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

[1] Christian ethics, like Christian theology, is a human enterprise. It is a human enterprise that engages in critical reflection on moral life. One of the tasks of Christian ethics is to uncover the principles, norms, and values that should and really do inform Christian communities in their struggle to answer the ethical question: what ought we (I) do in particular situations?

[2] Like most religions, Christianity has a text. The Bible reveals God’s intentions and desires of and for the human race, provides insights and commands for a moral life that is faithful to God. While Christians are free to employ other sources for making ethical decisions and to seek guidance for the moral life, The Bible is the central text that shapes and forms the followers of Jesus Christ. The locus of Christian ethics, then, begins with the story of God’s magnificent grace which entered and continues to enter multiple cultures in which humankind “live[s], and move[s], and have [their] being” (Acts 17: 28).

[3] However, in these contemporary times, the manifestation of God’s grace in and among multiple cultures raises some questions. Is it possible to have universal principles, norms, and values which serve as foundations for responsible decision-making? Does honoring, respecting, understanding, and engaging the many voices emerging from multiple cultures contribute to ethical and moral ambiguity and relativism? What is right and what is wrong? One of the implications of these questions is that it appears there may be conflicting perspectives on Christian ethics.

[4] In regard to this “problem” of the plurality of Christian voices, it may be helpful to identify some of the various approaches theological ethicists employ in the discipline of ethics. One approach would be the more secular or philosophical understanding of ethics (e.g., Alasdair MacIntyre). A second approach would be, theological in nature, as expressed, for example, by Reinhold Niebuhr and his realistic approach to the intersection of faith and politics. A third approach, liberation ethics as exemplified by the works of African American women and men or feminists, focuses on the “underside,” the poor in society and what they think about ethics and morality. A fourth approach is a more traditional perspective that engages key doctrines and their implications for ethics and morality. Robert Benne exemplifies this perspective. Each of these perspectives provides a framework from which members of the various Christian communities can answer the question: what ought we (I) to do in particular situations?

[5] Bioethics: A Primer for Christians is a book that seeks to provide a distinctively Christian perspective. Representing, in my opinion, the fourth perspective with some leanings toward the second perspective, Dr. Gilbert C. Meilaender, Jr., a theological ethicist serves as a member of the faculty of Valparaiso University in Valparaiso, Indiana. He is also one of the distinguished members of the President’s Council on Bioethics. The author’s social location (a Midwestern university with Lutheran foundations) and service (membership on a presidential council) contributes to his writing a book that is, indeed, a primer that can be easily read by laity, clergy, and students at the college and seminary level. His purpose, then, is to write Christian ethics directed to the Christian community about “bioethics.” People outside the Christian community are welcomed to listen to the conversation.

[6] Bioethics is organized around what should or ought a Christian think and do about issues like procreation and reproduction, abortion, genetics, prenatal screening, suicide and euthanasia, refusing medical treatment, who decides about medical treatment, organ donation, and human experimentation. Several chapters have been rewritten and the argument, Meilaender says, has been clarified in another chapter. A new chapter appears on a topic currently occupying public debate, research on embryos. In my opinion, that makes this new edition worth reading.

[7] While I may have already suggested the problem of the book, let me state it clearly. The fundamental problem Bioethics seeks to address is the minimalist rights language embedded in so much of bioethics. Said differently, since citizens of the United States of America live in a participatory democracy with pluralism of all kinds, in order to maintain a “civil” society one must adopt a least common denominator approach in order to secure consensus of the population about guiding principles one can employ in making biomedical decisions. Meilaender, and here I would agree with him, believes that Christians have a different language and vision to offer in the public debate on bioethical matters.

[8] Bioethics begins with “a Christian vision.” The author identifies various elements which constitute that vision. The first, baptism, grounds what a Christian should think and do relative to bioethics. God acts by naming and claiming individuals, in baptism. However, this naming and claiming connects individuals in “community with God”, with other individuals named and claimed by God through baptism.

[9] The second element is what constitutes a human being, finitude and freedom. Individuals are finite because we exist in “time and space.” Individuals have a body and history. Individuals are free; that is, we have the capacity to “transcend the limits of nature and history” (4). This dual nature of individuals leads to Meilaender’s ethical position: given that a person is both finite and free, a Christian ethic related to scientific medicine and progress must “be prepared to say no to some exercises of human freedom” (4-5). A continuing phrase throughout the text is that one can exercise his or her freedom, but “within certain limits.”

[10] The third element of Meilaender’s Christian vision is “person and body.” The primary thrust of this discussion is how we define a person. Meilaender’s take is that personhood is not something achieved at a certain point. Personhood happens throughout our journey of life. There is a beginning, our journey, and an ending. A person is a person because they have a history. However, there will be times when individuals may not have “certain empowering cognitive capacities.” Persons lacking those capacities are non-human; they are “the weakest and most needy” (6).

[11] The fourth element is suffering. Our author suggests that Christians ought to be of two minds. On the one hand, we should care for those who suffer. On the other hand, we should not believe suffering will be eliminated or serves no purpose. These two minds are grounded in a belief that God in Jesus Christ, our resurrected Lord, can bring some good out of suffering. Thus, as Christians we will not always be able to provide people what they want or desire relative to health. Ultimately, suffering is not victorious because Christians have a different language and vision of what constitutes life.

