Ukrainian Bioethics

I returned from Kyiv, Ukraine, last week as part of a team that is working to strengthen a partnership with a Christian seminary there. As we met with various program heads within the school, I asked a few questions about how ethics are taught, and what bioethical issues the Ukrainian people face. Some of the answers were surprising.

Ukraine, of course, is the long-suffering nation to the west of Russia, most often remembered as the breadbasket of the former Soviet Union, as the nation where millions starved to death in Stalin’s effort to break the farmers that resisted collectivization, as a nation where much of the fighting—and death—from World War II occurred, and as the location of the horrific Chernobyl nuclear disaster of 1986, some seventy miles north of Kyiv. Ukrainians know what it means to endure; their national anthem is “Ukraine Is Not Yet Dead.” Ukraine’s history has witnessed many affronts to human dignity, perhaps one most chillingly on display at the “Museum of the Great Patriotic War” (a.k.a., World War II) where gloves made of human skin and a bar of soap made from human fat show just what human beings are capable of doing to each other. The Ukrainian people were saved from the atrocities of the Nazis to be dominated by the Soviets, exchanging one form of tyranny for another.

Years of communist rule still leave their mark on Ukraine. Something especially notable when out and about in Kyiv is the utter absence of physically-challenged people, the handicapped, on the city’s streets. It isn’t that they don’t exist. But communism in the Soviet Union served to create an “ideal society,” free of suffering and disability, filled with “perfect” people. In reality, this meant warehousing the mentally and physically-handicapped—and orphans—into hidden-away institutions. This mindset has been slow to change. Handicapped access is limited, to be charitable, and it is hard to imagine that a shopping trip would be anything but excruciating for anyone in a wheelchair. As much as I groan at some of the excesses, as I perceive them, in our “Americans with Disabilities” Act, I’ll probably now more gladly accept its quirks and demands as a way of affirming the dignity of those who suffer challenges I have yet to face in my own life.

It is easy to criticize the post-Soviet outlook, this vestigial communist view of human beings, as an American. But how much do we sanitize the pursuit of perfection here? What are enhancement technologies but a reflection that we have a need to be free of problems, to be our “best selves?” We tuck away our dying elders in nursing homes so that the inevitability of decline and death don’t confront our pursuit of happiness.

A member of our team wryly reflected that, in Ukraine, their faces are from the West but their minds are from the East. As I mentally checked off the list of bioethical issues we face in the West—challenges with assisted reproductive technologies and pre-implantation genetic testing, with use of technologies for human enhancement, and with limitation of burdensome treatment at the end of life—it became clear in discussing bioethics with the seminary faculty in Kyiv that most of these issues are completely off the radar of the vast majority of Ukrainians. Abortion is still hideously common as a method of birth control in Ukraine, as it is in Russia and elsewhere in the former Soviet Union. But the idea that we would use medicine to end life with physician-assisted suicide or euthanasia, or spend scandalous amounts of financial treasure on cheating the aging and dying process, seem arcane in Ukraine. One director even noted that the people of his country don’t have time to be depressed (even as they have faced generations of addictions) because they are too busy just surviving. A study in contrasts, this nation, where children are forgotten in orphanages and old women, the babushkas, may beg for money to supplement their meager pensions, but where children are bundled for warmth with the smallest hint of chilly air and people give up their seats on crowded buses for the elderly and for women with small children. These are a people acquainted with suffering and sorrow, and they have a certain respect for those who have suffered for more years than most (the elderly) and for those who hold the eternal promise of a better future (the children). A rather elegant ethic there: respect and promise.

Wiser minds than mine have delved into the mystery that, within the crucible of suffering, we may be best equipped to find evidence of grace in daily life. It was a visit to a church in Kyiv that I could best see this illustrated. There is, in Ukraine, a national church that had been suppressed, harassed, and persecuted at every turn, one that has survived communism and the economic anarchy that followed, and today sends workers into other former Soviet republics. It is, in fact, a joyful and beautiful place. It is a church that is ministering to orphans and the mentally and physically handicapped, bringing them out of the shadows to which communism relegated them. Ukrainian bioethics is more, forgive the awful word here, “primitive” in a sense, because the technologies that are such qualified blessings in the West have yet to meet this part of the world. But it is the church that is leading the way toward negotiating the ethical issues in a society in transition and embracing the notion of human dignity, a church that just may impact the course of a nation that is, indeed, not yet dead.

 

A Genetic “Fix” for Down’s Syndrome?

