A fertility clinic that offers parents the chance to choose a baby’s sex is reporting a capability. It is not making a moral argument, even when the offer feels like one. Whether medicine should select a child’s traits or extend a life is a separate question, and ability alone cannot answer it. Dr. Patrick Smith, a bioethicist at Gordon-Conwell Theological Seminary, and Dr. Angela Guzman, an OB-GYN, offer a sharper test: does a new power treat a human being as a person to be received, or as a product to be quality-controlled?
Their conversation applies that test most fully to trait selection in IVF. It says much less about prolonging life with machines and treatments, and this article will not invent rules on their behalf. What they do address near the end of life is the power a healthy professional holds over a vulnerable patient. That turns out to be the same question in another setting.
The missing step between “can” and “should”
Smith calls the pull the technological imperative and states it as a plain conditional: “if we can do it, we ought to do it.” Few people defend that sentence out loud. Many decisions still run on it. A procedure becomes available, the cost drops, and whether to use it quietly becomes a question of when.
Laid out as an argument, the imperative skips a step. It moves from this technique works to this technique is permitted with nothing in between. Filling the gap would take a premise like whatever produces a benefit someone wants is good to do, and stated that baldly the premise falls apart, because many things produce wanted benefits and are still wrong.
The ethicist’s job, as Smith describes it, is to stop long enough to ask “just because we can do something, ought we do it.” He admits the question feels stifling. Medicine is moving, patients see real benefits, and the ethicist looks like the person slowing everyone down. He does not answer by shrinking the benefits. He grants them and still refuses to let them settle the moral question.
Why the facts matter but cannot decide
If capability cannot answer “should,” something else has to, and the first candidate is science itself. Guzman points out the limit: science can describe what it takes for life to begin, but it does not supply a definition of when a life counts. Smith’s answer is that God wrote two books, nature and Scripture, and that rightly interpreted they cohere. Science describes what is happening at the earliest stages of development. Theology asks why that matters.
He borrows a principle from moral philosophy: “many moral judgements turn on non-moral facts.” You cannot judge an action toward an embryo until you know what an embryo is. The facts constrain the judgment without making it. This is why an advance in technique never settles the ethics on its own. Learning to do something new to an embryo leaves open what the embryo is and what is owed to it.
On that further question, Smith reports that a large section of Christian bioethics holds that an entity clearly human has moral status, and some say full moral status. One line of argument, developed by many Catholic moral theologians, says that belonging to the human species confers the status and that stage of development is not the deciding criterion. The reasoning works backward from later life. People differ in development throughout their lives, and no one thinks a less developed adult has less standing. Why make development the line before birth? Smith is candid that the point is contested, saying that “theologians from different stripes land different in different places.” The argument that follows does not depend on resolving every part of that debate.
Person or product
Guzman brings the hard case. Through in vitro fertilization, parents can already select a child’s sex, and she notes discussion of a future in which hair and eye color could be chosen as well. Is that too far?
Smith answers by asking what is in the womb. Either it is a person, treated in its uniqueness and particularity, whatever that turns out to be, or it is a commodity, something that “by definition is supposed to make us happy,” and so something that can be expendable and subjected to quality control.
The distinction is cleaner than it first sounds. A product has specifications, and it is acceptable or defective depending on whether it meets them. A person has no specifications and is received rather than checked against an order. The test concerns the logic built into the act of selection more than parents’ feelings. Choosing one embryo over another for a trait applies a standard of acceptability to a human being before that human being has done anything.
Smith presses the point with a question: “is that a negative value judgment against those who don’t have those characteristics?” And then: “if not, then why those characteristics over some others”. This is a real dilemma. Either the selection ranks human traits, or it is arbitrary. A ranking implies something about the people who carry the unchosen traits. An arbitrary choice is hard to justify doing at all. An appeal to personal autonomy does not escape the dilemma, in Smith’s view. It raises the deeper question of what these choices reveal about what we think a human being is for.
Is the choice too stark?
The strongest objection is that person versus product is a false dilemma. A couple can select an embryo and then love that child completely. Parents make countless choices that shape their children, from nutrition to schooling, without treating them as products. Why is this choice different?
Smith feels the weight of that. “I hate to put in such stark ways, given the difficulties that some people have in wrestling with these issues, people who may be very well intentioned,” he says, drawing on his years in pastoral care settings. He is not accusing hopeful parents of contempt for their children.
The objection still misses where the test applies. Feeding and educating a child are acts of care for a person who already exists in their particularity. Selecting for a trait happens before that particular person is received, and it decides which person gets received according to a preferred feature. Love will usually follow the choice. The question is what standard the choice itself applies, and on that narrower point the two descriptions really do diverge.
