advisable in particular cases. In this sub-section, we take a closer look at the relationship between both. On the one hand, Orthodoxy’s general moral knowledge encompasses the recognition of the graveness of sins like murder and adultery (and fornication), and the ex-communication penalties codified in Holy Tradition, which are helpful in recognizing the gravity of such sins. Orthodoxy’s concern with pastoral care, on the other hand, is reflected both, on the level of either applying such codified penalties as prescribed or of adjusting the latter to the particular situation and spiritual state of the sinner, and on the level of offering guidance for the realm of licit actions not surfacing in the general injunctions. Both aspects of Orthodox discourse on sin serve the general therapeutic goal of helping the sinner to reconcile with God and to pursue the path of holiness for which he was made. That therapeutic aspect is often more visible in the pastoral care aspect of that discourse.

The need for differentiation between individuals in their different situations is confirmed by the Savior Himself when He says:

For there are eunuchs who have been so from birth, and there are eunuchs who have been made eunuchs by men, and there are eunuchs who have made themselves eunuchs for the sake of the kingdom of heaven. (Matth. 19:12)

Explaining Matth. 19:12, which in today’s world can be easily misunderstood, St. Gregory of Nazianzus states that these words “represent(s) higher things by bodily figures” so that this passage should be comprehended in spiritual sense. This is why under eunuchs, he implies not a bodily mutilated person but rather a person, spiritually cutting himself off from the passions.⁵ St. Gregory indirectly confirms different levels of believers’ spiritual maturity: some persons are naturally inclined to good, whereas others, to avoid evil, need to bitterly struggle with their passions. In accordance with St. Gregory’s teaching, the Russian Orthodox Church’s Grand Bishop Council used the same passage of Gospel to make a similar discernment extending to people of different spiritual maturity: an act can be counted merely a small offense if committed by a beginner, while that same act can become a grave sin for an advanced believer⁶. Penances (such as the ex-communication discussed above) should therefore be imposed on individuals differently. If having never participated in the Orthodox Mysteries, a person comes to Confession and repents of an act of fornication, it would be unhelpful to ex-communicate him for 15 years. Such a person has led a life, deprived of God’s Grace in the Eucharist, and if a priest expels him for even more years, he will be overwhelmed by grief. The odds are that such a sinner will never make another attempt to return to the Church. So a priest must prevent immature believers from altogether losing contact with God. For this reason, the priest can alleviate the penances. On the other hand, when seeing a believer who is mature enough spiritually to abstain even from what is not altogether forbidden, but still not spiritually helpful, he can increase the penance.

The theological term used for such discretion is oikonomia. It is the counterpart to the principle of akribia which refers to the application of the general rules according to their literal meaning⁷.

Thus, Saints Basil the Great and Gregory of Nyssa write that the penances for ex-communication of someone can be reduced or canceled altogether if the sinner shows proper repentance and willingness to re-orient himself. Or, to paraphrase, penances are only used in ways that promise to be beneficial. If a person has corrected himself and received healing already, the penance can be shortened. If, on the other hand, a canonical penance is not expected to help (for example, if a person would thereby be discouraged and in danger of abandoning the Church altogether), it can also be reduced. In later centuries, with believers becoming weaker in faith, penance rules were revised (see the canons of Saint John the Faster in Agapius and Nicodemus, 1957, 929–52) and rendered milder. Still, the goal of therapeutic benefit remains⁸.

At this point, it is perhaps helpful to summarize what may be unfamiliar to a non-Orthodox reader. (1) Some actions, of course, are defined as sinful in the general theological moral knowledge of Orthodoxy. These are sinful for everybody. (2) Within the realm of actions not clearly classified as sinful, it depends on persons’ maturity, if their choices are counted as sinful for them or not. (3) Such differentiation has consequences for the appropriate response: It depends on a person’s spiritual state how the penalties prescribed for the particular sins within the general moral knowledge should be adjusted. (4) The same holds for those actions which are left licit, but which for some people are counted as sinful or illicit, and for other people as not sinful and allowed. (For Orthodox believers, this implies the challenge of having to accept the fact that stricter limits are imposed on some than on others. But since strictness increases with spiritual maturity, and spiritual maturity with humility, no one will complain.)