A couple of weeks ago I mentioned some of the thoughts presented at the July Summer Conference hosted by the Center for Bioethics and Human Dignity—thoughts I am still processing in the afterglow of an enjoyable and stimulating few days. Much has re-shaped my thinking on a host of issues, to which I alluded previously. But there was one nugget that remains with me, nagging at me, even as it was presented as a rather small bit of fresh information in a larger context of bioethical analysis of prenatal diagnosis. In a workshop session led by the estimable David Prentice, formerly a faculty member at Indiana State University and now a Senior Fellow with the Family Research Council, it was mentioned that American scientists have been successful in experiments to eliminate the “third gene” that is found in various “trisomy” disorders. This, of course, is most commonly seen in Trisomy 21, the genetic abnormality responsible for Down’s syndrome. The process, perhaps best described in an article in The Guardian, essentially inactivates the third chromosome, the one that makes a crowd out of an otherwise happy pair, in a process that is similar to what happens in normal meiosis, where the female gametes are formed and a non-functioning Barr body is produced. In typical British style, and in reality, the science is described as “elegant,” and is worth a look.

My first impulse on hearing this news was joyous relief. For as long as amniocentesis has been commonplace, the default position of genetic counselors when guiding those with a diagnosis of Down’s has been one of pregnancy termination, of abortion of the fetus that would suffer the mental and physical tolls of Down’s. Now that we can fix it, I thought, these babies can live. If we view genetic disorders as the fallout from a world where brokenness pervades all of creation as the result of sin, then a “fix” is a manifestation of God’s grace to make straight what has been made crooked by the Fall. It is a good thing, and I can view it as such. But what if we find a way to “eradicate” trisomy 21 and Down’s syndrome, even as the technology is still quite nascent and the fix quite tentative? Is that an altogether good thing, to see a future free of people who suffer Down’s?

I used the word “suffer” when describing someone with Down’s because it is a descriptor that is common, provocative, and almost entirely wrong. Certainly the medical issues associated with Down’s are real, the cardiac and gastrointestinal problems, the increased risks of cancer and dementia. Yes, Down’s syndrome is linked with numerous medical maladies—ones that made a thirty-year old adult with Down’s a rarity just a generation ago. Individuals certainly live longer today, blessed by improved medical technology. But do they flourish? I think of my prayers for my children when they were infants: protect them, of course, but most of all, keep them devoted to God through their lives, let their eternity be inextricably linked with their Savior. I would rather their earthly lives be significant than they be happy, to be completely honest. And I reflect on my experiences with those who have Down’s syndrome. I have yet to meet one who seems to typify “suffering.”

So we may someday, perhaps sooner than we can imagine, be able to eliminate trisomy 21 with a genetic “zap.” Will the child whose chromosome count has been normalized be a very different one from the one who has not had genetic intervention? I think of an 18-month old I met this week, who sat in his stroller as I examined the new puppy his parents just adopted. They looked like many parents of children with a mental disability, who have learned to accept the modification of their dreams for a child and who, so sadly, must somehow justify their decision to even bring this child into a judging world, given the options. But as I do the checkup on this bundle of puppy energy, they could see the same smile I could see, one that is more manifestly beautiful than that from a “normal” child in how it processes the unfolding scene. I can’t quite describe its wonder and delight. This smile was a mark of grace in a seemingly graceless world, one that God has supplied to a youngster created in His image and whom He has declared will someday judge the angels. I would have missed that if this little boy had been “fixed” by a genetic repair.

I think of my cousin, now in his mid-thirties, who has faced so many medical issues, and who has so challenged the lives of his parents. I have, sadly, struggled to connect with him over the years, because I cannot relate to his experiences and cognitive abilities easily. It is only in recent years that I see what I’ve missed. The middle of three brothers, he is the one who has been best able to find a true sense of pure worship toward God, one that has become clouded by cynicism (at least for now) in his high-functioning, articulate siblings. Would I wish an easier ride for my aunt and uncle, and for anyone with a special needs child in a society that values the capabilities of an individual above all else? Of course. But how serious have I been in my prayers that my children develop a deep spiritual devotion—would I exchange their future college and career and social success for it? If they were never to inculcate this devotion, would I sacrifice all the “normal” stuff and hope for a child with a lower IQ, a host of medical challenges, and a heart that embraces God?

None of us will ever know what would have happened spiritually, or in the degree of happiness and earthly success, if those with mental disabilities like Down’s had been rendered “normal.” I initially rejoiced at the happy thought that Down’s syndrome and similar issues would be cured someday. In the weeks that have passed, I have found new ways to grieve the potential loss of these individuals in our world, individuals who have made it a richer place for being here. Is it ethically wrong to wish an end to genetic aberrations? I think not. Is it ethically wrong to appreciate the diversity of God’s blessings that transcend a fallen world? Increasingly, I find it isn’t.

