For over 30 years The Center for Bioethics & Human Dignity has responded to issues at the intersection of medicine, science, and technology from a Judeo-Christian, Hippocratic point of view. Given the rapid developments of the past few years, most notably the emergence of AI and its myriad applications in healthcare settings, CBHD’s 31st annual conference was dedicated to exploring The Future of Health: Faith, Ethics, and Our MedTech World.
The conference opened on Thursday evening with CBHD’s 2nd annual virtue ethics lecture, delivered by Keith Plummer.[1] Established last year by Dr. Richard and Mrs. Elizabeth Zimmerman in memory of their parents, Dr. Willis and Mrs. Janys Zimmerman and Mr. Henry and Mrs. Anna Wellhausen, because of their display of the virtues of generosity, kindness, and faithfulness, The Virtue Ethics Lecture Series Endowed Fund will allow this lecture to take place at each annual conference.
Technology has become so prevalent in our lives that much of it has reached what Neil Postman refers to as “mythic status”: it is seen not as an artifact of humankind but as a gift of nature, and people become unable to image how it could be altered or used differently. Plummer sought to push on this unthinking acceptance of technology: How does our increasing inhabitation of a virtual world form or deform virtue? “How might our devices be inclining us to vices?”
Plummer argued that digital tools are neither moral agents nor morally neutral. As Christians, therefore, we should reject both technological determinism, which ascribes to technologies an almost autonomous power and robs humans of agency, as well as an instrumentalist view of technology that says that the tool itself does matter, only how it is used. Instead, we must acknowledge that “our devices cast visions of the ways that life should be” and critically examine the ways in which our inhabitation of the technological world can shape us.
Plummer suggested three areas where Christians should be cautious of accepting a technological view of human flourishing over a biblical view. The first is our attention. We have a responsibility to steward our attention because it is a gift of God that should be used to know and worship him and come to know other people made in his likeness. We must attend to one another, and technologies that threaten our ability to do that are destructive to our discipleship. The second area is autonomy. Humans were created to be dependent on both God and one another, and we must therefore be mindful of technologies that claim to reduce these dependencies.
Third, advances in technology change how we think about our humanity and embodiment and give rise to the metaphors we use to explain our experiences and ourselves. The metaphors of digital technology are of “feedback,” being “in the loop,” “processing” our experiences, “downloading” information, “storing” memories, being “triggered,” lacking “bandwidth,” etc. These metaphors suggest both that we are no more than our brains, as well as that we are passive responders to the world around us. Digital worlds and social media drive us to ignore our embodiment, encouraging us that we can know people solely through their words, pictures, and likes.
Spiritual formation in the technological age must be biblically grounded and theologically informed. It must teach us to resist worldliness—the spirit of the age that encourages us to call good evil and evil good. To combat worldliness in our technological age, we must form people who remember that the spiritual life is corporate and do not place autonomy above all. As Plummer concluded, “Efficiency, speed, convenience, and choice are the values embedded in our devices and essential to the picture of the good life that they tell.” However, these are not the values of love in Corinthians 13, or of the fruit of the Spirit in Galatians 5. Efficiency, speed, and convenience may be goods, but they are not virtues, and we confuse them at our spiritual peril.
Friday morning began with a lecture by Matthew Lee Anderson on “The Will to Live and the Life of God.”[2] Anderson began by considering the attitude that imperfections as threats that must be eliminated through a recounting of Nathaniel Hawthorn’s short story “The Birthmark.” As medicine has developed it has rejected the idea that there are particular ends of nature, which reduces medicine to mere technique: “Medicine’s aim of healing is no longer tethered to an account of life that has internal norms and limits, which leaves us free to project our fantasies onto a blank canvas of ‘the human’ and then reconfigure our bodies accordingly.”
Anderson argued that behind this rejection of teleology is the primacy of death as a fundamental and preeminent fact of the universe. The primacy of death cannot be combatted merely by emphasizing the value of human life: “The assertion that life is valuable can only contradict death’s preeminence but cannot prevail against it.” Rather, we must come to see life in light of the life of God, the relations between the members of the Trinity.
