Even those without much Christian background know that Christmas is about the birth of the baby Jesus. Christmas carols, nativity scenes and creches, and even the pictures on Christmas cards depict the miraculous birth. What is interesting for bioethics is that the story starts before the birth.
Luke tells us in the first chapter of his gospel that the story began with an angel telling Mary that she was going to conceive a child through the intervention of the Holy Spirit without the usual sexual process. God didn’t take much time to do that because by the time she could get ready and hurry off to her relative Elizabeth’s house she was already pregnant. When she got there Elizabeth was in the sixth month of her pregnancy with her own angel-announced child. When Mary entered Elizabeth’s house, John (Elizabeth’s baby who later identified Jesus as the lamb of God) leapt in recognition of the presence of Jesus in Mary’s womb.
This detail of the story suggests that the incarnation impacts how we think about unborn human beings. Since Jesus became a human being it means that human beings have a special status as members of the class of beings that God chose to become. His beginning human life as an embryo and fetus that went through the usual nine months of prenatal life implies that the special status of human beings applies to human beings before they are born. The recognition between John and Jesus suggests the continuity of identity of individual human beings from early prenatal life to after birth.
Remembering that Jesus’ incarnation began nine months before his birth reminds us of the moral value of unborn lives. We should be just as amazed by that as those the shepherds told were amazed about his birth.
I just got back from the Taylor Christmas chapel and as my thoughts have been focused on the amazing incarnation of Jesus, I thought I would share some thoughts over the next few weeks on how Jesus’ incarnation impacts bioethics.
One of the most fundamental principles of bioethics is the inherent value and dignity of all human life. Our ideas of equality for human beings and equal human rights, moral status, and justice all depend on our understanding of the value that each of us has as a human being. When Christians think about the value of human beings we usually think about creation and our biblical understanding of human beings from the account of creation in Genesis 1 and the moral laws given to Noah in Genesis 9. Both of these passages refer to human beings being made in the image of God. We find an understanding of our inherent moral worth in how we were made.
Jesus’ incarnation adds richness to our understanding of who we are as human beings. God made us in his image not just so that we could be enough like him that he could communicate with us and have a relationship with us, but so that Jesus could become one of us. He made us able to choose between right and wrong, knowing we would choose the wrong. He planned all along to have Jesus, the Son, leave his glory as eternal God to become one of us, so that he could be the ransom for our sin. Being made in God’s image helps us see why every human being has moral value. Being one of the class of beings that God chose to become, and for whom he chose to die helps us see that value even more.
Glory to God in the highest.
I was recently talking with some students about how to be effective in teaching students how to apply Christian ethics to how they live their lives. They suggested that for a significant number of students it would be most effective if we did not tell them that we were teaching ethics. They thought that there were many students who would think that anything labeled as teaching ethics was something negative or of little interest to them, and they would not choose to be involved. They suggested it would be better to focus on topics of interest to students in their daily lives and incorporate teaching ethics into the discussion of those topics without identifying ethics as the topic. My own label for their idea was “stealth ethics.”
As I thought more about what they had said I began to wonder if it was ethical to teach ethics without openly stating that you were teaching ethics. My wife says I am the only person she knows who thinks about things like that, but I think she just doesn’t know enough ethicists.
My conclusion was that it was possible to do what the students were suggesting in a way that would be ethical and positive. Using the word “ethics” or the word “morality” is not necessary when we teach ethics and morals. Our desire is to get our students to think about why they do the things that they do and to learn to find standards to live by that are based in God’s revealed truth. If they can learn what God has to say about the value of every human life and how to treat every person with love and respect, and place obedience to God and caring for others first before their own desires we will have succeeded in teaching ethics. There will be those students who want to go deeper and understand how to discern Christian ethical values more rigorously and how to express that understanding to those who do not have a Christian foundation. They are a joy to teach. But my desire is that every student would have an understanding of how to live by God’s standards whether they call it ethics or not.
With Thanksgiving being celebrated tomorrow I have been thinking today about things I am thankful for in the context of bioethics. So here is my list of seven things I am thankful for this year.
1. Students who really want to learn how to make ethical decisions.
2. Medical technology that is effective enough that we have to make decisions on when to stop using it (much better than not being able to do anything for those with serious illnesses).
