Bioethikos: Bringing Life to Bioethics
In 1519, Captain Hernán Cortés and his Spanish conquistadors conquered the Aztecs and claimed Mexico for Spain. Legend reports that he ordered all the ships burned, so that his men would have to conquer or die trying. In reality, he merely scuttled the ships, making them unusable, but “burning the ships” has become a vivid metaphor to express total commitment to a cause.
Just two years ago last May, Chinese researchers reported the first use of a novel new gene editing technology, called CRISPR, on human embryos. The scientific and ethical world reacted with horror and dismay. “Germline engineering” of human beings, with genetic changes that could be passed on to future generations, has always been morally off-limits.
An international conference in December, 2016 proposed a worldwide moratorium on the use of CRISPR in human embryos. Yet within months, gene editing experiments began in the U.K. without much comment or apology. And just last week, similar experiments began at Oregon Health and Science University.
Here are a few of the many reasons why this is an ethically worrisome trend:
1. Experimenting on human embryos violates the sanctity of human life, period.
2. There is a ban in the U.S. on implanting CRISPR-edited embryos, but the temptation to implant and gestate them will be irresistible. This will first be done in other countries, debated and “cautiously” permitted here, and then the floodgates will open.
3. The goal is the cure of genetic diseases, but the results are completely unpredictable with our present level of knowledge. Germline therapies alter the entire genome of an afflicted individual, including reproductive cells. These changes will affect not only that person, but all subsequent generations.
4. All this won’t stop with the cure of diseases, as the new technology will quickly give rise to attempts at true enhancement: the altering (for better or worse) of human nature itself, possibly violating the image of God within each of us.
5. Informed consent, of course, is a major concern, since there is no way to get consent from future generations for the risks they will incur.
Yet despite the many risks, it seems that our scientists are willing, if not recklessly eager, to explore this new frontier. Like Cortés, their commitment is total, not to be distracted by bothersome ethical considerations.
And the ships are burning.
By center director Sullivan, along with guest blogger Keegan D’Alfonso
What can we say about poor little Charlie Gard? This 11-month-old infant in the U.K. suffers from a rare and incurable disease called mitochondrial depletion syndrome, leaving him unconscious, on life support, and with almost no prospects for survival. Until just a few days ago, his parents wanted to continue treating him, even consulting with a specialist in the U.S. The hospital and the government have refused to release the child, claiming it is not in his best interests to continue aggressive therapy.
Though the parents have now given up on the court case, the public debate has been intense and polarizing. Here are a few excerpts – note the widely divergent opinions expressed:
A professor at University College of London:
[C]hildren do not belong to their parents. . . Parents cannot always be the ultimate arbiters of their children’s interests. [source]
From Russel Moore: “The European courts’ abuse of their power by usurping the authority of Charlie’s parents regarding his care is shocking to the conscience.” [source]
From the Telegraph (U.K.): “A civilised society doesn’t let parents do what they like with their children – however much they love them.” [source]
Americans United for Life: “Vulnerable people – the sick, the elderly, the infirm – deserve life-saving treatment – not a death sentence.” [source]
A prominent physician-ethicist, in the Journal of the American Medical Association: “[We must maintain] a commitment to upholding the integrity of medical practice by refusing to provide treatments that fail to meet a reasonable threshold of scientific justification.” [source]
Finally, we conclude with lawyer Wesley Smith, writing in the journal First Things:
The refusal to allow Charlie’s parents to remove their baby boy from the hospital is an act of bioethical aggression that will extend futile-care controversies, creating a duty to die at the time and place of doctors’ choosing. And that raises a crucial liberty question: Whose baby is Charlie Gard? His parents’? Or are sick babies—and others facing futile-care impositions—ultimately owned by the hospital and the state?
By Guest Blogger Keegan D’Alfonso
There is an unintended irony in a recent study reported in the journal Nature on the immunology of fetuses in the womb. Researchers in Singapore studied tissue from 100 elective second-trimester abortions. In the process, they uncovered details of a fascinating mechanism that permits the immune system of a developing baby to develop, but not attack its mother. The irony lies in the fact that the scientists found such a way that babies can remain safe in the womb, even though these particular babies were aborted.
