Can Bioethics Be Lutheran?

[1] When invited to speak at a recent gathering of Lutheran ethicists I was asked to address the question “What are the distinctive contributions of a Lutheran bioethic?”1 Thus, my charge seemed to make two assumptions: the first, that there is a Lutheran bioethic and second, that its contributions to plenary debate are distinctive. Both are questionable and for that reason, I preferred to ask “Can bioethics be Lutheran?”2

[2] Before attempting to answer that question, I should explain that perhaps I was the wrong person to ask. You see, I was raised an American Baptist and nearly became an Episcopalian before I joined the Lutheran church. I taught briefly in the theology department at Notre Dame. For several years, I was the spouse of a Presbyterian clergywoman. Actually, I’m still her spouse though she was re-ordained as a Lutheran 18 years ago. My teachers in theology and ethics were Methodist, Catholic, Congregationalist, Episcopalian, and agnostic as well as Lutheran (not the same person). So my perspective might be described variously as ecumenical, tainted or, less charitably, theologically promiscuous.

[3] As a student when I first began reading Lutheran theological ethics, I was struck by the fact that some Lutherans seemed markedly ambivalent -if not downright suspicious-about ethics or moral theology (at least as I had come to understand them). There seemed to be more intuitionism, existentialism and occasionalism than disciplined moral reasoning. To the limited extent ethics was taught in Lutheran seminaries, usually it was an elective offered by a systematic theologian rather than someone with a PhD in ethics. That was not necessarily a bad thing but it did contrast with the practice of other Protestant traditions.

[4] During my short tenure in the Lutheran Church in America’s Department for Church in Society I often encountered the same misgivings. For example, one time back in the early 1980’s I was speaking to the Conference of Bishops about the possibility of the church addressing the problems of abortion more thoroughly than the brief reference to it in the 1970 Social Statement “Sex, Marriage and Family”. I recall suggesting that some abortions (for instance, in cases of ectopic or tubal pregnancy) are entirely justifiable while some others might be less so. A modest proposal, I thought, but it was not well received. Several bishops including the presiding bishop instructed me that making such casuistic distinctions was inappropriate for Lutherans because all human actions (and thus all abortions) were tainted with sin. To attempt to say more would be legalism and works righteousness. I stood corrected.

[5] Ironically, I think it can be said without departing too far from characteristically Lutheran humility, that no denomination has done more to help its people confront the challenges of bioethics than we have. Despite our scruples about moral theology, since 1958 Lutheran churches have produced a steady stream of conferences, social statements, messages, essays and study material on the bioethical questions of the day. Happily, this work continues. In recent years these efforts have produced splendid resources for individual and congregational reflection. So at least in this sense, bioethics has, in fact, been Lutheran.

[6] Nevertheless, a certain ambiguity surrounds the question of whether there is or can be a Lutheran approach to bioethics. Are there ethical approaches that are uniquely Lutheran (and, presumably, unavailable to our Catholic, Anglican and Reformed sisters and brothers)? Perhaps we should settle for characteristically Lutheran. In that case, we could examine the official teachings of Lutheran churches, the ethical writings of individual Lutheran theologians, or the convictions, judgments and patterns of moral reasoning widely shared among Lutheran folk. Whichever set of data were to be used, identifying the characteristically Lutheran would be a descriptive task, albeit a complicated one due to discrepancies between the data sets. Alternatively, the identification of a Lutheran approach might be a prescriptive enterprise, an attempt to articulate what Lutherans ought to believe or to set forth the normatively Lutheran approach.

[7] That is certainly possible so long as it is understood to be an attempt (one among others) to speak ‘Lutheranly’ about bioethical matters. Neither the Bible nor the Book of Concord can be expected to yield definitive judgments on the bioethical issues of today. Furthermore, Lutheran ethicists hold a range of views when it comes to things like stem cell research, cloning or physician-assisted suicide. Nevertheless, it is both possible and useful to sketch, with appropriate modesty, “A Lutheran Approach to Bioethics.”

[8] Several years ago under the auspices of the Lutheran World Federation a group of Nordic theologians and ethicists sought to do just that.3 Their account of Lutheran ethics is noteworthy (and particularly welcome in the American context) for its emphasis on natural law, the Golden Rule, reason, and vocation as well as agape and justification by faith. None of these themes is unique to Lutherans and today, in some quarters, it may not even be characteristic of Lutherans in a descriptive sense. Nevertheless, to my mind they are normatively and confessionally essential elements of Lutheran ethics.

