Vandrunen Bioethics and the Christian Life

A Guide to Making Difficult Decisions
1. Auflage 2009
ISBN: 978-1-4335-2183-6
Verlag: Crossway
Format: EPUB
Kopierschutz: 0 - No protection

E-Book, Englisch, 256 Seiten

Just about everyone will face a difficult bioethics decision at some point. In this book a theologian, ethicist, and lawyer equips Christians to make such decisions based on biblical truth, wisdom, and virtue. Though a relatively new discipline, bioethics has generated extraordinary interest due to a number of socially pressing issues. Bioethics and the Christian Life places bioethics within the holistic context of the Christian life, both developing a general Christian approach to making bioethics decisions and addressing a number of specific, controversial areas of bioethics. Clear, concise, and well-organized, the book is divided into three sections. The first lays the theological foundation for bioethics decision-making and discusses the importance of wisdom and virtue in working through these issues. The second section addresses beginning-of-life issues, such as abortion, stem-cell research, and infertility treatments. The third section covers end-of-life issues, such as living wills, accepting and refusing medical treatment, and treatment of patients in permanent vegetative states.

David VanDrunen (PhD, Loyola University Chicago) is the Robert B. Strimple Professor of Systematic Theology and Christian Ethics at Westminster Seminary California in Escondido, California.

Autoren/Hrsg.

Vandrunen, David

Leseproben

1

CHRISTIANITY AND HEALTH CARE IN A FALLEN WORLD

This book focuses primarily on personal bioethical decisions that Christians must make for themselves or for loved ones. As such it does not focus on bioethics in the public square, that is, upon the economic, legal, and political dimensions of bioethics. The fact that the book has this particular focus, however, does not imply that the public dimensions of bioethics are unimportant or that Christians should be uninvolved with them. If I am to set forth a Christian view of bioethics, then I must provide at least a general perspective on the relationship between the believer’s Christian commitment and his life in the broader—and largely unbelieving—world of health care. This is because thoughtful Christians who seek to be faithful in their private bioethical decisions will necessarily confront important issues that involve the public dimension of bioethics. Should Christians participate in the mainstream health-care system or should they establish their own Christian hospitals, medical schools, and insurance companies? Are Christians’ biblically shaped convictions on matters such as abortion or euthanasia unique to Christianity, or are they also binding upon non-Christians? Are believers able to have morally meaningful discussions with unbelievers and, if so, how should these discussions take place?

In this chapter I argue that, though readers should strive to attain a perspective on bioethics and to make private health-care decisions in ways that are consistent with their distinctive Christian life (the focus of this book), they should do so while continuing to participate in the mainstream health-care system and making appropriate contributions to public policy debates about bioethics.

Christian Bioethics and Secular Bioethics: Contemporary Approaches

To describe important contemporary perspectives on the relationship of Christianity to the public dimensions of bioethics, I use the terms Christian bioethics and secular bioethics. By “secular” bioethics I do not mean “evil” or “godless” bioethics, but simply the discussions and debates about bioethics that take place in the broader world where there is no universally shared religious faith. Where do Christians stand in relation to the broader world of health care, and how should they participate in the bioethical debates that take place within this world? Bioethicists from a variety of theological and philosophical persuasions have attempted to answer such questions, with a remarkable divergence of opinion.

Five general approaches to the relationship of Christian bioethics and secular bioethics can be found among contemporary writers: (1) secular bioethics only, (2) Christian bioethics only, (3) secular and Christian bioethics identical, (4) secular and Christian bioethics radically different, and (5) secular and Christian bioethics distinct but legitimate.

Secular Bioethics Only

Writers who represent the first category, secular bioethics only, make morally serious arguments about bioethical issues for society as a whole and do so through philosophical or pragmatic argumentation. Though some of these bioethicists are religious people, their writings are non-theological, and they seek to address all people in a way that appeals to their moral sensibilities no matter what their religious convictions. The influential framework for bioethics espoused by Tom Beauchamp and James Childress, often called principlism, falls into this category. Beau-champ and Childress argue for the existence of a “common morality” that is shared by all morally serious people in all cultures. This common morality is not a theory of ethics but a set of principles and norms of conduct. Beauchamp and Childress acknowledge that there are also moralities specific to particular communities and that some people in all cultures refuse to live by aspects of the common morality, but they believe that the common morality provides a means for cross-cultural critique of immoral practices in particular communities. Beauchamp and Childress derive four fundamental principles from the common morality that ought to guide the professional ethics of health-care providers: respect for autonomy, nonmalificence, beneficence, and justice. Through application of these principles in concrete circumstances, Beauchamp and Childress aim to provide an ethical standard for medical practice in a health-care system that encompasses people from a range of communities and creeds.

