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While the basic moral responsibilities of Christians have not changed through the ages, the circumstances under which Christians make ethical decisions certainly have. A good example of how cultural developments pose ever-new moral challenges is the rise of bioethics.
Due to the amazing progress of medical technology over the past decades, techniques now exist for creating, preserving, and even ending human life that were unimaginable to previous generations. Although many of the recent advances in medical research provoke a sense of thankful wonder, especially for those who have seen loved ones healed from otherwise fatal diseases, the advance of knowledge has produced a host of troubling moral questions.
What makes the rise of bioethics troubling for Christians? One reason is that Christians cannot simply turn to Scripture to find ready-made answers to the typical bioethics question. The biblical writers never discussed cloning, genetic therapy, or “death with dignity.” Furthermore, wrestling through such issues often requires detailed understanding of scientific and biological processes that seem quite inaccessible to the average person.
To make matters even more difficult, Christians often cannot make bioethics decisions for themselves or loved ones merely as private people. Instead, they must confront gut-wrenching choices in consultation with nurses, doctors, and other specialists who have their own professional guidelines to follow and often do not share their patients’ moral or theological convictions.
As much as we might wish otherwise, Christians cannot escape these moral challenges. Christians face infertility, learn that their unborn children have genetic abnormalities, and see aged parents held at the brink of death by extraordinary medical techniques. Increasingly, Christians are promised that suffering can be relieved and a prosperous life promoted.
Few Christians alive today will be able to avoid making the difficult decisions that arise from such promises. Furthermore, the burden undoubtedly will be all the more heavy for pastors, whose flocks will seek pastoral guidance from them as they face their own decisions. In light of all these issues, how is the twenty-first century Christian to think about bioethics?
Before turning to a specific bioethics issue, it is helpful first to consider some general guidelines. When confronting difficult bioethics decisions, Christians initially must strive to identify relevant theological truths. Though Scripture does not speak specifically about contemporary bioethics, its teaching does have important implications for it.
Perhaps most important are the biblical truths about human nature, or anthropology. Scripture teaches that a human is both body and soul, an affirmation that many people deny. This means that we must never treat people as if their bodily well-being were unimportant or physical illness merely a challenge to be endured. Conversely, it also means that we must never treat people as if their bodily well-being were the only thing that matters or were simply an end in itself.
In addition, a biblical anthropology reminds us that every human being is made in God’s image. This profound truth has many implications for bioethics. At the very least, it compels us to treat each person—even, and perhaps especially, the weak and vulnerable—with the dignity and respect that befits one made in the image of his Creator.
Certainly another area of theology important for bioethics is the biblical teaching on the nature of death and the life to come. Christians instructed in God’s word can never treat death lightly, for they know that death is a bitter curse and the last enemy of man (Gen 2:17; 1 Cor 15:26). Many non-Christians fear death, but Christians ought to have a far greater sense of how horrible it really is—thus we rightly believe that to preserve life in the face of death is a marvelous thing. At the same time, Christians have a true hope and consolation when death threatens, for Christ has conquered it. Therefore, Christians never need to view death, terrible as it is, as the last word. Instead, the gospel enables us to confess that in an ultimate sense to die is gain, for it means entering the presence of Christ (Phil 1:21; 2 Cor 5:8). Hence, the Christian’s proper desire to snatch life from the grip of death ought never mean that we view the preservation of earthly life as the greatest good, to be pursued at any cost.
Though such theological truths are crucial for making sound bioethics decisions, more is needed. In addition to an accurate knowledge of relevant moral and theological principles, Christians need a way to put such principles into proper practice. For this they require wisdom. Wisdom is an important theme in many places in Scripture, especially in Proverbs. Proverbs presents wisdom as an understanding of how the world works, how people respond to different things, and what consequences follow from which actions. Wisdom perceives the order that underlies the physical and especially the moral worlds that we inhabit. It recognizes that a word or deed that is helpful in one circumstance can be damaging in another.
In what ways, then, is the cultivation of wisdom important for bioethics? Wisdom requires us to think hard about the consequences of our bioethics decisions. In the midst of strong emotions that often accompany medical crises and force quick decisions, Christians ought to consider the risks involved in procedures and the kind of life they might produce for patient and family. Along similar lines, wisdom requires us to ask whether we are able to bear the responsibility for the bioethics decisions we make. As will be considered in the next section, going one direction in a bioethics crisis sometimes produces circumstances that are even more confusing and heart-breaking. The wise Christian will step carefully when there is such a danger. Another demand of wisdom is that Christians obtain as much information as necessary and possible for making informed bioethics decisions. Since wisdom instructs us to consider circumstances, Christians must make a genuine effort to learn what potential procedures involve, and this means reading relevant literature and asking medical professionals pointed questions. Finally, wisdom also suggests that we think about virtue and character. Scripture is interested not only in what we do, but also in the kind of people we are. We know that our moral decisions can permanently shape us, for better or worse, and this possibility cannot be underestimated when we face momentous decisions concerning life and death.