[9] Updating Luther’s distinction between ‘the two kingdoms’ while preserving its fundamental insight, the Nordic group says that Christians should

contribute to the establishment and maintenance of democratic societies….[using] their power to organize societies so that they accord as far as possible with the principles of beneficence and equality contained in neighborly love. Together these two principles entail that all human beings are entitled to a just share of the goods at hand, not just to help …in the form of charity. The unity of beneficence and equality entails justice4….
[10] What should be the church’s role in attempting to influence legislation and the administration of public policy? The group sees the church as the proponent and defender of,

inviolable values founded on the Christian view of creation and human beings. On the basis of a vision of the good life, the church must show how society may be better. But it is not for the church to be a legislator for society: that is a task for politicians, for the worldly kingdom not the spiritual one. What is a relevant task for the church is to criticize laws and politics.5
[11] This responsibility cannot be fulfilled without dialogue and co-operation with those who do not share their religious beliefs and values.

[12] Such efforts are not merely necessary accommodations to political realities. They are mandated by a Lutheran understanding of the natural moral law which holds

that all human beings have moral dignity and a conscience whose voice must be respected.6 [Accordingly,] Christians leave space for non-Christians to lead their life in ways quite different from the ways Christians have chosen for themselves.7 [Moreover, natural law allows Christians to assume that] the values and symbols of a culture include normative-ethical elements…. Some…ethical norms are shared across the borders of societies and cultures.8
[13] There are biblical and other theological warrants for the identification of a generically human ethic with Christian love of neighbor.

[14] When the church participates in public bioethical discourse, its theological convictions are a valuable resource. Of course, not all of this language must be used on every occasion. Christians can speak of human dignity without explicit reference to imago Dei. Sometimes it is prudent to speak in more accessible language (as, for example, in the idiom of human rights) but it is precisely the church’s distinctive insights and values that make its voice worth listening to.

[15] But if native moral insight and the “normative-ethical elements” of culture are so highly esteemed, some may ask what has become of the Reformation principle of ‘scripture alone’? According to a standard account, Lutheran Christians

do not discover what is to be done by special revelation, or by deduction from Scripture, or by ‘praying about it’ and obeying the next impulse from within. [They do not ask “What would Jesus do?; much less “What would Luther do?” Rather they] discover what is to be doneby rational consideration of the situation and of the neighbor’s possibilities in it”.9
[16] This opens the way to moral discourse with other traditions and is conducive to common agreement. As Luther once said, “Better to be ruled by a wise Turk than a foolish Christian”!

[17] Yet the Lutheran tradition has seldom failed to appreciate the degree to which the goodness of God’s creation is deformed by human sin. As an ELCA Social Statement observes: “Sin is both a condition of alienation from God and the acts that issue from this condition. Human judgments, actions, organizations, and practices are marked by a distortion of God’s will and purposes for life.”10 The universal and all-pervasive character of this distortion has sometimes been employed as a rationalization for moral laxity, sloth or even nihilism. However, at its best, it has served to cultivate a salutary awareness of moral ambiguity and to hedge against both hubris and legalism.

[18] The sober recognition that we are less than perfect people living in a far from perfect world, along with the conviction that we are, nevertheless, forgiven sinners are the two benchmarks of a Lutheran moral vision. The former precludes self-righteousness and underlies the sense that often we can do little else but choose between greater and lesser evils. The latter makes choice and action possible despite the attendant ambiguities. According to the Social Statement quoted above, “We areempowered so that we might do what is effective in serving the needs of the neighbor”.11 Not bound by any rigid legalism, Christians are free to be resourceful and pragmatic in the service of their neighbors, especially those who are most vulnerable.

[19] A colorful illustration of this Lutheran emphasis on Christian freedom is Luther’s dubious advice to confessors presented with difficult cases of conscience. Suppose, for example, a woman had unknowingly married a man suffering chronic impotence and later was “desirous of having children or [was] unable to remain continent”. In the absence of today’s reproductive technologies, it might seem that she had only two choices, both of them unhappy; suffer or jeopardize her eternal destiny. Were the man unwilling to submit to a divorce, Luther suggested that the woman might have intercourse with his brother or some other willing surrogate. Any child so conceived should be ascribed to the husband and supported as his heir. If the husband refused to consent to these arrangements, Luther “would counsel her to contract a marriage with another and flee to a distant unknown place”. In Luther’s mind, it was a situation of necessity requiring a “judgment of charity”. Desiring “to bring to [his] afflicted brethren in this captivity what little comfort [he] can,” Luther asked, “What other counsel could be given?”12

