How often seminary students and graduates comment to me about how unprepared they feel to address the bioethics issues they are encountering today. They often do not use the word bioethics, but the life-or-death, sickness-or-health challenges they are increasingly being bombarded with are what bioethics is all about. In fact, far more is at stake for the future than most people realize. The world we pass on to our children and their children may be dazzlingly wonderful or staggeringly horrible. And we can have something to say about which it is.
In that world, Michelle will be healed. She is a teenager who endures a life of stomach pain, vomiting, aching joints, skin sores, and the progressive breakdown of her blood. She has sickle-cell anemia, a disabling and potentially fatal disease. Its cause is a small mistake in her genetic code that will eventually be correctable. In fact, because of genetic and other technologies, many of the worst diseases you have heard about and are experiencing in your own family will be cured!
At the same time, David and Maria may wake up one morning horrified at what they have done. It started out fairly innocently, or so they thought. They had aborted their second child because they did not want a second boy. Then they had tried a new genetic intervention technique to ensure that the next child would be a girl; and at the same time they took advantage of the chance to boost the girl’s mental and physical abilities. But a genetic error had caused the baby’s right arm not to develop properly, and they decided to abort her as well. Two additional pregnancies resulted in similar deformities and more abortions. Since then Maria has not been able to get pregnant again. Now the morning newspaper is saying that the use of genetic “improvement” techniques were approved too quickly—with resulting deformities in children and infertility in women.
In other words, with the wonder comes a warning. It is expressed well by Bill Joy, the chief scientist of one of Silicon Valley’s top technology companies (and co-chairman of a U.S. Presidential Commission on the future of information technology). “We are being propelled into this new century with no plan, no control, no brakes.” Even worse, he adds: “The last chance to assert control—the failsafe point—is rapidly approaching” (“Why the Future Doesn’t Matter,” Ethics & Medicine 17.1  13-36). If this warning were from some paranoid fanatic with no real knowledge of the issues, it would be one thing. But Joy is a respected leader in cutting-edge technology.
What will make the difference in which way the future goes? Bioethics will. For example, we know having babies is a good thing, but would it be a good option to produce them through cloning? Would it be okay not just to make them a copy of another person, but to engineer them to be exactly the way we want them to be? The human race—that is you, plus everyone you know, plus others—must decide very soon what to pursue and what not to pursue. We need to decide long before the economic interests get too heavily involved and changing direction is virtually impossible.
If we truly can make such a difference in the future, then why in the world have we not all become bioethicists? Or why are we not all at least taking advantage of every opportunity to engage these issues as part of our preparation for future ministry?
Two reasons stand out. First, we are simply not aware of how huge and radically important the issues racing toward us are. Have you become familiar with the excellent information sources such as those identified later in this essay? They address not only reproductive, cloning, and genetic technologies—interventions you have heard something about but may not really understand—but also such developments as “cybernetics” and “nanotechnology” which you may have thought were pure science fiction, if you have heard about them at all.
What do you think about a computer chip implanted in your brain to give you a vast storehouse of information and even a live connection to the Internet (viruses included)? How about self-reproducing machines too small to see that can attack germs (or healthy tissue) in our bodies? Both are doable—but does “can do” mean “should do”?
There is a second important reason why we fail to make bioethics a priority. We simply do not realize that the decisions we already make concerning our health and lives are basically bioethical ones. If our dying mother or father needs one last medical treatment, we consider the decision to be purely medical and so ask our doctor to tell us what should be done. Or if we want to pursue one of 38 options for having children when we are infertile, we consider choosing the right option to be a decision for a fertility specialist to make.
We do need the best medical counsel we can get in such situations. But identifying the best decision will also require recognizing what is at stake ethically in each option before us. You may be told, for instance, that the use of dialysis to filter the impurities from your dying spouse’s blood would not be worthwhile. Rather, it would simply be best to provide good pain relief and emotional support. But what does “worthwhile” mean? Your spouse may have a quality of life on dialysis that a physician or administrator does not consider worth the cost of treatment. You or your spouse may think otherwise, were you to have all of the information.
How much should you be told? What role should you play in the treatment decision? How different might you and a particular physician be in the value each places on human life? People should be getting the best medical information available concerning all possible options and then tracking down the best possible ethical information to go with it. Both are necessary to be fully equipped to make good decisions. But people rarely leave the confines of the hospital. Of course, those blessed with a Christian physician may not have to, if the physician can provide patients with the bioethical as well as medical information they need.