For our example of IVF, which is (1) not defined as sinful by general moral knowledge, this means that (2) it may be called sinful for some couples (who would profit more by remaining childless) but licit for others (whose childlessness would tempt them to turn their back on the Church), and (3) it would be prohibited for the first, but allowed for the second couple.

That is to say: not in all cases does IVF involve sin. In some cases, engaging the technology might simply mean missing the target. Some couples must be kept out of trouble—others can be supported in advancing in their ascetic task. Or some couples can choose perfectly, others only imperfectly. Choosing to prefer preserving the intimacy of the marriage to fulfilling one’s desire for a child is surely more perfect than choosing the other way around.

Now how can one determine in any particular case and for any particular person, what actions they should avoid as “sinful”? At this point, a further feature of Orthodox normative orientation comes to the fore: the need for spiritual discernment and spiritual guidance.

The Importance of Spiritual Guidance

Since the Orthodox normative discourse is about therapy, about healing sick souls and helping them on their path of following Christ, the question arises about how such therapy can be secured, or, to be more specific, how a believer’s spiritual state can be known so as to adjust the needed corrections.

Here spiritual fatherhood is helpful. Such fatherhood is primarily available through spiritual Fathers. In the strict sense, a spiritual Father is a person who has received the Spirit of God and is, therefore, able, under the influence of the Divine grace, to discern what is helpful or unhelpful in another person’s specific life situation. A person, who wants spiritual guidance of that sort, must be willing to subject his self-will (recognized as the root of humans’ sinful inclinations) to the direction of his chosen guide. Such obedient submission is the norm in monastic communities, ever since these started to emerge during the fourth—sixth centuries. The crucial importance of personal face-to-face communication with and obedience to a trusted spiritual authority must here be clearly distinguished from what Protestants affirm as “situation ethics.”⁹ In the Orthodox context, the one seeking guidance—apart from not transgressing the moral boundaries set for everybody—about what to do and what to abstain from by the will of God must learn not to trust their own (fallen) intuitions, “values” or “principles.” They must exercise the ascesis of obedience to their spiritual father as his final authority. Training in Christian humility, after all, is recognized as central to a Christian’s path toward God.

Choosing one’s spiritual father imposes great responsibility on a believer. He must ask for Divine guidance in making sure that he will find proper spiritual advice, and avoid anyone seeking selfish guru-like power over others. This has become ever more important in recent times, as true Spirit-bearers have become rare.¹⁰ The problem was aggravated for the Russian Church, after it had regained freedom in the 1990s. In addition to the scarcity of Fathers with real spiritual discernment who had managed to survive Communist persecution, many false spiritual guides appeared. As a result, Orthodox people in Russia came to discount the very project of spiritual fatherhood.

This is why, in the 2010s, the Russian Orthodox Church decided to account for the indispensability of at least some general moral guidance not only about sins that require sanctioning but also about the types of considerations that should guide both the adjustment of the general penalties and the choices within the realm left to individual discretion. Such basic guidelines were, therefore, offered through the document “On participation of the Faithful in Eucharist” by the Great Bishop’s Assembly in 2015 (Great Bishop’s Assembly, 2015). This document explains how to navigate the many aspects of preparing for Holy Communion. Different levels of believers’ spiritual state are explicitly addressed. The document encourages different therapies to be applied to the more experienced Christians who can follow the strict rules imposed by Holy Tradition, as compared to beginners.

Here again, the importance for believers to turn to their chosen spiritual fathers is emphasized. To prevent dangerous reliance on inexperienced priests (or the “junior elders,” as they are called in the Russian Orthodox Church), the document extends the term “spiritual father” to one’s constant Father confessor—the priest to whom one routinely confesses. This very weak definition lacks any reference to the fundamental requirement of noetic experience in proper spiritual Fathers. Nevertheless, laypeople who have no access to such real Fathers learn that they need to choose one priest and confess and discuss their spiritual issues only with him, not with any arbitrary priest who does not know them well. To be sure, such a “father” can only function as an advisor, not as an ultimate authority. His advice is based not only on the fact that he knows all the circumstances of a person’s life, but also on prayer for the person seeking his advice. In this humble sense, the institution of spiritual guidance has been revived in the Russian Orthodox Church. It imposes on Father confessors the task to align their advice with Holy Tradition.

