A Christian Worldview Response to Current Bioethical Issues: Part One
My first memorable encounter with bioethics came when I was barely eighteen. As a student visiting a display area at a Christian college lectureship, I met a preacher who had developed a slide presentation for a sermon on abortion. He was circulating among the churches preaching this lesson trying to rally Christians to react to what he believed to be societal degradation associated with an increasing number of abortions and the ease with which abortions could be pursued. The presentation was an emotional appeal illustrated with traumatizing pictures of fetal remains— babies torn apart in abortion procedures. Such choices are emotional, and any illustrations one might use for such a lesson would be unavoidably so.
Even though I was young and immature, it still seemed obvious to me that only those who already agreed with this preacher would be convinced by his presentation. Those considering abortion seemed unlikely to be dissuaded, and those who previously had abortions might be driven into guilt and despair. Struggling women would probably find him unsympathetic and unpersuasive. The real issues involved in abortion would not be addressed with provocative slides and emotive language. Those inclined to think of abortion as a woman’s personal choice, a right that ought not be denied, might think this preacher’s approach was uninformed and judgmental. Those who disagreed with him would likely have other objections if they even bothered to listen to his presentation.
The approach this preacher proposed was more emotional and political than biblical. I found it to be poorly thought out and unlikely to reach people who really needed to consider the matter seriously. I was convinced that his presentation of the Christian position on abortion failed to adequately represent the Christian heart or a Christian worldview. It seemed to me that his approach would be ineffective with abortion proponents and any who needed compassionate guidance.
Others have their own stories of encountering the emerging bioethics issues of the twentieth and twenty-first centuries. Contemplating issues associated with Dr. Kevorkian, DNA research, the morning after pill, AIDS (and victims like Ryan White infected through blood transfusions), lapel pins with a fetal footprint, explosions at abortion clinics, or alleged mercy killing in other countries provoke us to tell our own stories of emotional and moral struggles. Some hear of the issues in news stories. Young Christians face such issues in high school debate programs and even in our Bible classes or youth rallies. All of us face such issues with relatives and friends dealing with sickness, suffering, or dying. Bioethical issues are everywhere. How should Christians respond?
The first place to begin is a review of what the Bible has to say about health and sickness. This can offer an important foundation for proper reflection on health, its loss, and Christian responses to issues associated with that aspect of our lives. People who are injured or find need to call on medical professionals for help seem also to fall within the purview of such an investigation. Our study of health and sickness in Scripture must start with consideration of life flourishing in the Garden of Eden, and continue with consideration of the uncomfortable loss of the tranquility introduced in that story of creation. God’s revelation about human struggles and His will for our response has been part of the record from the beginning of time and it is part of the record provided throughout the Judeo-Christian Scriptures.
In my judgment, too much of the discussion of current bioethical issues starts with topical, issue-oriented urgency. If we are to produce the best account of God’s answers to current bioethical issues we should begin with a solid foundation. Thus, this article will focus on the issues of health and disease in the Bible, laying the foundation for a basic account of how Christians should approach particular issues, before discussing twenty-first century medical ethics. Discussion of specific bioethical issues is not the focus of this article. Explanation of the context of contemporary bioethics and practical insight for Christians confronting difficult social issues and personal decisions about health, illness, and human choice will be addressed in subsequent articles.
Biblical Backgrounds for Christian Bioethics:
Pain, Sickness, and the Healer
Created in the image of God and placed in the Garden of Eden, Adam and Eve did not at first deal with health and illness, as people today must face those issues. Their access to the Tree of Life, until sin became part of their lives, put them in a unique situation. According to the first three chapters of Genesis, pain is not even mentioned until God describes the punishments that came from their sins. Increased pain in childbearing for woman is described as part of the curse coming with sin, as is painful toil for man. Death then becomes inevitable for all subsequent human generations. The first chapters of the Bible introduce life’s blessings and curses as well as pain and death. Understanding these first chapters and subsequent biblical passages should frame the Christian worldview and discussions of sickness and death from a Christian perspective.