Ethical Bullies, Part I

To the degree that there are any public sins anymore, particularly among the young, “bullying” may be the chief among them, wed as it is to the cardinal vice (in our culture, at least) of intolerance. The bullies of yesteryear, with their lunch-money-stealing, “uncle”-extorting bluster, are now replaced by the sophisticated “cyber-bully,” and with those who replace brawn with “hate-speech.”

Don’t read me wrong here—I think that a focus on the devastation that can come from cruelty from one person or group to potentially weaker individuals is well overdue. Many of us bear more scars from emotional cruelty than physical, and it is right to recognize that cruelty ought not to be regarded as normative, as a rite of passage, that must be endured to toughen us up.

That said, it seems fascinating that two recent issues that directly confront ethical choices seem to have bullying at their core. The first is perhaps more personal to me than the second, the second more consequential than the first.

The Boy Scouts of America (BSA), who count my 10-year old son as a member and me as a den leader, concluded a very public year of angst over the status of their ban on openly gay and lesbian scouts and adult leaders with an announcement last month that such individuals would be accepted (largely on the basis of “orientation”) as scouts, but not as adult leaders. This decision, of course, had the effect of making no-one entirely happy, though some were less unhappy than others.

I could spend countless words on the merits or lack thereof of such a decision. I could spend a lot of time on the issue of homosexuality itself, where the evangelical church has fallen so short of wrestling well with an issue that is deeply complex, that involves behavior springing from desire that vanishingly few feel can be chosen or denied, and where too many seem to declare that an entire group of human beings are not created in the image of God, but are marks of a very broken image. This view, in my mind, has little to support its theology. I have close friends and colleagues who struggle with their faith and their desires, and others who see a Christ presented to them that couldn’t possibly be seen as loving, one who will love sinners who gamble or are drug-addicted or engage in the heterosexual hook-up culture or plunge into materialism wholeheartedly, but not them. On the other hand, we live in a society of sexual entitlement, where full acceptance of anything that affirms our well-being in the pursuit of sexual desire must be embraced. The Jesus who told us to sell everything to buy the pearl of greatest price surely didn’t mean that we remain celibate inside an old-fashioned social construct.

Okay, so I spent some words on that. But none of those things directly address my concern with the position of the Boy Scouts. This decision, in reality, has little to do with the Scouts tackling the ethics of their policy, whatever its faults or merits. Their choice was based on the effective use of a much-shunned, quietly-devastating campaign of bullying by vociferous critics of the long-standing position. While the official words from the BSA reflect a clear sensitivity, the proponents of change spent many hours and much treasure threatening the Scouts, from loss of financial support from businesses that would face boycotts to overt efforts to thwart enrollment of new Cub Scouts. Every scouting manual, from Tiger Cub to Boy Scout, teaches young men to abandon bullying and to help each other stand up in defiance of it. In their national meeting in Grapevine, Texas, in 2013, the leadership of the Boy Scouts of America, facing shrinking enrollment and corporate abandonment, collapsed under the weight of sophisticated bullies, teaching their youth everything and nothing.

There is no small irony here. People who have faced historically awful levels of bullying in the gay and lesbian communities were successful with those same methods. More troubling, the BSA took an ethical position because they were backed into a corner when the numbers stopped adding up. Maybe I am naïve, but it seems that, even with wildly-different ethical groundings, people once brought their best ethical arguments to the table and then worked through them. Today, in a system marked by moral relativism, we are left with the ethical imperative that one choice is wrong because it is not on the “right side of history.” Only in a world that understands ethics and morality poorly, and history even more poorly, could such a weak appeal be made.

The ridiculous and anachronistic feudal system of czarist Russia was replaced by the regimes of Lenin and Stalin. Who was on the “right side of history” there? History may be a better a judge of ethical and moral choices than opinion polls, but the fact that something replaces an antecedent is a rotten marker of its moral worth, however untenable the system it may have replaced. Is this really the best we can bring to ethical conversation today? It is unsurprising, but is disappointing.

So what in the world does this have to do with bioethics? The second of the two issues, that of Internal Revenue Service shenanigans, which I hope to address next week, speaks directly to a concern that ethical choices will sublimate to forces of bullying. The Boy Scouts of America did not succumb to a superior ethical argument, but to an ethic of bullying by stronger cultural forces. When the government is involved, particularly the division assigned to implement our health care policy going forward, things ratchet up a bit, and we will all be wise to take notice.