In all cases, the development of a spiritual father-child relationship is a long and complex process. Such pursuit ideally results in a spiritual friendship where trust can grow, provided the spiritual guide knows how to deflect attention away from himself to Christ. The priest must be able to say with St. John the Baptist: “He must increase, but I must decrease.” (John. 3:30).

To sum up, Orthodoxy considers sin a hindrance to a person’s movement toward God. It insists on the purification of the heart and rectification of one’s life for paving the way toward the Kingdom of God. Such rectification aims at harmonizing one’s human will ever more perfectly with that of God, thus following Orthodoxy’s saintly role models. Holy Tradition teaches that sin is what prevents a person from such pursuits. Since for spiritually mature Christians, even a slight deviation from Holy Tradition might count as a grave sin, whereas for newly initiated Christians, greater levels of deviation are tolerable (with the hope that such neophytes eventually learn to focus their lives on God’s commandments), the spiritual discernment provided by a spiritual father or Father confessor is crucial. If, for example, a medical technique is not in principle illicit, that means that its acceptance might hinder a spiritually matured person’s movement to Lord, but at the same time, help (or at least not hinder) an immature person in approaching holiness. A Father Confessor might consider that technique as sinful in the former case and as non-sinful in the latter. Nevertheless, in no case, a father’s blessing encourages a person to overstep the boundaries of grave sins, even though the commitment of such sins is (again) treated differently in different cases. In aspiring to such discernment, father confessors must take their bearings also from the more recent guidance offered by the Church. Statements offering such guidance for biomedicine, therefore, become a new and additional Foundation for Christian bioethics, and we discuss such a statement in the next section while applying what has been said so far to the example of reproductive technologies.

Holy Tradition and Reproductive Technologies

With the rate of technological progress ever accelerating, Orthodox recourse to Holy Tradition encounters ever-new challenges. There are bioethical issues that had not surfaced at the time of the Fathers of the Church. Take in vitro fertilization: On what should Orthodox ethical evaluation of this procedure be based? It was introduced into bio-medicine only in the second half of the twentieth century. Scripture, of course, affirms the integrity of the marriage bed: “the marriage bed should be kept pure, for God will judge the adulterer and all the sexually immoral” (Heb. 13:4). On the issue of infertility, Scripture offers examples of prayer for the gift of offspring being answered (e.g., St. Anne, the mother of Samuel the prophet). In the holy Fathers’ writings, however, we also find cases of saints who refused to pray for the relief of infertility, because they understood that a child would not be useful for that parent’s salvation. Thus, for example, St. Sabbas Sanctified refused to pray for Empress Theodora, the wife of Emperor Justinian (Demetrius of Rostov, n.d.). Sometimes this case is invoked by Russian IFV opponents as an example supporting the view that saintly fathers would quite generally oppose any intrusion (including medical procedures) in the reproductive process (Tarabrin, 2020). Nevertheless, St. Basil the Great taught that one may turn to a physician if one wishes to use the healing received for spiritual perfection and salvation of the soul (Tarabrin, 2020). It would seem that such teaching could overrule the problem of external intrusion if IVF was sought with the appropriate Christian intentions. Given such diverse responses to Holy Tradition, one might conclude that Orthodoxy fails to provide clear guidance on the use of IVF. Nevertheless, the Orthodox Church strives to live by the direct influence of the Holy Spirit Who can and does direct the Holy Tradition to solve the new emerging bioethical issues.

Resources for Solving New Bioethical Issues in the Holy Tradition

The Holy Spirit, acting in the Orthodox Church ever since her birth at Pentecost, has revealed His presence in the Decrees of Bishops’ Councils, just as He initially revealed His will through the Decree decided by the council of the Apostles (Acts 15:28). Our ability to recognize such decrees as the expression of Truth hinges on an achieved unanimity among the bishops involved. Only by following Christ’s commandment (“A new commandment I give to you, that you love one another: just as I have loved you, you also are to love one another.” (John 13:34)) can bishops’ councils endeavor to render their decrees “canonical,” manifesting the love-based unifying action of the Holy Spirit in the Church. Their conciliar decision must then be accepted by priests and laypeople precisely as such a manifestation.