Reviewing Old Testament Texts
People through the ages have struggled to understand the cause of sickness and to cope with its effects on human life. Biblical terms associated with the struggle (like sickness, disease, healing, cure, health, and wellness) indicate texts relevant to our study. Serious diseases were inflicted on Pharaoh and his household (Genesis 12:17). In a similar incident Abimelech, from Gerar in the Negev, is described as “healed” along with his wife and the slave girls of his household (Genesis 20:17). Jacob is described as “healthy” or “alive and well” in Genesis 43:28, but is later described as “sick” or “ill” in Genesis 48:1, though he regained his strength when Joseph came to visit him (Genesis 48:2). After seventeen years living in Egypt, “when the time drew near for Israel to die,” Jacob is described with the frailties of aging (“eyes failing,” Genesis 47:28-31; 48:10; Hebrews 11:21).
When illness comes because of injury or infectious disease people in the ancient world questioned themselves and others about whether their suffering was an indication of God’s disfavor. Disease and injury did sometimes come directly from God as punishment or as His attempt to persuade people to repent or to turn to Him for help. The plagues on the Egyptians in Exodus 7-11 called for repentance, and the Amos 4 account of tragedies should have convinced the people to turn to God for help. The introduction to the book of Job clearly indicates some tragedy and suffering is allowed by God but originates elsewhere such as from Satan. Still, when illness and tragedy come, people are often perplexed, especially if the sickness seems to come without any direct relation to sin or unrighteousness. Job 9-10 provides a touching account of one sufferer’s struggle with a time in life that seems nothing but woe and misery. Our access to the first and last chapters of Job gives us a different perspective on God’s desire to help people struggling with illness, injury, and suffering too difficult to cope with unless one turns to the Lord for help. Similarly, the Psalmists often remind us that turning to God for help is the only way people can properly deal with sickness and tragedy in lamentable moments (e.g. Psalm 30:2; 103:3).
One might expect that the priests and prophets would function as physicians or healers in Israel, but they never had that role. Priests, in their role, were God’s representatives to protect public health (Leviticus 13-14). Medical services and healing were not their function. Similarly, the prophets did some wonderful works even raising the dead or offering guidance as in Elijah or Elisha’s interventions (1 Kings 17 and 2 Kings 4). Prophets also sometimes provided guidance about how one, like Naaman, might be healed by God’s power (2 Kings 5). Sometimes the Lord had a prophet instruct in the use of medicine as part of His healing process (1 Kings 20:7). The prophets also make reference to physicians and ointment for healing (e.g. Jeremiah 8:22). For God’s people healing and health are always gifts from the Lord (Jeremiah 30:17). The prophets’ primary role was as seers and spokesmen calling the nation to repent and turn back to God their healer. In the case of Ahaziah (2 Kings 1) sick or injured people inappropriately turned to idols, rather than God. Old and ailing Asa sought help “only from the physicians” failing to seek help from God (2 Chronicles 16:12). Like the priests, the prophets were not the nation’s physicians.
All such experiences in the Old Testament are shaped by an important claim about humanity’s relation to God. The Lord is not only described as Creator in Hebrew literature, but also as “healer.” The English Standard Version’s rendering of Exodus 15:26 says: “If you will diligently listen to the voice of the Lord your God, and do that which is right in his eyes, and give ear to his commandments and keep all his statutes, I will put none of the diseases on you that I put on the Egyptians, for I am the Lord, your healer.” For the Judeo-Christian worldview, the philosophy of medicine or guidance for moral choice in medicine begins with this important truth: God claims to be the “healer” for His people. This assertion does not prohibit people from helping one another or turning to special individuals for assistance and guidance, but for God’s people this insight sets dependence on God and His revelation as the fundamental context for attitudes and actions with regard to disease and the human situation.
The people and their stories recorded in the Old Testament reveal consequences, God’s approval or disapproval, and guidance. The insights provided in these accounts are too often neglected. To me it seems that, even for Christians, discussions of contemporary moral problems all too often focus on the pressures and issues of the moment without proper consideration of what might be gained from the advantages and insights available through special revelation.
