Science in Christian Perspective

Preface to Bioethics: Some Foundations for a Christian Approach to Bioethics

Al Truesdale

Professor of Philosophy of Religion and Christian Ethics
Nazarene Theological Seminary
Kansas City, Missouri

Before we construct a Christian bioethic, we must identify Christian convictions that apply directly to the encounter between biotechnology and ethics. All Christians who work on this frontier‹ethicists, members of the medical professions, research scientists, and developers of applied biotechnology‹share equally in the responsibility to be faithful to those convictions. They share a common responsibility for the integrity and moral content of the Christian faith. In this article, the author discusses three of the many primary Christian convictions that can provide a foundation for a Christian bioethic: (1) the value of human life; (2) individuality and social solidarity; and (3) God and technology.

Christians whose work involves them directly in biotechnology share equally in the responsibility for the moral implications of their work. The ethic developed in response to biotechnology should show that Christians accept and exercise their responsibility. In this paper, I will discuss three primary Christian convictions that can guide us in formulating a Christian bioethic: (1) the value of human life; (2) individuality and social solidarity; and (3) God and technology.

Seldom has an event so challenged Christian ethics as has the emergence of biotechnology. The sheer diversity in the availability and application of biotechnology is daunting enough. Even more challenging is the complexity of the moral questions biotechnology has spawned. Perhaps as never before, Christian ethicists, scientists, and industrialists face a range of moral problems for which the Scriptures and Christian tradition have very few direct answers. Written in pretechnological and prescientific times, the Bible cannot be expected to address directly the thorny moral questions the new reproductive technologies, for example, are generating. However, the Bible is most instructive not as a catalog of answers to moral questions, but as the primary source to learn about God and his relationship to humankind and the rest of creation. By listening carefully to God's Word and being transformed by him, we form virtues that reflect the character of God and that help us think and act in ways that are distinctively Christian.¹

As Christians we face the danger that our moral responses to biotechnology will not be distinctively Christian. While being morally defensible, our responses may result in little more than a philosophical ethic tinged with a religious flavor, not at all grounded in and informed by the faith we confess. A report of the Working Committee on Church and Society made to the World Council of Churches in 1981 warned against a Christian response to biotechnology that lacks a Christological center and unity. The report called for a bioethic that "makes sense of the claim that Christ is the unity of all life ..."² Christian ethicist James Gustafson lamented Christian ethicists who formulate responses to technology and the life sciences not as theologians but as moral philosophers who simply add a religious flavor.³ To help Christians make sense of their faith in relationship to bioethical decisions, the bioethic must build on primary Christian convictions and then press the moral questions to their deepest levels and widest horizons.

Although theologians and ethicists must do most of the theological and intellectual work, scientists and technologists who are Christians also bear responsibility for making clear the relationship between our moral response to biotechnology and our central theological convictions. All of us must give account of whether or not we do our work with clear reference to a Christian estimate of reality. Admittedly, the difficulties are often staggering, but for the sake of Christian integrity nothing less will be acceptable.

Gustafson, among others, has noted that the task for Christians is made more difficult because the problems arise and are defined without any reference to Christian faith. In science, the questions are technical and not theological in nature.⁴ They arise in a pluralistic and secular world⁵ where no single religion, including Christianity, provides normative answers. Instead, in the public arena the effort is to frame "an understanding of how a society will deport itself in conditions when one view of the good life, or of the nature of man, will not be imposed by force on all."⁶ While Christians understand the secularity of the public arena, we also know that responding to biotechnology only as secularists is an unacceptable option.

The standard by which we ought to be judged is not by how successfully we address a pluralistic society, but by how coherently we apply Christian convictions to questions raised in the ever-expanding applications of biotechnology. James Gustafson sums it up well: "[All of us] must help Christians understand technology in the light of their religious faith and convictions."⁷

There are beacons that can guide us in exercising our shared responsibility. Let us identify some primary Christian convictions that help form the foundation for a Christian bioethic. I will state them in their dialectical form.

The Value of Human Life

The first Christian conviction is that all human life is of inviolable but not ultimate value. This conviction provides sentinels that guard against both the exploitation and idolization of persons.

