Better than the Rules? Developing Virtue as a Guide for Making Bioethical Decisions

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People sometimes remark that churches are not very good at teaching and counseling their members concerning difficult bioethical issues. It is worth pondering why many faithful churches seem to fall short in this important area. Undoubtedly a variety of causes, rather than a single one, are to blame. These bioethical issues truly are challenging, some of them involve private and intimate matters, and many of them evoke memories of painful experiences—all of these factors can make churches hesitant to invest significant time in training their flocks to deal well with bioethical decisions.

But I would like to focus upon another factor: the rule-focused approach to ethics dominant in many churches often does not seem particularly helpful when wrestling with the biggest questions in contemporary bioethics. Of course, rules are important for the Christian moral life. God’s law revealed in Scripture gives many rules and sets boundaries we are obliged to follow. But even Scripture does not issue a comprehensive set of rules that provides a ready-made answer for every moral problem. We also need other resources for leading godly lives.

One of the other things we need is to be virtuous people of good character. Only people who have proper virtues are well equipped to make good decisions about complicated moral questions for which we do not have direct biblical rules. It is certainly easier for churches to teach rules than to train people to be virtuous. The Holy Spirit, after all, is our sanctifier and thus sanctification is a mystery; preachers and teachers cannot learn techniques to change another person’s heart. Yet God calls the church to disciple believers toward the goal of godly character, and the Holy Spirit sanctifies us only as we, by grace, strive toward holiness. As the church takes up its responsibilities in this area it simultaneously trains people to become better able to reflect upon and make decisions about difficult bioethical issues. And as the church trains people toward growth in virtue, it would be wise to help them think through the bioethical implications of godly character traits.

For the rest of this brief essay I focus upon only four virtues—the classical cardinal virtues that Scripture also commends—and use only the example of end-of-life medical treatment decisions. But I am confident that a similar analysis could be applied to other virtues and other areas of bioethics.

One of the cardinal virtues is prudence, or practical wisdom. This refers to understanding the proper goals to pursue in life and the proper means by which to achieve these goals given our concrete circumstances. Christians and non-Christians alike can grow in wisdom with respect to worthwhile goals for this present world, but Christians, illumined by Scripture and the Spirit, also come to understand the ends of Christ’s redemption and his eschatological kingdom. Wise Christians have crucial insight for wrestling with life-and-death treatment decisions. Wisdom enables Christians to step back from the crisis of the moment and to contemplate the larger issues at stake. What is the purpose of my life, and what is the purpose of medical care? The wise Christian realizes that she does not live to gratify her own desires but to glorify God and to be of service to her neighbors. She also acknowledges that proper use of medicine is not for vain pursuit of living forever but for promoting health in ways that enable her to pursue her responsibilities as best she can for as long as the Lord grants her life.

Another cardinal virtue is justice. Justice refers to an inclination toward right relations with others, achieved by giving to each person his due. Justice provides Christians with important resources for right conduct when death threatens. The just Christian considers treatment options not only in terms of what each option can do for him but also in terms of how each option will bring benefit or harm to other people. The just Christian will also be mindful of wounded relationships that may need to be mended and of how he made need to put his house in order as death approaches.

A third cardinal virtue is temperance, or self-control. Temperance is moderation in our desire for good things. God gives many good things that are proper to desire and enjoy, but our sinful hearts often seek these good things in excessive or disordered ways. Food, drink, and sex are perennial examples of good gifts we often pursue in ways that bring harm and hinder our pursuit of other good things. The temperate Christian exercises proper moderation and self-control not only with respect to food, drink, and sex but even with respect to life itself. She appreciates earthly life as a divine gift that should be fostered and promoted—but not at any cost. While never seeking death, she loves this life only within proper bounds and realizes that the pursuit of other worthy goals may mean she must forgo some attempts to prolong life as long as possible. Thus she is also moderate in utilization of health care, availing herself of its benefits only insofar as it allows her to pursue the range of good things God has given.

The final cardinal virtue is courage, a firmness of purpose toward proper goals in the face of obstacles and fear. Needless to say, imminent death and its accompanying medical interventions provoke their share of fear and may tempt us to shirk important responsibilities in our zeal to avoid them. The courageous Christian remembers Jesus’ exhortation to fear not. Christ is the victor over sin, death, and hell, and in this present age we suffer only in union with him. The courageous Christian therefore neither grasps desperately at earthly life out of terror at death nor refuses genuinely helpful medical treatment from fear of its side-effects. Armed with courage, he pursues the best course without being deterred by powerful foes.