Life unworthy of living

Sometimes we need to remember the past. Of course that is what historians try to teach us. The recent translation into Italian of the 1920 German book Allowing the Destruction of Life Unworthy of Living by Karl Binding and Alfred Hoche prompted a reminder by Italian historian Lucetta Scaraffia about how the central idea of the book played out over the next few decades in Germany (see Washington Post article).

She suggests that the history of that idea is relevant to current bioethical issues. Some of those have been discussed recently on this blog. A few days ago Joe Gibes wrote about decisions to abort fetuses found to have major abnormalities such as Down syndrome. Back in December Jon Holmlund wrote about the use of PGD to diagnose embryos with major genetic disorders so that parents at risk for having a child with such a disorder could choose to give birth to a child without the disorder and not bring embryos with the disorder to birth.

Both the practice of aborting fetuses with a major disorder and doing PGD to choose which embryos should be brought to birth to avoid giving birth to a child with a genetic disorder involve the concept of a life unworthy of living that Binding and Hoche wrote about. If we make a decision to abort a fetus with Down syndrome or even one with a more serious disorder we are making a decision that the life of the person who that fetus will be is not worth living. If we choose to create multiple embryos and choose to implant those who do not have a serious genetic disorder so that they can live, but choose not to implant those who have the disorder so that they will not live we are saying that the lives that would be lived by those embryos who are discarded are not worth living. Whether one believes that and embryo or a fetus has full moral status or not they are unique individuals who have live that they would live if they are allowed to. Not allowing them to live those lives due to the presence of a disorder is saying that those lives are not worth living.

Remembering what happened in Germany helps us remember what a serious thing it is to say that a person’s life is not worth living. The idea that Binding and Hoche wrote about began as a philosophical concept, but it was embraced by the German government under Hitler as a reason for German physicians to put to death mentally deficient children whose lives were thought to be not worth living. Later that was expanded to large numbers of Jews and others whose lives were not thought to be worth living. The experience in Germany helps us to see that the idea that there are people whose lives are not worth living depends on a negation of the fundamental idea that every human life has inherent value. As Christians we understand that this value is due to our being created in the image of God. Even for those who do not have that understanding the inherent value of every human being underlies the concept of universal human rights that has become the foundation for global justice.

The German experience reminds us that there are some lines that we must not cross. One of those is saying that another human being has a life that is not worth living and using that as the justification for ending the life of an embryo or fetus.

Embryos from laboratory produced eggs

The London newspaper The Independent recently reported that a researcher at Edinburgh University is ready to seek permission to try to produce human embryos by the fertilization of mature egg cells that have been produced from ovarian stem cells in the laboratory. The research team has taken immature human egg cells produced from ovarian stem cells by as researcher at Harvard and transformed them in the laboratory into cells that appear to be mature human eggs. The proof that they are mature eggs will be obtained by showing that they can be fertilized to produce human embryos. The embryos will then be frozen or destroyed since they are being produced for research and English law requires that they not be allowed to develop past 14 days.

The obvious ethical question is “Should we do this?”

Those who support doing this see the ability to develop fully functional human eggs from the stem cells found in the ovary as a way to provide the ability to have children for women who are past the time that their ovaries naturally produce eggs. They also express hope that the ability to produce new egg cells might be a way around the loss of ovulatory function that is associated with the development of menopause and its attendant problems. It would also be a way of producing a much less limited supply of eggs to use in research including cloning.

But should we do it?

Ethical concerns abound. Is it worthwhile to create and destroy human embryos to prove that a scientific technique is doing what it was designed to do? Is there any way to determine whether children born with the use of eggs developed from stem cells in the lab are at increased risk for defects without subjecting some children to those risks? How could you justify doing safety studies on children produced by this technique who could not give their consent? Would attempting to delay menopause by inducing the production of new eggs within aging ovaries be a good thing to do? Is it really good to make it easier to do things like human cloning?

For those of us who conclude that human embryos have full moral status it is clear that producing human embryos in the laboratory to confirm that this technique is successful and then destroying those embryos is wrong. Even those who do not think that human embryos have full moral status have reason to think that this is not a good path to start down from concern about the safety of the people who could be born using this technique.