Guidance about life and human choice, with its associated consequences, begins in the record of Eden in Genesis, but it continues in the stories and struggles of individuals throughout the history of God’s interaction with people. Hebrews 1:1 reminds us that our record is progressive instruction climaxing in God’s message in Jesus. God made sure that Noah was aware of a specific moral prohibition concerning the taking of innocent human life (Genesis 9:6). He guided His chosen people not only with the Ten Commandments (Exodus 20), but also explained how those commands applied in particular cases in the Book of the Covenant (Exodus 20-24). Moreover, God called attention to inappropriate moral choices with outcries of prophets calling the people back to His plan for them. He also preserved the insight of wise and inspired leaders (e.g. Proverbs 31:8-9). The Law, the Prophets, and the Writings all provide significant guidance intended “for our learning” (Romans 15:4).
Reviewing New Testament Texts
In the record of the New Testament, Jesus came healing and preaching the gospel (Luke 4:31-41). By the time John the Baptist sends messengers to question Jesus about His ministry, the gospel accounts of Jesus’ activities have preserved stories of many healings. The first two chapters of Mark, Matthew 8-11, and Luke 4-7 include many accounts of Jesus healing the sick. His ministry could, in many ways, be described as a ministry of healing. Jesus tells the messengers to “Go and tell John what you have seen and heard: the blind receive their sight, the lame walk, lepers are cleansed, and the deaf hear, the dead are raised up, the poor have good news preached to them” (Luke 7:22 ESV, also Matthew 11:4).
Many other passages in the gospels record accounts of Jesus healing the sick. Often multiple gospels record particular healings, and sometimes only one of the gospels provides the record. What is clear from any account of Jesus and His healing ministry is that He cared for the sick. His compassion was clear and He paid attention to those on the margins of society. Jesus healed the sick, and sometimes even raised the dead returning them to their grieving relatives. Signs and wonders—including the healings— confirmed that Jesus was God’s spokesman (Hebrews 2:3-4) and provided justification for believing in Him (John 20:30-31).
Of course, there is reason to believe that the primary mission of Jesus involved more than healings, more than signs and wonders. Luke says that Jesus came to seek and save the lost (Luke 19:10). John explains that Jesus makes the Father known to us (John 1:18) and that He “came as a witness, to bear witness about the light, that all might believe through him” (John 1:7 ESV). So, while information about Jesus as “the Great Physician” is valuable, we should not mistake that role as His primary reason for being part of human history.
Clearly not everyone who wanted to be healed by Jesus was healed. When crowds who knew that many were being healed by Jesus came searching for Him, Jesus told Simon Peter: “Let’s go somewhere else—to nearby villages—so I can preach there also” (Mark 1:36 NIV). There were sick and hungry people before Jesus came, and there were sick and hungry people after Jesus rose from the dead and ascended back to Heaven. Some were later healed by the apostles and by others empowered by God (e.g. Acts 3:6ff— where it is even said in 4:16: “a notable miracle has been done;” and Acts 28:8). Miracles including healing were among the gifts of the Spirit bestowed on some in the early church (1 Corinthians 12:9; Hebrews 2:4). Their primary work was proclamation of the gospel, God’s power to save (Romans 1:16-17), but God’s confirmation of their message in the name of Jesus did include signs, wonders, and miracles (Acts 8:13, et al.).
Any attempt to understand the place of healing in the ministry of Jesus needs to include an awareness of the compassionate mercy represented in His notice of and response to those who were sad and suffering. Repeatedly, the gospels call attention to Jesus’ “compassion” (from splanchna that refers to humanity’s inward parts and thus to the seat of emotion, metaphorically “the heart”). Some of the most notable examples of this occur in relation to His concern for the sick, suffering, and grieving (e.g. Mark 1:41; Matthew 20:34; Luke 7:13). Jesus also uses the term in reference to “sheep without a shepherd” (Mark 6:34, etc.) and in attempts to represent compassion and teach mercy in the parables (Matthew 18:27, 23-35; Luke 10:33, 25-38; and Luke 15:20, 11-32). The concept of compassionate mercy represents God’s care in the words of Mary and of Zechariah in their praise of God’s coming work in John and Jesus (Luke 1:50, 54, 72, and especially in verse 78 where Zechariah speaks of God’s merciful heart using the combination of terms from splanchna and eleos).
