Storytellers All

Another of my assignments for my bioethics class was to write a preachable text.  So here is mine.

Psalm 130

Out of the depths I cry to you, Lord;

Lord, hear my voice.
Let your ears be attentive
to my cry for mercy.

If you, Lord, kept a record of sins,
Lord, who could stand?
But with you there is forgiveness,
so that we can, with reverence, serve you.

I wait for the Lord, my whole being waits,
and in his word I put my hope.
I wait for the Lord
more than watchmen wait for the morning,
more than watchmen wait for the morning.

Israel, put your hope in the Lord,
for with the Lord is unfailing love
and with him is full redemption.
He himself will redeem Israel
from all their sins.

Mark 5:21-43

When Jesus had again crossed over by boat to the other side of the lake, a large crowd gathered around him while he was by the lake. 22 Then one of the synagogue leaders, named Jairus, came, and when he saw Jesus, he fell at his feet. 23 He pleaded earnestly with him, “My little daughter is dying. Please come and put your hands on her so that she will be healed and live.” 24 So Jesus went with him.

A large crowd followed and pressed around him. 25 And a woman was there who had been subject to bleeding for twelve years.26 She had suffered a great deal under the care of many doctors and had spent all she had, yet instead of getting better she grew worse. 27 When she heard about Jesus, she came up behind him in the crowd and touched his cloak, 28 because she thought, “If I just touch his clothes, I will be healed.”29 Immediately her bleeding stopped and she felt in her body that she was freed from her suffering.

30 At once Jesus realized that power had gone out from him. He turned around in the crowd and asked, “Who touched my clothes?”

31 “You see the people crowding against you,” his disciples answered, “and yet you can ask, ‘Who touched me?’ ”

32 But Jesus kept looking around to see who had done it.33 Then the woman, knowing what had happened to her, came and fell at his feet and, trembling with fear, told him the whole truth. 34 He said to her, “Daughter, your faith has healed you.Go in peace and be freed from your suffering.”

35 While Jesus was still speaking, some people came from the house of Jairus, the synagogue leader. “Your daughter is dead,” they said. “Why bother the teacher anymore?”

36 Overhearing what they said, Jesus told him, “Don’t be afraid; just believe.”

37 He did not let anyone follow him except Peter, James and John the brother of James. 38 When they came to the home of the synagogue leader, Jesus saw a commotion, with people crying and wailing loudly. 39 He went in and said to them, “Why all this commotion and wailing? The child is not dead but asleep.” 40 But they laughed at him.

After he put them all out, he took the child’s father and mother and the disciples who were with him, and went in where the child was. 41 He took her by the hand and said to her, “Talitha koum!” (which means “Little girl, I say to you, get up!”).42 Immediately the girl stood up and began to walk around (she was twelve years old). At this they were completely astonished.43 He gave strict orders not to let anyone know about this, and told them to give her something to eat.

…………………

I will be the first to admit that in my head my life is narrated and comes with its own soundtrack.  Sometimes it’s in the cultured tones of David Attenborough or the soothing bass of James Earl Jones and sometimes it’s the guy from the Outback Steakhouse commercials…  Regardless whether it’s an action movie, documentary, mystery or science fiction, my life is one big movie script or novel.

We as humans tell stories all the time and we have stories for everything.  There are fish stories, bedtime stories, sob stories, inspirational stories, short stories, mythical stories, horror stories, and histories.  We narrate our own lives every single day.  These stories we tell give meaning and order to the facts about our lives; they give us identity.

Even as we live the story of our own lives, we are a part of larger plot lines; stories which define our communities and the ways in which we view and live in the world.  Every community has its own stories and these shape its traditions which shape us in turn.  We as the Christian church come with our own codex of narratives, the Bible, and we are called to continue to write new chapters in the story of God’s people.

The Christian narrative is that of both God’s Kingdom that has already been inaugurated through the life, death and resurrection of Jesus Christ and that of the Kingdom that is yet to come when all will be resurrected.  The party’s already started, but we are still out on the front lawn.  We can hear the music, but the good stuff is inside.  This not-yet-but-now story shapes the way we live our lives, how we suffer, and how we heal.

