Why the Church Needs Bioethics: A Book Review

Return to Intersections Home

Why the Church Needs Bioethics: A Guide to Wise Engagement with Life’s Challenges

John Kilner, ed., Zondervan, 2011.
ISBN 978-0-3103-2852-0, 304 pages, Paperback, $26.99

“Where is wisdom to be found?” is a question as old as humanity, and one that grows more urgent and more difficult as the world grows more complex. Rapid developments in biotechnology have greatly expanded the scope of interventions at the beginning and end of life and at all points in between, but these developments arrive without any guidance as to what should be done. In this context, church leaders and other Christians can be overwhelmed into taking a fearful stance, either shunning technological developments reactively or ceding all authority to scientific and medical experts out of a sense of inadequacy.

Why the Church Needs Bioethics, edited by John Kilner, is a book designed for overwhelmed church leaders (and written in a way that will be accessible to any Christian) facing the panoply of new technologies in the life sciences and the new choices they enable. In its very structure it chooses charity over fear by drawing together multiple sources of expertise across a variety of disciplines without sidelining the voice of scripture in all aspects of life. Three case studies are considered: one pertaining to the beginning of life (a couple facing fertility issues); one from the end of life (terminal disease); and one asking questions about biotechnological enhancements to life along the way (a pill offering improved cognition). Each case study is addressed first by a biblical or theological scholar: Richard Averbeck applies wisdom from the Old Testament to questions of “a better birth,” Kevin Vanhoozer offers theological reflections on “a better life,” and D.A. Carson offers insights from the New Testament on “a better death.” But then, recognizing that the church consists of more than pastors, theologians, and biblical scholars, each case study is addressed by Christian practitioners in other fields: one ministry field (counseling, intercultural ministry, and pastoral care) and one additional discipline (business, law, and healthcare). Each case study concludes with a summary reflection seeking to synthesize and summarize insights from the preceding chapters.

To be clear, each discipline is applied to just one of the three case studies. The reader may naturally be curious as to how each of the disciplines would respond to the two case studies they aren’t asked to comment on: what are the business considerations surrounding end-of-life issues? What does the law have to say about rapidly developing approaches to fertility? But of course, the book would have been three times as long had all of its disciplines been applied to all of its questions (to say nothing of bringing in yet more disciples to answer additional questions!). Moreover, it is possible to glean from the contributions how each discipline thinks about bioethical challenges in a more general sense and to make the more crucial point that bioethical questions demand an interdisciplinary approach and the translation work necessary to bring disciplines into dialogue with one another. The best way to read the book, then, may be as providing illustrative examples that show the benefits of applying different disciplines to complex bioethical questions.

More importantly, this book clearly demonstrates not only that the church needs bioethics, but that bioethics needs the church. It makes a compelling case that Christians, both those leading churches and those serving God’s kingdom through the many other vocations to which he has called them, need wisdom from many sources to face bioethical challenges. At the same time, it insists that we not forget to include among those sources the Bible itself and the theological doctrines grounded in the Scriptures! This is a book that maintains that wisdom is first found, as it has always been, in the fear of the Lord, but then remembers that our triune Creator is also the Lord of business, law, healthcare, and every other field of knowledge under the sun, and so gratefully receives these other disciplines as gifts. “To say that the church needs bioethics,” reads the introduction, “is simply to insist that the church needs to help people handle bioethical challenges well. . . . The church needs to give these challenges serious attention, and the church has the necessary resources to engage such challenges well” (11).

John Kilner’s summary chapter, “Bioethics and a Better Birth,” goes right to the heart of the issue involved with most bioethical questions pertaining to the beginning of life: namely, who counts as a person? Does the fetus? What about the embryo? He helpfully addresses the debate surrounding these questions under four headings, concluding that it is better to consider all stages of human development, beginning with conception, as “persons with potential” and therefore fully vested with human dignity, rather than as “potential persons” not yet deserving of the same protection, care, and value we would assign to any one of our children after birth.

