The Dignity of Life, by Charles J. McFadden, Medicine and Christian Morality, by Thomas J. O’Donnell, Science, Ethics, and Medicine, edited by H. Tristram Engelhardt, Jr., and Daniel Callahan, and Genetics and the Law, edited by Aubrey Milunsky and George J. Annas
June 17, 1977
Do medical science and metaphysics come together as adversaries or companions? As research pushes the frontiers of medical knowledge and ability farther and farther beyond the traditional limits, the question of ethics looms larger and larger. There is a direct correlation between scientific advances and ethical confusion. And no group is more confused when it comes to bioethics than evangelicals. The Bible simply does not talk about cloning or test-tube fertilization or eugenics or psychosurgery. There are principles in Scripture to show us the way in areas like these, but it is a lot easier to discuss the options in dealing with the economically deprived than with the biologically deprived.
Four recent books are attempts to show us the way to final solutions in these difficult areas, but none really succeeds. Two are by Roman Catholic moral theologians and two are collections of essays by non-theologians.
Both Charles McFadden and Thomas O’Donnell write from the traditional Roman Catholic position. Both look to the Holy See and Canon Law to steer them through the tricky shoals of bioethics. As Roman Catholic moralists, they are convinced that reasoning according to Thomistic natural law will see them through. While we evangelicals are more persuaded by divine law (teachings of Jesus) than natural law, we must admit, in the absence of evangelical biblical scholarship in these areas, that this reliance on the reasoning of rational creatures committed to the Christian tradition is better than nothing. O’Donnell and McFadden give us chapter after chapter of case-by-case applications of general ethical principles in the area of medical ethics. While these chapters tend to become tedious, they nevertheless provide something of a reference tool for the neophyte and a guide to some of the best conservative Catholic opinion about the life sciences.
Both authors attempt to deal with a paradox of Christianity that has been brought to the fore by the acceleration of medical progress: We Christians affirm life with great vigor because it is sacred, and we oppose whatever endangers life (i.e., disease, hunger, war); at the same time we are not afraid to affirm death because of the resurrection of our Lord Jesus. From within this paradoxical faith these Thomists attempt to deal with the frightening irony that medical science can now fight so effectively for life that society is beginning to use that same technology to encourage people to cease their resistance to death. Regrettably, these warrior theologians are not armed with the “Word of life,” and so their answers fall short of being totally convincing to an evangelical mind.
Turning to the two collections of essays, one quickly finds that they are not for the beginner; both presuppose a knowledge of vocabulary and background and an understanding of the basic issues. The Hastings volume is the first in a series of four on ethics and science. It reflects the fact that there is no moral consensus among those engaged in bioethics. As the editors point out, “That moral philosophy has been in disarray for some decades is a proposition with which few will argue.” Clearly, the ethical system holding the field at present is contextual in foundation, but it breaks under the burden of trying to come up with answers when every situation is (by definition) “borderline.”
The nine essays in this collection range: in subject from “Are Science and Ethics Compatible?” to “Toward a Theory of Medical Fallibility.” In the course of them, opposing propositions are argued (e.g., science is value-free, science is value-laden; medical ethics is derivative of other ethical systems, medical ethics is originative). As one reads the essays, it becomes apparent that the confusion in bioethics stems in part from a defective epistemology and a failure to distinguish universal principles from particular applications. Once again we see that ethics without God is not satisfactory ethics.
The genetics volume is more esoteric than the Hastings collection. It is clearly aimed at the person who is seriously involved in genetics or the life sciences. This group of writings is more unified in its thrust, since it deals primarily not with ethics but with the present state of genetic research and how that research is transferred into public policy. Obviously this involves ethics, but for the most part the discussion deals with the practical decision-making process (mechanics) rather than with the origins, nature, and validity of ethical systems (universal presuppositions). Therefore, there is very little here about which one can constructively argue. The authors (forty-four scientists, physicians, and lawyers—no theologians) deal with such topics as the rights of the fetus, human experimentation, eugenics, cloning, and artificial insemination. After some of the essays there are round-robin discussions that make it apparent that a consensus among secularists cannot be found.
My recommendation concerning these books is this: If you are beginning your study of bioethics, forget them all. If you have done some reading in the field, you might profit from the Hastings volume. If you are deeply into medical ethics, then the genetics volume might be worth the time and money. The two Roman Catholic casuistic works are of limited worth unless you are willing to follow the finicky case-by-case application of certain rationalistic principles.
It is a tragedy of the first order that the two collections of essays do not contain any evangelical scholarship. This speaks more of our ethical forfeiture than of editorial prejudice. Because the secular ethicists have such a difficult time finding a normative ethical system from which to view the life sciences, we evangelicals are led to believe that bioethical problems and conflicts are inherent in bioethics and not (as I am convinced they are) in the secularists’ ethical systems.
Surely there are evangelical ethicists who are capable of providing pioneer leadership in these areas. Medical science and biblical scholarship are companion disciplines for the honoring of God and the service of mankind; Paul’s words in 2 Corinthians 10:5 press us to this conclusion. As Nathan Hatch of the University of Notre Dame has said, “Evangelicals need to be so culturally self-conscious that we do not have our agenda for concern determined by the secular world.” There should be forums for biblically informed ethicists to interact on these various life-science questions. The Church is still waiting for gifted men and women who know the Scriptures to help our thinking in this most human of all scientific areas of study.