Today’s reading from Mark is a story about the healings of Jesus.  While on the way to heal the young daughter of the local synagogue leader, a woman is healed through her faith, by merely touching his robe.  She thinks, “If only I can touch his robe, surely there must be some relief for me.”  As she brushes the hem of his robe, power flows out of Jesus and heals her bleeding.  But she gets more than just physical healing.  Jesus turns around and asks “Who touched me?”  Terrified, the woman confesses, but Jesus, seeing what happened, justifies the woman.  He gives her affirmation that her faith has not been misplaced, that faith in God and the works of the Son will indeed provide relief for the suffering.  She lives in the Kingdom-not-yet while she is physically sick, but she lives in the Kingdom-now through the healing of Jesus.

Such glimpses of the Kingdom-now can be seen throughout the healing and resurrecting actions of Jesus and so all of Jesus’ followers are called to offer the world glimpses of the coming Kingdom by enacting Christ’s radical love in a Kingdom-not-yet world.  We are to be, like Jesus, healers, teachers, and sufferers.

As a healer, Jesus understands that healing involves more than just physical healing.  He heals in hope and faith.  In the passage from Mark, Jesus heals a woman with a hemorrhage saying “your faith has made you well.”  This echoes an earlier passage in Mark, when Jesus says to a paralytic seeking healing “your sins are forgiven” before healing him.  This makes the point that healing is not just physical, that it involves an embodied person whose deepest wounds won’t always be tangible.  Even if there are physical insults plainly visible, the insult to the soul may be much greater.

This is not to say that physicians, who are commonly perceived as being the healing authorities, are doing anything wrong or not doing enough.  On the contrary, much praise is to be accorded to the physicians, nurses, and scientists who work tirelessly to alleviate suffering and delay unnecessary death.  They are the finest examples of the Christian ministry of physical healing.

But without communities and the stories they bring, physical healing is only a fact.  Another disease cured, another bone set, another lymphoma in retreat.  Sickness, suffering, and healing never happen as isolated events and it requires the whole community to write these events into a story and give them meaning.  Instead of simply being a chart on the door of a hospital room, the story proclaims that this is another person healed.  Jesus heals in public so that the whole community might share in the suffering of the sick and the relief of the healed.

But what happens when healing seems impossible?  Or when healing will take a long hard road that might get the better of us?

We’ve all been there, at the bedside of a loved one with a one of those rare or unexplained diseases, or perhaps they are passing into the night of death.  Or maybe we’ve been there ourselves, when a cure seems a long way off and relief can’t come soon enough.

We suffer.  We suffer because it seems to us that body and soul have gone to war against each other.  We suffer because sickness and death threaten to tear us from our friends, our family, and our community.  We suffer because we feel distant from God or as my professor says, we no longer trust God so we no longer have God to lean upon.

But we do not suffer alone.  Most obviously for us as Christians, Jesus comes to us as Jesus the sufferer, as the one who bore the cross.  But the Psalmist serves to remind us that throughout history, God’s people have suffered.  His lament is timeless in its emotion.  How often have we felt as though we were in the depths crying out to God?  “Out of the depths I cry to you, O lord. Lord hear my voice!  Let your ears be attentive to my… supplications.”  When we cry out, we cry out in company with all of God’s people, with the whole community of the faithful throughout history.

The Psalmists offers us hope in faith.  “O Israel, hope in the Lord!  For with the Lord there is steadfast love and with him is great power to redeem.”  Jesus in Mark teaches us of further hope.  You see, there is a second part to today’s story.  Jesus was on his way to heal a young girl, the daughter of a synagogue leader, when he heals the woman with a hemorrhage.  As Jesus continues his trip to the synagogue leader’s home word reaches him that the girl has died.  “Why trouble the teacher any further?” people council the understandably distraught parent.  But Jesus rolls up his sleeves and says “Do not fear, only believe.”  He then goes to the house and raises the girl by saying “Little girl, get up!”

Jesus teaches us in this passage that faith redeems us even from death.    In this story, he offers a glimpse into the future resurrection in the New Kingdom of God in which sins are forgiven, sickness and suffering are no more, and all are close to God.  The act of raising the little girl from the dead and the subsequent raising of Lazarus are the first acts of new life in the Kingdom of God.  It is as if Jesus says, “Look, you might not be resurrected again into this world, but if God can raise these people here and now, surely he can raise you into the coming Kingdom.  Do not fear, only believe.”

