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CHAPTER ONE: What Is Bioethics?
Samantha Jones is a seventeen-year-old speed skater. Her father
disappeared long ago. Sam has no idea where he is. Her mother has
worked two full-time jobs to earn the money to pay for the rink
time and skating instruction that she needed to achieve her cherished
dreams. She has won many regional and state competitions, and recently
was offered a chance of a lifetime. Samantha has been asked to join
the U.S. Olympic speed skating team for the upcoming international
races to be held in nine months in Oslo, Norway. She is ecstatic,
and her mother is so proud she literally glows.
Samantha has also been sharing her life and dreams with Loren Kelly,
another Olympic hopeful. They have spent hours at the rink together.
With Sam's mother gone so much of the time at her two jobs, with
her loneliness, and with her growing affection for Loren, Sam has
begun to sleep with Loren. They plan to marry some day, after they
both achieve some of their high aspirations.
Six months before the races, Sam misses her menstrual period. Perhaps
it is just her body adjusting to the new birth control pills she
received at Planned Parenthood. When she misses her second period,
however, she schedules an appointment to meet with the nurse clinician
at the local Planned Parenthood clinic. She is stunned to learn
she is pregnant. Not to worry, though, says the nurse. A minor procedure,
performed for a small fee, will allow her to go forward with her
plans and make her mother happy. All her hard work will still pay
off.
Joe and Ellen Pound are deeply in love. They have an ideal marriage
in almost every respect. They have wonderful jobs that provide excellent
financial security, are active in their church, and come from supportive
warm families. Their deep heartache, however, is their childlessness.
They would love to have children, but after six years without contraception,
and thousands of out-of-pocket dollars spent on infertility treatments,
they still have empty arms.
Then Dr. Faith tells them about an option they hadn't considered.
Since Joe's sperm count is normal, and his sperm motility is excellent,
would Joe and Ellen considered using Joe's sperm to fertilize a
donor egg? This could be grown in vitro and then surgically placed
into Ellen's uterus. The donor egg could be from an anonymous donor,
from a family member-such as Ellen's sister, or even purchased via
the internet from a beautiful, highly educated young woman. While
the cost would be significant, and the success rate only fair, the
danger to Ellen would be limited. If this were to be successful,
Joe and Ellen would provide a Godly, loving home for a long-awaited
child.
Thousands of children die every day in Bombay because their starving
families have no way to feed them. A dollar per day will feed, clothe,
house and educate a child.
Tom and Mary Gomez have been driving their Ford Taurus for seven
years. It has over 90,000 miles on the odometer. While Tom is channel
surfing on Saturday afternoon, he sees the "Child Care Ministries"
infomercial fund drive, and actually stops and watches the show
for about ten minutes. He changes back to the football game, and
flips open the Consumer Reports issue on new mid-size sedans. Should
they move on up to a Buick this year?
What do these scenarios have in common? They all involve bioethical
decision-making. Bioethics have been a part of human concerns from
the time that Cain decided to kill Abel in hopes of improving his
own quality of life. Hippocrates specifically discussed abortion,
infanticide, euthanasia, suicide and sexual relations between physicians
and patients. But while the broad field of bioethics is ancient,
some of today's questions are brand new.
Abortion was legalized in the U. S. in 1973 with Roe v. Wade. By
the 1980s artificial respirators had become common even in community
hospitals. The federal government began discussions to approve federal
funding of embryo research in the late 1990s. We may not realize
it, but on a frequent, almost daily basis bioethical questions confront
us.
As we study together for the next 13 lessons, we will use four
guides. John Wesley, the great English reformer and founder of the
Methodist movement summarized these in what has become known as
the Wesleyan Quadrilateral. We will employ Reason, God's gift uniquely
given to humankind, to explore Scripture, his Holy Word. Experience,
the inner witness of the Holy Spirit in our lives over many years,
and particularly God's wisdom given when we seek his assistance
in prayer, will be our third guide. Fourthly, the Tradition that
we will employ will include the thoughts and actions of the Protestant
and Roman Catholic churches through the ages, as well as the wisdom
of a new group: Christian bioethicists. These modern clinicians,
theologians, scholars and lawyers will help us understand the cumulative
wisdom of the ages, and then apply this wisdom to the burgeoning
discipline of Christian bioethics. Each lesson contains references
from Christian scholars that I highly recommend for review.
We have already been applying Reason to this effort, and I have
already been directing our thoughts to address some of the age old
Traditions, particularly as applied by our new Christian bioethicist
thought leaders. With each lesson I will highlight and reference
these Christian bioethicists, and try to tie these new thinkers
back to their deep church roots. Every lesson should begin and end
with a request for the Holy Spirit to illuminate our minds, reminding
us of his work in our lives over the years (Experience) and actively
leading us into deeper Scriptural truths together. With this in
mind, what does the Bible have to say about bioethics? A lot more
than you might first think. Let us examine some passages together
as we begin to survey this broad field.
Scripture and Discussion Questions
Exodus 20:1-17
Leviticus 18:1-23
Leviticus 19:9-10, 14-18
James 1:5-8
Romans 1:18-31
1) As you review the "Ten Commandments" is there an obvious
division between categories of command? Is there any significance
to the order in which the commandments occur?
2) Leviticus 18 delineates a number of unusual sexual relationships.
Have you heard of any of these occurring lately? If so, have these
sins been limited to "worldly" settings? What bearing
does this have on any of this bioethical discussion?
3) Leviticus 19 discusses rules for general social welfare? Do
we respect these guidelines today? If not, what happens in our society?
Are these rules characterized by principles not present in today's
welfare or international diplomacy laws?
4) James 1 is specifically referring to trials and temptations.
What temptations are inherent in today's bioethical debates?
