Medical ethics/Jim Behnke Comments
Kenneth Feucht (St_Augustine@msn.com)
Sat, 25 May 96 19:44:48 UTThank you for your questions. My message did not seem to get through in its
entirety for some reason or another, as a large section in the middle of the
message did not go through to the reflector. I will not be redundant and
repeat things in their entirety, but only answer the questions that you bring
up.
I have written a lengthy article analyzing the thought of Kilner. It was
originally was submitted to Perspectives, but when it sat for roughly 6
months, resubmitted it to the Journal of Biblical Ethics in Medicine, where it
will be published. Their address is P.O. Box 14488, Augusta, Georgia
30919-0488. You will find the Journal an interesting perspective of medical
ethics from a Reformed theological perspective. My primary comments were
directed at several issues, one being the idea of "rationing" health care, and
the other regarding the establishment of a truly Christian ethic.
The manner in which we do medical ethics will be influenced greatly by 1)our
theological orientation, 2) our political and socio-economic orientation. I
feel that we should not even being doing a medical ethic until these first two
issues are clear. I hold a deep value for modeling my personal ethic, and a
societal/economic ethic after the law of God. You might charge that I have
Theonomistic orientations and that would be correct. That makes it easy for
you to discuss medical ethics with me, as you can assume to know my
fundamental theory for doing ethics. But, it is easier to argue questions of
physician-assisted suicide, abortion, "test-tube babies" and the like knowing
that I will first approach the question by developing biblical laws and
principles that direct us.
Imagine trying to contest the ethic of the immanent Beauchamp and Childress.
In their textbook of Principles of Biomedical ethics, they state "We have
attempted in this book to construct a coherent account adequate for the
particular subject of biomedical ethics, but we do not clain to have developed
or to presuppose any particular comprehensive ethical theory ... we are
pluralists in that we accept as legitimate various aspects of several
different theories advanced in the history of ethics (p44-45). In essence,
they hold to a tacitly stated "theory" that will govern their eclectic picking
from various conflicting systems of medical ethics. How else will they decide
the criteria for using one part of one theory and another part of another
theory, than if they had a transcendent theory that they use (but won't admit
to) to ultimately establish their own ethical statements. This ultimate
ethical principle can be noted through reading their book, and is the author's
own sentimental notions of what is right or wrong. It is an unadmitted
emotivist ethic, disguised to hide the fact that Beauchamp and Childress are
using their own feelings of right or wrong to establish a universal medical
ethic. Need I quote Alistair McIntyre's work that has effectively destroyed
the use of emotivism in ethics.
How do you challenge a person when he defines his own sentimental impressions
as being universal ethical law? My answer is that it is necessary to retreat
to an infinite reference point, as defined in holy Scripture. Just as the
Westminster Catechism affirms the Scriptures as being necessary AND sufficient
to guide us in all ethical situations, our only contest is in interpreting the
law of God in particular circumstances. Kilner does not do that. In defining
the principles used to govern personal and medical ethics, he never places any
value on the law of God. Rather, it is on a "law of love", "reality-bounded",
and "Christ-centered" ethic. He fails like Joseph Fletcher in the text
Situational Ethics to define what it really means to love--is love an
emotional principle, or is it a rational principle that constantly refers back
to the law of God as its defining basis?
To answer your second question, no, I do not believe anywhere in Scripture
imposes a moral obligation on a person to provide some basic health care
(however you might define that) to everyone. Universal health care is based on
anti-Christian Marxist notions of justice, with delivery of health care to
each according to his need. How do you think about this issue? Is it a moral
obligation of society to provide basic health care to all? How are you going
to define "basic"? Why do you limit the universal provision to just health
care? Why not include the other exigencies of life, such as food, clothing,
shelter, etc.? What ethical principle do you use that obligates society to
such a task? What will be the economic implications on health care, when
health care becomes of person's right, rather than a person's earned
privelege?
Deus Vobiscum
Kenneth A. Feucht, MD, PhD, FACS
Good Samaritan Surgical Associates
Puyallup, Washington
kenf@kenf.seanet.com