Who’s Your Momma?

Recently, the Chicago Tribune reported the C-section delivery of Finnean Lee Connell on February 11, 2011 to 61-year-old Kristine Casey. Not only is Ms. Casey the oldest women on record in Illinois to bear a child, she also appears to be the state’s first parturient “grandmother.” Through the wonders of assisted reproductive technology, Ms. Casey’s uterus was recalled from post-menopausal retirement to incubate the child that her daughter, Sara Connell, and husband Bill had conceived via in vitro fertilization.

Commenting on the birth, Casey’s obstetrician, Dr. Susan Gerber, stated “the surgery itself was uncomplicated, and the emotional context of this delivery was so profound.” Indeed, it was for Ms. Casey, the fulfillment of a “deeper calling” that emerged as she contemplated her post-retirement years and her daughter’s protracted struggle to bear children. Of the whole experience, her daughter remarked, “It grew beyond the two of us having a child,. . . It was about the closeness with my mother, and our family having this experience that was unique and special.”

Also contained in the Tribune report was the analysis of Josephine Johnston, a research scholar at the Hastings Center, who reportedly “had no ethical objections to the idea of a 61-year-old having a baby, as long as she had undergone a thorough medical and psychological evaluation.” For Johnston, Ms. Casey’s surrogacy “seem[ed] like an unquestionably loving and generous thing for a family member to do . . . It’s a great story to tell the child . . . It’s one of those situations where outsiders might wonder if it’s OK or healthy. But the experience of that child and his family will be that it’s good. … If they treat it as good, it will be experienced that way.”

Your comments? Do you think Johnston has it right? Will this be “a great story” for Finnean and his family? Why might others “wonder if it’s OK or healthy?” Has Johnson passed over some important ethical concerns?

Kaddish “I Am Here”

This past fall, I had the privilege of attending the Houston Symphony’s production of

A prisoner in a special chamber responds to changing air pressure during high-altitude experiments. 1942. Dachau, Germany

Kaddish.  The Kaddish Project seeks to commemorate the noble struggle of individual Holocaust survivors, including four who have made their homes in Houston.  Much of my research at Trinity focused on the concept of personhood, that we are more than just biological systems but instead are “someones,” persons.  I couldn’t help but think of this as I heard the chorus sing the song of the persecuted Jews: I am someone and “I am here.”  Though mocked and beaten in the streets even in the days before World War II, the Jewish people of Europe taught their children that they were of value even though others thought otherwise.  The soloists and chorus related the story of one survivor’s recollection of a concentration camp.  When the prisoners arrived, those under 14 years of age and over 65 were separated to the left and killed.  They were less than optimal for the German labor camp, so they were eliminated.  Kaddish led me to reflect on how physicians were a significant part of the German “Final Solution.”  They were the ones who deemed the crippled and deformed, the mentally deranged and deficient economic burdens.  That’s why I think that as we look for disease and perform technical procedures, it’s important for us to remember that our patients are someones who we must relate to and care for.

Sterilization Decision Illustrates the Importance of Intent

In a recent British court case the mother of a 21-year-old woman who was pregnant with her second child asked that doctors perform a sterilization procedure at the time of her planned C-section.  The woman has a mental disability and the court is being asked to determine if she is capable of making her own decision regarding sterilization. If it is determined that she is not, her mother is asking for permission for her doctors to sterilize her.  The mother says that this would be in her daughter’s best interest due to her inability to care for further children and the likelihood that she would be separated from those children.

This request raises the concern that sterilization of those who had a mental disability was what the eugenics movement of the early 20th century proposed.  That attempt to rid society of those who were not desired by preventing their birth showed disrespect for the intrinsic human worth of those with a disability.  However, there is a big difference between sterilizing someone in order to decrease the burden on society and doing so because it is in the best interest of the person with the disability.  The mother says she  desires her daughter to be sterilized for the daughter’s benefit.

The moral difference between the eugenics movement and this mother’s request is one of intent.  To sterilize a person who lacks capability to make her own decisions with the sole intent of limiting the number of potentially mentally disabled offspring in society is wrong.  To sterilize a person who lacks capability to make her own decisions with the intent of doing what is in her best interest may be right thing to do.  If the mother’s intent is not actually her daughter’s best interest, but her own, then it may not be right.

Even though the acts may be the same and the consequences may be the same, intent is the deciding factor in this moral decision.

“Watson” vs. Humans

Watson supercomputer on Jeopardy.

Watson supercomputer on Jeopardy.Recently the quiz show “Jeopardy” pitted “Watson,” an IBM supercomputer, against the show’s previous top winners including Ken Jennings, the all time record holder for Jeopardy wins. With fascination, I watched “Watson” demolish the humans in a lopsided win. The event got me thinking. I tend to believe, contrary to futurists such as Ray Kurzweil and Nick Bostrom, that machine intelligence will never surpass human intelligence.

On the other hand, “Watson” “sounded” like a human and processed the information with a speed that surpassed the best human effort. Kurzweil, Bostrom and others believe that it is just a matter of time before technology will transform what it means to be human. The assumption is that human nature is malleable, not static. The hope is that technology can intervene to take humans to a higher level of existence and even immortality.

So my question is, what does this imply for human nature? Should Christians feel threatened by these developments?

Contemplating “The Scandal”

CBHD Scandal of Bioethics Conference Graphic

CBHD Scandal of Bioethics Conference Graphic

This coming July, the Center for Bioethics & Human Dignity will host its 18th annual conference. This year’s theme is “The Scandal of Bioethics: Reclaiming Christian Influence in Technology, Science & Medicine.” The conference theme poses a number of interesting questions that, I believe, would be worth considering in advance of the meeting.

First, do you believe Christian moral reflection has been marginalized in bioethical discourse and public policy decision-making, and if so, in what ways?