As humans, we are invited into union with God. Therefore, the end of human life lies beyond our own capabilities and rather in fellowship with God. As we look to Christ’s example, we see that the cross is not a catastrophe, but the telos of the incarnation—it “unmasks the folly and futility of death.” This side of the cross, death is no longer the end of life or a pause in our existence but has become a servant of life. Human frailty and incapability point us to the limits of our agency, and yet it is exactly at the edges of those limits where we encounter God.
Anderson went on to argue that the life of God has important implications for how we steward human life. “The content, meaning, and significance of human life is known only in the light of the revelation of God’s love to us, a love that gives us our existence in creation, preserves our life though providence, restores our life in redemption, and elevates our life in glorification.” The origin of our life in God is also humanity’s destination.
Anderson ended his talk with some reflections on honor, offering the provocative opinion that “honor of God is a more potent framework for Christian moral reasoning than the dignity of human life.” Dignity does not capture the elevation of human worth that being honored by God does. Dignity is also a static concept, while honor binds adherents together as members of the same moral community. Thus, Anderson concluded, “only when we learn to honor humanity as God has done will our will to live bring us that life which is life indeed—the knowledge of God that the Gospel of John tells us is life eternal.”
Friday afternoon saw two plenary sessions dealing with emerging AI technologies. The first was given by Jason Thacker on “Defining Humanity Down: The Irony of Generative AI and Human Anthropology in Christian Bioethics.”[3] Thacker opened by recognizing that there is a lot of hype around AI, but also a feeling that things are changing at a rapid pace, and that both as a society and as Christians we are unprepared for the changes that are on the horizon. He encouraged his listeners to slow down and ask the hard questions about new technologies and the way that they are shaping our lives. We cannot see technology as neutral—it is value laden and shapes every aspect of our life towards the values of our culture. Unchecked, it leads to a faulty, incomplete, instrumentalizing of humanity.
While emerging AI technologies may seem to present novel challenges, Thacker believes that they actually just raise perennial questions about what it means to be human. Why then is there so much consternation over generative AI? Thacker argued it is because we have anthropomorphized it, ascribing to AI models human levels of intelligence and even giving AI models human names. When we humanize our machines, we dehumanize ourselves. We have thought that what it means to be human is our ability to think, to create, to make decisions and perform complex tasks. If machines can do the same things, humans lose their uniqueness.
Thacker encouraged us to address this concern through the doctrine of the imago Dei. Throughout history, Christians have held differing views on what exactly the image of God means. The substantive view (the image is our capacity for reason, rationality, thinking, creativity, use of language, etc.), the relational view (the image involves our ability to form relationships with God and our fellow image-bearers), and the functional view (the image consists in how we represent God in the world) all contain truths about humanity, but are ultimately deficient. They define humanity by our comparison to the rest of creation rather than comparing us to the God in whose image we are made.
The image of God is not reduceable to traits and qualities. The substantive, relational, and functional views each reflect aspects of how the image of God is made manifest but are not themselves the image. In contrast to these views, Thacker believes that the image is an ontological status bestowed by God, unalterable and unchangeable, possessed by humans simply by nature of us being biological members of the human race. It is not about something that we do, but who we are.
As Christians addressing emerging technologies such as AI, we need to put forward an approach that is deeply rooted in the Christian traditions and accounts for human dignity. No matter how advanced machines become we do not have to approach them from a place of fear. We are specially created in the image of God and have a living God who sits at the right hand of the Father, giving us both a Christian ethic and an eschatological hope for navigating the challenges before us.
Thacker’s address was followed by Kristin Collier, whose talk “AI and Medicine: Living in the New Atlantis”[4] encouraged listeners to think deeply about the vocation of medicine and how it will be affected by artificial intelligence. Atlantis was the ideal nation-state proposed by Plato where philosophers ruled, and virtue was seen as the primary end of mankind. In contrast, Francis Bacon proposed a “New Atlantis,” a utopia where science, technology, and progress are the primary goals of humanity. The New Atlantis mindset is where medicine finds itself today.