Compassionate mercy for others has been too often neglected. Studying the use of eleos, oiktirmos (with a root reference to pity when seeing another’s ill-fortune), and splanchna referring to compassion and mercy in the New Testament, I am convinced that an aspect of God’s own nature has often been under-emphasized in our relationships with other people. This insight seems closely tied to two key passages in the teaching of Jesus—Matthew 5:48 and Luke 6:35-36. We should reflect the merciful nature of God in our contact with other people. If we are to become the godly people that we were created to be, we must be the children of God who increasingly embody His mercy. Of course, the most crucial place for showing God’s mercy concerns forgiveness and salvation. Nowhere is this more important in this life than on the occasions when we can show compassion and respond to the sick, injured, or grieving, with mercy. However, with regard to those disadvantaged and suffering individuals or populations around us, showing mercy is the heart of godlikeness.
Two passages in the gospel accounts of Jesus’ life and teaching especially remind me of the need for mercy. First, Luke 16:19- 31 records Jesus’ story of the rich man and Lazarus where the rich man cries out for mercy (16:24), but the rich man failed to listen to Moses and the prophets. Apparently, he had not shown mercy to Lazarus. The sick beggar suffered in life, but was the beneficiary of God’s mercy after death. The story provokes me to feel compassion for the sick beggar, but it also reminds me that all people need to listen to God’s messengers and prepare themselves to receive the mercy of God. Second, another report of a different Lazarus (John 11) reminds me of the compassion Jesus exemplified. Though the term embrimaomai representing Jesus’ emotional reaction is different from the terms mentioned above, John’s record of events associated with the sickness and death of Jesus’ friend, Lazarus, clearly shows the need for merciful compassion. Jesus was deeply, emotionally moved (“groaning” in His spirit, John 11:33, 38 KJV) when He considered the death of Lazarus and the grief associated with that death.
The extended account of Jesus’ reaction to Lazarus’ sickness and death in John’s gospel can teach us much about appropriate reaction when we encounter sufferers. What believer doubts that Jesus could have healed Lazarus if He had arrived before the sick man died? What believer doubts that Lazarus would conquer death in the final resurrection? His sister Mary did not doubt that in the resurrection, Lazarus would overcome death (John 11:24). Jesus did not arrive before Lazarus died. He did not arrive before the family and friends struggled with grief. Still, Jesus was emotionally affected by the situation; and Jesus’ reaction to this particular sickness and death reminds us of a worldview that approaches such events differently. Yes, “Jesus wept” (John 11:35). He was also emotionally moved deep within His soul by the encounter with sickness and death. For me, what was dramatically lacking in Luke’s recorded story of a rich man and another Lazarus is dramatically visible in John’s account of Jesus and His friend Lazarus. I am reminded that Jesus came to show us godliness embodied. In Jesus we observe mercy and compassion, and we discover a key element for the Christian response to needs we encounter. Who is it that shows God’s love to those injured and in need of care? The ones who show mercy are the ones who have learned the lessons from Jesus (Luke 10:37).
A Christian Worldview for Bioethics
While it may be inappropriate to make broad claims about the parameters of a Christian worldview for bioethics, some basic characteristics and insights may be identified. The preceding survey reviews some select biblical passages that intersect human life in terms of health, disease, injury, recovery, or the ultimate loss of life itself. From such a survey, we can propose a few foundational elements of a Christian worldview for bioethics, insights derived from the biblical record of God’s interaction with human blessings and woes.
First, human life is good and a great blessing from Him who created us in His image; however, life is not an absolute value to be preserved at all costs. Jesus could have saved His sick friend Lazarus from death. He could have healed all of the world’s sick. He could have raised (and will some day raise) the dead to live again—all of the dead. He could have avoided His own death on the cross, but He died for us. Life should be treasured as the blessing it is, but death is inevitable in this life. In some cases, death is even a blessing.
