Faithful presence

The CBHD conference last week was one of the best since I began attending in 2007.  One of the things that has stuck with me and that I am continuing to think about is Dennis Hollinger’s thoughts about living in the world in faithful presence, an idea he attributed to James Davison Hunter and his recent book, To Change the World. Hollinger said that the foundation of Christian bioethics is our Christian worldview which many in our society do not share and will not accept.  When we look at how we can try to translate the bioethical good that we are able to understand from our Christian worldview into a world that does not accept that starting point he suggested living in the world in faithful presence.

He indicated that there would be several characteristics of that approach.  We would focus on honoring God and loving our neighbor.  We would have modest expectations of our impact on our culture consistent with the Biblical metaphors of salt, light and leaven.  We would need to be bilingual, speaking in a thick fuller language to those who will accept God’s truth and a thin less complete language to those who will not.

I have been thinking about what it means to live in faithful presence in relation to bioethics in our society.  For me it includes caring for my patients compassionately and trying to be better at preparing them for the difficult places in life.  It includes helping my online bioethics students understand what a Christian worldview is and how it applies to the issues they will face in life.  It includes helping students on the Taylor campus see how their faith and how they live fit together.

What does it mean for you?

Solomon and bioethics (and prayer)

I’m still thinking about Solomon.  I keep coming back to the idea that when God told him to ask for whatever he wanted Solomon responded “give your servant a discerning heart to govern your people and to distinguish between right and wrong” (1 Kings 3:9 NIV).  I wrote about the governing part last week, but I keep thinking about his request that God give him the ability to discern between right and wrong.  That is the essence of what ethics is all about.  Solomon was given that ability because he asked God for it and was considered the wisest person on earth.

The word we use for asking God for things is prayer.  I think we sometimes forget the connection between prayer and ethics.  It is true that ethics involves our ability to reason, and what we can learn at a place like Trinity is very valuable, but prayer is a key that opens a connection with the one who knows all things and is the source of all we can know about right and wrong.  If we want to be able to discern what is right and wrong we should ask God for his help.

In light of the theme of the CBHD conference opening tomorrow let us remember that Christian influence in bioethics and our society will not come about solely by the power of our intellect, the persuasiveness of our arguments, or our political strength.  We will influence bioethics and our society when God uses us and the abilities he has given us as instruments of his power in causing his will to be done.

Join me in praying for all those involved in the conference and all of us, whether we are able to be at the conference or not, who are Christians concerned about bioethics.  Pray that God will give us the ability to discern what is right and wrong and help our society to do the same.

Ethics and government – Solomon’s request

Sometimes today ethics is seen as a very personal thing. Autonomy is emphasized and morality is about a person making the best decision for his or her circumstances.  Solomon’s request when God told him to ask for whatever he wanted reminds us that ethics undergirds the ability to govern well.  Solomon’s response to God in 1 Kings 3:9 was “give your servant a discerning heart to govern your people and to distinguish between right and wrong. For who is able to govern this great people of yours?”  He reminds us that governing well is based on being able to discern what is right and wrong (ethics).  If those who govern choose to believe that there are no objective values and that everyone must do as they see best then it will be difficult to govern well.

May God help those who govern to remember that governing well is based on ethics and being able to discern what is right and wrong.

Why the Church Needs Bioethics

One of the reasons that I became involved in bioethics and pursued the Masters in Bioethics at Trinity was my concern that many people in the church did not seem to understand the moral issues that they faced when dealing with their own medical issues and those of their family.  Abortion was seen as a significant moral issue, but many other important issues were ignored by the church.  My approach to making an impact in the church has been to help students at a Christian university understand bioethics so that they can impact the churches that they will be leading in the future.  John Kilner has added another way of impacting the church by editing the recently published book, Why the Church Needs Bioethics: A Guide to Wise Engagement with Life’s Challenges.

Attached is a flyer describing the new book. 1 Intro Flier

I want to express my thanks to John and all the others involved for providing this resource to help draw the church’s attention to the ethical issues we all face.

Cover-ups

Recently I have been reading the account of David’s life in first and second Samuel. Although he had a close relationship with God, David had his ethical failings. Much of his problems started with his adultery with Bathsheba which he tried to cover up when she became pregnant. His first cover-up attempt failed when he called her husband Uriah back from battle, but he refused to spend the night with his wife while his companions were at war. Next he tried to cover it up by having Uriah killed and taking Bathsheba as his wife. The consequences in David’s life and in his family were devastating.

Cover-ups have been a part of the fallen human response to errors and wrongdoing from the garden of Eden to Watergate.

One of the common ethical issues in medicine is how to deal with medical errors. For most of us our first response is to cover it up. Explaining to a patient that an error was made that has had or could have a bad effect is not an easy thing to do, but reading about David reminds us how bad a cover-up can be.