On (Being) Better than Human, Part 3A

As I noted in Part 1 of this series (see my 03/25/13 post), in Better than Human Allen Buchanan considers four major lines of objection to the “enhancement enterprise.” As Buchanan summarizes them, each of these objections claims that biomedical enhancement is “different” in morally significant ways from other kinds of (nonbiomedical) enhancement. Specifically, these objections assert that:

(1) biomedical enhancements are different because they change our biology; (2) biomedical enhancements are different because (some of them) change the human gene pool; (3) biomedical enhancements are different because they could change or destroy human nature; [and] (4) biomedical enhancements are different because they amount to playing God (p. 12).

In Chapter 2, Buchanan takes on the second and third of these objections—that is, the “changing the human gene pool” and “changing human nature” objections, respectively.

The heart of Buchanan’s discussion in this chapter is a consideration of two competing analogies in terms of which one might understand evolutionary biology—or, alternatively, “nature” (p. 29)—and its processes: the “master engineer” and the “grim tinkerer” analogies, respectively. On the former analogy, “organisms are like engineering masterpieces: beautifully designed, harmonious, finished products that are stable and durable (if we leave them alone)” (p. 29). On the latter, evolution is “morally blind,” “fickle,” and “tightly shackled” (p. 49)—it produces “cobbled-together, unstable works in progress, and then discards them” (p. 28).

Evolution is disanalogous to a master engineer, Buchanan says, in two key respects. First, “natural selection never gets the job done” (p. 28). Environments are constantly changing, and organisms are constantly adapting both to their environments and to each other, in “a ceaseless round of adaptation and counteradaptation” (p. 28)—resulting in further changes both to organisms and their environment, in a process that never arrives at a terminus. So rather than being “the end points of a process whereby they climb a ladder to perfect adaptation to their environment,” organisms instead exist in a state of perpetual instability, one that belies the “finely balanced” nature implied by the master engineer analogy (pp. 28-29). Second,

unlike a master engineer, evolution doesn’t design what it produces according to a plan that it draws up in advance. Instead, it modifies organisms in response to short-term problems, with no thought of long-term effects. Evolution has no overall game plan for any species, and the results show it. What’s useful for solving today’s problems can cause new problems—and even extinction—down the line (p. 29).

In the final analysis, Buchanan contends, “evolution is more like a morally blind, fickle, tightly shackled tinkerer” than a master engineer. The burden of the rest of the chapter is to provide reasons why (on Buchanan’s view) we ought to accept this analogy over against the master engineer analogy.

In order to adjudicate between these two analogies, Buchanan says, we need to grasp certain key aspects of the mechanisms of evolution (p. 29). The first thing to notice in this regard is that nature is replete with instances of “suboptimal design” (pp. 30-31), which Buchanan takes to be prima facie evidence that the master engineer analogy is problematic at best. Examples of such “design flaws” include, inter alia, the fact that in male mammals the urinary tract “passes through (rather than being routed around) the prostate gland, which can swell and block urinary function,” and the “hasty shift from quadruped to biped, which resulted in back and knee problems and a birth canal that passes through the pelvis, resulting in greatly increased risks to both mother and child in the birthing process” (p. 30). Numerous additional examples could be cited (and Buchanan cites several other illustrative examples here).[1] “Design flaws” such as these led Darwin to develop his theory of natural selection, with which, Buchanan informs us, “Darwin debunked the argument from intelligent design, one of the traditional arguments for the existence of God, by cataloguing the ‘clumsy, blundering, wasteful’ works of nature” (p. 30).

To show more clearly why nature is not best thought of as a “master engineer,” Buchanan introduces at this point a distinction between what he terms “Unintentional Genetic Modification” (UGM) and “Intentional Genetic Modification” (IGM). UGM is “evolution as usual, what Darwin called ‘descent with modification,’ where a driving force of the modification is natural selection”—in other words, “evolution without intentional modification of human genes by human beings” (p. 31). IGM, then, in the context relevant to our discussion, is intentional modification of human genes by human beings.

Buchanan’s aim here is actually two-fold: first, he wants to provide reasons why we ought to reject the “master engineer” analogy in favor of the “grim tinkerer” analogy, and second, he wants to give us reasons for considering the possibility that it may be preferable, in at least some circumstances, to actively pursue IGM rather than simply leaving the development of the human species entirely to UGM. His subsequent discussion in the remainder of this chapter is designed to accomplish both of these aims simultaneously. To that end, he begins by enumerating some of the built-in limitations of UGM, and then goes on to describe some ways in which IGM might be employed to overcome those limitations.