Through the life, death and resurrection of Christ, death has lost its grip on us.  We have cried out to God and he has heard us.  We may find healing on this earth, but there is a greater healing to come.  We may find redemption in this world, but we will not only be redeemed in the coming Kingdom, but resurrected, perfected in body and spirit.

It is through this story that we as a community declare that health and life are great goods, but they are not the greatest good.  Suffering and death are great evils, the enemy to be resisted, but they are not the greatest evil.  For God is the greatest good, and to walk without God is the greatest evil.

What then of suffering?  Are we to believe that in this story, there is no “real” suffering?  That our suffering is merely an illusion? Or perhaps an artificial construct of our bodies?

No.  Suffering in this broken and imperfect world is as real as the promise of resurrection.  Death is the great enemy.  Sickness still needs a cure.  But, when our powers of healing fail us, or when there is no healing to be found, the Christian story assures us that God has our backs.  The resurrected Christ declares that neither sickness, nor suffering, not even death will separate us from God.

So, what story will you tell?

There’s a story about an older gentleman who was out for his morning walk along the beach.  He came upon a boy who was absolutely frantic.  The boy would run up to the high tide line, grab something, run down to the water and toss it in before running back up the beach.  The older gentleman realized that the boy was tossing stranded starfish back into the ocean.  The previous night had been a full moon and the lunar tide had been higher than normal.  Tens of thousands of starfish had been washed ashore.
Suddenly the older gentleman felt angry.  He marched up to the boy.  “Boy what are you doing?”  he asked.
The boy replied “I have to save the starfish.  I have to get them back in the water.”
“Why bother?” shouted the old man.  He gestured to all of the thousands of starfish.   “You can’t save them all.  There are too many of them.  What you’re doing doesn’t matter.”
The boy stopped, picked up a starfish and said, “It matters to this one.”
We want to be like the boy, frantic in our attempts to throw starfish back into the ocean. And it is good for use to struggle on behalf of those who are stranded.  But, lest our pride get the better of us, we are reminded we aren’t called to heal the whole world, the world has already been healed through Christ.  We aren’t called to save the world, the world has already been saved by God.

Most of the time, though, we’re like the starfish.  We need to be tossed back when we get washed up.  It’s not about saving starfish, it’s about recognizing the difference between when we can help those in need by tapping into the power of God and when we have needs that can only be met by God.

One of the more illustrative endings to this story is that the older gentleman after some thought joined the boy, the two of them running up and down the beach to save the starfish.  Passerbys on the beach saw them and joined in.  And the folks up in the village on the hill above the beach saw this and they ran down to help and tens became hundreds became thousands.  And all the starfish were saved.

We can change our own lives; we can live our story instead of just telling it.  And when we have our story straight, we can tell it to other people.  And we can build our community around a story of faith, hope, healing, and dignity.  Then we can tell the whole world that whenever we are washed up, stranded, God tosses us back into the sea of life.

We are called to not be afraid and to struggle.  Struggle against sickness, struggle against death, struggle to tell our story, struggle to touch the robes of God.  We all have our part to play.   The whole community is called to bear witness, to comfort, and to support those who suffer and those who seek to relieve them.

We won’t win all of our struggles, that’s just human nature.   But we remember that our story says “Do not fear, only believe.”  Amen.

(c) Brad Kern 2012

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“Genetics”

This is the only “subject” blog entry I had written for class.  If you want me to address a different subject (end of life care, etc.) put it in the comments and I will try to address it over the next couple of months.

Here is the first and second installments introducing the subject of bioethics.

Genetics is a funny word.  It means a lot of different things to different people and depending on the way it’s used.  To some, genetics mean the collection of genes and alleles contained within a person’s genome.  To scientists, genetics is the study of genes and gene interactions. Others, when they speak of genetics, actually mean genetic enhancement or gene therapy.  As a scientist, I will stick to the scientific uses of genetics: the field of research involving genes and their products and as shorthand for the system of genes and regulators present in (almost) every cell that makes up the human body.  Genetic medicine will do to cover gene therapy, genetic enhancement and genetic analysis.