Development of this conviction must be prefaced by a Christian affirmation regarding anthropology. For Christians, "human" is first of all a theological category‹not a sociological, psychological, or economic one. As Christians our discussion of personhood begins with God who was incarnate in Jesus of Nazareth, the head of the new and true humanity. To be sure, political, biological, sociological, psychological, and economic factors figure prominently in our understanding of personhood. However, for Christians such elements are of lesser significance and must always be referenced to Christ, the ultimate anthropological axis. In Anthropology of the Old Testament, Hans Walter Wolff shows that personhood in the Old Testament is characteristically understood dialogically, or referentially. It originates and gains its significance in dialogue with God who is above all.  man sees himself as called in question, searched out and thus not so much established for what he is as called to new things. Man as he is, is anything but the measure of all things."⁸

That which is uniquely human derives not from being "of the dust of the earth," but from a unique relationship to God who breathes into humankind's nostrils the breath of life. "It is only the breath produced by the Creator that makes [humankind] a living soul, which is to say, therefore, a living being, a living person, a living individual."⁹

While knowing in advance that our anthropological starting point will not satisfy secularist orthodoxy, Christians nevertheless reject the post- Enlightenment practice of defining humanity in autonomous and immanentalist terms.¹⁰ The bioethic we develop must express a direct challenge to one founded on atheistic assumptions. We must be wise enough to know the difference.

Now let's turn more directly to the first conviction. The valuation of persons set forth in Scripture contrasts sharply with the valuation that issues from the Enlightenment and eighteenth century democratic philosophy. In the Bible, " Š the value of life is never independent or intrinsically cherishable by itself, for it always remains relative to the providential care and purposeful will of Yahweh."¹¹ Its value is bestowed, not intrinsic. Christ made known that everyone‹despite accidental differences such as gender, race, and social status‹is invited to enter the Kingdom by faith and to partake of all its riches. In continuity with the Old Testament, but reaching beyond it, Jesus reaffirmed the inviolable value God places on each person. Therefore, no person should reduce another to a "thing," an exploitable means to an end. Since each person has received inviolable value as God's gift, no one can disregard another's bestowed value without also disregarding the Divine giver. Alfred N. Whitehead referred to the Christian estimate of persons as humankind's "most precious instrument of progress."¹²

That human life is inviolable is the first part of the dialectic. The second part‹that human life is not of ultimate significance‹saves us from idolatry, a pervasive tendency in modern medicine and technology. In clear disagreement with Fredreich Nietzsche, Sidney Hook, et al., Christians believe that treating human life as autonomously valuable apart from theological considerations cheapens rather than elevates life. The modern worship of the individual as complete apart from God, Donald Shriver says, actually degrades personhood.¹³

From the first conviction, Christians can anticipate implications for bioethics. Because we know that our value before God doesn't depend on mutable circumstances, we can‹under certain circumstances‹willfully relinquish life without in any way jeopardizing our being valued by God. We don't have to hoard life. It is but one value set within constellations of other values that are also valued, and therefore secured, by God.

The first Christian conviction in its dialectical form will guard against two eminent dangers which face bioethics: (1) to devalue persons because society judges them undesirable, and (2) greedily to consume limited therapeutic resources when they could have a much greater salutary impact on others. Only those who treat human life as of ultimate value need exact its last morsel. Karl Barth stated both parts of the dialectic when he warned Christians against worshiping health even as he urged them to "improve, raise and perhaps radically transform the general living conditions of all men," perhaps even requiring "a new and quite different order of society, guaranteeing better living conditions for all."¹⁴

Because Christians place a value on human life that transcends the shifting valuations which arise from within mutable society, it saves us from debasing life through idolatrous self-worship. For Christians, both the preservation and surrender of life are transcendently anchored.¹⁵

Individuality and Social Solidarity
A second foundational Christian conviction is that in the Christian faith the individual is important, but individuality is always understood relationally. Hans Walter Wolff says that in the life of ancient Israel, the individual was always firmly integrated into the bonds of his family and thus of his people. "Wherever he is set apart or isolated, something unusual, if not something threatening, is happening, although it is also ultimately something essential if man is truly to become man."¹⁶

The second conviction was worked out systematically in Paul Ramsey's covenant-centered Christian ethic. According to Ramsey, God has made a covenant with people who therefore have an obligation to be faithful to that covenant by replicating it in all their relationships with each other. Fidelity to the covenant requires congruent fidelity between persons.¹⁷ Throughout, the biblical narrative constructs a picture of human life as essentially personal and essentially relational. Its unitary quality entails both.