Second, what may we cite as the evidence of a contemporary bioethics bereft of Christian influence? How might the bioethical terrain differ from its present state if the Christian voice had enjoyed a more sustained presence in public policy discourse?

Third, to what may one attribute this marginalization of Christian moral reflection in bioethics? Is the problem external to the Christian community, or do we share in the blame? If the latter, in what way?

We’ll save the question of a way forward for another post, but perhaps you have other questions pertaining to the diagnosis of a diminished Christian influence in contemporary bioethics and its underlying cause(s).

Your comments?

How Important Are Those with Moral Status to Us?

I have a friend who is from Africa.  She sees a lot of things in this country from a different perspective that makes me think, and sometimes makes me uncomfortable.  We were recently in a discussion in a group at church about how we define who has moral status and how that impacts our moral decisions about human embryos and fetuses.  After the discussion she said she had noted that many Christians in America were quite passionate about the value of the life of those who were unborn, but didn’t seem to care as much about those who were born.  She said we stand up for the value of the lives of the unborn whom we will never know and who do not put any demands on us, but seem to neglect the value of the lives of those around us who are in need because valuing their lives would put demands on us.

I think my friend is right.  If we really believe that all human beings have full moral status we need to help people see the moral problems with abortion, destructive research on embryos, and the making and discarding of excess embryos in IVF, but we need to do much more.  We need to affirm the moral worth of those who have been born.  We need to care for widows, orphans, the poor, and those who are oppressed.  We can see God’s heart for them in the prophets and in Jesus.  There are many Christians who reach out to those in need and love them in tangible ways that express their understanding of their value as human beings.  More of us need to do that.  I need to do that more.

Ethics Ruminations from the Front, #1, Carolyn

John Kilner is one of my heroes—brilliant, erudite, engaging, willing to take on today’s ethical challenges. He also was my mentor while doing graduate study. I owe him. So, when he asked if I would consider working on a CBHD ethics blog, I didn’t hesitate—very long anyway—to agree.

I am a neurologist, active in a busy clinical practice. Additionally, I chair a hospital ethics program. My third job is as a group practice medical director supervising approximately 70 doctors in their work. My parents were missionaries. I am happily married and we have three of the world’s most beautiful, intelligent, grown children. I hope to reflect on life from these perspectives.

Carolyn

Carolyn was a dynamic, energetic, intelligent woman who ran libraries, administered programs, taught college students, and in a good way was always a force with which to be reckoned. She retired in her late sixties, still near the top of her game.

These days, at age 84, she lives in a nursing home, is doubly incontinent, wheelchair bound and often confused. She misses social nuances, and usually does not know the correct day. She doesn’t ask for assistance, she barks out orders. She is nearly deaf, and says embarrassing things to her family members during quiet moments at social functions. Her goal each morning is to make sure that someone lays out her clothes for the day. Not knowing what she will wear on wakening weighs heavily on her, but this burden is relieved by seeing the pants, T-shirt, (she no longer wears a bra), shirt and sweater (she’s always cold), on her closet door.

She has a Kleenex and Vaseline lip balm obsession, and can’t be without either of these. She cannot carry on a conversation.

What a tragedy, some would say. She will die without dignity, having lost her intellectual faculties, control of her bodily functions, her sense of humor, and her social skills. Isn’t her continued existence a waste? We could use Carolyn as a poster child for why we should allow mercy killing, some might say. She is using up financial resources and her loved ones’ limited time and energy. She is directly helping no one, and each of her days is just like the last.

Her son notes that as deaf as she is, she never wants to miss church. She has lost her singing voice, but she hums or softly mouths lyrics to the hymns. She grouses and commands, but she often eventually says thank you. She doesn’t read scripture anymore, but she completes verses aloud that others start. Whenever she sees him, the first question she asks is about his wife and her health.

He relates that his daily visits with his mother remind him that it’s not about him and that God uses hard times to grow our patience and character. He remembers the untold hours of teaching, care and prayer she poured into his life, and realizes that he could never repay this debt. He has come to realize that God wants his children to grow more and more into God’s likeness, not have easy, fun lives. He reflects that his mother may be helping him grow closer to God now than she ever did when he was a child, a young adult, or even a middle-aged man. The son is in no hurry to see Mom go home to be with Christ. He has come to see that God’s timing is best, and that God doesn’t abuse his children. More than ever, he is learning that God is all-wise, all-powerful, and all-loving.

I am Carolyn’s son.

Welcome to the Trinity Bioethics blog!

Warm greetings to the 300 or so alumni, students, and faculty connected with the bioethics degree programs at Trinity International University—and to others listening in!

The Trinity Bioethics Community (TBC) is a tremendous network of bioethics-trained people who have many insights and produce many resources that are well worth sharing. In addition to this blog, Trinity is launching a new online archive of excellent bioethics papers and projects that bioethics students at Trinity have produced. Members of the TBC are receiving information directly regarding how their best resources can become available through this archive. Whenever a new resource enters the archive, starting sometime in Fall 2011, posts to this blog will notify readers of its availability.

The alumni members of the TBC are also receiving information regarding how they can send to Trinity Town (the online alumni network) information describing the vocational and other settings in which they are using their Trinity bioethics training. Those communications will automatically be posted to this blog as well. So will announcements about bioethics-related events and other opportunities at Trinity.

Of special interest to many, though, will be the commentaries on news events and bioethical issues that will regularly appear in this blog. You are encouraged to reply to such posts as often as you can, to generate insightful discussions. Please also submit a new commentary/post of your own whenever you wish.

Wonderful new opportunities lie ahead for informing, challenging, and inspiring one another through the Trinity Bioethics blog!

 

John Kilner
Director
Trinity Bioethics Degree Programs