3. Palliative care for those who are suffering, particularly at the end of life.
4. The amazing miracle of the birth of a new life.
5. People who care for unborn human beings and their mothers.
6. The impact of prayer in people’s lives.
7. God, who made us to be enough like him to be able to have a relationship with him and to bring glory to him.
Like Joe, who wrote Friday about visiting his sister in a nursing home, I was in a nursing home with a family member Saturday. I was there with my mother and father visiting my 97-year-old grandmother who was dying of end stage dementia. Grandma had a gradually progressive dementia and had been unable to communicate verbally for the past year or so.
Thursday my mother had called to let me know that Grandma had become unresponsive and unable to eat or drink. The nurses had asked if they should give her fluids and nutrition by feeding tube or IV. My mother wanted my advice as her son and the doctor and ethicist in the family.
This was an easy ethics consult. Grandma had made it clear before her dementia progressed to the point that she could not make her own decisions that she did not want anything like that done. She had let us know that when it came time for her to die she was ready to go. She had put it in writing as well, but most importantly we knew what she wanted. Even so my mother needed me to reassure her that it was OK to say no. I was able to tell her that doing those things would not change the fact that Grandma was going to die and would just cause unneeded discomfort. Her doctor agreed and she was allowed to ease peacefully out of this life.
When I visited Saturday even the limited ability to respond that she had before was gone. I sat with her for a while with my hand on hers remembering all she meant to me and telling her I loved her. Then we moved furniture. My grandmother and my mother shared being very practical women. It seemed appropriate to take care of things like finding a use for the furniture she no longer needed, so I had brought my truck to haul some things home. I understood it was my mother’s way of coping with losing her mother.
Last night my parents called to say Grandma had died quietly. Later this week we will gather to remember her life and all she meant to us. I will express my thankfulness for her and that she was able to ease gently into the arms of her Lord.
Back in June I wrote a post to let people know about the newly published book Why the Church Needs Bioethics edited by John Kilner with contributions from many people connected to Trinity and the Center for Bioethics and Human Dignity. At the time my appreciation for what the book represented was based on the people involved and what they had set out to do. I just finished reading the book and they have accomplished their goal well.
They titled the book Why the Church Needs Bioethics, but it could easily have been titled Why Bioethics Needs the Church, because what comes through is how bioethics and the church need each other. I found the insights of biblical scholars and theologians such as Richard Averbeck, Kevin Vanhoozer and D.A. Carson particularly helpful in dealing with the issues of infertility treatment, enhancement, and the end of life that are the focus of the book. But many others from areas as diverse as business ethics, counseling, law, intercultural ministry, medicine and nursing, pastoral care, preaching and Christian education brought insights from all parts of the church to enlighten how we see the bioethical issues that people deal with in real life and how the church can play a role in helping them through difficult times. John Kilner, William Cheshire and John Dunlop brought each section of the book together to help the reader see how it all fit.
The church needs an understanding of bioethics to be able to help people as they face bioethical issues in their lives. Bioethics needs the church to enrich its understanding of how biblical truth impacts bioethical issues and how the body of Christ can prepare people for and help people through the bioethical challenges they face in their lives. Those of us involved in both bioethics and the church are challenged to bring those two together for the good of all.
The issue of how we define personhood or how we define who has full moral status is one of the most fundamental issues in bioethics. It determines who is included in our considerations of ethical issues. The worldview of Christians who understand the Bible to be the foundation of our understanding of God’s moral truth and who hold to the traditional creeds of the church points to a biological definition of personhood. This biological definition would include every living human being from the time he or she became a separate biologic entity as a zygote following fertilization or its equivalent. This is in contrast to those who would define personhood functionally by the presence of what are considered human attributes.
Next week the people of Louisiana will vote on an amendment to the state constitution that would add the following statement, “Person defined. As used in this Article III of the state constitution, “The term ‘person’ or ‘persons’ shall include every human being from the moment of fertilization, cloning or the functional equivalent thereof.”
For those of us with a Christian worldview the proposed amendment raises two questions. 1) Is this definition correct? We would answer that with an unequivocal yes. 2) Is it prudent to add this definition to a state constitution? The answer to that is less clear. If by adding this definition the lives of defenseless unborn human beings are spared then it is clearly a good thing. If this amendment leads to a reaction at a national level which more deeply establishes personal autonomy as the legal priority over the value of the lives of those who are unable to speak for themselves then more unborn lives may be lost than if it were not passed.