Many Christian theologians and ethicists have developed this central Christian theme. J. Robert Nelson has done so eloquently in Human Life: A Biblical Perspective for Bioethics. He explains the relationship between the personal (individual) and social (relational) poles of human existence with reference to the Christian doctrine of the image of God. "Personal relationship in love belongs to the very being of God, from which human community and love derive."¹⁸ Nelson borrows from Karl Barth's Trinitarian idea that human beings constitute a parable of the divine nature itself, in the sense that authentic humanity requires complementarity among persons. Even gender distinctions have importance that rise above mere biological reproduction. The division of sexes enables human beings to know the most intimate I-thou relationship, which is love. Viewed parabolically, "the personal relation of complementarity between men and women is eternally pre-figured in the communal nature of God, namely, in the mystery of the divine trinity."¹⁹

A characteristically Christian understanding of individuality is markedly different from the narcissistic and even solipsistic perception of individuality so characteristic of late- and post-modernity. In both the Old and New Testaments, the individual receives one's being qua individual only in relationship to others, to the community. As presented in the New Testament, the Christian understanding of the individual is intensely dialectical. The individual is, but is not, apart from the community. In the New Testament, the church is the creation of God and is far more than the sum of its parts; yet importantly, the ecclesia includes its many members, with Christ as its head. The church both is, and is not, apart from its members.

The Christian understanding of self as socially constituted and corporately united stands against all atomistic and anarchic estimates of selfhood. It fosters awareness of social solidarity and cultivates responsibility. It raises a strong counter voice against the almost unchecked egoism and nationalism that often creep into the development and consumption of biotechnology. A Christian understanding of personhood should incline Christians to think and act with global and neighborly interests that moderate individual ones. For example, Christians should raise a united voice against the maldistribution of medical resources and the inequality of access to health care that exists in developing countries and in the United States. Stewart Kingma explains:

For vast portions of this part of the world [developing countries], 60­80% of the population do not have reasonable access to even minimal health services, while others in those same countries can readily get good care, including that of the very highest technology. Rural peoples in the developing world suffer from a host of preventable diseases and often cannot avail themselves of the simple techniques of preventive care; at the same time the urban people enjoy the presence of a concentration of doctors, clinics and hospitals. Even the provisions of meeting basic needs, safe water, sanitation, transportation and the like exhibit similar inequalities in distribution.²⁰

Commitment to a Christian understanding of personhood should motivate Christians to rise above the egoism and nationalism Kingma describes. It should lead us to place our own claims upon costly and limited medical resources within the context of more universal needs, even to the point of self-sacrifice where necessary.

Lisa S. Cahill has drawn a series of moral correlations that lay out the implications of the second conviction. They stand in a dialectical relationship to each other:

We cannot neatly summarize the Christian outlook on technology as either optimistic or pessimistic. Christians know as well as anyone that technology can be used for either salutary or destructive ends. We have witnessed too many abuses of technology, and the resultant tragedies, to be naively optimistic. More importantly, our doctrine of original sin predisposes us to be always alert to the likelihood that technology will be conscripted into evil's service. On the other hand, far from thinking of technology and the risks that come with it as inherently evil, the prevailing Christian posture holds that one important dimension of the imago Dei evidences itself in the imagination and creativity that research and technology express, although the Fall has negatively impacted that image.

Because we worship God alone and believe that he is creatively and governmentally present in his creation, and because the world for us has been demythologized, we are freed from both a crippling fear and a worship of technology.²⁴ Jack W. Moore puts it this way, "Humans can be co-workers with God's creative activity in maintaining and improving the patterns and processes of nature." This is, he says, both our right and responsibility.²⁵ Moore admits that placed against this positive evaluation of technology is a strain in Christian tradition that views the human being as a creature of the universe who should not tamper with its mysteries. God has designed the natural order and we must respect that order to preserve the structures of our humanity.²⁶ Nevertheless, Moore thinks it is consistently Christian to believe that through research and technology humankind can more richly exercise its stewardship over the creation.

In the biblical sense, a steward must not only conserve what has been given to him or her but also must develop (oikodomeo, build further) it. The steward, an administrator who creatively expresses the will of the owner, should return to the master more than was entrusted to him or her.²⁷ The gains, however, must not occur at the expense of impoverishing the entrusted estate, but in a way that enhances the estate and shows respect for the owner.