The study may help scientists to better understand certain types of miscarriages and a deadly immune response in premature babies, and may also help to treat autoimmune diseases in adults. With autoimmune diseases affecting an increasing number of people worldwide, this seems like a reasonable goal, but at what price?
The dilemma, of course, is that the research used tissue from elective late-term abortions. Was permission to study this tissue obtained before or after the procedure? Did the possibility of research on the “products of conception” give further incentives for the abortion itself?
Doctors have a duty to study ways to cure illnesses, but they also have a duty to protect the dignity of life. The debate on abortion aside, a human life, even an unborn one, should never be reduced to disposable parts. Where is the line between a doctor’s duty of care and his or her duty to protect life?
My guest is Seth Dreyer, Director of Training for Created Equal, a pro-life advocacy group based in Columbus, Ohio. We talk about attempts to limit or restrict abortion through legislation, especially in Ohio. We discuss how these attempts may fare in the larger goal of overturning the 1973 Roe v. Wade Supreme Court decision. Seth also shares ways to engage the public, and to appeal to hearts and minds on the question of abortion.
In a modern movement right of of H.G. Wells, transhumanism is on the rise. This atheistic brand of scientism calls for the perfecting of the human species, and for bringing us through to the “next stage” of our evolution. In fact, the idea has an ancient pedigree.
The quest for genetic purity is as old as Plato, who argued that handicapped babies should be “exposed” in the open to get rid of them. In the early 20th Century, it took the form of the flawed pseudo-science of eugenics, which led to widespread discrimination, even forced sterilizations, to permit only the “best”among us to reproduce. The American and European eugenics movement lost its steam when the Nazis incorporated it into their Final Solution, leading to the Holocaust.
But human perfectionism is alive and well in the 21st Century, now called transhumanism. Aided by biotechnology and speculative applications from robotics and artificial intelligence, it is gaining momentum in our increasingly secular society. One of its patron saints is futurist and computer pioneer Ray Kurzweil. Dr. Kurzweil has said:
By the time we get to the 2040s, we’ll be able to multiply human intelligence a billionfold. That will be a profound change that’s singular in nature. Computers are going to keep getting smaller and smaller. Ultimately, they will go inside our bodies and brains and make us healthier, make us smarter (source).
But that’s not all. Kurzweil wants to actually upload our consciousness, like software, into computers, helping us to achieve a sort of immortality. He thinks this can happen some time in the next 20 years.
I have a suggestion for Dr. Kurzweil. He should consult the Owner’s Manual for human beings, designed by our Creator. We do not need to engineer our species to be better. There is a coming spiritual transformation for the believer that will be better than any transhumanist vision:
Behold, I tell you a mystery; we will not all sleep, but we will all be changed, in a moment, in the twinkling of an eye, at the last trumpet; for the trumpet will sound, and the dead will be raised imperishable, and we will be changed. For this perishable must put on the imperishable, and this mortal must put on immortality (I Corinthians 15:51-53).
Transhumanism is a flawed and empty promise, and we should expose it for the lie it is. True change, true human perfection can only come through Christ.
(by guest blogger Eric Stigall, student at Ashland Theological Seminary)
Is Health Care a Right or a Privilege? In this era of managed care and the Affordable Care Act (AKA “Obamacare”), this is a loaded question. According to the U.S. Department of Health, about 10% of the population currently does not have access to health care. Since health insurance is tied to employment, this may largely be due to the poor coverage of low to medium income jobs, or to ineligibility to financial assistance and Medicaid.
OK, so this raises a big moral question: how do we treat our brothers and sisters in Christ, created in God’s image? It’s too easy to frame this as merely an economic question, as though the unemployed have only themselves to blame. A casual glance at the gospel record should give us pause:
For I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you welcomed me, I was naked and you clothed me, I was sick and you visited me, I was in prison and you came to me (Matthew 25:36-37).
So this implies that we have a moral duty to offer basic health care to all. Ethicist Ronald Sider put it this way:
It is a sinful abomination for one part of the world’s Christians to grow richer year by year while our brothers and sisters ache and suffer for lack of minimal health care, minimal education, and even — in some cases — enough food to escape starvation.*
I know this seems simplistic, but these facts should at least make us humble. As the people of God, we must continue to reflect upon and deeply discern the needs that impact so many in our society today.
