Review of Gilbert Meilaender’s Bioethics: A Primer for Christians

[1] Vergil puts these words into the mouth of the Trojan hero Aeneas when he was shipwrecked in a country he feared was populated with barbarians, in which case he would have been able to establish no common bond: “These men know the pathos of life, and mortal things touch their hearts.” It is always comforting to know that we live in the midst of people with human feeling for others, that we are not surrounded by callous, uncaring, unprincipled beasts. To live otherwise, to exist among folk with no moral sense and no belief in the authority of a higher power not only is intolerable, it is down-right dangerous. One cannot survive long in such an arid spiritual environment.

[2] Anyone who has not been in a coma for the last thirty years may wonder if Aeneas’ judgment about American society would be so generous. That the Terry Schiavo case would result in such “red state, blue state” fragmentation over whether a helpless woman should be starved to death, a debate carried out bitterly even within the Churches, indicates something is not right with the moral patrimony of the nation. And, when denominational leaders sound so certain about the “Christian alignment” of the national budget, but obviously lack any overt prophetic passion for the 1.1 million deaths of innocents by abortion, that just might be a sign that something is terribly lacking in the moral perspicacity of American Church leaders. By any light, American society is in urgent need of a moral compass.

[3] Morality gives us the rules by which we live with others. It is the code, spoken or tacit, governing how we behave in our relationships with others, or at least how we wish we would behave under life’s many challenges and temptations. Moral strictures limit what we do. That is their essential function. And they provide the basis for our thinking and judging about the worthiness our own and others’ actions.

[4] No sane person, no matter how base, is devoid of all sense of right and wrong. No culture provides a unique moral system completely alien to that of other civilizations. C. S. Lewis spoke of the “Tao”, or universal moral compass, that is shared by all human civilizations – including those deemed “barbaric”. Even Nietzsche, who denied the existence of a universal moral law valid for all times, had to admit: “A tablet of virtues hangs over every people.” This tablet is morality. And it is part of the fabric of human existence.

[5] For the soul immersed in the biblical view of morality, “right and wrong” are not subjective judgments arrived at by autonomous, self-guided individuals, but are part of a standard grounded in the eternal law of God. This law is, as the psalmist says, “a lamp unto our feet” (Ps. 119: 105). Its sanctity consists in its ability to guide us to God Himself (Ps. 43:3), even if it cannot make us right with Him. The Bible speaks of such a divine morality as a thing we ought to delight in, something that, under ideal conditions, could serve as our counselor in times of perplexity and confusion. From the biblical perspective, morality is given by God and is intended to lead its devotees to perfect wisdom (Prov. 2: 6,7).

[6] By and large, Lutherans are not at home with this view of morality and divine law. Because we understand the theological use of the law as a mirror that reveals our spiritual warts and drives us to Christ, we tend to be cautious about ascribing a positive function to moral codes. Further, as clergy more influenced by a Barthian than a Lutheran view of law, we get seduced into an antinomian stance toward morality. Add to that the tendency of seminaries and students to dismiss theology as a serious “science” of life, and it is no mystery that Lutheranism, like Protestantism, has fallen into deep confusion over some of the gravest moral questions of our time.

[7] That is what makes so urgent this book written nine years ago by one of Lutheranism’s premier ethicists. Gilbert Meilaender is one of Lutheranism’s brightest lights in the field of bioethics. He is the Phyllis and Richard Duesenberg Professor of Christian Ethics at Valparaiso University in Indiana and a member of the President’s Council on Bioethics. In this book, he provides Lutheran clergy and laity with a most welcome challenge to the pervading secularist outlook of our day, and offers concrete guidance on many of the perplexing ethical challenges arising from the recent explosion of technological innovations in scientific medicine. This small book is chock full of wisdom for the modern soul. And it is solidly grounded in a Christian perspective on life.

[8] The book’s starting-point is stated up front: this is a book written by a Christian for those who share Christian belief. Others are welcomed to listen in, but no apology is rendered for speaking of public issues from the creedal stance of Christian faith. Meilaender acknowledges that much public argumentation on medical ethics is based upon a minimalist, lowest common denominator ethic. He has no intention of following this approach. Rather, he writes for those who see in the God of Abraham, Isaac, and Jacob the same Lord who was incarnate in Jesus of Nazareth. His purpose is to say what followers of Christ ought to think about public issues, if they are to remain true to the faith they hold. Many of the problems he deals with are new – the result of lightning fast technological advances in science – but the wisdom he seeks to bring to them comes out of a tradition that extends over the millennia.

[9] The book is remarkably “user friendly”. A preacher looking for insight into the major themes challenging faith from the arena of scientific innovation has, in this book, solid guidance for her ruminating. A classroom teacher, leading a study of medical ethics, has here a quality text for students. And the pastor searching for sound reasoning among the clamor of contemporary voices confronting his parishioners, has a resource of much depth and thoughtfulness.