For Christians, the lesson is clear. Along with increased technological powers and promise come increased risks and responsibilities. When technology slips away from its anchorage in transcendent values and becomes an end in itself, it repeats the sin of the tenant farmers Jesus described in Luke 20:9­16. They rejected the owner of the farm at harvest time and attempted by fraudulent means to take the estate for themselves. By contrast, as Christians we believe that the story can turn out differently. The steward can cultivate the farm in a way that honors the owner, respects the estate as belonging to someone else, and generates approval for the farmers.

Because we worship God alone and believe that human creativity is positively related to the creativity of God and to our role as stewards, we believe that technology can serve human, moral, and redemptive ends. On principle, biotechnology is governable by theological and moral standards. At the same time, because of the fallenness of humankind, technology will always be vulnerable to misuse. If Christians must come down on the side of either optimism or pessimism regarding technology, we should be guardedly optimistic, to the extent that we submit technology to regulation by transcendent values.

Paul Tillich's warning is worth recalling: while technological reason is a legitimate and divinely ordained dimension of reason, it must always be governed by ontological reason.²⁸ Admittedly, when it comes to applying this principle, Christians disagree sharply over how to achieve balance. One area of greatest controversy even among Christians is over the moral boundaries for employing the available array of reproductive technologies.²⁹

Especially in the West, where technology always threatens to take on godlike qualities, once a particular form of biotechnology is available, it can bring subtle, powerful pressures to bear on moral reasoning and public policy. The current parliamentary debate in Great Britain over the use of fetal eggs for in vitro fertilization is a prime example. From another perspective, Andrew Simons has shown how the idolatry of technology can rule out all responses to suffering other than the technological one. It can powerfully erode a Christian understanding of suffering.³⁰ In Holland Richard Fenigsen has demonstrated how technology contributed to a subtle social coercion in favor of a national policy on euthanasia. Public pressure increased to a point where the "voluntariness" of euthanasia often became counterfeit and questionable.³¹ Nevertheless, while the second Christian conviction entails moral vigilance at every point, it also fosters a creative stewardship of technology.

In each era, culture has presented to the church new opportunities for explaining what it means to say that Jesus is Lord. In each case Christians have had to demonstrate the integrity of the Christian faith. Today, biotechnology offers another challenge and opportunity.³²

Notes

¹John F. Kilner, Life on the Line: Ethics, Aging, Ending Patient's Lives, and Allocating Vital Resources (Grand Rapids, MI: William B. Eerdmans Publishing Co., 1992), 14.

²Manipulating Life: Ethical Issues in Genetic Engineering (Geneva, Switzerland: World Council of Churches, 1982), 2.

³James Gustafson, "Theology Confronts Technology and the Life Sciences," On Moral Medicine: Theological Perspectives in Medical Ethics, Steven E. Lammers and Allen Verhey, eds. (Grand Rapids, MI: William B. Eerdmans Publishing Co., 1987), 35­41.

⁴Ibid.

⁵On the limits of a secularist medical ethic, see Allen Verhey and Steven E. Lammers, "Rediscovering Religious Traditions in Medical Ethics," Theological Voices in Medical Ethics, Allen Verhey and Steven E. Lammers, eds. (Grand Rapids, MI: William B. Eerdmans Publishing Co., 1993), 1­6.

⁶Englehardt H. Tristan, "Bioethics in Pluralistic Societies," Perspectives in Biology and Medicine 26 no. 1 (Autumn 1982): 64­77.

⁷Gustafson, 41.

⁸Hans Walter Wolff, Anthropology of the Old Testament, trans. Margaret Kohl (Philadelphia: Fortress Press, 1974), 3.

⁹Ibid., 22. In his study of Old Testament anthropology, Wolff raises questions that apply directly to biotechnology and to bioethics: "Why does the progress of science and technology not only penetrate into new light but also into new darkness? Why is the misuse of scientific and scholarly knowledge and methods assuming threatening form, not only in the practice of the natural sciences but even in the so-called humanities? Why is research designed for the use of man‹in medicine, chemistry, pharmacology, sociology, psychology and theology‹suddenly by-passing man altogether?" (ibid.). Attempts to know who man is by looking to the world alone has in the end led to the fundamental being of humankind becoming the most alien dimension of all. Wolff says that there exists an "elemental hunger" to know who a human being is beyond the naturalistic and reductionistic definitions secularity offers. The essence of personhood, he says, is to be found not in the thicket of clever plans and misguided impulses,"but in God's bond with man, and man's bond with God, the Other who enters human history and enquires anew of every fresh generation: `man, where are you?' and before whom every fresh generation can ask yet again, `what is man? Who am I?'" (ibid., 1­2).