Genetics, genetic enhancement, and gene analysis have been received with mixed aplomb.  Two clear camps have emerged.  On one side are those who support all or most forms of genetics, gene therapy and various degrees of genetic enhancement.  This group believes, at its most modest stance, that gene therapy can overcome genetic diseases and, in the extreme, help humanity fulfill its full potential, whatever that may be, through genetic enhancement. The opposing camp agrees that genetics research and most gene therapies can be used beneficially, but genetic analysis and genetic enhancement demean our humanness.

This brings up the very good question: What is human?  We started in the previous section with the position that understanding the relationship between the soul and the body is essential to answering this question.  The simple Christian “top down” answer is that humans are embodied persons in a relationship with God.  The simple scientific answer is that being human is having one of the gene combinations particular to Homo sapiens.  Given the preceding discussion of the complexities of the relationship of the human soul with the body, it seems clear that a discussion of what it is to be human will be equally complex.

Human dignity is often invoked in these conversations about genetic medicine and it seems to stand as a proxy for certain visions of “being human.”  If the technology seems  to go against human dignity, then it must go against being human.  There is some merit to this.  A case can be made for dignity as “being human,” of flourishing as humans.  We are somewhere between animals and angels, according to Gilbert Meilaender, and this gives humans the unique position of having dignity.  Human dignity, according to Meilaender, is the display of the distinguishing qualities of humanity.  These qualities may be freedom of choice, intellectual or athletic accomplishment, or spiritual piety, to name a few.

Meilaender also defines what he calls personal dignity, which is the fact that “every person is equidistant from Eternity.”  That is, every person is due equal respect because of their intrinsic humanness and this humanness comes from everyone’s equal relation to God.  This can be seen in our common mortality and common “individual neediness.”

A word of warning.  Human dignity relies on some level of accomplishment of a defining human characteristic and is therefore too easily substituted for “value.”   This has the danger of causing us to value those who display more dignity over those who cannot fully display dignity such as the severely mentally retarded.  Personal dignity, according to Meilaender must have a transformative effect on human dignity.  This means that though a person might be incapable of fully expressing human dignity, their personal dignity refuses to allow us to see them as anything but human, equally distant from eternity as ourselves.

This is all well and good, but dignity seems to not precisely define humanness.  But that’s the point.  Humanness is the quality of having dignity, the expression of universally human characteristics.   Dignity situates us uniquely as a little above animals, but a little below angels.  Everything else about being human must fall within dignity.

Where do genetics and genetic medicine fall?  It would be too easy to discount genetics and genetic medicine as being outside human dignity as they mostly involve altering the “natural” human state and therefore human dignity.  However, given our complex relationship with our bodies and how that reflects our relationship with God, the answer should honor that complexity.
The demands of stewardship, that we use the appropriate means at our disposal – including gene therapy – to keep our bodies healthy, seems to be at odds with not changing our nature.  Recalling the example of metabolism, I showed how, though the body may change its molecular composition, the essential person remains the same.  It is too basic to define an entire human and is limited to defining physical phenotype.  Therefore, being human is not defined by the body, but by being embodied.

Does genetic medicine change what it means to be embodied?  I would argue no.  Even genes and gene products synthesized and expressed de novo in the human for the purpose of genetic enhancement must obey the biological rules governing gene expression and protein activity.  Our bodies will never overcome the physical boundaries imposed by our biology.  Therefore, genetic medicine cannot make us more than human, or transhuman, and is no threat to our personal dignity on its own.

What do threaten to undermine our collective dignity are issues of social justice.  Disparities in the distribution of the fruits of genetics research and availability of therapies threaten to place humans differentially closer or further from Eternity.  Those with the means and access to gene therapies or enhancements could place themselves in a better position to fully display human dignity which in turn could have a negative transformative effect on personal dignity.  Personal dignity might suffer the “Animal Farm” effect, that is, all are equal, but some are more equal than others.  With this in mind, it is clear that in order for genetics and genetic medicine to be consistent with human and personal dignity, it must first address issues of social justice and fair distribution of benefits.

Although social justice presents a clear stumbling block to the dignified use of genetic information and genetic medicine, we must press forward with research.  It is only through continued research that better and cheaper ways to give genetics-based therapies will be discovered.  If we allow fear of new technologies to dictate our path, then we will have rejected dignity, human dignity in the form of scientific achievement, and personal dignity in rejection of those we are too afraid to help with genetic medicine.  At the same time we must not allow our technologies to define what is human.