Second, though He is our Healer, God does not always immediately heal people of all diseases or injuries. Jesus did not heal all the sick while He was on Earth. He was moved with compassion and showed mercy to those He encountered. He healed many and was touched with their sadness and suffering. We also should bring godly mercy to our encounters with sickness and grief, doing what we can for the sick and suffering.
Finally, people created in the image of God should show His mercy to others. Jesus is our supreme example of godly compassion. For now, this world is a place of sickness, injury, and death. We must notice those who suffer and show mercy to them. Whatever illness we encounter, feeling compassion is appropriate and showing mercy is good. We must care for the suffering, but death is inevitable (Hebrews 9:27).
These three observations represent my partial account of how we may apply a Christian worldview to issues of bioethics. These guidelines build on the historic revelation of God about human struggles with health, its loss in sickness or injury, and the inevitability of death. God’s people needed to learn that defending their “blamelessness” was less important than learning to depend on the mercy of God. They needed to learn that showing godly mercy would never mean they could prevent sickness or death. Coping with life’s struggles with the assistance of God our Healer was more important than claiming innocence. Job learned this lesson, and Jesus came to help us learn it too. Bringing our Christian worldview to life’s challenges is the right and good way to respond. Yes, Jesus healed people, but sick people were still around when He left this world. People still died. Life is good in spite of the sickness and suffering that must be endured. Death is tragic, but inevitable. We must do what we can to help. We should feel compassion. We should treasure and celebrate health and the blessings of life. More important than any of this, however, Christians must show the mercy of God. This is how Jesus dealt with such matters. This is a crucial element distinguishing a godly worldview from a godless worldview, and such a distinction may bring remarkably different reactions to contemporary issues in bioethics.
Some Current Bioethical Issues
Many Christians may have been introduced to challenging issues in bioethics through discussions arising from the Roe v. Wade court ruling on abortion and the associated social conflict from the 1970s. For others the introduction to moral controversy and Christian living may have come from news stories about organ transplant surgeries. Some may have struggled with childlessness in their families and found themselves wrestling with questions associated with new options at fertility clinics. Many have found themselves confused or conflicted when asked about Stem Cells, Living Wills, Durable Power of Attorney for Health Care, or Do Not Resuscitate orders (DNR’s).
For many Christians, exposure to issues in bioethics is very personal and comes with much theological, political, and emotional baggage. All of this makes it crucially important that we pause in our contemplation of such issues to ask what impact our Christian worldview should have on our decisions.
Conclusion
The Bible does not offer an encyclopedic, systematic account of bioethics; in fact, use of the term may in some ways be anachronistic. The Bible provides us with God’s revelation of a Christian worldview to inform our moral choices. Knowing what God has told us about the entrance of death into human experience, the place of illness and suffering, and the urgency of interactive mercy informs our Christian worldview and empowers our response to bioethics issues.
The Christian answer will always include an awareness of the value of life buffered by the awareness that we will all die. Christians, dealing with issues in bioethics, will always consider the reality of suffering and death in a world where God preferred us to have tranquility and the Tree of Life. Moreover, Christians should always be focused on mercy for the sick and suffering. When Jesus showed emotion, He was often most upset about those abusing and accusing not just the sufferers who had made mistakes. Our responses to issues in bioethics must not place us in the camp of the judgmental and merciless. Harsh and sensationalized emotive responses should not be the Christian approach to complex contemporary bioethical issues. Our worldview and practice should show God’s mercy.
Notes
Though Asa’s forty-one year reign was generally characterized as righteous (1 Kings 15:11), 2 Chronicles 16:7-10 indicates that his heart was not fully committed to the Lord. He had depended on other allies, had rejected the message of Hanani the seer, and had oppressed some of the people. The comment about depending “only on the physicians” (2 Chronicles 16:12), during the 39-41 years of his reign when his feet were diseased, seems to be a further illustration of Asa’s failure late in his time as king.