This is one of those things we should not do.

Religious freedom and health insurance

On January 20, 2011 the department of Health and Human Services announced its ruling regarding a controversial part of the current administration’s healthcare plan. The health care plan includes a provision requiring all insurance providers to cover contraception at no cost to those who are insured. There is a religious exemption in the plan that allows churches who are morally opposed to contraception to offer insurance to their employees which does not provide this coverage. However, this exemption does not include church-affiliated organizations such as schools and hospitals. After the original requirement was made public last August, many church-affiliated organizations had requested that they be included in the exemption. The announcement a week and a half ago stated that such church-affiliated organizations would not be included in the exemption and would have to provide the coverage even if it violated the moral convictions of the organization. Those organizations were given an extra year before they have to comply with the regulation, but their compliance will be required.

This ruling is a significant attack on religious liberty in the United States. Religious liberty should include protection from being forced by the government to violate one’s moral values. It should include more than just the freedom to have beliefs. It must include the freedom to live in a way that does not violate those beliefs. Since the primary religious organization that has taken a moral stand against the use of contraception is the Roman Catholic Church, many see this is a purely Catholic issue, but it is much more than that. I do not happen to agree with the Roman Catholic position that says that all contraception is morally impermissible, but it is a well reasoned position based on fundamental parts of the Roman Catholic faith. As such their position should be respected, and they should not be forced by our government to violate their moral beliefs.

One part of the ruling impacts many non-Catholic church-affiliated organizations. The requirement for covering contraception includes drugs such as Plan B and Ella that are used after unprotected sexual intercourse to prevent a pregnancy from continuing if one has occurred. These medicines are not actually contraception because they do not work primarily to prevent conception, but to prevent the continuation of a pregnancy before the pregnancy is known to exist. Many of us to come from an evangelical Christian position find being forced to pay for these medicines just as morally objectionable as the Roman Catholic Church views other types of contraception.

It is interesting that when Robert George, Timothy George, and Chuck Colson drafted the Manhattan Declaration back in 2009 they chose to affirm three foundational moral principles which Christians from the Orthodox, Roman Catholic, and Evangelical traditions all supported. Those three principles were the inherent dignity of every human being, marriage as a conjugal union of man and woman, and religious liberty. I think there are many who may have wondered why they included the third principle as something on which Christians needed to take a stand. This ruling by HHS helps to make that more clear.

Eight is Enough

 

In response to a family’s having eight babies by IVF and gestational surrogacy:

“In this society, if you have money, you can have miracles!”

“Having children is now a luxurious game for the rich!”

“This completely topples the traditional meaning of parents.”

“From the sound of it, they just tried to have some kind of baby machine.”

“Gestational surrogacy is the business of renting out organs.”

“Why did they have to hire so many people to have babies for them? Did they think they had the right to bear children just because they were rich? Secondly, what respect to life did they show? Multiple pregnancies are super risky.”

These are reactions from the public, press, and government officials to a wealthy couple having two sets of triplets and one set of twins via IVF and two surrogates in China, where there has been an official one-child-per-family policy since 1978. Last month a southern Chinese newspaper broke the story of this family, and you can sense the angry reaction of their society in the quotes above.

(There is apparently a large surrogacy industry in China, despite a 2001 ban on Chinese hospitals doing the procedures. The manager of one surrogacy agency reports being overwhelmed with applications from aspiring surrogate mothers, most of whom are having emergencies and “need a large sum of money.”)

In the uproar, we can see erupting some of the tensions surrounding these technologies that are still somewhat under the surface in our own society: What about the divide between those who can and can’t afford reproductive technology? What does it mean to be a parent, especially where surrogacy is involved? Is surrogacy the commodification of women, the reduction of woman to womb?

There is a lot of worrying that China will catch up and surpass western economy and culture. It seems that in some areas they have already caught up with us: pushing the envelope of societal norms with the use of reproductive technologies, and the commodification of women in the process. In another area they are still far behind us: they have not yet lost the ability to be uncomfortable, shocked, even a little disgusted at the ethical implications of these technologies for families and society.

