Yesterday I gave an oral exam to a student (who is bound for medical school) in my bioethics course. On a list of unpleasant encounters, oral exams probably rank somewhere close to the top next to “giving a class presentation” and “asking a girl out for the first time.” However, this exam was an enjoyable experience for both of us, I believe. We engaged in friendly dialog about several bioethical issues, but the focus was on the status of preimplanted embryos. He admitted early on that he wasn’t convinced that preimplanted embryos are individual persons deserving moral protection. After all, there is the issue of twinning that may occur during the first 12-14 days (not to mention the amount of fetal loss). How can it be that the fertilized zygote is an individual human being when it could possibly twin before it implants?
Admittedly, the twinning argument appears forceful. Many ethicists (including some professing Christians) agree and contend that human embryonic stem cell (hESC) research is not morally wrong because it does not entail the destruction of individual human persons. Furthermore, it’s better to be “sorry than safe” about the matter i.e., it’s better if we proceed with hESC research and reap the benefits, even if it turns out that we are wrong about the status of early embryos. On the other hand, if we play it safe and forego hESC research, then we’ll be sorry that we missed out on a technology that may revolutionize human health care.
In my initial response, I noted that twinning is a rare phenomenon that we don’t fully understand. Of course, this student wasn’t going to fall for the “it’s all a mystery” reply. But before I tell you how eventually responded, I would like to hear your thoughts. How would you convince this student that the zygote is an individual human being deserving moral protection? Or, perhaps you disagree with this point of view.
This past week I picked up a copy of The Immortal Cell, written by gerontologist Michael D. West, founder of Geron Corporation and, later, CEO of Advanced Cell Technology (ACT). Geron and ACT were quite significant in the early development of human embryonic stem (HES) cell research. In West’s personal account of the history of the field, there is much to grab the reader’s attention, perhaps none more so than the conclusions he reached one afternoon as a young baccalaureate while reflecting upon death. As he recounts (p.30),
“I realized that it was simply not in my nature to accept death or be defeated by it. The call wasn’t even a close one. I could never again resign myself to laying my loved ones down in the grave. It was crystal clear to me what I had to do. I had to defeat death.“
Interestingly, West presents this life-changing experience on the back-end of a discussion of how he came to surrender his belief in man as a special creation to an evolutionary account of human origins. This juxtaposition raises some interesting questions:
Can evolutionary theory truly accommodate West’s intense loathing of human suffering and death? On what account can these be viewed in negative terms if they come part and parcel with the evolutionary process?
Does West’s crusade against death entail the notion that human evolution has somehow reached its pinnacle?
If West et al conquer death, how might human evolution proceed? If people are going to live forever and the resources to support them are finite, then it would seem that the instinct for self-preservation would demand a halt to reproduction. Ironically, a core feature of the evolutionary process – reproductive success – will have to be resisted, or so it seems.
Setting aside the consideration of a campaign against death within an evolutionary paradigm, on what points may Christians agree and disagree with West in his view towards death?
And he called the twelve together and gave them power and authority over all demons and to cure diseases, and he sent them out to proclaim the kingdom of God and to heal. – Luke 9:1-2
As I sit writing this article on the 21st floor of M.D. Anderson’s Pickens Tower, I survey the names that dot the skyline of the Texas Medical Center: St. Luke’s Episcopal Hospital, the Methodist Hospital, Baylor (Baptist) College of Medicine—all philanthropic ventures founded by Christians. Today, their respective denominations are only nominally involved, providing some guidance for chaplaincy programs, some of which include Muslim services. Granted, these medical institutions are now massive, multi-million dollar operations, yet many of their congregations have significant wealth that could be used to provide funding. Obviously, they are plagued by the theological waywardness of their respective churches, but other more traditional churches lack involvement in health care in a similar fashion. In speaking with a pastor of a large Baptist megachurch, I learned that they had stopped investigating opportunities to build a charitable medical clinic because of the fear of lawsuits. Financial and physician resources were at their disposal, but such a ministry was a risk they were not willing to take.
