Edited by John F Kilner, Paige C Cunningham and W David Hager, Grand Rapids Michigan, William B Eardmans Publishing Company, 2000, 290 pages, $20, £12.99.

In their preface to this book, the editors rightly state that “few social or technological developments in history have captivated people's imagination or raised more ethical questions than today's reproduction revolution”. The authors then set that revolution in a wider context from which it is all too easily divorced today, namely the nature and meaning of sexuality and the fundamental importance of the family. As a “Christian appraisal” it is a useful apologia pro vita sua for those of us who share this credo. It also sets down a clear and consistent ethical position for all interested in the field.

It never pretends that the issues are simple and straightforward. I, for example, empathised strongly with William Cutrer's “physician's perspective”: “we all need to listen, to think, to analyze and to pray for wisdom and discernment as we struggle with these issues”. In his chapter, A child of one's own: at what price, Gilbert Meilander argues that our headlong pursuit of technology and commercial gain has “fashioned a world in which we regularly create moral conundrums that are beyond our ability not only to solve but even to name”.

Among the fundamental issues that are dealt with are the nature and meaning of sex and the consequences of separating sex and reproduction; there is a key chapter on the moral status of embryos. At the end of the book, Charles Sell powerfully affirms the family and a strong commitment to marriage as the bedrock of intimate and compassionate communities. Here and elsewhere there is recognition of the importance of strong genetic ties and kinship within society. Among the practical issues dealt with in depth are hormonal contraception, using donor eggs and sperm, surrogacy and human cloning. We are reminded on several occasions of the subtle but significant shift from use of the word “procreation” to “reproduction”. The editors state that this “embodies a fundamental shift from the implicitly God-honoring term (procreation) to the human-centered manufacturing language of production”.

As an obstetrician and gynaecologist I am greatly concerned by the seeming conspiracy of silence on the profoundly deleterious effects of the contemporary understanding and commercialisation of sex among our young people as nothing more than a means of self gratification. The true underlying causes of the havoc consequent on the current epidemic of sexually transmitted diseases (particularly chlamydia trachomatis) and high rates of teenage pregnancy are not only being ignored but are deemed to be inadmissible. These issues are dealt with from the American perspective in chapters on the casualties of the sexual revolution and sexually transmitted diseases. We badly need to heed these messages.

In his chapter, The hidden plaintiff, Martin Palmer brings home the importance of having a touchstone we can employ to assist us in knowing what we should do when faced with moral decisions. He quotes the late Dr Jerome Lejeune who, in 1993, reminded us that there was such a touchstone which, “if the politicians remember it, they can make honest laws; if the technicians do not forget it, technology will remain the honest servant of humanity.–This phrase–judges everything and forever. It just says: ‘What you have done unto the smallest of Mine, you have done it unto Me’.” Not everyone reading this will be able to affirm the specifically Christian reference in that statement but it remains a fundamental principle that speaks to our shared humanity whatever our beliefs or world-view.