 

(Sources: Here and Here)

Q&A: On the Observance of Sanctity of Human Life Sunday

 

 1) What do we mean by the phrase “Sanctity of Human Life?”

Specifically, we mean to communicate the biblical truth that each and every human life, being made in the very image of God, is a special object of God’s love and concern (Gen 1:26-27; 9:6; James 3:9).

God is no respecter of persons, and so we ought not to be either. Every human life, no matter how young or old, no matter how functional or dysfunctional, is truly worthy of our love and deepest respect. While human life is not to be worshipped, it is to be valued greatly and protected.

 

2) What is the origin of the practice of observing a “Sanctity of Human Life” day each year?

President Ronald Reagan began the annual tradition. By his proclamation, January 22, 1984, the 11th anniversary of the Roe v Wade decision, marked the first national observance of the Sanctity of Human Life. That tradition has been continued by some, but not all, presidents since Reagan.

Political observances aside, Christians across the denominational spectrum have annually been calling attention to the tragedy of abortion on demand ever since the Roe v Wade decision (Jan 22, 1973).

Roe v Wade was a wake up call. Specifically, it awakened evangelical Christians in America to the responsibility of being salt and light (Matt 5:13—16) in a culture that was growing increasing callous towards human life.

 

3) What does it mean to be “salt and light?”

Being salt and light entails bringing the gospel of Jesus Christ to bear on a lost and dying world. Preaching and personal evangelism are of paramount importance to the task, but they are incomplete and often rendered ineffective if our words are not matched by lives radically altered by the Gospel.

A life radically altered by the Gospel is one that is no longer controlled by fleshly desires and worldly thinking, but rather, it is in tune with God. It values what God values, and it finds deep and abiding joy in obeying His commands.

What is it, then, that God commands of His people?  Here is the answer He gave through the prophet Micah:

He has told you, O man, what is good;
And what does the LORD require of you
But to do justice, to love kindness,
And to walk humbly with your God?   (Micah 6:8, NASB)

 “Doing Justice” – that is what Sanctity of Human Life Sunday is about.

Among other things, “doing justice” demands that we advocate for those who cannot advocate for themselves, that we uphold the interests of the weak over and against the schemes of those who would oppress them.

Human Life is under attack, and doing justice demands that Christians concern themselves with the problem and minister accordingly.

 

4) In what ways is human life under attack today?

Human life is under attack across its entire spectrum. On the back end, it is threatened by the evil of euthanasia. The notion that killing can be a genuinely compassionate ministry to the aged, disabled, and/or infirm is a lie borne straight from the pit of Hell.

Even towards the healthy, we see in our culture a blatant disregard for the value of human life. Murder and violent crime are the obvious signs, but no less concerning is the disregard for human life that permeates much of what passes these days for entertainment.

For the Romans, the sinful appetite for violence was satiated at the Coliseum; for Americans, the appetite is no less strong though the venue for its satisfaction may be different. Yes we have our sports arenas for modern-day gladiatorial contests that feature all the violence without, it is hoped, the killing (e.g., UFC);  but we also have our television viewing rooms, our video game stations, and comfortable cinemas where, for our viewing pleasure, human bodies are violated, desecrated, and discarded like rubbish.

Now, what generally gets the most attention at Sanctity of Human Life observances is the assault on human life on the front end, and elective abortion in particular, which has claimed over 50 million lives in the US since Roe v Wade.

Many, frankly, have grown tired of the public controversy over abortion and just wish it would go away. But, absent a mass awakening in our country to the Gospel of Jesus Christ, the killing will continue. As the Christian’s charge to protect the innocent and vulnerable is neither optional nor in harmony with the worldly ethos of our day, we may expect that the controversy will continue.

We can take heart, however, in the fact that we stand in good company for Christians have been battling the evil of infanticide from the Church’s earliest beginnings. In Roman culture, it was socially acceptable for fathers to abandon unwanted babies on the doorstep of the family home – death by exposure largely served the same purpose that abortion does today. Convinced, however, that all human life is a gift of the Creator God and thus to be valued and protected, early Christians not only refused to participate in the horrific practice, but even more, they rescued many an abandoned child.  As they did so, they provided a powerful witness to the love of God and his gracious salvation extended to helpless sinners.