On the other hand, a close friend or family member may be diagnosed with infertility. Perhaps she receives medical counsel to pursue in vitro fertilization (fertilizing her eggs in the lab and then implanting the resulting embryos in her womb). The process may be described to her, for her to approve; and she may be pleased that she has been informed and even consulted for her approval. No ethical dilemmas here, right?
Did you know that it was not medically necessary to have so many eggs fertilized in order to end up with an embryo to implant? Did you know that the number was so high in order to improve the odds of a successful pregnancy, but that some embryonic human beings—your loved one’s newly conceived children—would almost certainly die as a result? What significance does an early human embryo have, and how does a risk to such an embryo compare with a risk of not giving birth at all? People should be getting the best medical information they can and then hunting down their clergy or other well-informed Christian leaders to get the ethical information they need just as much. But they rarely do, either because they see the issue as purely medical rather than ethical, or because they see Christian leaders as unlikely to have useful bioethical resources available.
This must change. If we do not recognize today’s bioethical issues of life, death, sickness, and health clamoring for attention all around us, we will likely remain unaware of tomorrow’s issues as well. Many individuals including our loved ones will suffer today as a result. Tomorrow the entire human race will be in jeopardy.
But what a different picture is possible if we recognize the issues and know how to engage them! People can live and die well, with the confidence that God is pleased with the choices they are making. Health care professionals can be a welcome source of information and counsel in the decision-making process. Elderly, embryonic, and other persons, instead of being “used” for the benefit of others, can be respected as the human beings they are—created in the image of God.
Many resources now exist to help foster such a world. Some of these resources focus on matters with special significance for human embryos, such as stem cell research, cloning, and abortion. Others address end-of-life challenges such as withholding and withdrawing treatment—and how such decisions differ from resource allocation decisions with which they are often confused—along with the temptations of assisted suicide and euthanasia. Still others go beyond more familiar health care issues to grapple with some major emerging biotech issues: genetic, cybernetic, and nano technologies. Let me flag for you a few examples of such Christian resources with which I am particularly familiar, and then note some other avenues to consider as well. These Christian resources in turn will help connect you with their secular counterparts.
At the same time, there are plenty of other Christian sources to turn to, many of which are referenced in the recent report of the Bioethics Working Group of the Lausanne Movement, Bioethics: Obstacle or Opportunity for the Gospel? (also available through CBHD). See, for example, such web sites as pfm.org, cmdahome.org, thecbc.org, and cmf.org.uk. You will also want to make sure you know what bioethics courses are available in your own seminary, with a critical eye to making sure that the theological perspective emphasized and the interaction of perspectives included match what you are seeking.
The ongoing Lausanne process itself, just alluded to, is testimony to the Christian significance of bioethics—not only for people’s temporal well-being but also for their eternal future. In the past 40 years, the Lausanne organization has held four major worldwide leadership gatherings. After extensive research in more than 200 locations around the globe, the Lausanne leadership has identified the top challenges and opportunities that the worldwide body of Christ needs to address in order to reach the world for Christ in our generation. One of these involves reaching people with the gospel through bioethics.
Most people go through their entire lives without ever knowing the God who created them. They normally are not concerned about this, since they have most of what they need and feel pretty much in control. But when their own bodies—their own selves—break down due to end-of-life illness, infertility, etc., many people recognize for the first time that they are not truly in control—that in fact they are ultimately helpless in the universe. For many people, helping them deal with threatening life and health issues—which is what “bioethics” is all about—creates a unique opportunity to help them deal with larger, eternal issues as well. Sadly, relatively few Christians are well-educated bioethically, and the church is missing one of the great opportunities to reach the world in our day. Today’s seminary students need to overcome this educational deficit.
We cannot wait much longer to become informed and engaged. People all around us are experiencing great bioethical challenges from the beginning to the end of their lives. Meanwhile, the lure of commercial profits is attracting vast resources to underwrite unfettered biotech research. We must not underestimate the danger if we do not formulate ethical guidelines for the development and use of emerging biotechnologies.
Imagine the grief of the parents of the patient at a major U.S. university medical center who was not expected to die soon, but who abruptly died in a genetic therapy experiment. Their lawsuit suggests they are convinced that they were given inadequate warnings because of the pressures to push ahead with the research as quickly as possible. If we wait too long to develop better safeguards, it will be like waiting until after a flood has occurred to try to dig a channel to direct the flood waters in a productive way. The time to design and dig the channel is before the flood hits!
Think of those opposed to abortion living in the years leading up to the Roe vs. Wade U.S. Supreme Court decision that opened the legal door to abortion. Very few took notice of what surely was coming until after it came. May that not be said of the current generation of seminary students in the face of a much larger array of vital bioethical challenges.