“The Great Physician” is not a biblical phrase, though it is a biblical idea. A hymn “Christ, the Physician” originally published by William Hunter in the 1850s has embedded in our consciousness the words “The Great Physician now is near, the sympathizing Jesus.” Some of us may even find ourselves looking for the very words in Scripture. Jesus does say that it is those who are sick who need a physician, justifying His own interest and efforts on behalf of the lost (Matthew 9:12).
I was tempted to include the problem of evil in this partial list of elements of a Christian worldview and its response to bioethical issues. Suffering haunts so many of us when we struggle with issues in bioethics that I considered introducing some elements of response to those issues herein. People struggling with various illnesses may feel that their suffering is unjust, but God is not blameworthy for human illness or injuries. I do believe that God sometimes directly inflicts plagues (as on the Egyptians in the time of Moses) and He allows tragedy to affect individuals (like Job). However, injustice is not the proper characterization of His responsibility for such human suffering. Many responses to the problem of evil and suffering have been elsewhere provided, and introducing such issues here seemed inappropriate.
I was also tempted to include some proposal about a basic argument for discussing bioethical issues. If God is and the Bible is the Creator’s message to people about His expectations and plan for them, then we can know what God wants us to know about health, illness, death, and coping with life in this world. Though the Bible is not a systematic, encyclopedic account of God’s message, Scripture does provide some passages about people and the principles and goals God intends for them to consider as they make choices about how to live and help others live in a world that provides opportunities and challenges. The materials included here partially develop that argument and show, at least in a preliminary way, how it may be included in accounts of a Christian worldview. I have provided a hint at how we will demonstrate that application to some particular issues after setting the context with a discussion of the contemporary morass of issues in bioethics.
Our Christian worldview represents the best integration of what it means to see the world originating with a Creator who wants to bless us with the opportunity to live well, learning love and mercy, anticipating a Savior who will show us our eternal purpose. People’s response to life’s challenges should include choosing mercy for themselves and others, whether in health or struggles with sickness, injury, and dying. When that opportunity to choose well intersects health, illness, or the actions of those who profess to help others cope with life, contemporary moral discussions generally categorize the topics as bioethics, including issues associated with the beginning of life, the preservation or restoration of health, or the meaning of death and choices associated with any such issues.
4The term “bioethics” is a twentieth century term, and perhaps it would be inappropriate to speak of a biblical response to bioethical issues. That would be “anachronistic”—prior to the time when such a term was even used. However, it is clearly appropriate to speak of how twenty-first century Christians should respond to such issues.
For most readers, the plan for subsequent articles may be of more particular interest since we resisted the temptation to focus herein on specific issues and our response. In some treatments of bioethics with which I am familiar, especially among those writing for periodicals and volumes circulated among members of the churches of Christ, people have focused more on telling what is wrong with proposed choices some are making. Regrettably, that preoccupation has in my judgment led to responses that are generally perceived by many readers as reactionary and judgmental. I believe many of the efforts have been genuine, loving efforts to provide guidance and to stand for truth and sound doctrine. Nevertheless, some of the lessons I have listened to in pulpits and lectureship programs seem appropriately described as hyper-critical, negative, and simplistic; and many of them have settled for “proof texts” offering more in terms of the speaker’s personal opinion than careful biblical exegesis or informed sympathetic guidance from a Christian worldview.
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Rolland W. Pack earned the M.A. degree in Christian Doctrine from Harding University with Thomas B. Warren as his mentor and earned the Ph.D. in Philosophy from Georgetown University with Edmund Pellegrino as his mentor. He was a research and teaching fellow of the Kennedy Institute for Ethics while at Georgetown. The former Professor of Philosophy and Biblical Studies at Freed-Hardeman University, and was also Dean of the Honors College and Associate Vice President. His book, Truth Acknowledged, Rejected, and Applied: Engaging Moral Philosophy for Contemporary Apologetics, was published by the Warren Center in 2012. He may be reached at Rolland.Pack@gmail.com.