Ethics and Atheists

Jim Spiegel, a colleague of mine at Taylor University, published a book last year titled The Making of an Atheist. In the book he contends that the rejection of God is a matter of will, not of intellect.  He suggests that immoral behavior leads to an inability to see the clear evidence for the existence of God.  Atheists choose to reject God for psychological reasons such as the lack of a loving human father and because they do not want a God to exist to whom they would be accountable for their immorality.

Not surprisingly, his book did not go over very well with the atheist community, but there is the seed of an idea there that suggests a way ethics can be used to draw those who reject God toward truth about God.  Many who reject God still believe that there are things that are intrinsically right and wrong.  While a desire not to be subject to ethical standards leads a person to atheism, the understanding that there are ethical standards is the first step toward God.

So the next time someone who does not believe in God disagrees with you on an ethical issue commend them for their belief that morality is something to be concerned about.  Taking morality seriously can be the first step toward the one who is the source of all that is good.

Thanks, GAVI!

In a world full of inequities in health care including a child mortality rate in some developing countries that continues to be alarming, it is good to recognize those who are making a difference.  The Global Alliance for Vaccines and Immunisation (GAVI) recently announced that they had entered into agreements with several vaccine manufacturers to obtain vaccines for developing countries at reduced costs.

GAVI is an international organization that attempts to unite donor nations, private donors, developing nations, international organizations, and immunization suppliers to meet the goal of saving children’s lives and protecting people’s health through better access to immunizations.  In the ten years from 2000 to 2010 more than 288 million children were immunized with GAVI-funded vaccines, and an estimated 5 million deaths prevented.

Organizations like GAVI deserve our thanks and support for making a positive impact on the lives of children around the world.

Suicide Assistance for Sale

The Oregon Senate recently approved a bill to ban the sale of suicide kits.  It is interesting that this occurred in the first state to legalize physician assisted suicide.  The move was in response to the death of a 29-year-old Oregon man who suffered from depression related to problems with pain and fatigue and took his life using a helium hood suicide kit that he bought by mail order for $60.  The helium hood method of suicide was developed and promoted by Derek Humphry and the kit was sold by a follower of Humphry to whom he refers business.  Humphry, who lives in the same area in Oregon as the man who committed suicide, founded the Hemlock Society that was a primary force behind the passage of Oregon’s assisted suicide law.

Although the Oregon law he helped to pass limits physician assisted suicide to those with a terminal illness, Humphry made it clear in an interview with The Register-Guard, the local Eugene, Oregon newspaper, that limiting assisted suicide to those with a terminal illness is not important to him.  Speaking of this particular case, Humphrey said, “It may be very sad and tragic, but if this man had ongoing health issues and had struggled with that, I wouldn’t criticize his decision.  It was his right.”

The logic of assisted suicide is clear.  If we accept that ending the life of the sufferer is an appropriate response to suffering and that a person who is suffering should be able to request assistance to end his or her life, then there is no reason to limit that assistance to those whose suffering we think is intolerable or who are terminal or who request the assistance from a physician.  A mail order kit fits the logic just as well.

Love and Respect

A fellow family physician who cares for people at a clinic in Central America wrote about the death of one of her long-time patients in an e-mail last week.  The woman came to the clinic barely able to breathe and with her heart failing.  As they tried to stabilize her to take her to a hospital for further care, she knew that she was dying and requested not to be taken there.  She said “I want to die here, with the people who loved and respected me, my clinic.”

She expressed the understanding that there are some things that are more important than having the ability to treat diseases effectively and extend people’s lives.  We should strive to provide high quality, effective medical treatment, but caring for people is more than that.  It includes loving them and showing them respect as sisters and brothers in the human family.

All of our patients eventually die.  When they do will they know that they were loved and respected by us as we cared for them?

Treatment of HIV-infected Individuals to Prevent Transmission

The interim results of the HPTN 052 study released last week indicate that treating HIV-infected individuals dramatically reduces the likelihood that they will transmit the virus to their sexual partners.  This study of HIV-positive patients whose heterosexual partners were HIV-negative and whose disease was at a stage at which treatment would be considered optional showed a dramatic decrease in transmission to their sexual partners for those treated immediately and was stopped early due to the results.

This study raises some interesting ethical questions.

Are HIV-positive persons who have an unaffected partner now obligated to undergo treatment even if there is not evidence that the benefit of the treatment outweighs the adverse effects for the individual?

If treatment of infected persons is an effective means of preventing the spread of HIV, how aggressive should those responsible for public health be in seeking to identify and treat those with HIV?

What should be done in countries with a high level of HIV that already cannot afford antiretroviral treatment for the more severely affected?  If treatment of all infected people would dramatically reduce the incidence of new cases in those countries where do we get the resources to provide that treatment?