Collier posited that medicine currently has two very different anthropologies: One sees the human body as a biological machine in need of mending, while the other sees a human person in need of healing. She reviewed the many technologies, from the microscope to modern AI, that have gradually changed the ways in which doctors interact with their patients and shifted the definition and scope of medicine. One result of this has been the depersonalization of patients as they have been reduced to mere bodies with diseases to be treated. There is a difference between disease and illness. Disease refers to a specific pathological condition. Illnesses are experienced in the person; the patient’s personal, subjective experience of their disease is their illness. Treating illness requires empathy and compassion, something machines lack. AI is like a sociopath: it might have the answers to treating your disease, but it will take nothing of your personhood into account.
Collier gave the example of a doctor looking through a microscope. The scientific, technological world of medicine requires you to look through with one eye closed. But what is needed is for doctors to open the other eye, to see not just through the microscope but to also take in the person before them. “Medicine is primarily a person-to-person vocation,” and we should be extremely wary of anything, such as AI, that threatens to come between or interfere with the physician-patient dyad.
Though proponents of AI claim that it will improve the practice of medicine, Collier pushed back that it simply cannot live up to the hype. Some think that AI will assist in diagnosis, but she warned that the likely result will be a rise in “pre-disease,” a category that already is over diagnosed and medicalizes normal human variations. Others claim that AI will assist doctors with creating treatment plans, but this is not really a problem in patient care right now—doctors for the most part do not lack knowledge but rather effective ways of communicating with their patients.
One of the most important attributes to providing good medical care is wisdom, or phronesis. It is the doctor’s job to help patients navigate a world of competing goods and to choose the good most aligned with human flourishing, something AI will never be able to do. A machine cannot become wise, because wisdom arises in community. “Machines are apersonal, and amoral, and nonhuman entities that are unwise, and they cannot understand human persons and their metaphysical commitments.”
Not only will AI fail to live up to its promises of transforming and improving medical care, Collier also foresaw numerous risks accompanying its widespread adoption, including the deskilling of doctors and other healthcare professionals as reliance on AI in medical training short circuits the learning process; an increase in workloads as AI’s supposed greater efficiency leads to expectations that doctors meet with more patients per day; and a worsening of healthcare disparities as the rich dominate the time of skilled human doctors while everyone else is stuck with inferior machines. She concluded with several prospective steps forward, such as the resurrection of the President’s Council on Bioethics with a special focus on AI. Ultimately, Collier called for a reclamation of the role of wisdom through the humanities in medicine in healthcare and for keeping AI in its proper place: outside of direct patient care.
On Friday evening one of CBHD’s conference partners, the Tennessee Center for Bioethics and Culture, hosted a dinner with Sylvie Vanhoozer. Her presentation, adapted from her recent book The Art of Living in Season,[5] encouraged attendees to attend to God and our spiritual lives at all times of the year and in the varying seasons of life. Those who attended were blessed with a good meal and even better conversations, and we are grateful to D. Joy Riley and all those at TN-CBC who made this event possible.
Farr Curlin opened the final day of the conference by considering whether there is a “way of medicine” for Christians.[6] To answer this question, we must first ask “what is medicine”? There are two broad answers to this question today. One is that medicine is “the practice of healing humans, preserving and restoring the health of those who suffer injury or illness.” This account of medicine gives rise to norms of medical morality, such as “do not act contrary to a patient’s health” and “do not let your patient’s health be subverted by prejudice, apathy, or self-interest.” Curlin argued that this conception of medicine and its morality should guide medical practice.
He contrasts this with what he calls the “provider of services” model, an approach that has appeared over the past 50 years. In the provider of services model, medicine is seen as merely a set of “technical skills used primarily in service of a patient’s autonomously chosen preferences and goals, even if those preferences and goals detach from or even directly contradict the patient’s health.” This model leads to a different set of moral norms. In the provider of services model, a doctor does whatever a patient wishes so long as it is legal, effectively brings about the patient’s goals, and is freely chosen by the patient.
These two models are helpful for understanding many of the conflicts that arise in medicine, from issues of conscientious objection to abortion to treatment for gender dysphoria. In the way of medicine, a doctor may decline to provide a treatment, even if a patient sincerely desires it, if he finds it inconsistent with the nature of medicine and the goal of furthering the patient’s health. In the provider of services model, as long the treatment is legal and sincerely requested, the physician has no legitimate basis for refusal.
Curlin shared that there is a way of medicine unique to Christians. In discerning this way, Christians must start with a commitment to the way of medicine itself, and an accompanying commitment to “act only insofar as your actions are consistent with a commitment to the patient’s health.