Decrees issued by a Church Council, after all, differ from resolutions proclaimed by democratic parties with majority rule. All bishops possess the same Divine gift to rule the Church and articulate her teachings. At their assemblies, even the presider does not have more power than the other bishops; no simple fiat by him can resolve disagreements. The need to settle for someone occupying the position of “first” among the bishops in such an assembly and to charge him with the initiative of convoking, and with the authority of leading it is merely pragmatic. A bishop endowed with such priority of rank among his episcopal colleagues must do nothing without the latter’s consent.¹¹ Thus, to pronounce “for it seemed good to the Holy Spirit, and to us” (Acts 15:28), all those assembled have to agree upon the issue in question.

On the other hand, even a unanimously reached decision of a bishops’ assembly is not by itself authoritative enough to justify simply imposing on the believers. According to that same principle of Christian love, bishops cannot issue a decree that will later be rejected by the laity, as happened at what was later denounced as the Robbers’ Council (449 AD).¹² Following the original Eucharistic understanding of the Church, as recently recalled by Nicholas Afanasiev (2007, 33–80), the laity in each local Church, while enjoined to offer unquestioning obedience to the bishop as to the representative of Christ, is also called to subject that obedience to their liturgical mission of watchfulness and discernment, of acceptance or rejection regarding everything the bishop and his priests do. The kenotic element of this relationship of love between the presider over the Holy Eucharist and those being presided over surfaces, on the bishop’s part, in his willingness to ask for obedience from those in his care only to an extent they can thus, faithfully ratify. On account of his own commitment to Christ-like rule, a bishop must therefore actively enable those in his care to fulfill that guardian role. On the part of the laity, by contrast, that same kenotic character resides in their efforts to accept such training as a safeguard of their rightly oriented obedience and discernment.

This kenotic love between every local bishop and his flock reflects a similar kenosis manifested on the level of conciliar decision-making. Following the same principle of Christian love, bishops should be willing to behave in a conciliatory manner in view of some (i.e., not directly dogmatic) disputed points, so as to preserve the spirit of peace and unanimity among those assembled. As loving shepherds of their flock, they are however also enjoined to avoid any decisions that cannot later be accepted by their flock. In this way, the love manifested in the life of the Church distantly recalls the love within the Holy Trinity, as described by St. Basil (1995a): Here as well, if we are allowed to speak in the anthropomorphic terms employed by the great saint, God Father, God Son, and Holy Spirit, united in mutual love, do nothing without Each Other’s willing cooperation. It is only within this framework that the role the laity has played in ratifying the decisions of a council as “ecumenical,” i.e., as guided by the Holy Spirit and thus valid for the Church, can be understood: the decisions of conciliar assemblies are thus limited to what the consent of the whole Church will faithfully ratify. This is why some Councils that at first had claimed ecumenical status were later repudiated by the Church.

Thus, the Orthodox Church has a time-hallowed method of tackling disputed issues. Ultimate canonical authority resides in councils that were later recognized as Ecumenical¹³. These are acknowledged in the Church as manifestations of God’s having acted through Her members.

Yet, twelve centuries have passed since the last Ecumenical Council took place (the last seventh Council was in 787 AD). During these centuries, an emergency measure has gained general acceptance. It rests on a decision to entrust the consensus of the Church as a whole to the experience of local Churches, acting independently of one another. This is why, for local purposes and, moreover, for resolving canonical or moral inquiries within a certain ecclesial territory, every Local Church, such as the Russian Orthodox Church, has adopted the practice of convening her own bishops for discussion and resolution. The decrees issued from such local councils can also be regarded as an expression of the Holy Spirit working in such a local Church and as conveying His guidance. This holds, at least as a preliminary measure, and before a universal council can be convened, even if such decrees might not at the same time be recognized by other Local Churches.

In this manner, in 2000, the Russian Orthodox Church convened its Bishops’ Council to express its official teaching on critical socio-economical and political issues of the time in a document entitled “The Basis of the Social Concept of the Russian Orthodox Church.” Chapter XII thereof is devoted to bioethical issues. Moreover, this chapter became the first official Orthodox Church’s statement on bioethical issues globally.