In the next post in this series, we’ll finish up our explication of Buchanan’s argument, and then develop some critical observations regarding that argument. By way of preview, three major limitations of UGM to which Buchanan draws our attention are the facts that (1) UGM is “insensitive” to post-reproductive quality of life (pp. 32-37); (2) in UGM, beneficial mutations spread only by way of a “nasty, brutish, and long” process (37-45); and (3) UGM selects only for “reproductive fitness, not human good” (pp. 45-48). Critical remarks will focus, in turn, on several epistemological, ontological, and moral issues raised by the way Buchanan frames and develops his argument in this chapter.

 


[1] A bonus for the philosophy buffs out there: In the context of this discussion of “design flaws,” Buchanan offers an arresting image in answer to Nagel’s famous query regarding what it’s like to be a bat. As Buchanan explains, “bats spend a good deal of their time hanging upside down, closely packed together, with their feces pouring down over their bodies to their heads. (Imagine yourself holding a toothpaste tube upright and squeezing it until the contents cover your hands. That’s what it’s like to be a bat.)” (p. 31).

The Fragility of Life: Some (Very Brief) Musings Occasioned by Recent Events

If the events of recent weeks and months—last week’s bombing in Boston; the explosion at the fertilizer plant in West, Texas; and the Newtown massacre, to name a few—remind us of anything, it is that life is fragile. Death, suffering, pain, and struggle can come to us unbidden, at any time, and can forever alter the trajectory of our lives. Experiences such as these undermine our well-established and carefully fortified illusions of control, of mastery over our lives. There is, in the end, so little that we can directly control. We would do well to heed these much-needed reminders of our mortality and vulnerability.

Unfortunately, our culture largely proceeds on the basis of unexamined assumptions about the nature of our lives, of what it means to be “truly human.” To a large extent, it seems we have bought into the notion that the core of what it means to be human has to do with “selfhood” and “agency”—that we are, in the end, makers of our own meaning; controllers of our own destinies; independent, rational, agents of choice whose “rights” to “freedom,” “individuality,” and “self-expression” are of paramount importance. To be sure, freedom, self-expression, and the like are not illegitimate in and of themselves. Yet we lose something crucial when we give in to the temptation to think of ourselves exclusively or even primarily as fully-autonomous, atomistic “selves” rather than as members of larger communities, with whom we exist in relationships of interdependence rather than pure self-reliance.

The dialectic between these various ideas is of relevance to many issues in contemporary bioethics, including questions surrounding enhancement. To what extent does the “enhancement enterprise,” for example, reflect our illusion of control, of self-mastery—we will be the masters of our own destinies; we will assert our own visions of the “good life”; we will, perhaps, even “cheat” death (at least temporarily) by radically extending the length of our lives?

The events of the recent past helpfully remind us, once again, that even our best-laid plans, the ambitions “of mice and of men,” frequently come to naught.

The question, in light of that reality, is: how then shall we live now – todayin the present?

Journeys of Transformation

In my last post, “A Preview of Coming Attractions” (02-11-13), I signaled the start of a multi-part series of review essays covering three recently published books addressing ethical issues surrounding enhancement technologies and practices. I had intended to launch that series with today’s post. Before starting that series, however, I want to go on a brief discursus, one that will, I believe, turn out to be relevant to the themes to be touched on in the forthcoming series.

Last week, I attended the annual “Christ and Culture” lecture at California Baptist University in Riverside, California. This year’s speaker was Ralph Winter, producer of the first three X-Men films and numerous other successful film projects. Using such recent films as Les Miserables, Toy Story, Avatar, and others as illustrative examples, Winter set out, in the broadest sense, to show “how the gospel is often displayed in… contemporary film.” The unifying theme in all these stories is what Winter referred to as a “journey of transformation.” In each of these stories, the main character/hero grows through experiencing some form of adversity, learns something important about him or herself, and is transformed positively in some way.

One of Winter’s central concerns in his lecture was to explore the general question of how Christians engage with the broader culture, and particularly with how they communicate their messages to that culture. Here, Winter contends that “Christian stories often fail because we’re afraid of the journey,” by which he means that “our stories often hide from pain”—they avoid addressing the painful, the difficult, the ugly, the uncomfortable aspects of life—and place an emphasis on propositional assent over against an embrace of the “transformational journey” that is the life of faith. That is to say, there is a tendency to focus on the destination (heaven) to the exclusion of the journey that we take along the way.

What does all of this have to do with bioethics? There are at least two central lessons to be learned here.