A broader version of the objection says all medicine intervenes in nature. Vaccines, surgery and fertility treatment itself alter what would have happened, so does the test condemn all of them? It does not. Treating a disease serves the person who has it. The test bites only when an intervention sets a standard a human being must meet in order to be wanted. Locating that line in particular cases is hard, and honest people will argue about it, but a hard line to find is still a line.
Why a private choice is never only private
Guzman takes the conversation where many readers would prefer it not go. If people begin choosing traits, which will they treat as more correct or more pure? “I think people are gonna breed characteristics for one population over the other and intentionally try to breed out certain traits,” she says, and adds that “those who can afford to even do this kind of technology are already the ones that don’t look like us.”
Her point is a forecast rather than a documented outcome, and it should be read that way. Its logic holds. Preferences do not form in a vacuum. If a society already values some features above others, selection will tend to amplify that valuation, and those with the means to select will set the pattern.
Smith connects this to arguments from the disability community. Societies decide which traits they value and build institutions around those values, which can disable people through the structure more than through anything wrong with them. He then names a specific misuse of theology, in which the image of God was treated as though its prototype were white European, so that people claimed Black people were made in some lesser image. A doctrine meant to ground the equal dignity of every human being was turned into a ranking, and he describes that as theology hijacked.
Smith knows this sounds far from one couple’s choice about eye color, and he grants the distance up to a point. Then he holds his ground: “these individual choices and what informs those individual choices are not wholly detached from the larger social vision that we see about the world”. A choice can be private in who makes it and public in what it assumes. Asking why a trait looks like an advantage is a way of asking which social vision the choice carries forward.
Does “leave it to God” settle anything?
A tempting shortcut for Christians is to sort decisions into God’s side and ours and to file genetic selection under God’s. Smith resists it. Divine providence and human responsibility stand in real tension, people make genuine choices, and God is not pushed out of the world when they do. The shortcut is also usually applied unevenly: “Sometimes we would cherry pick for things we are uncomfortable with.” Whatever unsettles us becomes God’s prerogative, and whatever we like becomes our decision, so the shortcut ends up tracking our comfort instead of any principle. Used consistently, “playing God” rarely tells us where the line falls.
Smith grounds the theological point more carefully. He points to Psalm 139 and Psalm 22. The first includes the line “For thou hast possessed my reins: thou hast covered me in my mother’s womb” (Psalm 139:13). The psalm is a poem of praise, not a description of embryology, and it should be read as poetry. What it plainly affirms is that the psalmist was formed under God’s knowledge and care. Smith draws a modest conclusion: the uniqueness and particularity of developing human beings seems to be “under the purview of God,” whatever their genetic makeup.
He adds an observation that strengthens the point: “what’s normal about the human genome is this variance”. If variation is the normal human condition, picking a preferred version invents a standard where none existed. The test becomes concrete. Are we receiving the particular person God is forming, or writing a specification and asking that person to meet it?
The same question at the bedside
Near the end of life, the conversation turns from what a technology can do to an embryo to what a professional can do to a patient. The structure of the problem is the same: one party holds power, the other is vulnerable, and the question is whether the weaker one is treated as a person or as a project.
Guzman recalls training under a Christian hospice physician who spoke with every patient about Christ, and she asks whether that is ethical given the patients’ vulnerability. Smith, who defers to clinicians on practice, agrees the power gap is real. He warns Christians not to “manipulate people or have them thinking that our genuine care for them, our genuine love of neighbor” depends on a patient’s openness to Christian spirituality, and he suggests taking cues from patients and families. He also questions the fear that silence leaves a patient’s blood on the doctor’s hands, calling it something that “could potentially be a bit of hubris,” since no clinician knows what God has been doing across a person’s whole life.
The same reasoning carries over to the question of prolonging life, even though the doctors do not develop it. That a treatment can extend a life does not settle whether it serves the person receiving it. The question remains whether this person is someone to care for or a problem to manage.
A power that can be laid down
The person-or-product test is a diagnostic, not a rulebook. It shows why “can” never settles “should,” and it places the moral weight in what a practice assumes about human beings. Christians still disagree about how moral status attaches at the earliest stages, and particular technologies will need particular judgment from people who know both the medicine and the moral questions.
Smith closes with a different kind of limit, drawn from Philippians 2. Christ “made himself of no reputation, and took upon him the form of a servant, and was made in the likeness of men” (Philippians 2:7). Smith reads the incarnation as the Son setting aside privileges in order to serve broken humanity, and he applies it directly: “There are certain privileges that maybe we have that perhaps we should give up for the sake of serving others, so that we can, in the end, ironically, be more like Christ.”
That reverses the technological imperative. The imperative says an ability, once held, must be used. The pattern of Christ says an ability, once held, may be set aside for someone weaker. Sometimes declining a power we have is exactly what love of neighbor costs.