We must always be clear in expressing what we understand to be God’s moral truth. When we venture into public policy we need to understand that we are working in a fallen world where that truth may not be understood and a focus on the self may distort it. We need wisdom to decide how to proceed because what is most prudent may not be clear.
Christian bioethics continuously lives at the interface of biotechnology and Christian moral values. Recently some students asked me to talk with them about whether I saw any conflicts between science and a Christian worldview. Their question took me back to the first CBHD bioethics conference that I attended in 2007 and Alvin Plantinga’s talk about that issue. He expressed things that I had understood, but had never heard expressed as well as he expressed them.
Plantinga made it clear that the conflict was not a conflict between Christian thought and science, but a conflict between the philosophy of naturalism and Christianity. He pointed out that many people assume that science, which is a method of acquiring knowledge about the physical world, was identical with philosophical naturalism which says that all that exists and all that we can know is what we can know through the empirical methods of science. However, understanding that science is a proper way to learn about the physical universe does not imply that naturalism is true, and science does not depend on supposing naturalism. In fact Plantinga showed that naturalism forms a very poor foundation for science, because the unguided evolution that must be assumed by the naturalist as the process by which human cognitive processes were formed does not give us reason to believe that those cognitive processes would be reliable sources for truth. (I always knew there was some reason why I liked epistemology.)
It is actually a Christian worldview that provides the foundation that science needs to function. We believe that God has created the universe so that it is rationally understandable and has given human beings the ability to accurately perceive the universe and cognitive faculties that are designed to comprehend truth. Those are the presuppositions needed to expect science to be a valid method for discovering the nature of our universe.
The problem is not that there is a conflict between science and a Christian world view. The problem is why someone without a Christian worldview would think that science is a reliable source of truth.
I am currently reading The Help by Kathryn Stockett. I saw the movie first and as I read the book it really is true the book is better, even though the movie is very well done. For those who haven’t done either one, the story is about a young white woman in Jackson, Mississippi who decides to write a book that tells the stories of African American maids working for white families in Jackson in the early 1960s. But the book, like her book, is mostly about those women and the truth of what their lives were like.
As I experience their lives in the midst of the novel I have been thinking about the ethical issues that were going on during the turbulent times of the civil rights movement in the sixties. The major issues revolve around what it means to be human and how one human being should treat another. That resonates with what is at the heart of many of the issues we face in bioethics today.
Aibilene is the first of the maids to agree to tell her story. Interestingly she is a woman with a strong Christian faith who writes out her prayers to God and sees him answer as she expresses her concern mostly for others and occasionally for herself. She models virtues of love and compassion while hurting from the injustice of life in a world where she is not seen as a person of full moral value. She is not perfect, but her virtues and endurance under hardship demonstrate a humanity that touches me. It is amazing that as a society we could have told her she was not fully human.
How many are being told today that they are not fully human by the things our society chooses to do?
A recent article in Toronto’s National Post tells of the experience of Dr. Rosanna Weksberg, a University of Toronto geneticist, when she presented a talk on the need to study risks associated with IVF (in vitro fertilization) to the Canadian Fertility and Andrology Society. Her talk related her experience in seeing an increased number of children with rare genetic disorders among children conceived by IVF. Some of those disorders are seen as much as 10 times more often in children born by IVF.
She expressed her concern that follow-up studies of children born by IVF are needed. The reception from the meeting of fertility specialists was polite, but no interest in her proposal for study was expressed. She said she has been trying to find fertility clinics willing to partner in studies of children born with the help of reproductive technology, but has not found any willing to work with her. A spokesman for the fertility society said they were interested, but that clinics could not afford to fund research.
In the United States assisted reproduction is a 3 billion dollar a year industry, but like in Canada there is no accurate information on the risk of genetic disorders, birth defects, or other increased health risks of the children produced by these procedures. Our culture has set apart everything having to do with sexuality and reproduction in a domain protected by privacy. That protection is so complete that it causes assisted reproductive technology to be entirely unregulated and makes any attempt to study the outcomes of the children produced exceedingly difficult. We need to recognize that, even though privacy in reproductive decisions is important, people cannot make responsible decisions without good information. Those contemplating the use of assisted reproductive technology need to know what the risks are for the children they bring into the world. They owe it to their children.