[20] In such circumstances, moral rules may have to yield to a natural sense of justice. Prudent moral agents understand this and will act accordingly in their professional or public roles no less than in their personal lives. For example, Luther observed, “No state is governed successfully by means of laws. If the ruler is wise, he will govern better by a natural sense of justice than by laws. If he is not wise, he will foster nothing through legislation, since he will not know what use to make of the laws nor how to adapt them to the case at hand.” Good and wise rulers “will themselves be the very best of laws, and will judge every variety of case with a lively sense of equity.”13 In contemporary Lutheran social teaching all men and women are encouraged to temper their moral judgments with equity. Narrow moral legalism is inadequate. An ELCA Message on Social Issues acknowledges that Christians must face complex bioethical decisions “in all their ambiguity, knowing they are responsible ultimately to God, whose grace comforts, forgives, and frees [them] in [their] dilemma.”14

[21] These are the important benchmarks for any ethic that aspires to be distinctly or confessionally Lutheran. When they serve as perennially important correctives applied to catholic substance (which was Luther’s understanding), they allow us to engage in careful moral reasoning without abandoning confessional Lutheranism. Since the Confessions prudently refrain from mandating a particular method of moral reasoning, their corrective principles may be considered permanently valid cautions for any style of Christian ethics. Understood in this way, the Lutheran confessions allow ethicists considerable methodological latitude, so long as the sola fide is not violated.

[22] Diverse interpretations of Lutheran ethics have always co-existed. In the last century, Werner Elert, Paul Althaus, and Helmut Thielicke in Germany, Knud Logstrup in Denmark, and William Lazareth and Joseph Sittler in America were hardly of one methodological mind. And long before that, had not Luther, Melanchthon, Strigel, Illyricus and Osiander disagreed vigorously, there would have been no need for a Formula of Concord, Today in Scandinavia, many Lutheran ethicists write from a humanistic perspective that is not distinctly or uniquely Christian. Predominant approaches to ethics are Kantian or influenced by Jurgen Habermas’ ‘discourse ethics’. Some ethicists continue in the tradition of Logstrup who denied the possibility of a specifically Christian ethic, preferring instead to base ethics on the ontological structure of human relationships.15 Such diversity within the Lutheran tradition is not to be lamented. It is a strength.

[23] Having identified some of the theological underpinnings of normatively Lutheran approaches to bioethics, let us examine its actual practice in the work of the following unscientific sample of four contemporary American Lutheran bioethicists: Gilbert Meilaender, Ted Peters, Daniel Lee, and Mark Brocker. (Let me be the first to observe that this group does not model the diversity to which our church aspires. But if I had cast my net more widely, it might seem that I had made my task too easy.) Which of them is more distinctly Lutheran? Are any of their perspectives unrecognizably Lutheran?

[24] Meilaender and Peters are certainly the two most prominent Lutheran voices in bioethics today. They are prolific and widely read authors who frequently appear in the media.

[25] Meilaender, a member of the President’s Council on Bioethics, takes his bearings from human nature theologically described as created, disordered and redeemed; three perspectives which taken together disclose how things are and ought to be with us in relation to ourselves, our creator and each other. His themes are those of classical Lutheran theology and his vision is unfailingly orthodox. His bioethical judgments stem from the conviction that we are finite, embodied creatures who must learn to respect limits. Sometimes Christians must “decline to do what medical technology makes possible. There are circumstances in which we can [relieve suffering or] save life only by destroying the kind of world in which we should all want to live.”16

[26] In sharp contrast, Peters deplores the fact that ” ‘NO’ seems to be only word in [most] ethicists’ public vocabulary [in regard to genetic research].”17 Most bioethicists (and Meilaender is surely among them) regard non-maleficence a more stringent duty than beneficence even at the cost of halting or slowing medical progress. For Peters, beneficence is equally important. “To conceive the ethical taskas merely one of setting boundaries and shutting off opportunities is itself… unethical.”18 Peters, ever the optimist, is usually disposed to pursue potential for Good where others see only risk of Harm. When the reduction of human suffering is in prospect, Peters says “Selective use of ‘Yes, indeed!’ should be heard from the lips of…ethicists.”19 Doubtless, he’d say that is especially true if they are Lutheran. The conviction that one is justified by faith should allow one to take risks on behalf of the neighbor.20

[27] If Meilaender and Peters represent the two poles of the Lutheran spectrum, somewhere in between would fall two recent discussions of physician-assisted suicide by Brocker and Lee. Brocker thinks Christians should forswear moral certainty on this issue and above all show compassion for the terminally ill. He believes that Bonhoeffer’s “concept of an extraordinary situation of responsibility” applies to physician-assisted suicide. This may be an exceptional case in which for the sake of the suffering neighbor it is necessary to venture beyond the conventional moral boundary. To be sure, he doesn’t wish to see physician-assisted suicide become easy or routine. But in his judgment, the best way to prevent that from happening is to lift the prohibition and submit the practice to prudent regulation (as in Oregon).21