First, in the context of genetic enhancement technologies and practices, it is worth asking the question: to what extent is the “enhancement enterprise” (broadly speaking, the attempt to “improve” human capacities by way of genetic or other interventions and/or technologies, as well as the cultural push toward embracing that agenda) in fact driven by a deep-seated, underlying “fear of the journey”—that is, a fear of those aspects of the aging process that are ugly, uncomfortable, painful, and so forth? Put more simply, to what extent is the drive toward “enhancement” really a flight from the inevitable realities of our lives as embodied creatures? (I do not propose to answer this question here; I pose it, however, as an important background issue to be kept in mind when considering specific arguments regarding the enhancement enterprise.)

Second, and more generally, our bioethical reflections—whether on beginning of life issues, end of life issues, or whatever—must always be attentive to the lived reality of embodied human existence. In particular, we must be willing to face the sometimes harsh realities of pain, suffering, indignity, and so forth, that can accompany the experience of various medical and other conditions. This is especially pertinent at the end of life, where the dying process can (but does not necessarily) involve significant levels of pain, discomfort, and distress. In a word, our bioethical reflections must tell “stories” that are true to the lived realities of human existence. If we are not willing to face these sometimes difficult realities, our pronouncements on bioethical issues are likely to seem shallow, insensitive, or even irrelevant.

This is not to say, of course, that our arguments and other reflections on bioethical issues should be overly-negative or fatalistic. Indeed, a focus on truth mandates that we tell “the truth, the whole truth, and nothing but.” This means being attentive to the fact (for example) that while the aging and dying processes can be characterized by pain, discomfort, and suffering, they are not always so characterized (indeed, with the skillful use of pain management techniques, they rarely need to be—but that is a different post altogether). The aging and dying processes can also be characterized by peace, joy, personal growth and development, and a sense of fulfillment. In a phrase: these processes can themselves be “journeys of transformation.” From the perspective of Christian theology, of course, the entire human lifespan can be understood in this way as well. The key point for present purposes is simply this: our bioethical reflections and arguments must attend to the potentially transformational aspects of the experience of pain, suffering, and the like, in addition to other considerations having to do with rights, obligations, principles, and so on.

Human life, in other words, is as much about the journey as it is about the destination. And that fact can make all the difference when it comes to bioethics.

Medicine Men of the Mind

This past week I made my yearly journey from Wisconsin to Arizona by automobile with my dog to visit my husband who winThis past week I made my yearly journey from Wisconsin to Arizona by automobile with my dog to visit my husband who winters there. In this yearly process, I have discovered the delight of audiobooks. This year, I explored the holdings of our local library in rural Wisconsin, but the only audiobook of substance that they had (the only non-Evanovich) was Ayn Rand’s Atlas Shrugged, an author of whom I had heard, but with whom I was not acquainted. It has been fearfully intriguing to ponder the ways in which her philosophical ideas have crept (or been smuggled) into our culture—not wholesale, but part and parcel.

While her political ideas are not too dissimilar from anti-socialist emails that are making the rounds these days (or so I’ve heard—emails about professors applying socialist paradigms to grades and failing the whole class because those students with ambition and ability ultimately refused to carry the weight of the non-ambitious in the class—“Atlas shrugging”), it is her ethical ideologies that are most disturbing. For Rand, the moral measure of man is his hedonistic happiness. Correspondingly, she also rejects any doctrine of altruism. Her ideal is a society ruled by Men of the Mind, where selfishness, or rational self-interest, is the primary virtue. Ironically, Rand’s appeal is to the ideal of rationalism and not the reality of fallen rationality in a fallen world. While Rand objects to hedonism, in reality she makes no distinction between rational and irrational happiness, and therefore hedonism is a reality in a society of fallen persons of differing rational capabilities.

Men of the Mind are persons who choose to think, and such thinking requires a state of fully focused awareness achieved by the volitional act of focusing one’s consciousness. One can choose to focus their mind to a fully active, purposefully directed awareness of reality—or one can become unfocussed and let oneself drift in a semiconscious daze, merely reacting to any chance stimulus of the immediate moment, and making random, irrational associations. Such an unfocused semi-conscious drift as Rand describes is alarmingly true of our culture today, as we have become fractionated and distracted by the barrage of stimulants that confront our senses, and, as a result, are losing our ability to “perceive.” There is no time for, or importance given to, the use of the mind for thoughtful reflection–just mindless reacting to external stimuli which we require to ever greater degrees.