Genetics and genetic medicine can give a great many people hope that their genetic conditions might be overcome.  We must remember that the people who are treated using genetic medicine are embodied persons with dignity.  As physicians and scientists we must discover and create treatments that comport with the personhood and dignity of the patient.

Meilaender, Gilbert. Neither Beast nor God: The Dignity of the Human Person. Encounter Books, New York. 2009.

Foundations: An Embodied Soul or an Ensouled Body

This is part two of my four part series on bioethics.  Please see Part 1 for an introduction.

Jesus answered, “Very truly I tell you, no one can enter the kingdom of God unless they are born of water and the Spirit. Flesh gives birth to flesh, but the Spirit gives birth to spirit. You should not be surprised at my saying, ‘You must be born again.’ The wind blows wherever it pleases. You hear its sound, but you cannot tell where it comes from or where it is going. So it is with everyone born of the Spirit.” – John 3:5-8

Much has been said by secular bioethicist about the many and often disparate areas of the biomedical enterprise.  However, all questions of bioethics come back to a single question of the body and its subsequent corollaries: “Is the body something we are or something we have?” which is followed by “What is a body?” “When does a body become a person?” “When does a body stop being a person?” etc.  This question is essential to answering the question “What is human?” as so much of human life is dictated and accomplished through our bodies.

The answer to the prime question, I will argue, is both.  We are, after all, defined by our bodies in ways that are both duality and unity.  An easy example is “When I think about moving my arm, my arm moves.  But if I were quadriplegic, my arm would not move, no matter how hard I thought about it.”  There is no doubt that in illness and injury that we are reminded just how bipartite our existence can be, while when in perfect working order, our body and anima (animating principle or force, ie soul) seem as one.

Biblically, there seems to be this same ambivalence.  In Genesis, God creates man out of dust and breathes life into his body.  Literally the form of man existed before life and becomes ensouled through the breath of life.  In the New Testament, Jesus heals the crippled by proclaiming “Your sins are forgiven” recognizing that we are more than body, that our bodies and souls are interdependent and that forgiveness is a form of healing as important as curing disease.  Jesus tells Nicodemus that “what is born of the flesh is flesh and what is born of the [Holy] Spirit, spirit” (John 3:6)  Jesus himself dies on the cross, his body buried, but three days later we wake up to the reality of an empty tomb and the resurrection of the embodied Christ.

Science offers us another perspective.  Metabolism is the intake of raw biological materials in the form of nutrients (food) which are then converted into a form usable by the body to replenish and repair other biological systems.  Metabolism is significant in that it continually replaces the building block molecules that make up our body.  That is to say, that if you were to take a snapshot of our bodies from one moment to the next, no snapshot would have exactly the same molecular composition and if you looked at a sufficiently later snapshot compared to the first snapshot, not one molecule would be the same.  Despite this, the person would still be the same person and the total body would still look much the same.  And yet, without this constant change of material, the person wouldn’t exist either, because when metabolism stops, the organism is dead.  It is clear, even scientifically, that our bodies described as collections of biological systems is not sufficient to describe personhood, and yet without these core systems we would not be able to live.

What then are we?  Some secular ethicists would reduce us to mere agents of choice.  Some neurobiologist would reduce us to biocomputers, collections of interacting neurons and cells that encode the entirety of our beings.  Some theological bioethicists would seek to reduce us to our embodied spiritual selves, an embodied soul.  (A note: Theological bioethicist Paul Ramsey would hold that an embodied soul and ensouled body are the same, that they are two ways of looking at the “whole spiritual self.”  I prefer to use them separately.   An embodied soul implies that the soul is clad in a body and that they are one.  An ensouled body implies that the body existed without the soul and later becomes inhabited by the soul.)

Is it possible for us to be both embodied souls and ensouled bodies at the same time?  The answer is yes and furthermore that this embodied duet is important to our story as Christians.  Reductionist answers refuse to confront the complexity of our relationship with our bodies.  A “bottom up” view would state that we are on one hand physical beings, biologically defined, on the other hand, spiritual beings who in our own self awareness recognize a certain transcendence beyond and through our biology, and somewhere in between is a gamish of interdependent body and spirit.