[12] The final element of Meilaender’s Christian vision is “disease and healing.” Here we encounter Meilaender’s second use of a biblical reference. Employing 2 Chronicles chapters 14-16, Meilaender argues that the story of King Asa raises the question of how we secure ourselves in the world. In stark clarity to the human impulse toward immediacy in everything, especially medical care, security tests whether we trust God. Here Meilaender concludes that doctors are not saviors and ‘health’ is not ‘Health.” Therefore, one does not have to fear approaching medical science because we can trust that God cares for us through doctors and others.

[13] This ethic Meilaender applies consistently throughout Bioethics. In the remainder of the review I want to focus on the new chapter dealing with research with embryos. Following that I will conclude with some constructive remarks.

[14] The problem of stem cell research continues to occupy public debate. Stem cell research remains in the public eye because it touches on a group of intimate issues. Among these are abortion, Parkinson’s and Alzheimer’s diseases, heart disease, and diabetes. Stem cell research also tugs at our spirit because of the potential it has for regenerative medicine. At a more deeper level, and here one can hardly disagree with Meilaender, stem cell research pushes the Christian community to become clearer about its beliefs.

[15] Meilaender, as he does throughout Bioethics applies the Christian ethic he believes is a proper one. That is, if one concludes that the distinctive calling of medicine is to heal, that does not mean the “mission should proceed without any limits” (111). Saying no is appropriate, especially since the human has the capacity to transcend; that is develop more creative therapies to illness.

[16] Meilaender does us a great favor, I think, by including two of history’s well known examples of research ethics gone bad, the Tuskegee syphilis and the Nazi concentration camp debacles. Meilaender suggests that these two examples illustrate the “nothing is lost position,” especially in the context of what to do with ‘spare’ embryos. Since these embryos are going to die anyway, why not use them for the good that may emerge from their death? Here the author wonders about the application of this argument for research on embryos.

[17] I couldn’t agree more with Meilaender on this point. Christians of good will ought to be concerned about a “nothing is lost” position. Not only must Christians be concerned about the argument, Christians ought to be concerned about the ethos which supports this type of thinking. What is it about the human spirit that fosters this understanding of the human being?

[18] I would contend that what fosters this type of spirit is one’s understanding of the human being. As the Tuskegee syphilis experiment and Nazi concentration camp debacles lifts up for me, at least, is the sinful tendency to reduce people created in the image of God to mere objects to be used for a multitude of diabolical purposes.

[19] A deeper issue, for me, is the theology. That is, reducing human beings to mere objects implies that God made a mistake. There is immense complexity, for example, in the Tuskegee syphilis experiment. My own research into the issues of health, the dispensing of health care, and the discipline of bioethics, reveals that race, gender, and religious persuasion has everything to do with deeply held religious beliefs of scientists and doctors. My question is what of the theology, ethics, and morality of Christian people who failed to speak out, on the basis of their deeply held religious beliefs, about the wrong being conducted by research scientists?

[20] Bioethics: A Primer for Christians is a useful book. The book delivers on its purpose. One may not agree with the author’s position; namely, saying no to medical progress but recognizing that there are limits on the human impulse to exercise freedom. Readers will appreciate, in the end, that Meilaender concludes that, as followers of Jesus Christ, our call is “to retain a sense of responsibility for health and a spirit of compassion for those who are ill” (122). Our hope “for Health and Wholeness” resides in God who entered and continues to enter the human situation; yet overcomes and lives.

[21] If there are criticisms of Bioethics, they are two. I would have appreciated a little more conversation with theologians and other scholars of African descent on some of the issues of bioethics. For example, theology written by women and men of African descent have something to say about what constitutes a Christian vision, health, and matters related to bioethics. Or, as I have discovered, other disciplines like law, philosophers, and medical personnel have something to say, for example, about procreation and reproduction concerns within the African American community. Here I would direct the reader to Dorothy Roberts book Killing the Black Body: Race, Reproduction, and the Meaning of Liberty (New York: Vintage Books, 1997). Or, one would do well to read African-American Perspectives on Biomedical Ethics, edited by Harley E. Flack and Edmund D. Pellegrino (Washington, D.C.: Georgetown University Press, 1992).

[22] My second criticism is the lack of guidance for pastoral care. While Meilaender does provide some examples, how does one conduct ministry in light of what he thinks should and ought to be a Christian ethic related to bioethical issues?

[23] In my opinion, thinking about bioethical issues is necessary. That is one task of Christian ethics. Another task is putting some feet on the thinking. While one may not want to prescribe what a Christian ought to do, I believe those of us who have taken on the vocation of theologian or ethicist should embody our own thinking. In the spirit of our author, God does work through us, to bring hope that our God is a loving and just God.

Richard J. Perry

Richard J. Perry, Jr. is Associate Professor of Church and Society and Urban Ministry at the Lutheran School of Theology at Chicago. Dr. Perry is a member of the Advisory Council for the Journal of Lutheran Ethics, represents the Lutheran Ethicists Network on the Theological Roundtable, and serves as convener of the Conference of International Black Lutherans (CIBL, USA).