Thinking Theologically About Bioethics

by Hans Madueme, M.D.

The life of bioethics is in theology. As theology goes, so goes bioethics. But theological reflection has fallen on hard times of late. To be sure, this has much to do with the perception (often warranted) that career theologians—those whose craft is to reflect theologically on Holy Writ—hide away in ivory towers speaking in abstract discourse, irrelevant to the vicissitudes of contemporary life. Theology at its best, however, is faith seeking understanding. Theology is canonical faith seeking practical understanding. It is the humble, Christian attempt to understand the Word and the world aright. To what end theology? Theology is for the sake of wisdom, living faithfully before God and human beings.

Tertullian once asked: what has Athens to do with Jerusalem? So the question in our day may be: what has Medicine to do with Theology? More than we often think. At its best, theology is on the one hand the proper understanding of the Old and New Testaments, and on the other hand, it is the faithful living out of these Scriptures within new contexts. Or, as one theologian puts it, “[it] is a matter of deliberating well (e.g., canonically) about the gospel in non-canonical (e.g., contemporary) situations.”¹ This is a fruitful way of seeing the relationship between theology (deliberating canonically) and medicine (contemporary situation). Bioethics, roughly, is deliberation and reflection on relevant aspects of modern medicine. This deliberation and reflection, however, cannot take place in a theological vacuum. Theological assumption is simply inescapable. In short, we need a theological bioethics.

The following brief comments are merely priming the pump. Much more work needs to be done on the relationship between theology and bioethics. I want to suggest four basic theological propositions, points of reference, from which to engage in bioethics. To be sure, these points of reference give coordinates to most (if not all) areas of life, yet modern bioethical reflection is often abstracted from the larger narrative. We need to resist this cul-de-sac.

1) We must be canonical people, men and women of the Old and New Testaments, servants of Jesus Christ.
At their best, orthodox Christians are people of the Book. They are men and women who believe that God has spoken in the Old and New Testaments, in the canonical Scriptures, and ultimately, in his Son Jesus the Messiah. The message of the life, death, and resurrection of the Messiah is precisely the Gospel (the Good News). Followers of the Messiah need to live according to the Gospel, the Word of God. Jesus himself said, “Man shall not live by bread alone, but by every word that proceeds out of the mouth God” (Matt 4:4). The life ambition of every Christian is to become more and more like Jesus. Christians need to be steeped in the rich wells of the Scriptures; we need to be increasingly shaped by the psalms, the laments, the apocalyptic passages, the letters, the narratives. Our deepest sense of identity must be as the people of God, participants in the divine drama of redemption, holy actors in this final act between the first and second coming of the Messiah. We need the Word of God in all its richness to equip us to live life to the glory of God.

2) We must strive to live faithfully in our day, in all areas of life.
This is what we as Christians, followers of Christ, are all about. Being a Christian is not merely about having certain positions on certain issues. Christian ethics is not merely about having particular conservative positions on “difficult cases.” This sort of thinking may be symptomatic of an anemic theology. It may reflect a “secular-sacred” fallacy, the radical privatization of faith. Indeed, being faithful disciples of Christ is more than traditional piety. It is these things, but much more. Hence the rebuke of Jesus: “You should have practiced the latter without leaving the former undone” (Luke 11:42). In other words—although you wouldn’t know this if you observed many churches—we are not Christians only during prescribed times of the week (e.g., Sunday morning, during Bible study). We are Christians 24-7. “Whether you eat or drink or whatever you do, do it all for the glory of God” (1 Cor 10:31). For Christians who work in secular fields, this theology of life and vocation is critical. The larger chunk of our time is spent at work doing things that don’t fall into the allegedly “kosher” category of activities. We must remember to see all that we do under the Lordship of Messiah. If we haven’t learned to think Christianly about all of life—from the mundane to the exciting—we may become functional atheists.

3) We must not only understand the Word, but we must also understand the world.
Our world is always changing. Our cultures are always changing. Scripture is God’s communication to us. Scripture does not change. But theology is about thinking and speaking and living according to the Scriptures, in new contexts and changing cultures. We need repeatedly to be thinking biblically about our culture and our time. One of the best tasks of theology—and we are all theologians, whether we choose to call ourselves such or not—is to critique the idols and ideologies of our age/culture. In Western contexts, for instance, we need adults who have blown the whistle on our consumerism, who have thought carefully with fear and trembling about how to live in a land of affluence. In contemporary bioethical debates, for instance, we need to better discern the scientism and utilitarianism that domesticate other more eminent considerations.

Moreover, we must see the limitations in the “proof-text” approach to life, especially in the 21st century. In the past, many of us were happy to find texts in Scripture that we would simply apply to our situations. That approach has its merits, but it also has limitations. What happens if we’re in contemporary situations that have no precedent in Scripture? How are we supposed to think about cloning, birth control, or globalization? Or even the Internet? There are no explicit proof-texts for these issues. As increasing parts of our lives look different from the world of Scripture, what usually happens is that we fail to think and live Christianly in these areas. We become functional atheists. We need to be better at thinking in the context of the whole Canon and in the context of our cultural situation.

4) We must pursue both virtue and deontology in our ethics as we seek canonical fidelity.
By deontology, I mean that way of making ethical decisions out of a sense of duty. Our decisions are informed by commands that tell us what is right and wrong. By virtue, we mean that we also have to be certain kinds of people who orient ourselves to life in certain kinds of ways. Being a kind of person allows us to meet new contemporary situations, and skillfully, make decisions that reflect good judgments. On the Christian view, the virtues are fruit of the Spirit. There is a debate about whether we must hold to either a virtue ethic or a deontological ethic. The Bible teaches both. For instance, suppose you want to be a truth-telling person. At least one of the ways to grow in that virtue is by telling the truth. The two go together. In favor of virtue ethics, John’s Gospel says, “For the law was given through Moses; grace and truth came through Jesus Christ” (John 1:17). In favor of a deontological ethic, Matthew’s Gospel says, “Teacher, which is the greatest commandment in the Law?” Jesus replied: “ ‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ This is the first and greatest commandment. And the second is like it: ‘Love your neighbor as yourself.’ All the Law and the Prophets hang on these two commandments.” In other words, Scripture encourages us both to pursue virtues and obey commandments. Put succinctly, it could be said: there are commandments we must obey, and there are virtues we must display.²

These four propositions are obviously just a starting point. More needs to be said. Theology and bioethics have become strangers for too long. Let us bring them together again in happy marital union. CBHD

¹ Kevin J. Vanhoozer, “The Voice and the Actor: A Dramatic Proposal about the Ministry and Minstrelsy of Theology,” in Evangelical Futures: A Conversation on Theological Method, ed. John G. Stackhouse, Jr. (Vancouver: Regent College Publishing, 2000), p.84. Vanhoozer’s fuller exposition of this directional view of doctrine is in his forthcoming The Drama of Doctrine: A Canonical-Linguistic Approach to Theology (Louisville, KY: Westminster/John Knox, 2005).

² For one helpful attempt to explore the relationship between virtue and deontology, see John F. Kilner, Life on the Line: Ethics, Aging, Ending Patients’ Lives and Allocating Vital Resources. (Grand Rapids, MI: Eerdmans, 1992), chapter 1.