Next, Curlin encouraged Christians to situate medicine within the Christian story and in so doing participate in God’s redemption of the world. The Christian story, which emphasizes that all people are possessed of inherent dignity because they are made in the image of God, provides a better account of why we bother caring for the sick. The Christian story provides a better account of the physician-patient relationship, reminding us that patients are persons deserving reverence, not machines or abstractions or statistics, and that we are accountable to both God and one another for how we treat them. The Christian story provides a better account of our obligations to the underserved through its emphasis on a preferential option for the poor and the teaching that we are all part of one body in which the weaker members are given special honor. The Christian story gives healthcare providers a better account of the limits of medicine, reminding us that we are created beings who must live within the reality of our own contingency. Finally, the Christian story provides a better check on the hubris of medicine, the temptation to medicalize life and idolize health. Curlin thus contended that the Christian story is superior to all other accounts for understanding the way of medicine and concluded that when medicine is set in the context of the Christian story, it is remarkably good.
The penultimate plenary for the conference was given by Mihretu Guta and CBHD’s own Anna Vollema as they considered in what ways technology could be an idol.[7] Technology is ubiquitous today, and we cannot simply dismiss it or refuse to use it. Thus, Guta and Vollema sought to present an interdisciplinary account of technology and idolatry from the perspectives of biblical studies and philosophy.
Vollema presented the biblical studies portion of the presentation, arguing that idolatry is not just believing in other gods but entails a worldview commitment. A worldview involves 3 types of beliefs: (1) existential, or descriptive, beliefs that deal with matters of truth of falsehood; (2) evaluative beliefs—the determination of a belief as good or bad; and (3) prescriptive or proscriptive beliefs—how one should or should not act.
Vollema then walked attendees through a biblical theology of idolatry. She began with the reality that humans are created in the image and likeness of God for the purposes of having a relationship with God and representing him in creation. After tracing biblical teaching on idolatry through the Old and New Testament, she concluded that idolatry is a distortion of these purposes. When we form relationships with idols, we represent an earthly object of our affections rather than God. This in turn shapes our worldview, and this idolatrous shift can be found in each of the three types of belief. For example, an idolatrous descriptive belief is that I am able to control God according to my desires because he is limited and finite. An idolatrous evaluative belief is prioritizing the pursuit of wealth, power, and personal security. An idolatrous prescriptive belief is that I should be able to act according to my own desires. Vollema concluded by demonstrating that we can already find concrete examples of these worldview shifts occurring among those developing and using AI and social media.
Guta then presented some philosophical considerations around idolatry. He began by noting that technology influences how we answer existential questions about our worldview as well as our theological/metaphysical beliefs. For example, proponents of strong AI claim that digital machines will at some point become superior to biological humans. Transhumanists seek to address the issue of biological death through digital immortality, eliminating humans altogether and transitioning to a posthuman state. And some proponents of virtual reality claim that objects and experiences in the virtual world are just as real as those in the physical world.
Guta suggested that from a metaphysical standpoint, the problem with idolatry is that it places something between us and God, and he gave several features of “techno-idolatry.” At its base, techno-idolatry involves creating a discontinuity between ourselves and the things we create and then ascribing to those properties and traits that should only be attributable to humans. He concluded that our choices are clear: we can be served by technology, or we will become its servants.
The closing address of the conference was given by Michael Sleasman on “Reframing the Future of Health: Lessons for Faithfulness and Flourishing in a MedTech World.”[8] He began with several questions: Given all that we have looked at throughout this conference, how then should we live? What does a Christian Hippocratic approach to medicine and technology have to offer? And what can we as Christians be for, not simply against?
Sleasman advocated for Christians to do the work of cultural diagnosis. Part of this “understanding the times” is responsible tech assessment. All too often, Christians look at emerging technologies and see only worst-case scenarios and existential risks. Sleasman reminded us that not every innovation will bring about the end of the world. We must thus avoid catastrophism on the one hand and wishful thinking on the other, taking the time to reflect soberly on our technologies, both those that are with us now and those that are appearing on the horizon. Secular tech assessment narrowly focuses safety, efficiency/effectiveness, and economic impact (revenue generation). As Christians, our tech assessment must be more robust. We need to look for the social and ethical consequences of new technologies; they are not exempt from the questions of bioethics. We cannot be mere consumers of our MedTech world but must recognize that it is shaping and reshaping us in profound ways.