During my year at Trinity in 2008-2009, I made several trips to Lawndale Community Church in downtown Chicago. As many of you know, Lawndale has built an extensive medical clinic for the people of that neighborhood. Though drawing its membership from some of the poorest of people, Lawndale has made it a priority to spread the Gospel through practical programs ranging from sponsoring a pizza parlor to providing medical care. In Christian circles some mention that poorer patients look for opportunities to win cash through lawsuits, but Lawndale views medical outreach as a necessary risk in their pursuit of Christian goals.
Today, unfortunately, we face the trend of Christian groups pulling out of medical care. American Christianity now boasts some of the largest churches ever, with extensive programs and services that include multi-site ventures and online attractions. Few, however, see medical care as a main function of the church. Take the Baptist Medical Centre (BMC) in northern Ghana, for example. BMC, like other Christian hospitals founded by Americans in Africa, is facing the withdrawal of American financial support for its mission. Part of the reasoning behind the separation is to allow Ghanaians to mature in their leadership of such projects. This is certainly a proper goal. However, much of the termination in sponsorship is based on the idea that hospitals siphon off funding that could be better used in programs that are specifically evangelistic. The fact of the matter is that chaplaincies in hospitals provide excellent ways to present the Gospel to people who would avoid any other Christian ministry. The Muslim population is one of the major groups BMC serves, and these people would never enter a Christian building otherwise. The fact of the matter is that pastors (not to mention Christian doctors and nurses) stationed at the hospital have a constant opportunity to communicate the hope and healing of Jesus. No pastor hidden behind church doors here.
Conflict between two philosophies of health care in America has reached a fever pitch. The medical field is marked by a battle between health care based on government oversight versus medical services maintained by profit found in the marketplace. I recommend we reconsider medical care based on philanthropy as a third option. There is great wealth to draw from, and health care is tailor-made to work hand and hand with the Gospel of Jesus.
For more information about Christian philanthropy and medical care, visit these websites:
As I sat sipping coffee and reading articles on the moral implications of genetic interventions in the germ-line (don’t yawn), a perfect picture was painted at the table across from me. A young and boisterous child spoke of his aspirations for the future, vehemently proclaiming to a doubting adult audience, “I want to be a teacher, a singer, a dancer, a hospital man, I want to be everything.”
His ambitions were a bit outlandish.
His father, or who I believed to be his father, responded: “Do you know how you can be all of those things? You can be an actor. This way you can be a teacher one day, and a singer another, and…”
“No, I want to be them all!”– Clearly the aspirations of the father were distinct from that of the son.
Imagine, if you will, that your direct (active) influence on your child could begin before conception. What if you could unify your aspirations before birth? No longer would you have to squelch his dreams as he bellows across Starbucks…
John Harris, recognizing this future possibility in his book Enhancing Evolution, avows an ethical parity in genetic interventions before conception and parental influences after birth. Could this be true? Are encouraging your child to play an instrument and (in some future world) fashioning an embryo to be a world-class musician morally equivalent?
I would say there is a distinct difference between choosing for our children potential traits in embryo and guiding our children along in life. No doubt both influences are according to parental values. However, by choosing traits we are no longer discussing influence in terms of persuasion and direction, we are discussing a new kind of coercion.
If you haven’t read the news reports, Joseph Maraachli is a little boy with Leigh syndrome. The degenerative neurologic disorder left him on a ventilator in a hospital in Ontario. His parents requested that he have a tracheotomy to allow him to be cared for at home like his older sister who had died of the same disorder several years before. Joseph’s physicians and the hospital where he was in Canada did not think the tracheotomy was in his best interest and obtained a court order to remove him from the ventilator to allow him to die. In March he was transferred to a hospital in St. Louis against the wishes of those treating him and on March 21 he had the tracheotomy, described by his physician in St. Louis as a common palliative procedure. Within three weeks he was able to be weaned off the ventilator and was able to return home with his parents on April 21. His life expectancy at that point was about 4 to 6 months.
What can we learn from Joseph’s experience?
It seems that those of us who are physicians sometimes feel that our training and experience allow us to know better than others what is best for our patients. We need to remember to listen to those who know our patients best. Sometimes parents really do know what is best for their child.
It also seems that when people disagree on what is best it is better to err on the side of life.
