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Bioethikos: Bringing Life to Bioethics

Archive for the ‘commentary’ Category

 

Editing Humanity: The Ships are Burning

Tuesday, August 1st, 2017 by Dr. Dennis Sullivan

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.

The Bioethics of Charlie Gard

Wednesday, July 26th, 2017 by Dr. Dennis Sullivan

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?

 

Elective Abortions: Material for Research?

Monday, July 17th, 2017 by Dr. Dennis Sullivan

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?

Research Report Summary

New Transhumanism – Same Old Story

Thursday, March 23rd, 2017 by Dr. Dennis Sullivan

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.

Christian Post Article

 

Health Care: Right or Privilege?

Monday, February 27th, 2017 by Dr. Dennis Sullivan

(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?

References:

*Ronal Sider, Rich Christians in an Age of Hunger: Moving from Affluence to Generosity, Thomas Nelson, 2015.
Pro and Con Arguments on Healthcare

 

 

 

 

 

 

Center Challenges AAP Radical Pro-Abortion Stance

Monday, February 6th, 2017 by Dr. Dennis Sullivan

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.

Ohio Right to Life Press Release

New ‘Incentives’ to Choose Death

Wednesday, February 1st, 2017 by Dr. Dennis Sullivan

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 & Practice: Latest Issue

Tuesday, January 24th, 2017 by Dr. Dennis Sullivan

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:

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.

 

Bioethics Challenges for the New Year

Monday, January 9th, 2017 by Dr. Dennis Sullivan

A colleague of mine has referred to this modern era as the “Biotech Century.” More than ever before, biological research and medical science have improved our lives, but have created new ethical dilemmas as well. Here are some of the major trends to watch for in the coming year.

Issues at the Beginning of Life

  1. Abortion. Forty-four years after the Roe v. Wade Supreme Court decision, Americans are more conflicted about the issue of abortion than ever before. 18 states have banned the procedure at 20 weeks of gestation. Such “pain-capable” abortion bans are based on the idea that the 20 week-old fetus has enough neurological development to feel pain, making abortion a form of torture. With a Republican administration in Washington, watch for renewed attempts to appoint conservatives to the bench and to overturn Roe.
  2. Reproductive technologies. Choices, choices: so many ways to have a baby. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). have pushed the envelope, making a genetically-related baby more and more possible for childless couples. The downside? Thousands of human embryos frozen for future use, discarded, or experimented on. A fundamental question remains: Are our children the God-ordained offspring of a loving marital union, or are they merely the products of an assembly line?

Issues at the End of Life

  1. When does death occur? New protocols are making it easier to withdraw care from acutely-injured patients, in order to provide more organs for transplants. Slippery-slope concerns should cause all of us to worry about the details.
  2. Assisted suicide. The American Medical Association is re-thinking its traditional opposition to medically-assisted death. As a part of this trend, five states have passed laws allowing doctors to help terminally-ill patients to end their lives at a time of their choosing. So who owns the life that we live, we ourselves or the Creator Who made us?

From the Laboratory

  1. Animal-human chimeras. Here’s an interesting idea: genetically modify a species of pig, making it incapable of growing a pancreas. Incubate the pig embryo with human pancreas cells, so that the resulting piglet has a human-derived pancreas, which can be used as a donor organ for transplant. Such a procedure might be a cure for diabetes, and may be ready for human trials soon. How about the ethics of all this? The devil is in the details.
  2. Gene editing. The completion of the Human Genome Project in 2003 produced the genetic blueprint of the human species, leading to a plethora of new research ideas. One revolutionary new insight takes advantage of a bacterial defense mechanism to recognize foreign DNA. A new procedure modifies this into a molecular “machine” that can actually edit any genome, including those of human beings. So-called CRISPR technology may make some very nifty things possible: think of engineered mosquitoes incapable of transmitting the Zika virus. But this new technique opens up some very disturbing ideas about modifying human nature itself.

Stay tuned – We’ll be talking about these and other trends in 2017.

In the meantime, have a blessed and productive New Year!

Links Related to Topics Discussed:
Pain-Capable Abortion Bans
Reproductive Technologies

Brain Death

Assisted Suicide

Animal-Human Chimeras
More about Gene Editing

The New Push for Assisted Suicide

Tuesday, December 6th, 2016 by Dr. Dennis Sullivan

Mortar 

There is a growing movement within the American Medical Association (AMA) to legalize “aid in dying,” otherwise known as physician-assisted suicide. The current ethics statement of the AMA, with roots going back thousands of years, states the following:

It is the policy of the AMA that:
1.Physician assisted suicide is fundamentally inconsistent with the physician’s professional role.
2.It is critical that the medical profession redouble its efforts to ensure that dying patients are provided optimal treatment for their pain and other discomfort.
3.Physicians must resist the natural tendency to withdraw physically and emotionally from their terminally ill patients.
4.Requests for physician assisted suicide should be a signal to the physician that the patient’s needs are unmet . . .

 

Now this commonsense, compassionate standard is giving way to something more radical. At its meeting last June, the AMA’s Council for Ethical and Judicial Affairs approved the study of “aid in dying,” prior to its next annual meeting in 2017. The stated goal is to consider going “neutral” on assisted suicide. This would be an historical departure for the AMA.

There are many reasons this is a bad idea. It impairs the trust relationship between a doctor and her patients. It would detract from modern efforts to improve  palliative care and hospice. And given our utilitarian society that so devalues the sanctity of life, a “right to die” could easily morph into a “duty to die.”

All of this is bad medicine, and we should oppose it.

Current AMA Ethics Statement