In 2015, while serving as President of the Evangelical Theological Society (ETS), I took the opportunity in the annual presidential address to raise what I think are some of the most pressing issues facing the church today in medicine, particularly at the edges of life. What follows are thoughts adapted from my presentation.
In my experience, churches are undereducated when it comes to ethical issues raised by advances in medicine and technology, a neglect that is critical because these issues are not just academic ones but touch people’s lives in very tangible and deep ways.
Take abortion for example. I suspect you could frequent many of the churches we attend or pastor for quite a long time without knowing that there is anything morally problematic about abortion. I routinely ask my seminary students when we cover this subject in class if their churches do anything to commemorate “Sanctity of Life Sunday.” Most of my students have never even heard of that particular Sunday, nor do they know when it is.
I understand the pastoral reluctance to delve into what is, for some women, a very painful subject, the discussion of which amounts to re-opening old wounds. But it seems to me that the cost of neglecting that topic is high, if the men and women in our churches think that there’s ambiguity from our pulpits on this.
A second area in which I believe that our churches are undereducated is that of assisted reproductive technology (ART). This lack of education in this area deeply affected some of my good friends who had triplets through a version of IVF (in vitro fertilization). They had triplets on the first try, with five embryos remaining in storage, when the wife developed lupus, making future pregnancies a very bad idea. They then came to me and asked what their options were. The options are to implant the remaining embryos themselves, preferably not all five at one time, or if that’s not possible, to put them up for adoption, through various embryo adoption programs (see the Snowflake program in California as an example); they chose the latter for all five of the remaining embryos. In addition, if they become pregnant with more than three, which sometimes does happen, their physician will likely advise them strongly to reduce the number of pregnancies to a safer number, known as selective reduction.
I have found that most Christian couples attempting IVF are ignorant of the moral dilemmas they are likely to face in the normal process of IVF. In fact, I have found that most infertile couples are not that interested in the moral dimension of IVF, caring only about the cost and the success rate. It is not uncommon for infertile couples, whose pain is especially real and extremely deep, for their desperation to transform them into uncritical utilitarians about ART in general: that getting a baby at whatever cost is all that matters.
A final area in which I would suggest our churches are under-educated is at the end of life. This is an area of significant opportunity for deep pastoral ministry, both at the bedside and with the family. Though the most pressing issues may be medical, the questions which are of most interest to most patients are spiritual ones: What is my destiny? What is my legacy? Am I right with the most important people in my life? Though we preach regularly about resurrection and eternity, I rarely hear biblical principles on death, dying, and eternity applied to how we should approach the end of life as patients and family members. In my 15+ years as a hospital ethics consultant, I have often wanted to ask believing families (but didn’t) if they really believed what they professed about resurrection and eternity, because it sure didn’t look like they did, based on how tenaciously they were holding on to earthly life for their loved one (who may not have wanted to have his or her homecoming delayed!).
First Corinthians 15 indicates that death is a conquered enemy, which suggests that it need not always be resisted, that under the right conditions (when treatment is futile, or more burdensome than beneficial) it is acceptable to say “enough” to medicine and not delay one’s homecoming any longer. I vividly remember wheeling my father-in-law out of the hospital for the last time following surgery for bladder cancer. He could only speak in a whisper and he motioned to me to lean down so he could whisper in my ear, and he said, “Don’t ever bring me here again.” Though he could not articulate it this way, I think he meant to say, “I will accept the rest of my days, however many, as gifts from the hand of God, but without medicine intervening.”
Saying “enough” to medicine is not necessarily violating the sanctity of life, since earthly life, theologically, is a penultimate good, not our highest good. Belief in the sanctity of life does not require striving to keep all people alive at all times and at all costs. Neither is it a lack of faith in a miracle-working God to turn off life support. I have often wanted to say to families (but didn’t) who expressed this sentiment, that, if we’re waiting for a miracle, then let’s go for broke and turn off everything! Of course, they are waiting for a medically assisted miracle, without realizing that God doesn’t need, and has never needed, medicine to work miracles. I try to explain to families that God is about to work a major miracle, healing your loved one of all his or her diseases, but most likely on the other side of eternity. The paradigm of resurrection and eternity is what should govern the way we approach the end of life. Our churches should be encouraging and equipping the followers of Jesus to walk with families and patients through the end of life, realizing that these are sacred moments which we have the opportunity to experience with them.
 Adapted from the Presidential Address to the 67th meeting of the Evangelical Theological Society on November 17, 2015. The complete address is published as “Bioethics: The Church and the Family,” Journal of the Evangelical Theological Society 59, no. 1, (2016): 5–16 Scott Rae, “Bioethics: The Church and the Family,” Journal of the Evangelical Theological Society 59, no. 1 (2016): 5–16.