¹⁰J. Robert Nelson, Human Life: A Biblical Perspective for Bioethics (Philadelphia: Fortress Press, 1984), 57­81. See also Karl Barth, The Humanity of God (Richmond, VA.: John Knox Press, 1969). Will Durant was one among many who clearly stated and embraced the secularist anthropology Christians reject: "We [Humanists] are content to be wholly a part of Nature‹of the magnificent and impartial panorama that greets our senses and instruments" Will Durant, The Humanist, reprinted in Humanist Ethics, Morris B. Storer, ed. (Buffalo, NY: Prometheus Books, 1980), 6­9.

¹¹Ibid., 66.

¹²Alfred N. Whitehead, Adventures of Ideas (New York: The MacMillan Company, 1936), 17.

¹³Donald Shriver, "Inter-relationships of Religion and Medicine," On Moral Medicine: Theological Perspectives in Medical Ethics, Steven E. Lammers and Allen Verhey, eds. (Grand Rapids, MI: William B. Eerdmans Publishing Co., 1987), 11.

¹⁴Karl Barth, "Respect for Life," Church Dogmatics Vol. III, 4, trans. A. T. Mackey, et al. (Edinburgh: T. and T. Clark, 1961), 363. Barth says: "Where some are necessarily ill the others cannot with good conscience will to be well. Nor can they really do it at all if they are not concerned about neighbors who are inevitably sick because of their social position."

¹⁵Stanley Hauerwas, Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church (Notre Dame, IN; University of Notre Dame Press, 1986), 36.

¹⁶Hans Walter Wolff, Anthropology of the Old Testament, trans. Margaret Kohl (Philadelphia: Fortress Press, 1974), 214.

¹⁷Paul Ramsey, Basic Christian Ethics (New York: Scribners, 1950).

¹⁸Nelson, 77.

¹⁹Ibid.

²⁰Stuart Kingma, "Biomedical Ethics: In Search of Touchstones for Tough Choices," The Ecumenical Review 32, no. 3 (July 1980): 273­80.

²¹Lisa Cahill, "Notes on Moral Theology," Theological Studies 48 (March 1987): 105­23.

²²David Neff, "The Eugenic Temptation," Christianity Today 34 (November 19, 1990): 23.

²³See Harman L. Smith and Paul A. Lewis, "A Protestant View of Reproductive Technologies," Second Opinion 14 (July 1990): 94­106.

²⁴Ibid., 96. Hans Walter Wolff says that the Genesis creation accounts display or presuppose a demythologized world. "All and everything that is to be found in the world is revealed as being in God's creation; consequently, for the man who has grasped this, there is neither a divine earth, nor divine beasts, nor divine constellations, or any other divine spheres basically inaccessible to man. The whole demythologized world can become man's environment, his space for living, something which he can mould" (Wolff, Anthropology of the Old Testament, 162).

²⁵Jack W. Moore, "Human In Vitro Fertilization: Can We Support It?" Christian Century (April 22, 1981): 442­6.

²⁶Ibid., 445.

²⁷J. Goetzmann, "House, Build, Manage, Steward" [Oikos and its derivatives], The New International Dictionary of New Testament Theology, ed. Colin Brown, Vol. 2 (Grand Rapids, MI: Zondervan Publishing House, 1979), 247­56.

²⁸Paul Tillich, Systematic Theology, Vol. 1(Chicago: University of Chicago Press, 1951), 71­5

²⁹See Arthur Griel's survey of this controversy in "The Religious Response to Reproductive Technology," Christian Century (January 4­11, 1989): 11­14.

³⁰Andrew Simons, "Brave New Harvest," Christianity Today 34, no. 19 (November 19, 1990): 27.

³¹Richard Fenigsen, "A Case Against Dutch Euthanasia," Hastings Center Report 19, no. 1 (January/February 1989): 22­30.

³²Ibid., 96. Hans Walter Wolff says that the Genesis creation accounts display or presuppose a demythologized world. "All and everything that is to be found in the world is revealed as being in God's creation; consequently, for the man who has grasped this, there is neither a divine earth, nor divine beasts, nor divine constellations, or any other divine spheres basically inaccessible to man. The whole demythologized world can become man's environment, his space for living, something which he can mould" (Wolff, Anthropology of the Old Testament, 162).

From Perspectives on Science and Christian Faith 48:4 (December 1996): 114­229.