Bonhoeffer and ethical principles

I just finished reading Eric Metaxas’s excellent biography of Dietrich Bonhoeffer. Two weeks ago I wrote about how Bonhoeffer’s upbringing led to his unique ability to combine reason and faith in his theology and his life. This week I would like to reflect on his understanding of ethical principles.

Dietrich Bonhoeffer was raised to believe and live by strong moral principles, as were many in German society. Early in Hitler’s ascent to power Bonhoeffer recognized that Hitler’s desire to exclude those of Jewish heritage from participation in German society was a serious violation of the principles of justice and the universal value of human beings long before Hitler began his mass murder of the Jewish population. As Hitler sought to limit the participation of Christians with Jewish heritage in the German national church, Bonhoeffer saw that as a violation of the principle of the unity of the church that was foundational to the gospel. That violation of principle was sufficient reason for him to be a founder of the confessing church in Germany that claimed that such a foundational violation of Christian principles meant that the national church was no longer a valid church and that true Christians could no longer be a part of it.

However, Bonhoeffer also saw that there were limitations to ethical principles. Many of the leaders in the church in Germany and many of the military leaders in Germany who were devout Christians had as one of their basic moral principles that they should be subject to the government of their nation and not violate its laws or disobey military orders. When they found themselves serving a government and national leader who were doing things that violated their moral principles of justice they had a moral dilemma that they had much difficulty resolving. Hitler was able to use the principles of his opponents who sought to be law-abiding citizens and obedient soldiers for his advantage.

Bonhoeffer himself faced an even greater ethical dilemma. After years of standing up for the moral principles of biblical Christianity and those churches who were willing to hold to the truth of scripture against those who sought to destroy those things, he learned that there was a group of military leaders that included his brother-in-law who were plotting to assassinate Hitler and bring down the Nazi government. They desired for him to be a part of their conspiracy and he had to choose whether he should be a part of killing a ruthless and evil dictator. By that time Bonhoeffer was aware of the mass murders of the mentally disabled and Jews that many in Germany and the rest of the world did not know about. He understood how evil Hitler and his followers were, and yet he also understood how wrong it is both to kill another human being and to assassinate the leader of one’s own country.

Bonhoeffer’s answer to this dilemma was found in his theology and his personal faith in Christ. He understood that to be a Christian was to be obedient to the call of Christ. He understood that moral principles were grounded in the goodness of God, but that there are times when moral principles can fall short of being able to guide us. At those times obedience to God is more important than anything else. He was clear that God had called him to do all he could to put an end to the evil of Hitler’s reign, so he joined with the conspirators and was hanged just before the end of the war for his part in their failed attempts to kill Hitler. Although I would hope that none of us ever face anything like what Bonhoeffer faced, we can learn from him. As we face the bioethical issues of our day we rely on ethical principles based on our understanding of God’s revealed truth to know what is right. That is good. However, it is not the principles, but God himself who is good and who is the foundation of all we believe and the guide for how we live.

Faith and reason: Bonhoeffer and bioethics

I am currently reading the biography of Dietrich Bonhoeffer written by Eric Metaxas. As I have been reading about his early life, I have been struck by how his family impacted his development as a theologian. He inherited from his parents a brilliant mind and a gift for music. From his father who was a prominent psychiatrist/neurologist, research scientist, and professor in Berlin he learned a rigorous use of reason and appreciation for truth. From his mother he learned a deep personal faith in God expressed in music and worship. All the Bonhoeffer children were very capable and great things were expected from them all. His oldest brother was an eminent nuclear physicist. Dietrich surprised his family with his choice of theology as his field of study. He surprised even more as he forged his own path very different from that of the prominent theologians of Berlin as he completed his PhD by age 21.

Bonhoeffer pursued an intellectually rigorous study of the truth about God. Unlike his professors who saw the Bible from the prevalent view of historical textual criticism as something that was man-made and in need of being torn apart and put back together, Bonhoeffer saw the Bible as God’s revelation of the truth about himself to us. His study of theology combined reason and logic with a personal relationship with the God who he studied. He astounded the leading theologians of Germany with a well-reasoned position that they had to respect even though it totally contradicted their own positions, and yet he was very capable of expressing that truth to children that he taught as an associate pastor.