However, a difficulty inherent in that same document has subsequently provoked debates on the admissibility of IVF. On the one hand, “Basis” states that

[T]he Church cannot regard as morally justified the ways to childbirth disagreeable with the design of the Creator of life. If a husband or a wife is sterile and the therapeutic and surgical methods of infertility treatment do not help the spouses, they should humbly accept childlessness as a special calling in life. (Bishops’ Council of the Russian Orthodox Church, 2000, XII.4.2)

On the other hand, “Basis” seems to limit its opposition to in vitro fertilization to cases where “excess” embryos are formed:

Morally inadmissible from the Orthodox point of view are also all kinds of extracorporeal fertilization involving the production, conservation and purposeful destruction of spare embryo. (Bishops’ Council of the Russian Orthodox Church, 2000, XII.4.2)

Here one might conclude that IVF without excess embryo formation would be licit since no embryo is intentionally destroyed, which is otherwise considered as a sort of homicide equal to abortion. Still, while opponents of IVF use the “Basis of Social Concept” to argue that any assisted reproductive technology (including IVF) fails to follow the “design of the Creator of life,” proponents argue for distinguishing between acceptable and unacceptable measures to overcome infertility (Tarabrin, 2020).

Debates on this issue have continued during the last ten years in the Russian Orthodox community (Tarabrin, 2021). The conflict among believers was aggravated by the fact that since 2016, IVF has been financed by Russia’s compulsory health insurance. This means that every infertile couple may apply for this procedure for free (Letter of the Ministry of Health of the Russian Federation, 2018). As a result, many involuntary childless couples have started to seek treatment through in vitro fertilization.

Given such disagreements, laypeople and fathers-confessors are at a loss to find guidance in view of the various types of IVF. For this reason, the Church has resorted to still further theologically validated methods of coping with disagreements. Thus, the Russian Bishops’ Council, confronted with the challenges of modern issues in general (which also include bioethical issues), has established an institution called “the Inter-Council Presence,” (Savva, n.d.) charged with deliberating all the details, forming a draft document and presenting that document for discussion at the Bishops’ Council.

The Work of the Inter-council Presence on Infertility Treatments of Russian Orthodox Church

As was made clear in the previous section, the Holy Spirit’s guidance of the Church can be discerned in unanimous resolutions of a Bishops’ Council. In the special case of infertility treatment considered here, the Inter-Council Presence of the Russian Orthodox Church is designed for preparing such a local Bishops’ Council on artificial reproduction, a subject for which the Holy Tradition offers no clear guidance so far.¹⁴ When such a Council reaches a consensus on that issue, its decision, once it is generally accepted, will have been ascertained as “canonical,” and thus as a new source for Christian bioethics. Then it provides both general moral guidance for the evaluation of various reproductive techniques and also offers advice for priests on how to implement that general evaluation in their pastoral care. In the case of infertility, pastors would know how to navigate the free space left over and above avoiding what is strictly forbidden, and doing so in response to the different situations and maturity of the infertile couple asking for their help.

With this goal in mind, the Inter-Council Presence began its preparatory work by charging a group of bioethics experts with providing an analysis of the process of reproduction, the main ethical problems involved with technical interventions in the various stages in that process, and with sketching some preliminary guidance. These experts took their bearing from St. Basil the Great’s teaching on the use of medicine for monks, and thus, since Orthodoxy does not distinguish between the divine calling of monks and lay people in the world, for Christians generally. St. Basil specifies that it is permissible to seek medical help even for patients who are to blame for their illness¹⁵: The reason is that there is always hope that their treatment will help them to improve not only their bodily health but also their soul. On this basis, seeking treatment for infertility that results, for example, from a sexually transmitted disease, so the experts submitted, may in certain cases be considered acceptable. In addition to medical care, of course, Tradition encourages turning to prayers, especially Liturgical prayers.¹⁶

At the same time, the bioethical group distinguished childlessness caused by disease from other types of infertility. For example, when a woman’s reproductive system in her post-menopausal period has ceased to function, her inability to conceive is not due to any disease but instead reflects a natural process. This is why, so that group has argued, it would be sinful both for the physician to provide her with medical help for overcoming her “infertility” and for herself to seek such help. The same holds for homosexual couples and single persons. According to the Orthodox understanding of humans’ divine vocation, infertility in such cases results not from a failure in bodily functioning but is a natural consequence of their unnatural (in the Orthodox sense of the term, i.e., sinful) lifestyle.¹⁷

At this point, it is important to recall that even Orthodox healthcare providers are obligated to remain within the boundaries of what the general moral teaching of the Church identifies as licit. Whereas Orthodoxy’s spiritually therapeutic understanding of sin makes it necessary for pastors to identify the “sinfulness” or acceptability of requests for medical interventions, and to do so by paying attention to believers’ diverse spiritual states, the role of healthcare professionals is different. Christian physicians, while generally bound by what the Church defines as moral boundaries for their practice, only need to ascertain quite generally whether their Christian patients have been blessed for what they request.