In Atlas Shrugged Rand vividly depicts the “end” of a society ruled by the “Mystics” (persons who rule society on the basis of faith, altruism, or other non-rational ideologies which find their source and goal in God or society) as one ensconced in violence which is the means to the promotion of their ways. Yet she, fatefully does not portray what a society ruled by Men of the Mind would look like. She claims that objectivism and capitalism are the systems most beneficial to the poor but she does not portray what would happen to those who are unproductive or somehow rationally challenged in a society where there is no altruism. Does she not believe that they would then turn to violence to support themselves, taking from those who have what they need for their lives and happiness by force and justifying such actions as their only means of procuring their own survival and happiness? Would not the end be the same but with a different ruling class?

It seems that her rational perception has been blinded to the reality of evil inherent in mankind. And that blindness is easily coupled with her attitude toward the fact of original sin. Rand refers to the concept of “original sin” as an evil and a monstrous absurdity which she claims makes a mockery of nature, justice, reason, and morality.

Her perceiving is also blinded by failing to perceive the reality of our human interdependence as objectively evidenced in that fact of our birth and growth. In Atlas Shrugged there are no families, no marriages, no children. One can easily surmise the reason: marriages, families, and children require self-sacrifice, a cardinal vice in Rand’s philosophical world. Even romantic love is a matter of rational self-interest; hence, there is no room for agape love. But with no marriages and families, the society she envisions is an unstable collection of hedonistic individuals, subject to disintegration. And with no children that society has no future, unless, of course, they can continue to cull members from the wider world.

Medicine, too, has fallen prey to her ideologies, where Men of the Mind have taken over from Men of Compassion; where the data of our senses is replaced by data from machines; where there is no room for altruism; where personally defined “happiness” and self-fulfillment have become the goals and ends of “medical care”; where technology and innovation serve the desires of the wealthy, but not the basic needs of the poor; where Money, Productivity, and Efficiency have come to be the image and symbol of success—the gods of a profession that was. Medicine is no longer about caring, because caring belongs to subjectivity, and is unproductive and inefficient, to the Mystics of the Spirit or of Society (which Rand lumps together in one malevolent category). Such a system no longer serves the needs of the vulnerable and needy for whom it was intended. Is this indeed where we are headed?

After the Super Bowl: Reflections on “Perfection” and Enhancement

By the time you are reading this, many of us—myself included—are (or soon will be) in full “withdrawal” mode from the “high” of yesterday’s Super Bowl. We were amazed by the awesome displays of athletic prowess on the field and caught up in the drama of watching this year’s AFC and NFC champions battle it out to the very end for the right to be called “Super Bowl champions”—the very best in the game of football, at least for a short while. Who could not have been impressed by the on-field exploits of Joe Flacco, Ray Rice, Jacoby Jones, and Colin Kaepernick? Who could not have been touched by the soaring notes of Jennifer Hudson singing “God Bess America,” or the soulful tones of Alicia Keyes singing the national anthem?

In similar fashion, we find ourselves fascinated by the accomplishment of Olympic athletes, musicians, artists, intellectuals, and others at the “top of their game,” or their art, or their craft.

Truly, these are specimens of excellence—indeed, one might say, of a certain kind of “perfection.”

Or are they?

Perhaps these NFL players, “great” as they already are, could in fact be more than what they are now—faster, stronger, more agile, more powerful. Wouldn’t that be good for the game? Wouldn’t that make the game even more exciting, more engaging, more thrilling?

Suppose, by way of a taking a pill or getting an injection—Human Growth Hormone (HGH), for example—football players could develop stronger muscles and greater physical stamina.  Would we want them to do so? Would we consider their resulting on-field performances as genuine reflections of their actual athletic abilities, or more akin to “cheating the system”?[1]

Suppose, more generally, that we “mere mortals”—those of us who are not Super Bowl champions, famous musicians, acclaimed scholars, or Nobel prize-winning scientists—could take a pill that would improve our memory, make us more intelligent, or help us feel more confident? Would this be a good thing?

And, finally, suppose we could alter the human genetic code permanently, through genetic engineering, either to eliminate unwanted conditions (diseases, genetic disorders, and so forth) or to enhance certain desired, genetically-linked traits (intelligence or sociability, for example). Should we avail ourselves of such opportunities?

In the wake of the Human Genome Project and other scientific breakthroughs, each of these scenarios is increasingly moving from the realm of “science fiction” to “reality,” a fact that should prompt us to ask—and reflect upon—a number of important philosophical and theological questions, among them the following:

  • What does it mean to be an “excellent” specimen of something (a book, a table, a human being)?
  • What does it mean to “flourish” as a human being?
  • Should we seek to “enhance” ourselves? If so, are there limits to how far we should go in pursuing enhancement?
  • What, if anything, is the value in human limitation? Are there limits that we should never seek to surpass?