[28] Lee disagrees with Brocker in that personally he is “strongly opposed” to physician-assisted suicide and does not favor its legalization. But he shares Brocker’s prudential concerns. Lee doubts that opponents of physician-assisted suicide “have any business using the coercive power of government to try to prevent those who disagree…from doing what they believe is right.”22 Given that many Americans do not share his scruples, Lee concludes with Brocker that legalization of physician-assisted suicide and construction of a regulatory firewall between physician-assisted suicide and the “morally reprehensible” act of non-voluntary euthanasia may be the wisest social policy. Opponents of physician-assisted suicide “can accomplish far more by reaching out in a loving, caring manner to those experiencing great suffering, instead of sitting around moralizing about what they should or should not do and threatening physicians with legal penalties if they act in ways at odds with the values we hold dear.”23

[29] The views of Meilaender, Peters, Brocker and Lee sketched above all reflect characteristically (though not exclusively) Lutheran convictions. Yet they represent very different judgments about contemporary bioethical issues. Can bioethics be Lutheran? Yes, but in more than one way.

End Notes

1 I am grateful for both the invitation and the critical comments of my colleagues.

2 I have adapted the title of James M. Gustafson’s Can Ethics Be Christian? (University of Chicago Press, 1975). It might be fruitful to apply his analysis to the question before us but I have not attempted to do so.

3 Lars Ostnor, Jaana Hallamaa, Svend Andersen, Bjorn Bjornsson, Gert Nilson and Lars Thunberg, “The Lutheran Approach to Bioethics” in Viggo Mortensen (ed) Life and Death: Moral Implications of Biotechnology (WCC Publications, 1995): 9-34. For a summary of the LWF study, see Paul Nelson, “Bioethics and the Lutheran Communion”, in B. Andrew Lustig (ed), Theological Developments in Bioethics 1992-1994, Bioethics Yearbook Vol.5, (Kluwer Academic Publishers, 1997): 143-169.

4 Ibid., 20.

5 Ibid., 27-28.

6 Ibid., 13.

7 Ibid., 21.

8 Ibid., 23.

9 Eric W. Gritsch and Robert W. Jenson, Lutheranism: The Theological Movement and its Confessional Writings (Fortress Press, 1976): 149.

10 “Abortion” (Evangelical Lutheran Church in America, 1991): 3.

11 Ibid.

12 Martin Luther, Three Treatises (Fortress Press, 1988): 233-235.

13 Ibid., 226.

14 “End of Life Decisions” (Evangelical Lutheran Church in America, 1992): 1.

15 Paul Nelson, “Lutheran Perspectives on Bioethics” in B. Andrew Lustig et al. (eds), Theological Developments in Bioethics: 19908-1992, Bioethics Yearbook Vol.3 (Kluwer Academic Publishers, 1993): 150. See also Paul Nelson, “Bioethics in the Lutheran Tradition” in Baruch A. Brody et al. (eds), Theological Developments in Bioethics: 1988-1990, Bioethics Yearbook Vol.1 (Kluwer Academic Publishers, 1991): 120-122.

16 See Gilbert Meilaender, Bioethics: A Primer for Christians (Eerdmans Publishing Co., 1996): 103.

17 Ted Peters, “Praying for Future Cures”, Theology and Science 1 no.2 (2003): 146. Certainly he would include Meilaender in this indictment but it seems to be based upon a highly idiosyncratic reading of the literature.

18 Ibid.

19 Ibid.

20 Gary Simpson suggested to me that Peters’ perspective is grounded in Creation and is wary of the sin of sloth whereas Meilaender’s is grounded in Redemption and is wary of the sin of pride. While I think this helps to illuminate their disagreement, I doubt that either would be prepared to cede doctrinal territory to the other.

21 Mark S. Brocker, “Let God Be the Judge: Who Will Throw the First Stone?”, Journal of Lutheran Ethics 2 no.8 (2002).

22 Daniel E. Lee, “Physician-Assisted Suicide: A Conservative Critique of Intervention”, Hastings Center Report 33 no.1 (2003): 17.

23 Ibid., 19. While to date Oregon seems to have avoided the slippery slope critics feared, the Netherlands experience may be less benign than Lee supposes it to be. But these are matters of prudential reckoning rather than principle.