Reading about Bonhoeffer’s life has made me think of how we combine faith and reason in bioethics. Application of God’s moral truth to the complex issues of medicine and biotechnology requires us to reason clearly and rigorously, yet our pursuit of bioethics is not just an academic endeavor. The reason that we are concerned about what is right and wrong is that we know and worship God who is by his nature good and desires his children to live according to what is good. He desires for us to care for those who are hurting and to protect the weak and oppressed. He wants us to have his heart for them. We should be as academically rigorous as young Bonhoeffer’s challenge to the theologians of Berlin and as compassionate as his caring for the lives of the boys he taught in the toughest part of inner city Berlin.

Prayerfulness on the Hospital Ward

As I have visited a family friend in the hospital the last two weeks, I have been reminded of the importance of a spirit of prayer when working or visiting at a hospital.  Aside from all our impressive technology and reams of laboratory data, there is a lot that is unknown and beyond our control.

In times past, prayerfulness went hand in hand with medical practice for two reasons.  First, medical cures were much more limited than they are today.  In the days before antibiotics and anesthesia, there was a lot less the physicians of that era could do compared to the doctors of today.  It was only natural to regularly turn to prayer to entreat the One on high for healing.

And, secondly and most notably, in times past hospitals were Christian endeavors.  The chaplain was the daily partner with the physician in caring for the sick.  The very foundations of these hospitals were laid with the knowledge that all healing ultimately comes from the One who is the Great Physician and who left us a record of what a healing ministry looks like.

Ethical uncertainty

A few days ago I sensed that the students in my medical ethics class left feeling frustrated. We had been talking about whether it was ethically permissible from a Christian worldview to use in vitro fertilization for treatment of infertility. We agreed that the creation of excess embryos that would not be implanted was not permissible and that there were serious concerns about conceiving a child by the use of donor eggs or sperm and by the use of a surrogate mother. We had difficulty agreeing on whether IVF itself without any of those things was permissible.

We could see that some people would see IVF as a reasonable way to treat the problem of infertility and find it permissible as long of the other things we had concerns about were avoided. We also saw how others would see that there were things inherent to IVF that would make them think that it was not permissible. Those things included the separation of conception from the natural expression of love in a marriage, the instrumentalization of the body, treating the making of a child like a manufacturing project, and destruction of embryos in the development of the process of IVF and by those who practice IVF even if not done in this specific instance. The question was whether those things were significant enough to override the good of having a child.

We were not able to resolve this. That left the students feeling uncomfortable.

For many of the things that we face in life it is clear what is right. Our biggest problem is actually doing what we know to be right. But there are some times when it is not so clear what is right. Even Christian ethicists whom we respect may not agree on some issues. Learning how to deal with uncertainty is a difficult thing to do. It takes a fairly high level of maturity to learn how to make the best choices we can and trust God to help us find our way when things are uncertain. Life is not always clear. I hope that one of the things my students can learn is that we can trust God even when it is difficult to see clearly what the right choice is in a specific situation.

A place for common morality

Although the weather in the Midwest does not seem as much like winter as it usually does at this time of year, I just received the winter edition of Dignitas from CBHD. In the lead article Erik Clary makes the astute observation that when those who have been trained as Christian theologians abandon their Biblical foundations and use the methods of secular philosophy, the ideas that they propose lose their Christian distinctiveness. He traces the loss of influence of Christian thought in bioethics to those who have identified themselves as Christian theologians, but have left that biblical foundation.

His examples are James Childress, who paired with philosopher Tom Beauchamp to introduce principilism to bioethics, and Joseph Fletcher, who introduced a capacity based concept of personhood to bioethics. In Fletcher’s case he abandoned the biblical foundations of Christianity to the point that he eventually rejected Christianity altogether. The concept of capacity based personhood has extensively undermined the theological concept of the inherent dignity of human beings based on being made in the image of God.