5) What does Romans 1 have to do with this whole discussion?
6) Why are Americans so willing to spend great sums of money on
infertility work-ups but less willing to adopt? What are the moral
and cultural implications of cross-cultural adoptions?
7) Is capitalism Biblical?
8) Many Christians would feel comfortable selling their hair to
a wig-maker, or the blood to a plasma program. What is the difference
between this and selling sperm or eggs to the highest bidder? Remember
neither sperm nor eggs are live, and each contains only 23 chromosomes.
9) What role does television play in forming public opinion regarding
bioethical issues? Give examples.
10) Is there a moral difference between adoption and surrogate
motherhood?
11) Do you know what percent of your gift goes to overhead when
you give to the charities that you support? Should you?
Comments
1) Samantha's mother's decision to work two jobs may have contributed
to Samantha's situation. Time may be the most important thing we
can give our children.
2) Contraceptives are available for our children through organizations
like Planned Parenthood, with no parental notification. Abortion
is legal in many states without parental notification.
3) Every abortion has multiple victims. Abortion involves the baby,
the mother, the father, the extended family, and all of society.
4) Justice is a term often applied to situations within our own
national or regional borders. Many Christians in emerging nations
find America's hoarding of natural resources and wealth incomprehensible.
Many Christians in America feel that even on a national level there
are great injustices in allocation of goods and services.
5) "A minor procedure"-from the first vignette emphasizes
the power of terminology. Advocates of abortion are never called
Pro-abortion. Interestingly, however, the press often refers to
"sanctity of life" or Pro-life forces as "anti-abortionists".
6) There is an old adage "He is so heavenly-minded that he
is no earthly good." Jesus spent much of his ministry addressing
pain, disease, suffering and interpersonal discord. We cannot abandon
these issues to those who do not honor Christ.
PRAYER REQUESTS
As you close today's lesson together, pray that God will illuminate
your mind and heart in the upcoming weeks. Pray that the Holy Spirit
will show you areas in society and in your own life that require
more thoughtful deliberation and wisdom from God.
For Further Reading:
Scott B. Rae, Moral Choices, an Introduction to Ethics (Grand Rapids,
Michigan: Zondervan Publishing, 1995). Dr. Rae is a professor at
BIOLA University in Los Angeles. His text is a very readable introduction
to bioethics, from a Christian perspective. While giving reasonable
perspectives from various schools of thought he does not leave the
reader wondering what he believes on various difficult issues. If
one has limited time and desires a broad Christian overview of the
field, this text is well worth reading and keeping for your reference
library.
John S. Feinberg and Paul D. Feinberg, Ethics for a Brave New World
(Wheaton, Illinois: Crossway Books, 1993). The Drs. Feinberg serve
on faculty at Trinity Evangelical Divinity School in Deerfield,
Illinois. These brothers individually write alternating chapters
of an engaging, stimulating nature, that each deal with one of the
major issues of the day. This is an excellent resource for Christians
seeking a broad introduction to the field of bioethics. A list of
abbreviations and a Scriptural index are helpful for the inquiring
believer.
Stephen E. Lammers and Allen Verhey, eds., On Moral Medicine, 2d
ed. (Grand Rapids, Michigan: Eerdmans Publishing Company, 1998)
offers a series of scholarly essays for those who wish to dig a
little deeper. Parts I and II focus on the relationship between
religion and medicine and specific concepts within this domain.
Part III has nine chapters addressing specific issues within medical
ethics. Chapter essays are authored by a "Who's Who" of
Christian thought leaders such as Pope John Paul II, William May,
Karl Barth, Paul Ramsey, Nicholas Wolterstorff and many others.
While not designed to be a general reference, it may well provide
thought-provoking reading for several years if taken an essay per
week, chewed thoughtfully, and digested slowly.
In what many people feel is a classic, Tom L. Beauchamp and James
F. Childress, Principles of Biomedical Ethics, 4th ed. (New York,
New York: Oxford University Press, 1994), provide a broad-based
foundation for a secular approach to bioethics. The inquiring Christian
desiring a scriptural foundation for their pursuit of bioethical
knowledge might do best with Rae's or the Feinbergs' book, but this
would certainly help to round out one's limited library.
Much discussion and debate in ethics devolves eventually to the
question of authority. Are we to fall back to our basic native intellect
to sort through this marshland, or will we rely primarily on scripture
and religious tradition? Nicholas Wolterstorff, Reason Within the
Bounds of Religion, 2d ed., (Grand Rapids, Michigan: Eerdmans Publishing
Company, 1984), answers the latter, resoundingly. However, he challenges
the reader to be very careful to establish exactly what a sound
interpretation of Scripture really does tell us before we become
too dogmatic about our moral positions.
Co-founding editor of the Journal of Biblical Ethics in Medicine,
Franklin E. Payne, Jr., M. D., Biblical Healing for Modern Medicine
(Augusta, Georgia: Covenant Books, 1993), offers an insightful insider's
tour through medicine as seen from the perspective of a conservative
Biblical worldview. This should probably be read after one of the
basic texts. While one may not agree with everything Dr. Payne writes,
this book will certainly challenge to deeper thought.
A lively debate, not within the scope of this curriculum, focuses
on scripture itself, and our ability to understand what scripture
is saying. Hermeneutics is the discipline that concerns itself with
interpretation. Deconstructionism and associated patterns of reinterpreting
texts of all sorts and particularly scripture, is a widespread phenomenon
on secular and Christian campuses throughout the world. For a full
discussion see Kevin J. Vanhoozer, Is There a Meaning in This Text?
(Grand Rapids, Michigan: Zondervan Publishing House, 1998). Pages
9-35 set the stage for the debate.
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