[10] Chapter One uncovers the “background beliefs” underlying any thoughtful Christian critique of the cultural assumptions of our day. They can be quickly summarized:

a. Whenever speaking of the “individual”, the Christian cannot have in mind someone fully autonomous. We neither receive our dignity from our parents’ conferring it upon us, nor do we create it ourselves; it is inherent from our being in communion with God. This view makes imperative our protecting the dignity of every person, no matter how weak or imperfect.

b. There is a created duality to human nature: we are both finite and free. Thus we are limited by our creatureliness – we will never be “gods”, regardless of how technologically clever we become. But we are blessed with a “freedom”, a capacity for self-transcendence that impels research into the frontiers of human knowing. Kept in balance, this means we can stretch toward the skies in the field of science, but that doesn’t mean we should always follow every impulse to tinker with our humanity. “Ought” is a limiting concept for those who hold to the Christian faith.

c. The present-day enthrallment to the concept of “personhood” – based upon the capacity to fulfill certain criteria – is unacceptable from a Christian standpoint. Believers see dependence as an essential ingredient of our humanity, not as something disqualifying us from the human family. Attempting to fathom the human mystery by inventing artificial criteria for what constitutes a fully human person is shallow and demeaning, in the view of faith.

d. Suffering is an evil. But it is not the greatest evil. Suffering ought to be addressed by the Christian. But it should never be the Christian’s goal to arrogate himself to the mission of eliminating all suffering. Our task is to try to care for those who suffer; but we should never assume that we can erase suffering from the human scene in this life.

e. Lastly, we can always wish that a particular illness will be cured in us. But we must not think that medicine can ever bring us wholeness. That is God’s purview.

[11] With these principles firmly fixed, Meilaender proceeds to deal with the pressing medical\scientific issues of our day. And he does it with intelligence, sensitivity and brevity. This book truly qualifies as a primer: it is the book that provides a foundation for pastors wanting to think through the medical muddles of our day from the stand-point of Christian belief.

[12] Ten of the chapters are centered on the key bioethical issues of our time: procreation (a warning against the ‘I want a child at any cost’ trap;) abortion (I was impatient with his careful, rational, low-key approach to this vital issue; but am forced to admit the power of his persuasion;) genetic engineering (an important distinction between somatic and germ cell therapies;) prenatal screening (a warning against “quality control”;) suicide and euthanasia (with the attendant issues of autonomy and suffering;) refusal of treatment (a sterling discussion of the difference between aim and result;) who decides to end treatment (including a great question to ask before leaping to ‘death as a solution’;) organ donation (a caveat against “a noble form of cannibalism”;) human experimentation (a reminder that the march of progress of human history is not itself redemptive;) and the use of embryos for research (the Christian way of life involves renunciation when the alternative is sacrifice of character.)

[13] Three key insights are hidden within this book’s pages, ideas not outlined in chapter one, nor given extended treatment, but all of which are central to a truly Christian approach to science and technology in the realm of health and wholeness. First is the importance of using words with integrity. When arguing for one side in a heated debate on questions of public import, it is way too tempting to slant the argument by verbal sleight of hand, and dishonesty. This is especially true in the abortion debate where “choice” is made to sound noble, and a human in the fetal stage of development is spoken of as a blob of tissue. But it also applies when describing a comatose person as a “vegetable”, or as “on life support” when the person relies only on a feeding tube. Meilaender reminds us of the power of words to either enlighten or poison a discussion, and of the stakes involved when we intentionally or carelessly misrepresent the truth.

[14] In chapter ten, we are confronted with the reality of the different goals of scientific medicine and clinical medicine. Most patients want to be treated for their ailments, not used as scientific objects for the benefit of research. It is vital that we not allow medicine to be transformed from “giving care” to sufferers, into “using suffering” to advance the exciting frontiers of scientific knowledge. The myth of Prometheus alerts us to the ambivalent blessing that science can be. It would be a horrid society in which care of persons took a back seat to scientific “progress”.

[15] Lastly, permeating this book is a most wholesome Lutheran ‘blik’ on society and the human creature. Its essence is an anti-utopian, anti-grandiose estimate of humanity and its achievements that harkens back to Paul, Augustine and Luther. This Lutheran emphasis refuses to be carried away with Arcadian visions of a ‘new humanity’ engineered by scientific and technological creativity. Meilaender consistently resists all such allurements, and repeatedly asks us to reign in idealistic fantasies in favor of a world of limited possibilities and proximate goods.

[16] If there is any flaw in the book, it is the lack of a general discussion of philosophical ethics. It would be welcome to have Meilaender’s “take” on cultural relativism and the current fad of considering all moral judgments subjective. But this is nit-picking to the ‘n’th degree. Truthfully, I was unable to find some way in which this book failed to fulfill its stated aim.

[17] There is not a chapter in this small book that fails to inform and enlighten. There is hardly a superfluous sentence in the entire volume. This book (along with Robert Benne’s The Paradoxical Vision, Carl Braaten’s No Other Gospel, and Braaten and Jenson’s Christian Dogmatics), ought to be required reading for any seminarian seeking ordination in the Lutheran Church.

Michael Shahan

Michael Shahan is Book Review Editor of Journal of Lutheran Ethics. A retired ELCA clergyman, Shahan does freelance writing from his Nashville home.