It is true that there are problems with Beauchamp and Childress’ principle based system of bioethics. Their concept of common morality lacks a solid foundation. That probably comes in part from an abandonment of biblical authority on Childress’ part and a desire to appeal to everyone in a multicultural society. Because of the lack of solid foundation there is the ability to emphasize various principles as one desires to support one’s own biases. But there is something about the use of common morality that should appeal to Christian bioethicists.

While we need to be solidly grounded in the Bible as the source of moral truth, and never drift into ethical concepts that contradict that truth, we also need to find ways to communicate the theologically grounded moral truth that we have to those who do not yet realize the value of what God has communicated to us in the Bible. That’s where common morality comes in. As a Christian I understand that God has communicated his moral truth both specifically through scripture and more generally through what he has written on the heart of every human being deep in our conscience. Although Beauchamp and Childress do not seem to understand the foundation of common morality, they understand that it is there. Recognition of the presence of basic moral truths that are known to all who are willing to reflect seriously on them no matter what culture they belong to is a beginning point to understanding that there are objective moral values that go beyond personal reasoning and societal culture and point to an authority beyond us.

An understanding of the existence of common mortality can lead to knowing that there must be a source of moral truth and the need to be reconciled to that source. Until people see that, the Christian message of God sending his son to redeem the world doesn’t make sense. Common morality can be one step along the path to a relationship with God.

How nonmoral beliefs impact our moral decisions

When people try to support a belief in cultural relativism they often point to the diversity of moral practices in different cultures. One of the ways to explain how that diversity can exist even if morality is really based on objective moral values that are universal is to show how two cultures with similar basic moral beliefs can have different moral practices due to differing nonmoral beliefs. The treatment of the elderly by Eskimos is a common example. However a recent discussion in my medical ethics class reminded me that differing nonmoral beliefs can lead to differences in the ethical judgments we make as individuals as well.

The class was discussing the case of a patient with ambiguous genitalia who sought care at age nineteen wanting to know why she had never menstruated. The physicians discovered that even though the patient had a generally female body type and had been raised as being female this person had no female genitalia and was genetically male. We were discussing whether it was permissible for the physicians to withhold the information that the patient was genetically male. The class was divided with some saying the whole truth needed to be revealed and others saying that to do what was in the best interest of the patient it was permissible to withhold that information.

As I reflected on how the students had supported their positions it became clear that there was a difference in the nonmoral beliefs between the two groups of students that led to their different moral positions, even though they all had very similar basic moral beliefs. Some of the students believed that gender was determined by genetics and this patient was truly male. They were the ones who said it was not permissible to withhold the information that the patient was genetically male. The other group of students believed that there were other things besides genetics that entered into the determination of gender (such as the influence of hormones on fetal development at certain critical times in development and socialization based on the assumed gender from body type). They were the ones who thought it was permissible to withhold the information.

I had intended for the case discussion to be focused on what it means to tell the truth and whether that always needs to include the whole truth. The students’ responses reminded me how important our nonmoral beliefs are in making moral decisions.

Costly grace and bioethics

I am currently reading Dietrich Bonhoeffer’s book, Discipleship, and thinking about how what he said relates to bioethics. One of the significant concepts in this book is the idea of costly grace. Bonhoeffer wrote “It is costly, because it calls to discipleship; it is grace because it calls us to follow Jesus Christ. It is costly, because it costs people their lives; it is grace, because it thereby makes them live. It is costly, because it condemns sin; it is grace, because it justifies the sinner. Above all, grace is costly, because it was costly to God, because it costs God the life of God’s Son – “you were bought with a price” – and because nothing can be cheap to us which is costly to God. Above all, it is grace because the life of God’s Son was not too costly for God to give in order to make us live.” (45)

One of the difficulties of Christian ethics (including Christian bioethics) is that when we focus on doing what is right it can seem like we are saying that doing what is right is necessary to gain God’s favor and that we are negating the foundational Christian doctrine of salvation by grace. That was a significant issue in Bonhoeffer’s Germany. The established church had taken a position which Bonhoeffer called cheap grace. They were saying that since God’s grace is freely given and we can do nothing to earn it, we should not try to do what is right, but should conform to the standards of society to show that our salvation is entirely free and not related to any effort of our own. That led them to conform to the Nazi regime’s practices that were engulfing their country and not to oppose them.