I don’t claim to have all the answers, and there are surely two sides to this complex question. Please help me to think this one through: is healthcare just simple economics, or is it a basic human right?
*Ronal Sider, Rich Christians in an Age of Hunger: Moving from Affluence to Generosity, Thomas Nelson, 2015.
Pro and Con Arguments on Healthcare
Ohio Right to Life recently asked us if we would join them in a letter critical of the American Academy of Pediatrics, a move we were happy to make. We signed the letter, along with other medical groups, to urge the American Academy of Pediatrics to wind back its position that even teenagers have a clear right to abortion. The Academy’s position further contends that this is an unfettered right with no restrictions, no even parental involvement. Ohio Right to Life president Mike Gonidakis said this:
In a sad twist, the Academy in fact harms children twice: First, the teen seeking the abortion; and second, the child who is the target of abortion. The statement appears to be first and foremost that of a political agenda. . . [T]he modern-day American medical profession was founded with the intent of stamping out harmful practices like abortion—practices that contradict the physician’s duty to ‘First, do no harm.’ If the American Academy of Pediatrics is to honor that legacy and truly dedicate themselves to the health of all children, they will rescind this horrific polemic in favor of sound medical science.
What a distortion of parental duties — implying that we protect our adolescent children by allowing them to commit such an immoral act. We stand with Ohio Right to Life and other professional organizations that expose this as a lie.
As we have commented in this blog recently, the American Medical Association (AMA) is thinking of reversing its opposition to physician-assisted suicide (PAS). Canada and five U.S. states have made this practice legal, and “aid in dying” is now a part of everyday medical discussions. Here are a few more reasons to worry about all this:
In January, the Canadian Medical Association Journal published a “Cost Analysis of Medical Assistance in Dying in Canada.” Their conclusion: patients that choose PAS could save the national healthcare system millions of dollars over more expensive palliative care. My colleague Phillip Thompson discusses this issue in his blog here.
More grease for this slippery slope comes from the prestigious Journal of Medical Ethics. The December issue features an article entitled, “Organ Donation after Medical Assistance in Dying” (link). PAS may become more attractive for some terminally-ill patients if they could donate their organs. So add the subtle social coercion of doing a “noble” act as another reason to choose PAS. John Holmlund reacts to the trend here.
Those who endorse these ideas are acting compassionately, to be sure, but with individual radical autonomy as the underlying principle, rather than an absolute commitment to the sanctity of human life. May God have mercy on all of us as we struggle to find our way in the modern context of managed health care.
Bioethics in Faith and Practice has just published its latest issue. As we close out 2016, the New Year brings many ethical challenges. This edition of the journal features dilemmas at the beginning of life, the end of life, and in the laboratory. Features in this issue:
- Senior Editor Commentary – The New Push for Assisted Suicide, by Dennis Sullivan
- Managing Editor Commentary – CRISPR: Race to the Cure, by Heather Kuruvilla
- Peer-Reviewed Article – Method in Catholic Bioethics: ANH and PVS Patients, by Gregory J. Smith
- Peer-Reviewed Article – A Christian Ethical Perspective on Surrogacy, by Mark E. Lones
The first editorial discusses the new trend to facilitate assisted suicide, now legal by statute in five states. This is a dangerous trend, with serious negative implications for modern medicine. Dr. Kuruvilla, our Managing Editor, then discusses the new CRISPR technology, a novel new gene-editing technology that may allow for some truly breathtaking possibilities, especially in the fight against cancer. But there are many hidden ethical dangers.
The first of our full-length articles in this issue is by attorney Gregory Smith, and deals with the thorny issue of the persistent vegetative state (PVS). Using a perspective from Catholic moral philosophy, he asks if artificial nutrition and hydration are always obligatory in such cases.
Finally, pastor and hospital chaplain Mark Lones discusses the issue of reproductive surrogacy. His analysis gives us multiple reasons to consider surrogacy highly problematic from an ethical perspective.
All of these articles, along with the Senior Editor’s preview, are available in the Cedarville University Digital Commons, at this link.