Through a glass darkly: Coping with ethical and theological uncertainty D Gareth Jones

Through a glass darkly: Coping with ethical and theological uncertainty D Gareth Jones

The disconcerting world of modern medicine

Has medicine gone too far?

Have Christian drivers been replaced by a secular humanistic worldview?

Makes for good polemical debate

The science-faith divide is just beneath the surface of the rhetoric

My general attitude towards medical technology is cautiously positive


Is medicine intruding intodivine centre of human existence, especially at beginning and end of life?

Divine chance has been replaced by non-divine choice

Sentiments about ever-increasing power of medical technology are rife with theological overtones


Has the divine been displaced from everyday life?

Prayer appears to fail but a drug is effective

Temptation to maintain ethical and legislative status quo

Cannot sit back and decide where we do or do not go

No technology is perfectly developed

Where I am coming from

A Christian searching for directions for medicine and for theological guidance

How might theology contribute to a world dominated by biomedical intrusions?

When to use technology and when to desist

Dependence upon God and his direction


‘For now we see through a glass, darkly; but then face to face: now I know in part; but then shall I know even as also I am known.’

‘Now we see only puzzling reflections in a mirror, but then we shall see face to face. My knowledge now is partial; then it will be whole, like God’s knowledge of me.’

1 Corinthians 13:12


We are walking in uncertain territory

The ground we are covering was unknown to the biblical writers

Assurance versus despair

We do not see as clearly as we would like

Theological guidance

. . . the use of the Bible is not a matter of selecting texts and of trying to apply them as though they were legislation for modern situations. . . . the Bible’s primary function is to bring us to faith and to keep us in faith. The faith which we confess is faith in a God who responds to human need, who justifies the unrighteous and who seeks the outcast. The Bible lays upon us imperatives that derive from the heart of our salvation, and our task is to work out those imperatives in the situation in which we find ourselves.

John Rogerson


The Bible does not address in any direct manner the techniques available in modern societies

‘Include unborn children along with the defenceless and minorities whose task it is for the strong to defend’


Allen Verhey’s interpretive rules:

Scripture is to be read

humbly avoiding interpretive arrogance within the context provided by the

Christian community


1. Humble

Not one of us has assured answers on every point raised by current bioethical debate

2. Avoid interpretive arrogance

Questionable bioethical assertions that go way beyond any views that the biblical writers could possibly have had in mind


3. No privatization of ethical deliberation

We cannot determine a Christianresponse without reference to a wider Christian community

We need each other within community of faith

The strange world of sickness in Scripture


‘In memory of Jesus and in hope the Christian community will delight in human flourishing, including the human flourishing we call “health”, but also be able to endure even the diminishing of human strength we call “sickness” with confidence in God’

Verhey


respect for the embodied integrity of people

their freedom and identity the need to nurture community to support, care for and cure the sick

Limited nature of our medical powers - we are not to have extravagant expectations


Not yet character of our life and medicine

‘The memory of Jesus does not provide any neat and easy resolution to such conflict. It does not usher in a new heaven and a new earth, either. Here and now there is ambiguity.’

Verhey

Techniques should not become idols around which we create an alternative salvation-history


Ian Barns argues that:

‘the project of transcendence through technology is unsustainable and a destructive folly, and that human life needs to be lived gladly within the limits and diverse possibilities of our existing material condition’

We do not aim to project human power but trust God and become a suffering servant

Address what it means to be human in a post-human(ist) culture.


Influence of Jesus felt in acts of healing, exorcism and control over nature

To take seriously contribution of science and technology to Christian imperatives

Provide guidance in face of dilemmas


Neil Messer - four diagnostic questions:

1. Is the project good news to the poor, powerless, oppressed or marginalized?

2. Is the project a way of acting that conforms to the imago dei, or is it an attempt to be ‘like God’?


3. What attitude does the project manifest towards the material world (including our own bodies)?

4. What attitude does the project manifest towards past human failures?


The same principles will be interpreted in a variety of ways by different commentators

None to be dismissed if seeking to faithfully reflect core principles

‘A more theologically adequate attitude to the physical will . . . recognize the material world as good and worth taking trouble over, yet flawed and in need to transformation and will not make the mistake of thinking that physical life in the present material world exhausts what humanity has to hope for.’

Messer

What sort of assistance does the Bible provide?