Human life on the front end is also threatened in our day by the effort to control reproductive outcomes and, in particular, the attributes of our progeny. Whereas the Romans had to wait and see what “nature” delivered, nowadays we have the increasing capacity  to determine what first goes into the womb.

Implicit to the drive to select children of a specific type or kind is the judgment that some children are not worth having.

In China, that judgment has manifested in a higher abortion rate for female offspring that has left the population with an enormous gender imbalance. That imbalance poses for China serious threats to peace and order – both internally, and with its neighbors.

Here in the U.S., gender selection is occurring, though not on the same scale as in China. Its not that we are any more humane, however, its just that our focus has been more on the elimination of babies perceived as defective.

And so, for example, those among us who lived in the days prior to pre-natal testing recognize that we have in our midst fewer children with Down’s Syndrome. Current estimates are that somewhere close to 90% of children identified through pre-natal tests as having Down’s Syndrome are now aborted.

 

Reproductive medicine has not only yielded an increasing capacity to control the makeup of our children, it has also created a huge “surplus” of human embryos. Most of these embryos have been consigned to the freezer. Few will ever come to occupy a womb, but instead, most will either expire on the freezer shelf or be dissected and destroyed in a medical laboratory.

To assuage the conscience uneasy about embryonic experimentation, researchers and their supporters tell us that these embryos are not really human beings or “persons,” but we know better. We were all embryos at some point, just as we were infants, and then toddlers, and then children, and so on.

From conception onward, we are who we are: individual persons known and loved by God and, thus, to be loved according to His command: as neighbor. Neighbor love is sacrificial, but note, it sacrifices not the interests of the one being loved, but rather, those of the one who loves. Killing an innocent neighbor can never be a genuinely loving thing to do.

 

 5) So, what is the Christian to do?

First, we must recognize the assault against human life for what it is. Most fundamentally, it is spiritual warfare. We face an enemy, Satan, whom the Scripture describes as a “murderer” (John 8:44) who “prowls around like a roaring lion looking for someone to devour (1 Pet 5:8).

Second, we must then utilize spiritual weapons.

1)    The Gospel Truth

The Gospel of Jesus Christ calls sin for what it is, but doesn’t leave the matter there;

It also proclaims in Christ Jesus redemption and forgiveness to all who would repent and place their faith in Christ Jesus;

It is lived out through daily ministry to neighbor – word and deed must be in sync.

2)    Prayer

Much prayer is required. We are up against a mighty foe, and so, we must call upon the Most High God

3)    Guarding our hearts and minds

We must take care to not let that which is unwholesome and impure to capture our hearts or minds;

This is not a call to disengage from culture, but rather, a reminder of the need to filter it and deny it a controlling influence.

 Third,  we get involved  i.e., we seek to be salt and light.

1)    Through personal evangelism

Hearts and minds must be transformed by the Gospel. Yet, as the Apostle Paul in his letter to the Romans declared, “how can they believe in the one of whom they have not heard?”

2)    A personal, social ministry – several avenues exist

Making other people’s problems our own; sharing burdens

Working with agencies whose aim it is to uphold the value of human life

Advocacy in the Public Square: telling the truth in love, pointing our culture to God’s vision of the good life

Science, politics, ethics, and emergency contraception

Last December 7th, Health and Human Services Secretary Kathleen Sebelius instructed the FDA not to give over-the-counter (OTC) status to the emergency contraceptive drug Plan B One-Step for girls under age 17 (It is currently OTC for all women 17 years of age and older). Sebelius gave as her reason her “conclusion that the data … are not sufficient to support making Plan B One-Step available to all girls 16 and younger, without talking to a health care professional.”

Commentators immediately went ballistic, bemoaning the “fact” that the science shows that this product should be approved OTC for all ages, but that politics overruled the science. Last week a Perspective piece in the New England Journal of Medicine (NEJM) made the same assertion, as did an earlier Viewpoint in JAMA.