Recently, the Chicago Tribune reported the C-section delivery of Finnean Lee Connell on February 11, 2011 to 61-year-old Kristine Casey. Not only is Ms. Casey the oldest women on record in Illinois to bear a child, she also appears to be the state’s first parturient “grandmother.” Through the wonders of assisted reproductive technology, Ms. Casey’s uterus was recalled from post-menopausal retirement to incubate the child that her daughter, Sara Connell, and husband Bill had conceived via in vitro fertilization.
Commenting on the birth, Casey’s obstetrician, Dr. Susan Gerber, stated “the surgery itself was uncomplicated, and the emotional context of this delivery was so profound.” Indeed, it was for Ms. Casey, the fulfillment of a “deeper calling” that emerged as she contemplated her post-retirement years and her daughter’s protracted struggle to bear children. Of the whole experience, her daughter remarked, “It grew beyond the two of us having a child,. . . It was about the closeness with my mother, and our family having this experience that was unique and special.”
Also contained in the Tribune report was the analysis of Josephine Johnston, a research scholar at the Hastings Center, who reportedly “had no ethical objections to the idea of a 61-year-old having a baby, as long as she had undergone a thorough medical and psychological evaluation.” For Johnston, Ms. Casey’s surrogacy “seem[ed] like an unquestionably loving and generous thing for a family member to do . . . It’s a great story to tell the child . . . It’s one of those situations where outsiders might wonder if it’s OK or healthy. But the experience of that child and his family will be that it’s good. … If they treat it as good, it will be experienced that way.”
Your comments? Do you think Johnston has it right? Will this be “a great story” for Finnean and his family? Why might others “wonder if it’s OK or healthy?” Has Johnson passed over some important ethical concerns?
Recently the quiz show “Jeopardy” pitted “Watson,” an IBM supercomputer, against the show’s previous top winners including Ken Jennings, the all time record holder for Jeopardy wins. With fascination, I watched “Watson” demolish the humans in a lopsided win. The event got me thinking. I tend to believe, contrary to futurists such as Ray Kurzweil and Nick Bostrom, that machine intelligence will never surpass human intelligence.
On the other hand, “Watson” “sounded” like a human and processed the information with a speed that surpassed the best human effort. Kurzweil, Bostrom and others believe that it is just a matter of time before technology will transform what it means to be human. The assumption is that human nature is malleable, not static. The hope is that technology can intervene to take humans to a higher level of existence and even immortality.
So my question is, what does this imply for human nature? Should Christians feel threatened by these developments?
First, do you believe Christian moral reflection has been marginalized in bioethical discourse and public policy decision-making, and if so, in what ways?
Second, what may we cite as the evidence of a contemporary bioethics bereft of Christian influence? How might the bioethical terrain differ from its present state if the Christian voice had enjoyed a more sustained presence in public policy discourse?
Third, to what may one attribute this marginalization of Christian moral reflection in bioethics? Is the problem external to the Christian community, or do we share in the blame? If the latter, in what way?
We’ll save the question of a way forward for another post, but perhaps you have other questions pertaining to the diagnosis of a diminished Christian influence in contemporary bioethics and its underlying cause(s).
Warm greetings to the 300 or so alumni, students, and faculty connected with the bioethics degree programs at Trinity International University—and to others listening in!
The Trinity Bioethics Community (TBC) is a tremendous network of bioethics-trained people who have many insights and produce many resources that are well worth sharing. In addition to this blog, Trinity is launching a new online archive of excellent bioethics papers and projects that bioethics students at Trinity have produced. Members of the TBC are receiving information directly regarding how their best resources can become available through this archive. Whenever a new resource enters the archive, starting sometime in Fall 2011, posts to this blog will notify readers of its availability.
The alumni members of the TBC are also receiving information regarding how they can send to Trinity Town (the online alumni network) information describing the vocational and other settings in which they are using their Trinity bioethics training. Those communications will automatically be posted to this blog as well. So will announcements about bioethics-related events and other opportunities at Trinity.
Of special interest to many, though, will be the commentaries on news events and bioethical issues that will regularly appear in this blog. You are encouraged to reply to such posts as often as you can, to generate insightful discussions. Please also submit a new commentary/post of your own whenever you wish.
Wonderful new opportunities lie ahead for informing, challenging, and inspiring one another through the Trinity Bioethics blog!
Trinity Bioethics Degree Programs