Coming back to the different cases of technologically assisted reproduction, a more complicated case of “social infertility” results from delayed attempts at reproduction, caused by a woman’s desire for social status and a career. The modern trend for women in developed countries is to set aside pregnancy up to the age of 35 (Baldwin et al., 2014; Austin, 2001), and only then to start thinking of having a child. It often takes several years for them to find a partner able and willing to support a family (or at least to have a reliable relationship). So, at age 37–39, when such women start attempting to get pregnant, their ability to produce eggs may be diminished to the point that their chances to conceive a child through natural intercourse are close to zero. Such women often resort to in vitro fertilization. Now their inability to get pregnant cannot be considered a disease and, therefore, the Church’s general endorsement of the use of medicine would not extend to such cases. Nevertheless, two further considerations are necessary. On the one hand, the condition of such a woman results from a conscious decision to dismiss God’s blessing “Be fruitful and multiply” (Gen. 1:28), and one might conclude that it would be wrong to provide her with medical assistance in getting pregnant at such a late stage. On the other hand, Orthodoxy enjoins us never to give up hopes that a sinner may repent and change her mind, a reorientation that is desirable and even joyful for the Church (Lk. 15:10). Therefore, if a woman has wholeheartedly repented her previous decision to postpone family life, it might still be permissible for her to participate in a program of assisted reproduction.

Having in mind such instructions of Holy Tradition on medicine, the experts of the Bioethical Committee then used the general teaching of the Orthodox Church on sin as a basis for their analysis of the ethical issues arising in the course of in vitro fertilization. Some actions completely distract a person from moving toward God and holiness, whereas others do not entirely fall short of the mark. The former represents acts that are strictly forbidden for everyone. Here, Church canons define hard boundaries a Christian must never cross, including his use of medicine. At the same time, as explained above, Orthodoxy defines sin not exclusively, and even not essentially, through boundaries a Christian must not overstep. Rather, those boundaries also designate a field within which a person can freely orient his life toward God. This enables us to talk about different degrees of being involved in (what might be identified in particular situations as) sin. Here, experts recognize that some involvement in IVF might entail a degree of imperfection that falls somewhat short of but does not altogether miss the mark. Such actions do not fully preserve the unique intimacy of the union between husband and wife as ascetically directed toward God, that is, directed away from self-love and self-satisfaction to a pure love of one’s spouse and of God. These actions may be allowed, provided they are designed in such a way as to avoid too much distraction from that goal.

Nevertheless, in a draft document called “Ethical Issues Associated with In Vitro Fertilization” (Intercouncil Presence of Russian Orthodox Church, 2021), the Committee recognizes that the best way toward God for an infertile couple is to wholeheartedly trust in God’s loving providence and to abstain from interfering with that providence by securing reproduction through assisting technologies. The desire of such couples for a child, after all, can be fulfilled through the adoption of a child already born. However, bearing in mind different degrees of spiritual readiness to bring up someone else’s child, and the spiritual weakness of contemporary parishioners generally, the experts stated that pastoral oikonomia (dispensation) might be applied by allowing such couples to participate in IVF treatment, provided that they would not cross hard or illicit boundaries.

Thus, the Bioethical Committee points out that the more interference from outside of the union of husband and wife is involved in the process of reproduction, the less the couple undergoing such a process can promote their path to holiness. The experts thereby acknowledged that the use of IVF can inhibit the couple’s movement toward holiness. Now given the broken character of the world and the circumstance that “the intention of man’s heart is evil from his youth” (Gen 8:21), the Committee recognized variation in terms of the level of maturity of Christians and thus different kinds of spiritual therapy necessary for them. For more spiritually developed believers, it is suggested not to use IVF, whereas for beginners and less mature persons some variants IVF may be still allowed.