However, there is more to these claims of scientific-objectivity-being-overruled-by-politics than meets the eye. Science can only tell us what is or what can be, never what should be. You cannot from the premise, “We can do such-and-such,” derive the conclusion, “Therefore, we should do such-and-such,” without the intervening value statement that “Such-and-such is good, or desirable, or right.”

In his inaugural address, President Obama promised to “restore science to its rightful place” in government, to “base our public policies on the soundest science.” But public policy decisions are inevitably decisions about what should be done; every regulation in the law is an acknowledgement that those governing believe that one particular way of doing or taxing or regulating something is better than the alternatives. In other words, every policy decision is based in some part on ethics and morals — things which objective science cannot reveal to us. To “restore science to its rightful place” means “let’s get our facts straight.” This is important: good ethics (and good policy) must start with good facts. But science’s rightful place is not, and cannot be, to make the ethical decision for us.

Science can tell us the chances of Plan B One-Step preventing pregnancy after unprotected intercourse. It can give us statistics about how women use it and what the potential side effects are. It can not tell us whether or not it is a good thing that a 12-year-old who just had unprotected intercourse should be able to get the medicine without talking to an adult such as a medical provider.

Sebelius appealed to a lack of scientific data in making her decision; I do not know if she also had an unspoken political agenda. It seems at least mildly improbable that someone so staunchly pro-choice, who is part of the administration of a President and a political party that do not oppose Plan B on political or ideological grounds, would herself do so to gain political points or power. But I do know that, contrary to all the pundits, this decision, like all policy decisions, cannot be made by empirical science alone. The accusation of “Politics trumps science” is just a front for those whose own politics, morals, and ethics lead them to a different conclusion.

Losing control at Christmas

 

Throughout most of history, having children was not a matter of exerting control, but of accepting uncertainty. Whether and how the act of making love resulted in children was a mystery. In the pages of Scripture, having children — especially when one had been considered barren — was most often seen as a sign of God’s blessing: think of Eve, Sarah, Rachel and Leah, Hannah, Elizabeth …

Somewhere in the modern epoch the mindset changed. Children are still a blessing, but now they are also a liability, and we calculate how many hundreds of thousands of dollars it costs to raise a child. In the modern purview, since childbirth brings liability, it must be brought under control. The most portentous embodiment of this mindset change is the development of contraception. We now speak of “planned” and “unplanned” pregnancies — another way of saying “controlled” vs. “uncontrolled.”

But this is not enough control for moderns, for all contraception, other than abstinence, is imperfect. So when contraception fails, when we lose control, we establish the option of abortion, by which we re-assert control, by which we affirm the supreme modern value of control over life.

But even this degree of control is not enough. Why should we stop at merely preventing children, when we can control their conception? Thus we pursue reproductive technologies, by which the woman barren, like Rachel, or too-old-to-have-children, like Elizabeth, can produce a child. Yet this is still not enough; there is still too great an element of uncertainty, so we assert an ever-greater control over the process of conception by testing these children of reproductive technology before they are born or even en-wombed, in order to control who will live and who will not. Again, the mindset changes: children now are not only a blessing and a liability, but a product, manufactured to certain specifications and precise tolerances.

“Control” is not a bad thing. There are many in this world who would be much better off if they had a greater degree of control over their lives. But since we are a fallen race, the more we seize control of something, the more we ruin it in the process. We see this in our physical environment as we have increasingly asserted control over it; we will see it in our humanity if we continue in the path of controlling ourselves through enhancement and controlling our offspring through genetic manipulation.  One of the most vexing questions bioethics must answer is, How much control is right? And when have we gone too far?

Contrast the modern techno-birth with the most important birth in all of history, which was not a matter of control, but of surrender, surrendering control over birth. In the process, the “perfect” contraception — abstinence — fails! Yet from this act of surrendering comes the greatest gift the world has ever received. Is there a lesson here? Does our greatest good always lie not in grasping for greater and greater control, but in knowing when to relinquish control and surrender?