Bonhoeffer helps us to see that Jesus has paid the price for our salvation and that we can do nothing to earn it, but that God’s grace calls us to be disciples of Jesus. As we seek to follow him by the power of his Spirit and his transforming grace, we will seek to live by his standards. The moral reflection of Christian bioethics helps us to understand how God would have us live in response to his grace in our increasingly complex world.

Bonhoeffer, Dietrich. Discipleship. Minneapolis: Fortress Press, 2003.

Bioethics and Christmas part 3

Over the last two weeks I have been reflecting on how Christmas relates to bioethics. My thoughts were focused on how Jesus’ incarnation helps us understand the inherent moral value of every human life and particularly the value of unborn human beings. But I think there is another way that Christmas relates to ethics that may be even more significant.

One of the problems with ethics in general and bioethics in particular is that none of us lives up to even our own ethical standards. All of us, whether Christian or not, understand that there are ethical standards that we ought to live up to, but we are not able to do it. Ethics by itself raises the problem of our being unable to live up to ethical standards, but it doesn’t give us a good solution. One way to respond to our inability to live up to ethical standards would be to give up in despair. Jesus’ incarnation gives another alternative, hope.

When the angel announced Jesus’ birth to the shepherds outside of Bethlehem, the message was “I bring you good news that will cause great joy for all the people. Today in the town of David a Savior has been born to you; he is the Messiah, the Lord.” (Luke 2:10-11 NIV) The joy in that message is based on the hope it provides. The angel gave us the answer to the problem raised by ethics. Since we all fall short of both our own standards and God’s, we need help. The angel announced that the help we need is the Messiah who has come to be our savior. Instead of despair at our inability to live up to moral standards there is hope, hope that begins with the arrival of God in the form of a baby born in a stable and lying in a manger.

Glory to God in the highest!

Abortion: Unbridled Democracy in Action

 

When reading a piece by Joseph Ellis on the founding of the US, American Creation, I came upon an insightful saying. I am not sure if this is a common saying and/or if I have heard it before and it just didn’t click. Whatever the case may be, it caught my attention.

The context in which Ellis wrote the phrase, “Unbridled democracy in action,” was concerning the gradual removal of Native American tribes by the expanding United States. However, is it not the case that we see unbridled democracy in action, perhaps even more than ever, in America today?

Here I am not necessarily referring to the destruction of a people as an exercise of liberty, although addressing that may be apropos. I am talking about the extension of liberty at the expense of morality and justice. While we all stand firmly on the preservation of liberty, is this not the very principle people use to justify all kinds of deeds?

 

One such deed is abortion under the guise of “procreative liberty”. This is portrayed best, perhaps, in the mistaken ruling of Roe vs. Wade delivered by Mr. Justice Blackmun:

 

“The principle thrust of appellant’s attack on the Texas statutes is that they improperly invade a right, said to be possessed by the pregnant woman [Doe], to choose to terminate her pregnancy. Appellant would discover this right in the concept of personal “liberty” embodied in the Fourteenth Amendment’s Due Process Clause; or in personal, marital, familial, and sexual privacy said to be protected by the Bill of Rights…” (Section V)

 

The ruling did two dangerous things: 1.) Extended the rights of woman based upon an abstraction of the language of liberty in the constitution (I understand Blackmun cited case precedence also), and 2.) Usurped state’s rights.

The first is true because of a soft/fluid interpretation of the constitution. And despite the claims of Mr. Justice later in his delivery of the opinion of the court,  the second is true because the ruling made abortion legal nationally, which demolished standing state legislation across our nation without legislative due process.

Not to mention that this ruling negated the foundational facet of a three-faceted ideal: the right to life, the right to liberty and the right to the pursuit of happiness. What about life?

Stealth ethics

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.