Perhaps useful to this discussion is the Calvinist idea of total depravity, that all things human are subject to corruption by and through sin.  This would include the relationship between our bodies and souls.  While ideally our bodies and souls are one, as in the resurrected Christ, because of the corruption we experience our bodies and anima don’t always fit perfectly.  However, even when we experience duality we must remember that our life, our embodiment, and therefore our bodies are gifts from God.  This is the “top down” view which places us and our humanity in relationship to God.

I would like to take a moment and distinguish between duality, the experience of two different states, and dualism, the total separation between body and soul.  Dualism at its core, argues that what makes a person is the anima and that the same anima in any body is the same person.   This leads to all sorts of dangerous possibilities, from downloading human personalities into computers, to creating “humans” de novo through “programming” of “uninhabited” bodies.  It does not acknowledge the importance of our relationship with our bodies except as vessels for our “person.”  Duality allows for a total embodied relationship with other embodied beings as well as God while at the same time recognizing our existence in a broken world.

The Christian narrative demands that regardless of our state of embodiment, we use our bodies to enact the not-yet-but-now story of the resurrection of Christ and the New Kingdom that has come and is not yet come.  Our bodies have glimpses of the embodied resurrection when the relationship between our souls and bodies seems harmonious, but we live in the not yet, when our bodies and souls seem to be at opposition.  We must, then, accept the dual nature of our bodies.  We are at once defined as/by our bodies and our bodies are something which we have.  Our bodies come to symbolize the anima within and so are “who” we are, the gift of life, and yet our bodies are in their own right gifts.  Why is this duality important?  How then do we live this narrative?

One answer is in Matthew 25.  The second parable in this chapter has the most bearing on the present issue and is that of three slaves who are given money.  Two of them invest their money and double it.  The master is pleased with them and gives them great authority in his affairs.  The third buries the money, earning no interest, displeasing the master.  Important to this parable is the idea of stewardship, that we are to maximize the investment of what we have.  This includes our bodies, which I have already shown to be a gift of God.  Stewardship of our bodies require us to utilize them in ways which are consistent with the not-yet-but-now nature of the Kingdom.  We must keep ourselves healthy to the best of our abilities consistent with our embodied nature and a state of good health allows us to maximize our capacity to be embodied and therefore Christ-like.  Medical interventions and therapies which keep us healthy are thus justified.

A second aspect of stewardship that is consistent with our dualistic experience is also implied.   The use of our body for the benefit other people is a “return on investment” of our gift of body.  Since our bodies are God’s (as well and ours/us), it is expected that we use our bodies in the service of God to their full extent just as we might use any other gift of talent we might have.  This might entail giving or receiving blood and organ donations and even somatic stem cells and biopsies for research.  Again, this requires that we live healthy lives so that our bodies, when it comes to donate organs or other tissue, can best benefit those who receive them.

The body is important to our story as humans.  It is part of the way we relate to God and to each other.  Our relationship with it can be complex, sometimes harmonious, sometimes full of conflict.  We are reminded that our bodies, regardless of whether we feel like embodied souls or ensouled bodies, are gifts, to be used to the benefit of ourselves and others, to be good stewards.

Theological Bioethics: An Introduction

This is the first part of a multi-part series on bioethics.  These essays were written in place of my term paper for a bioethics class I had with Dr. Allen Verhey at Duke Divinity.  I’m hoping for a post a week.  Stay tuned.  But first, an introduction.

The term “bioethics” was first coined in the 1960’s, but its history is much older, dating back to the ancient Greek philosophers and the eventual adoption of the Hippocratic Oath by physicians.  For much of its early history, bioethics has been mostly driven by religion and theology, with the gods or God standing as the final arbiter of a moral ethic.  Important to this (relatively) early history is the medical and scientific ethic put forth by Sir Francis Bacon (1561-1626) that medicine and science should seek to eliminate human suffering and alleviate death.  For much of recent history since Bacon, this ethic (sometimes called the Baconian Project) has held sway in the medical and scientific communities and, though Bacon had Puritan leanings, set the stage for the future secularization of bioethics.Bioethics has recently arisen as a distinct field of study among ethicists.  Part history of science, part philosophy, part sociology, and part science fiction, bioethics is the study of ethics as it relates to medical, biomedical, and biological research practices. It addresses imminent issues such as current requirements for care, just distribution of the fruits of research, the choices to be made at the end of life, and the ethical conduct of research.  Bioethics also addresses the ramifications of far-future biological technologies and seeks to direct these to an ethical conclusion consistent with our humanity.