To specify the hard boundaries not to be overstepped even by the most immature Christians, the Committee classified all ethical issues as either “totally unacceptable” or “acceptable under certain conditions.” Among the utterly unacceptable are the killing of embryos and certain kinds of third-party interference with a couple’s reproductive process. In particular, the sanctity of human life from the moment of conception is emphasized, as following the provision of The Basis of the Social Concept that “from the moment of conception any encroachment on the life of a future human being is a criminal act” (Bishops’ Council of the Russian Orthodox Church, 2000). Based on this provision, the draft document states the ethical unacceptability of the elimination of embryos, their cryopreservation, or the reduction of fetuses. At the same time, the death of embryos during transfer into the uterine cavity is recognized as a consequence of natural causes, so this risk is not sufficient to render IVF totally unacceptable (Tarabrin, 2022). The document also considers pre-implantation diagnosis as unethical since the latter “induces parents to choose more ‘promising’ embryos” (Intercouncil Presence of Russian Orthodox Church, 2021). The second hard boundary which Orthodox Christians should not cross when applying for IVF is determined to be third-party intervention in the reproductive process through the use of donor gametes or surrogacy. Gamete donation and surrogate motherhood are considered sinful because they represent a form of adultery desecrating the unique intimacy of the marriage bed (Hebr. 13:4). The intervention of the physician, on the other hand, is recognized as acceptable for immature Christians even though not quite appropriate for mature believers. Moreover, an issue the experts recognized as problematic even though not sufficient to constitute total impermissibility is the practice of masturbation indispensable for the procedure, as well as the fact that the historical development of IVF as a new technology had involved the destruction of countless embryos that had been sacrificed for the cause of “medical progress.”

Based on this analysis, in-principle licit IVF must exclude (1) producing excess embryos; (2) elimination, reduction, or cryopreservation of embryos; (3) pre-implantation diagnosis; (4) donor’s gamete; (5) surrogate motherhood. Accordingly, the draft document names possible methods that remain within what the moral boundaries circumscribe as in principle licit. They are (1) IVF in a natural cycle without any hormone stimulation. In such a case, a woman produces only one or a maximum of two eggs in her natural cycle. (2) IVF in a modified natural cycle. Here, in order to improve the chances of retrieving a naturally matured egg, a physician employs a hormone shot. Still, in this type of IVF, only one or two oocytes are obtained for the fertilization in a Petri dish; (3) IVF in a hormone-stimulated cycle but with the fertilization of such a number of eggs that could be simultaneously transferred into the wife’s uterus. The latter variant may be necessary if a woman has diminished ovarian reserve, ovarian stimulation being the only option to get her eggs.

Also, the draft document points out that assisted conception should be performed only between a husband and wife of child-bearing age who sustain their marital relationship. To better evaluate the spiritual level of different couples and ensure mourning of their trespasses and the use of all possible spiritual means, the document advises couples to engage in IVF only with the blessing of their spiritual father or (if no such father is available) their constant Father confessor.

The idea behind such referral to a priest is to help already well-churched believers to correct their path toward God, as well as to encourage un-churched believers to come into the Church and move toward the Lord. Thus, this referral has two purposes. First, for church-going people, their father-confessor, who knows their spiritual needs and conditions of life, may advise them to postpone extracorporeal fertilization and suggest instead increased prayer and participation in the mysteries of the Church. Sometimes the sacrament of marriage (among those with only a civil marriage) or a pilgrimage to holy places will be effective for them to conceive a child naturally. The second group of couples do not attend Church, do not confess or receive Holy Communion, but have tried every possible medical treatment without positive results. They turn to the Church for a blessing to their next IVF attempt. For them, the recommendation of contacting a priest can serve as their first meeting with the Church (i.e., with a priest as their guide and intercessor). Counseling such couples, the priest can direct them to God, telling them about the close interconnection between persons’ bodily illness and their spiritual condition. He can point out spiritual causes of infertility, such as previous sins, thus encouraging them to repent through the mystery of Confession. Still, in that second case, it would be wrong to limit such unchurched people all too strictly to spiritual measures, denying them medical methods of relief. Such couples, after all, are most likely be unable to bear any rigorous verdict and would turn their back on the Church without ever having encountered her. Instead, it is appropriate here to explain to them the content of the document being developed, and the reasons why the Church cannot allow all possible methods of infertility treatment. In either case, of course, a counseling priest profits greatly from an already developed unambiguous position of the Church.