In subsequent posts, we will explore some of the issues surrounding enhancement (genetic and otherwise). For the moment, as we bask in the afterglow of this year’s Super Bowl, it is worth taking a few moments to reflect on just what it is about “great” athletic, musical, intellectual and other human achievements that we find so appealing, and whether “enhancement” would render those accomplishments more or less so.


[1] The NFL is reportedly looking seriously at introducing HGH testing prior to the start of the 2013 season. See http://www.nfl.com/news/story/0ap1000000133761/article/goodell-confident-hgh-testing-in-place-by-next-season

The Whitewashed Tombs of the Right

“Woe to you, scribes and Pharisees, hypocrites! For you are like whitewashed tombs, which outwardly appear beautiful, but within are full of dead people’s bones and all uncleanness.”– Matthew 23:27

I received several comments on last week’s post about Hubertus Strughold, so I thought I’d follow up with another post.  The fact that Strughold has been well-respected in American medical circles despite his leadership in medical experimentation in Nazi Germany may shed light on deep-seated philosophical problems that undergird America’s healthcare crisis.  It is no secret that the Allies marveled at the technological and scientific capabilities of the Germans as they marched through that country in the final days of World War II.  Though it used the scientists of the Third Reich to the ultimate success of putting a man on the moon, American medicine may also have adopted harmful philosophical ideas that cripple U.S. medicine to this day.  The technological and scientific accomplishments of American medicine may be the whitewash that hides the philosophical problems that are the dead people’s bones that affect patient care and make us incapable of solving systemic healthcare problems.

Dachau, notorious for its human experimentation

Several writers on this blog have commented on the failures of the “business model” of medicine.  Joe Gibes has written several posts on the subject (see his “Black Friday” post), and Steve Phillips has recently mentioned the “manufacturing efficiency” that has been brought to human reproduction.  It is well-known that many Americans sided with the National Socialists in Germany in the 1920s and 30s because they saw them as a bulwark against the tide of communism that seemed to be sweeping over Europe (Russia fell to the Communists in 1917).  In the culture wars in America the last two decades, it appears the right-wing has propelled the “business model” of medicine to the fore as a bulwark against the Left’s move to bring government-run healthcare to America.  It is a classic case of the end justifies the means.  Why Christians allied themselves with the right-wing to form the “Religious Right” in the 1980s I’ll never know.  But it looks like a deal with the Devil.

The New Sabbath: The Preaching of the Word and the Healing of the Sick

Citing our rat-race lifestyle and dependence on technological gadgets, many Christian commentators have written about our need for a Sabbath.  Many talk of a “Sabbath” as abstinence from anything for any period time while others consider the need to take a day off, though it might not be Sunday.  I think there are a number of reasons to make the first day of the week, when we commemorate the Resurrection, a time of not only worship and rest but also fellowship with those who are sick.

Luke chapter 9, for instance, shows how Jesus’s ministry coupled preaching with healing.  It is fitting that as we set aside the Lord’s Day to hear the preaching of the Word, alongside the other aspects of worship such as the celebration of the sacraments, we should dedicate the rest of the day to fellowship with others, particular those who are in need.  A good friend of mine related the story of how his friend’s church had a list of people to bring food ready within a day when she had cancer.  Too often we think of “home visits” and hospital visitation as the job of professional clergy.  However, using the Sabbath to extend the body of Christ into the homes and rooms of those who are ill is the role of every Christian.  I’m sure none of the pastors of our churches would mind if we asked for the names of those in the hospital.  Some churches print such information in the weekly bulletin.

Yes, Sunday afternoons are a good time for a nap, but I think our Lord’s Day could be richer if we spent time in fellowship with others, especially those who are ill.  As Thanksgiving approaches, I remember fondly my front-yard football games with my cousins at my grandparents’ house after a turkey meal.  That’s the spirit of the Sabbath: a time of rejuvenation for not only the mind and body but also the soul.  I also think those who are sick and injured are happy to have someone take them outside, too, even it’s not to throw around the pigskin.  I’m always disappointed when hospitals do not take the opportunity to provide at least an outdoor courtyard for patients to sit with their friends and family.  For instance, I visited a hospital that was just a quarter mile down the street from a nice, municipal park several miles in length (and an adjacent lot available no less).  When it’s a hot summer day in Texas, it’s too far to walk with someone who is ill.  Just a little more thoughtfulness and a little better planning and the hospital really could have put something nice together for its patients.

Now if you’ll excuse me … I have two loved ones to see in the hospital.