Another example of a secular bioethics only approach is that of Robert Veatch. Veatch argues against a medical ethics derived solely from within the medical profession and advocates instead a medical ethics that emerges out of a social contract or covenant among all the members of society—medical professionals and nonprofessionals, those with social power and those without it. Though Veatch determines the content of bioethics in a way different from Beauchamp and Childress, the two approaches agree in seeking to develop a universally applicable bioethics governing a medical system comprised of people from all communities and faiths.

Christian Bioethics Only

A starkly different alternative to the secular bioethics only perspective is the Christian bioethics only approach. Adherents to this approach set forth a bioethics derived solely from their theological convictions and wish their distinctively Christian approach to bioethics to control all health-care practice. John Frame’s Medical Ethics provides an example. Appealing to the doctrine of sola Scriptura, Frame sets out to answer various bioethical questions through application of biblical teaching. He notes the deficiencies of secular bioethics, but never discusses whether secular bioethics is a legitimate enterprise in any respect, nor does he acknowledge the legitimacy or usefulness of any nonbiblical source of moral knowledge (such as a concept of natural law known through God’s general revelation). For Frame, society-wide bioethical questions are simply to be solved by applying biblical principles. Should the child of a Jehovah’s Witness be given a blood transfusion against the wishes of her parents? Frame states that the Bible considers people “competent” who obey God’s will, and therefore since Jehovah’s Witnesses have a false view of God, they are not competent to make such decisions for their children. Civil courts should order the transfusion against their objections. What if a physician becomes concerned about the question of confidentiality? Frame says that he should require his patients to agree to “biblical principles of confidentiality.”

Other examples of a Christian bioethics only approach may be found in various visions of the Christian transformation of modern health care. Marsha Fowler’s contribution to a volume of essays on Christian engagement in society’s bioethical debates is illustrative. Appealing to the convictions of her own denomination (Presbyterian Church [USA]) and to her interpretation of the broader Reformed tradition, Fowler argues that the church is to be actively involved in transforming the health-care practices of the world. The church should have a prophetic voice in society and engage in political action and critique. Through an “incarnational ministry” that “embraces the whole of life,” the church must seek to usher in the biblical vision of shalom. As an example she points to her own congregation’s “health ministry,” which offers aerobics classes, walking groups, and free blood pressure screening for church members and the community.

Secular and Christian Bioethics Identical

A third general approach is what I call the secular and Christian bioethics identical perspective. This approach differs from the secular bioethics only approach because it seeks to bring religious and theological considerations to bear upon bioethical discussions. It also differs from the Christian bioethics only approach in that it refuses to see theological reasoning as the only way to resolve bioethical questions and does not attempt to impose a distinctively Christian vision upon the broader society. This secular and Christian bioethics identical approach is probably best exemplified by a number of prominent Roman Catholic bioethicists. These writers refer to a concept of natural law in order to identify sets of goods, values, and experiences that are common to all people, promote general human flourishing, and provide a foundation for a universal and cross-cultural morality. Bioethics, then, ought to develop in conformity with this universal morality.

For such writers, Christianity and theological truth contribute little or nothing substantive to bioethics, but serve to reinforce and enrich natural law bioethics in various ways. For the late Richard McCormick, “the Christian tradition only illumines human values, supports them, provides a context for their reading at given points in history. It aids us in staying human by underlining the truly human against all cultural attempts to distort the human.” For Lisa Sowle Cahill, theology can contribute to bioethics by raising awareness of the importance of justice and social solidarity and “explicitly religious narratives and symbols can also have a public role in widening the moral imaginations of people from diverse traditions and faiths.” James Walter and Thomas Shannon argue that religion, and specifically their Roman Catholic tradition, illumines or “adds value to” certain aspects of issues that are often overlooked, such as inclusive concern for all people through ideas of the...