The draft document that had resulted from the bioethicists’ preliminary ethical evaluation of IVF was then published and distributed in order to invite a critical response from the entire Church, recognized in her Catholicity as the continued bearer of Holy Tradition. This publication triggered discussions both on official portals of the Church and in the media (in the format of conferences and video broadcasts) (Tarabrin, 2021). Once all relevant concerns have been laid on the table and feedback received from each diocese, the original draft document will be modified so as to have it reflect the mind of the Russian Church.¹⁸ Any remaining disagreements will also be noted and directed to the bishops for further consideration.

After having been accepted by the Secretariat of Inter-Council Presence (where the draft document can be blocked if too many controversies remain), it is then presented to the Plenum of the Inter-Council Presence. This Plenum, consisting of approximately thirty bishops, is headed by the Russian Patriarch. Even though a certain group of “activist” bishops can push such a document further up that step-by-step procedure, such efforts are not sufficient to determine the outcome of discussions in the Great Council: Here, after all, more than 400 bishops give their vote. Obviously, the greater the number of bishops, the harder it is to make a decision that would go against their conscience.

Their approval, after all, either of the draft document itself or of any modification resulting from their discussions, hinges on their responsibility to preserve unanimity not only among themselves but also with their respective eparchial flock.

This circumspect and extended method of discussing and deciding on any draft document within the Russian hierarchy, even though in appearance bureaucratic, is meant to manifest the spirit of love described above (i.e., the kenosis of the higher ranks condescending to listen to those whom they are to guide, and who in turn are called to obey their word, and of the loving obedience of the laity that nevertheless maintains higher obedience to Christ). This same method bears witness to the fact that Orthodoxy is, in essence, not a juridical system, but an attempt to allow the Holy Spirit to guide the Church on her path through the ever-new challenges presented by history. This method also leaves space for the fact that we always wait for a Saint who is able to provide truly theological guidance. It is only during the intervals in which such a saint has not been revealed that the method described above serves as a sort of emergency placeholder. During such intervals, issues that, despite all attempts to achieve a common consent, fail to gain universal acceptance among those charged with maintaining the traditional mind of the Church, must be left undecided. Such un-decidedness then surfaces in strategic ambiguities in her official documents, meant to provide opportunities for testing the way in which the various, mutually exclusive moral positions turn out more or less in harmony with Holy Tradition, and thus eventually to win universal consent.

If it turns out, in other words, that the issue of technology-assisted reproduction at present still divides the Russian Orthodox Church, the bishops, charged with preserving unanimity, will have to altogether refrain from reaching a decision. They must, at least for the time being, step back and refer laypeople and their confessors to the ambiguous guidance already available from the “Basis of the Social Concept.”

III. CONCLUSION

The Orthodox understanding of how to form bioethical judgments in personal pastoral care and in the general moral guidance provided for law and public policy in traditionally (and still confessed as such by a significant majority) “Orthodox” countries differs profoundly from the understanding endorsed by both secular and non-Orthodox Christian bioethicists. Christian bioethics defines what should count as “unethical” through the notion of “sin.” Through its Holy Tradition, Orthodoxy underscores the Christian calling to Holiness. Sin is understood here as what obstructs that calling, rendering believers either altogether unable to commune with God or causing them to miss the mark that supports their proper cooperation with the Divine gift of such communion. Thus, sin in Orthodox teaching is placed in the context of Church that is conceived as a hospital of souls; that teaching has a therapeutic focus. It reveals boundaries for human choice that reflect unconditional limitations as well as concerns for ever more perfect harmonization with the Divine will. That same teaching thus takes serious account of the different treatments needed by people with different degrees of spiritual maturity. To discern the measure of sin and to define the spiritual resources of a person, the guidance provided by holy elders is required. Wherever such Spirit-bearers are unavailable, the decision, over and above some “grave” sins (like blasphemy, sexual impurity, and murder) about which acts a particular person should avoid as sinful or as distracting and distorting his pursuit of holiness should be entrusted to a Father confessor who knows his flock and can provide personalized spiritual guidance. While Holy Tradition is acknowledged as the source of all such advice, сouncils of Bishops can pass judgment on new bioethical issues, thus becoming a new source for Christian bioethics.

ACKNOWLEDGEMENT

This work was carried out as part of the Russian Science Foundation project No. 18-78-10018 (prolongation) “Problems of bioethics in historical context and socio-cultural dynamics of society.”

REFERENCES

Footnotes