In the 1950’s, there was a move away from a theological basis for bioethics, described as an Enlightenment of sorts, that insisted that all moral principles be expressed in a universally understood lexicon.   Theological voices were silenced, or at least moved away from using explicitly theological language.  Then, starting in the 1980’s, there was recognition that there was a need for theological voices to re-enter the dialogue, and there was a Reawakening of sorts.  This brings us to today and the resurgence of strong theological voices being heard today in the discourse.

In the next months I hope to bring to you a fresh look at theology based bioethics from the perspective of one who is both a scientist and a Christian.  I will look at some key ethical issues and review a few case studies within the bioethics debates.

Helpful to my review will be several key concepts in ethics.  To start with, I will reference three primary ways of looking at moral dilemmas: teleology, deontology, and aretalogy; the management, political, and identity modes of thought respectively.  Teleology has been reduced in modern secular ethics to a concern with the goods and ends of a particular action.  It asks, “What good is accomplished?” and is subject to the corollaries “What is good?” and “Whose good is it?”  The result of teleological inquiry is that those actions that will bring the most good to the most people will be permissible.  For example, genetic therapies are permissible only if they maximize the positive outcomes and are made widely available.

Alternatively, deontology is concerned with rights, laws and duties related ethical decisions in its modern, reduced form.  It asks “Whose choice is it?” thereby placing emphasis on one’s agency for choice.  Rights under deontology come in two forms: positive and negative.  The negative right is that one has a right to something, but not necessarily to all of the means to achieving that something.  Positive rights state that other people have a duty to help you exercise your right.  For example, the negative right to an abortion allows any woman to seek an abortion, but does not require doctors to perform it.  The positive right to an abortion would require that any doctor with the ability to perform an abortion to assist any woman seeking one.

Finally, aretology is attentive to the identity of the moral being faced with an ethical question.  Central to an aretological line of questioning is the questioner’s narrative and relationships to communities with which they associate (church, school, neighborhood association, professional association, etc.).  Aretology asks “Which choice has integrity with my identity?”  For example when faced with the choice to remove a dying loved one from life support, one has to ask “What choice fits my story?”

Of these three, aretology is the most important for a theological perspective in bioethics.  The utility and legality of ethical situations has been thoroughly explored and debated by the secular bioethics community and are important for making value judgments (in both senses of the word value).  However, theology is based around a narrative, in the case of Christianity provided by the Bible, and a community, the church.  Any ethical decision by a professed Christian must conform both to the story and communal relationship of the Christian church.  Certainly, one can find goods and laws in the Bible, and the importance of these is not to be discounted, but integrity to identity is perhaps the most useful contribution of Christian theology to the modern bioethics debate.

The Christian narrative I confess is that only God is God and that the highest miracle is the miracle of salvation and resurrection through the life, death, and resurrection of Jesus Christ.  We live in a story in which our own salvation and resurrection in the New Kingdom of God has not yet been realized, but which has already been inaugurated by Christ and glimpses of which can be seen in our healing, teaching, and loving acts. This not-yet-but-now narrative demands attention to how we order our lives and health that is consistent with the resurrection that was, is, and is yet to come.

Thus, the Christian story rejects the Baconian project, as it is too easy to hold life and health as idols with in it.  Instead, the Christian story declares that life and health are great goods, but not the greatest good.  Similarly, death is a great evil, but not the greatest evil, because of the promised resurrection which has broken the spiritual power of death over us.  Therefore, when we as Christians seek to preserve life, avoid death and enhance health, we must do so in preparation for and within the New Kingdom realized.  We are freed from the duality that is body and soul, but are called to maintain life and health as goods, to oppose the evils of death and suffering, and to live the example set by Christ as embodied persons.   How is this simply expressed Christian ethic enacted in the world of science in medicine?  How does this ethic place limits on our actions and desires in seeking biomedical solutions to issues of health and life and death?

The following essays are not meant to be a condemnation of theology, bioethics, science or medicine.  They all have a part to play in recognizing the human condition and defining human nature.  These essays are meant to reconcile Christian theological bioethics, and more broadly Christian theology, with science and medicine in James Gustafson’s “dialogue of participation.”  By pointing out how each bears on the other, I hope to reveal the ways in which all are interdependent in discerning the human enterprise.