How would such general guidelines play out in specific bioethics matters? In vitro fertilization (IVF) is perhaps a helpful test case, for it offers the possibility of great blessing for many dejected Christian families, yet also raises troubling moral issues. Simply put, IVF describes a number of related procedures in which eggs are fertilized by semen outside of a female body—in a lab—and at some later point injected into a woman’s uterus with the hope of implantation and successful pregnancy. The reason why IVF is attractive to many families is obvious: it provides hope for infertile, grieving couples to have their own biological children. (In the space allowed here, I consider briefly the most morally attractive circumstances for IVF: when an infertile married couple donates their own sperm and eggs and have the embryos injected into the wife’s body. I will not address some of the most troubling circumstances under which IVF is sometimes performed, such as third-party parenthood, i.e., when eggs or sperm are donated by someone other than the husband or wife, or surrogacy, i.e., when an embryo is injected into a woman other than the egg-provider, often for pay.)
What moral issues does IVF raise? First, Christians cannot overlook the moral good that IVF offers. Bearing and raising children is part of the mandate given to mankind at creation (Gen 1:28) and Scripture often speaks of this as one of the great callings and blessings of human life. At the same time, many have condemned IVF outright. The Roman Catholic Church, for example, has taught that the procedure in and of itself is morally objectionable. I find its arguments unpersuasive, though there is no space here to examine them. There is no clear moral principle that the act of IVF violates, nor is there a principle demanding that infertile couples pursue IVF. If this is true, it means that Christians should not absolutely commend or condemn the procedure, nor lay a moral ultimatum about this issue upon another person’s conscience. However, considerations of wisdom, as outlined above, do suggest reasons why Christians who are considering this procedure should exercise great moral caution.
One thing wisdom requires is that we think about the consequences of our choices. In IVF there is inevitably a time gap between the point of fertilization in the lab and the injection of the embryo into the woman. Ordinarily the embryos are frozen to preserve them for considerable lengths of time (due to the high costs of the procedure, couples usually have a number of embryos created all at once, in order to provide for multiple attempts at pregnancy). Christian couples, presumably, would insist on the injection of all their embryos, due to their pro-life conviction that all human life, even at its earliest stages, ought to be cherished. However, despite good intentions, no couple can be certain the wife will be able to receive all the embryos, no matter how short the gap between fertilization and injection. Serious illness or even death may make injection impossible. What then is to be done with the embryos? One option is destroying them, but there are grave moral objections to such an act. Another option is keeping them permanently frozen; this, however, seems a strikingly improper way to treat an image-bearer of God. The remaining option is to implant them in another woman, but this itself raises all sorts of troubling moral questions. Is surrogate motherhood ever morally acceptable? Do women actually have an obligation to “rescue” frozen, unwanted embryos that otherwise face certain destruction? The consequence of IVF may be the joy of parenthood for many couples, but in other cases the consequence may be the production of embryos that sit in a freezer with no morally viable future. Wisdom, therefore, would suggest great caution in embracing a procedure that might create such a tragic situation.
What are other considerations of wisdom that couples pondering IVF ought to reflect upon? Certainly they ought to consider the virtue of contentment. Desiring children is in itself commendable, but every couple ought to beware lest this healthy desire become a matter of greed or selfishness. Another thing to consider is financial stewardship, for IVF remains a very expensive procedure. How far can couples responsibly expend their limited resources in the potentially unsuccessful quest to have a child, particularly when such resources can be put to many other God-glorifying purposes? Finally, infertile couples ought to consider how their childless state may serve for the good of society or the church. Certain occupations—e.g., going on the mission field in a dangerous location—may be much more suitable for those without the responsibility of raising and protecting children. Couples might turn their disappointing situation into other people’s good.
Bioethics matters such as IVF are often harrowing. Considerations such as those offered in the previous paragraphs are, I believe, worth pondering, but they surely do not provide a definitive moral verdict in every case. Nevertheless, Christians who begin with a sound theology and work through issues with godly wisdom need not despair when faced with such decisions. In the end, we remember that God, who is all-wise, protects and cares for his children even in their times of weakness and indecision.