William Cheshire provides the summary chapter on “Bioethics and a Better Life” following a case study involving a hypothetical pill offering cognitive enhancement; it is this section of the book that deals with the question of whether it is appropriate for us to apply the life sciences not only to healing disease but to becoming “better than well.” Cheshire points out that in the context of a physicalist reductionism that sees us as nothing but our molecules and the chemical reactions constantly taking place within them, there really is no way to ask ethical questions of what we ought to do; instead, everything is a question of technique, asking what can we do, and how?

What would it mean to avoid this reductionism? Cheshire and Kevin Vanhoozer (in his chapter offering theological reflections on “a better life”) give a similar answer: it would mean acknowledging that there is such a thing as human nature, and particularly that if creation by God is our beginning, then we can meaningfully talk about God having also given us our end. In the absence of such a teleological account of what it means to be human it proves nearly impossible to draw a line between enhancement and therapy, or to draw a line between technologies that extend human capabilities and those that fundamentally replace or override them.

Vanhoozer and Cheshire both quote Nick Bostrom and Julian Savulescu, who write in their book Human Enhancement: “In one sense, all technology can be viewed as an enhancement of our native human capacities.” Theologically or biblically, we might draw attention to the distinction between technologies that address effects of the fall and those that confront the limitations of a good creation. Vanhoozer points out that the only way to begin to draw this line is “to say more about the end for which humans were created” (116). For this, Vanhoozer turns to two biblical sources: the image of God as worked out in the creation narrative and the person of Jesus Christ, including as we see him in his bodily resurrected and glorified state, which “anticipates the future realization of God’s design plan for creation” (117). He concludes that “God’s purpose in creating the world was to form persons with whom he can have fellowship and share his life—persons in his image, fully human (but not transhuman) persons who, like Jesus, know how to love God and others” (121).

Vanhoozer’s chapter is a good example of how the reflections following one case study can be applied to the others: all three case studies hinge strongly on our notions of what it means be human and what humans are for. Vanhoozer draws on sources including Oliver O’Donovan, Jürgen Habermas, and Wendell Berry to critique the modern social imaginary, consisting of “the presumption of physicalism,” “the authority of scientism,” and “the promise of medicalization.” If our imagination is formed instead after the likeness of Christ, we are placed in a posture of gratitude that values responsibility as God’s vice-regents rather than one of discontent that prizes innovation and creativity, as though we were ourselves gods (120). Harold Netland, Bruce Fields, and Elizabeth Sung’s chapter on intercultural ministry further reminds us that the modern social imaginary is but one way of viewing the world, something that is hard for westerners to remember when it is the air we breathe. Their chapter provides a healthy reminder that as the church speaks into bioethical issues it must pay attention to the cultural background of a given situation and the people involved.

In his summary of the penultimate section of the book, “Bioethics and a Better Death,” John Dunlop, like Vanhoozer, points us to the example of Christ, whose own death illustrates many of the aspects of his definition of a good death. And like Vanhoozer, Dunlop questions the modern social imaginary that assumes that more freedom and more choices are always preferable. The case study in this section of the book concerns terminal disease and involves the question of assisted suicide. Dunlop points out that making available the option of suicide may close off the option of “staying alive without having to justify one’s existence” (251). Dunlop’s chapter also considers the impact of end-of-life decisions on stakeholders outside the person suffering disease, or even their immediate loved ones, but extending out to society as a whole; this kind of expansive view of who is impacted by bioethical decisions is something that carries throughout the book.

It may seem unfair to critique a book covering so many different approaches to so many questions for leaving anything out, but there are a few notable omissions from this volume. One is the wisdom of scientists: the chapter presenting the view on healthcare is helpful, but largely takes the perspective of clinical practitioners rather than researchers on the frontier of biotechnology. It would have been helpful, in a book about bioethics, to have sought wisdom from biology—and likewise, to have included the wisdom of ethics as its own discipline. Here the omission is less glaring: numerous authors in the book (and the critiquers listed at the outset, who did not write chapters in the book but provided helpful advice as the volume was being written) are themselves ethicists and write from that perspective. And yet, they don’t delve deeply into how different ethical frameworks, with or without a biblical-theological basis, would approach these issues. Many people in the modern world operate with a default utilitarian view, which could profitably have been engaged here. Likewise, many theologians today are making a powerful case for a Christian form of virtue ethics that pays attention to the lived realities of how humans, as creatures of habit, are formed in the church.