Do the biblical writers provideany specific input?

Possible approaches:

1. The Bible alone provides a complete guide to ways in which Christian decision-making should be framed, making scientific input irrelevant


2. The Bible is one of a number of sources of concepts and information, but is the major determinant whenever there is conflict or confusion

3. The Bible is one of a number of sources and helps to inform decision-making, but may not be the major source

4. The Bible is irrelevant and hence can provide nothing of any interest to scientists or ethicists


A real life scenario

A couple had two new grandchildren, first a girl who epitomized the delight of a gorgeous newborn, then a boy who turned out to have cystic fibrosis (CF)

How should the grandparents respond as Christians?


Their grandson with CF is intimately dependent upon a very high level of technological expertise

Science and technology at its most impressive, and in the service of humanity

Centrality of research: The life expectancy of those with CF has been transformed over the past 20-30 years


The parents begin to contemplate the birth of a second child

Options

1. Take a chance, and hope their next child will be unaffected. Continue the pregnancy whatever eventuates - the welfare of the child is in God’s hands


2. Take a chance and have an abortion as a last resort if the fetus turns out to be affected – a morally tainted path

3. IVF and PGD (pre-implantation genetic diagnosis). Only an unaffected embryo would be transferred; an affected embryo would be discarded - a very delicate and uncertain path spiritually


They have to choose, and have to live with the repercussions and consequences

Child with CF; child without CF; embryos/fetuses that will never live as children

Parents cannot escape ethical decision-making and making choices that resonate with theological meaning


Competing forces pit one life against another, and one set of values against another set

Where does the Bible enter the picture?

One answer: protect embryo or fetus at all costs

Is this perspective based upon unequivocal biblical teaching?


How far does the Bible take us?

Category 1

Difficult to see how the Bible taken in isolation of scientific input can possibly provide the only relevant input for decision-making in these circumstances


Categories 2 & 3

More plausible

Driving force is the balance between biblical and scientific inputs, and the extent of any biblical input

Treatment will be scientific in nature

Way in which science used will stem from Christian character of decision-making


Option 1 (accepts what comes)

Perfectly acceptable, but not self-evidently the only or even the ideal way for Christians

rejects some possibilities of scientific advance

Prepared to allow damaged individual into world when this could be prevented


Option 2 (possible abortion of affected fetus)

Most problematic

severe negative repercussions for parents

life-denying

no clear biblical warrant one way or the other

Need to assess interests of all involved


Option 3 (use of IVF/PGD)

financial costs

invasive

choosing one embryo over another; inevitably destroying embryos

What resources do Christians possess?


Theological perspectives

protect the defenceless and disenfranchised

importance of human flourishing

our ultimate dependence upon God

human life is not devoid of meaning simply because it is physically flawed


transformative power of the healing that Jesus brought and that can be experienced today

grateful for medical achievements bringing hope

Uncertainty and ambiguity

The limited nature of human powers should never be downplayed


Balance conflicting interests: reflect relationships that characterize family, human and church communities

Any decision will be an agonizing one (dispose of affected embryos?)

Remain ignorant; take what comes

Technology makes certain things possible, but with this come inevitable ethical choices


Do we have biblical mandate for remaining ignorant?

Is freely chosen ignorance a Christian virtue? Is this a denial of biblical mandate to be stewards of God’s creation?

Is ignorance in-and-of-itself a moral virtue?

Genetic advance forces us to confront and then make hard choices


Paul and applied ethical issues (1 Corinthians 8) – eating food sacrificed to idols

“Knowledge puffs up, while love builds up”

Never resort to a technological solution without considerable reflection; put into broad human and divine framework

A technological direction as an end-in-itself will end in dehumanization; ignorance as an end-in-itself leads to fatalism

Trust in God as basis for all 3 options

Concluding comments

There is guidance to be found in the Bible

Guidance is at general level; leaves great deal to the judgement and discernment of individuals and communities

Are there also more precise and finely honed directives in Scripture (world of rules and regulations, and cautious prohibitions)?

Concluding comments

Simple formulae stem far more from extra-biblical thinking than from anything inherent within Scripture

How does one act as a Christian in the midst of the tensions and pressures?

Act as Spirit-led decision-makers using our God-given abilities and responsibility to be his people in a far from ideal world

Documents

Through a glass darkly: Coping with ethical and theological uncertainty D Gareth Jones