Sleasman reminded us that medical and technological solutionism look towards medicine and technology to lead us to a better life. He acknowledged that humans are better off now than at any other period in history, but he also recognized that the advances of medicine and technology have not been unmitigated goods: “We have been lulled to passivity, to an acquiescence of life, by the cultural liturgies of our MedTech times.” He argued that we must awake from that slumber if we are to responsibly engage with the medical and scientific advances in which we are immersed.
Part of awakening from our slumber is to embrace a Christian Hippocratic ethic that can guide us in our reflections on faithfulness and flourishing in our MedTech world. Sleasman provided several recommendations to shape these reflections. We must rediscover a robust doctrine of creation. We need to maintain a focus on the imago Dei and the reality that all human beings are created in the image of God. We need to develop a more robust understanding of what it means to be human that goes beyond the imago doctrine and accounts for the relational nature of humanity, our physical embodiment, our finitude, and our contingency and vulnerability. And we must not lose sight of our eschatological hope.
Sleasman concluded that the way we operationalize these crucial Christian doctrines is through the practice of virtue. Christians should cultivate patience, accepting that the easiest way forward is not necessarily the best way forward. We must practice contentment and humility as part of the practice of the ethics of restraint. Contentment we learn in the context of our finitude, while humility helps us to know ourselves properly and reminds us to put others first. Christians are called to display hospitality, the unconditional welcome of the other. We need the courage to live counterculturally, and the wisdom to navigate the complexities of contemporary life. To all these Sleasman added those greatest of the virtues, faith, hope and love. As he concluded, “may we learn from these things as we reframe the future of health in the work we have before us in Christian bioethics.”
We at the Center are so grateful for all of those who came and made this conference a success! Preparations are already underway for CBHD’s 32nd conference, Living in the Biotech Century: The First 25 Years. Speakers include Nigel Cameron, PhD; Maureen Condic, PhD; Paul Dassow, MD, MSPH; Ewan Goligher, PhD; Brent Waters, PhD, as well as representatives from CBHD’s Chinese bioethics initiative. We hope to see you there!
[1] Keith Plummer, “Discipled by Our Devices: Spiritual Formation in Our Technological Age” (plenary address, The Center for Bioethics & Human Dignity’s 31st Annual Conference, The Future of Health: Faith, Ethics, and Our MedTech World, Deerfield, IL, June 27, 2024), https://www.youtube.com/live/_3u7_on5qeE.
[2] Matthew Lee Anderson, “The Will to Live and the Life of God” (plenary address, The Future of Health, June 28, 2024), https://www.youtube.com/live/_3u7_on5qeE.
[3] Jason Thacker, “Defining Humanity Down: The Irony of Generative AI and Human Anthropology in Christian Bioethics,” (plenary address, The Future of Health, June 28, 2024), https://www.youtube.com/live/uYyRwL-ueEk.
[4] Kristin Collier, “AI and Medicine: Living in the New Atlantis” (plenary address, The Future of Health, June 28, 2024), https://www.youtube.com/live/Oy6w8YW7D4U.
[5] Sylvie Vanhoozer, The Art of Living in Season: A Year of Reflections for Everyday Saints (IVP, 2024).
[6] Farr Curlin, “The Way of Medicine for Christians” (plenary address, The Future of Health, June 29, 2024), https://www.youtube.com/live/xDJLyJWQFlI.
[7] Mihretu Guta and Anna Vollema, “In What Ways Can Technology Be an Idol?” (plenary address, The Future of Health, June 29, 2024), https://www.youtube.com/live/n3cj5CIXmco.
[8] Michael Sleasman, “Reframing the Future of Health: Lessons for Faithfulness and Flourishing in a MedTech World” (plenary address, The Future of Health, June 29, 2024), https://www.youtube.com/live/UqYgn9Xwjz4.
Bryan A. Just, "The Future of Health: 2024 Conference Recap," Dignitas 31, no. 3-4 (2024): 19–23, www.cbhd.org/dignitas-articles/the-future-of-health-2024-conference-recap.