 

Why Bioethics Needs the Church (and vice versa)

Back in June I wrote a post to let people know about the newly published book Why the Church Needs Bioethics edited by John Kilner with contributions from many people connected to Trinity and the Center for Bioethics and Human Dignity. At the time my appreciation for what the book represented was based on the people involved and what they had set out to do. I just finished reading the book and they have accomplished their goal well.
They titled the book Why the Church Needs Bioethics, but it could easily have been titled Why Bioethics Needs the Church, because what comes through is how bioethics and the church need each other. I found the insights of biblical scholars and theologians such as Richard Averbeck, Kevin Vanhoozer and D.A. Carson particularly helpful in dealing with the issues of infertility treatment, enhancement, and the end of life that are the focus of the book. But many others from areas as diverse as business ethics, counseling, law, intercultural ministry, medicine and nursing, pastoral care, preaching and Christian education brought insights from all parts of the church to enlighten how we see the bioethical issues that people deal with in real life and how the church can play a role in helping them through difficult times. John Kilner, William Cheshire and John Dunlop brought each section of the book together to help the reader see how it all fit.
The church needs an understanding of bioethics to be able to help people as they face bioethical issues in their lives. Bioethics needs the church to enrich its understanding of how biblical truth impacts bioethical issues and how the body of Christ can prepare people for and help people through the bioethical challenges they face in their lives. Those of us involved in both bioethics and the church are challenged to bring those two together for the good of all.

Voting on personhood

The issue of how we define personhood or how we define who has full moral status is one of the most fundamental issues in bioethics. It determines who is included in our considerations of ethical issues. The worldview of Christians who understand the Bible to be the foundation of our understanding of God’s moral truth and who hold to the traditional creeds of the church points to a biological definition of personhood. This biological definition would include every living human being from the time he or she became a separate biologic entity as a zygote following fertilization or its equivalent. This is in contrast to those who would define personhood functionally by the presence of what are considered human attributes.
Next week the people of Louisiana will vote on an amendment to the state constitution that would add the following statement, “Person defined. As used in this Article III of the state constitution, “The term ‘person’ or ‘persons’ shall include every human being from the moment of fertilization, cloning or the functional equivalent thereof.”
For those of us with a Christian worldview the proposed amendment raises two questions. 1) Is this definition correct? We would answer that with an unequivocal yes. 2) Is it prudent to add this definition to a state constitution? The answer to that is less clear. If by adding this definition the lives of defenseless unborn human beings are spared then it is clearly a good thing. If this amendment leads to a reaction at a national level which more deeply establishes personal autonomy as the legal priority over the value of the lives of those who are unable to speak for themselves then more unborn lives may be lost than if it were not passed.
We must always be clear in expressing what we understand to be God’s moral truth. When we venture into public policy we need to understand that we are working in a fallen world where that truth may not be understood and a focus on the self may distort it. We need wisdom to decide how to proceed because what is most prudent may not be clear.

The Price of Knowledge

Is it ever good to not know? Is all information good information? These questions, I would contend, are at the heart of some of the testing options during pregnancy. Now before I stick my foot in my mouth, I am not referring to any medically necessary tests or procedures for pregnancies. These offer options for therapeutic solutions.

What I am referring to are tests that are in an effort to uncover “birth defects”, such as Down syndrome and Cystic Fibrosis. These two happen to be the most contentious of diagnoses because knowing your developing child has either of them offers no therapeutic solution(s). (I say “therapeutic solutions” because abortions are rarely that and are definitely not in the case of either of these diagnoses).

Opting to receive this particular kind of information during pregnancy does not offer much resolve. There are only two answers that it offers. One is somewhat reasonable and the other is not.

The first answer is so that parents may prepare themselves. This foreknowledge gives parents an opportunity to say: “brace yourself”, but it offers no power or control over the things to come. (I would interject that having knowledge about temporal things we cannot change is often more enfeebling than it is empowering).

The second is to take the life of the child. This “solution” is the real concern. Parents are offered information/diagnoses that leave some feeling as if their only choice is to end the life of a person of potential. This is a travesty that neglects the inherent value of this person, which is abandoned in the act of placing value upon an external instead of the value given by God.