Every week we hear of a new drug, life-saving therapy or reproductive technology, and our communities are filled with families wrestling with whether to withdraw ventilator support from a loved one.
Evangelicals often turn to the people they trust for spiritual guidance, hoping to find a sound voice of moral reason based on biblical principles. Sadly, few Christian ministers feel prepared to discuss medical dilemmas with their congregation. In like manner, many health-care professionals don’t understand the assumptions and moral viewpoints of American evangelicals.
James Thobaben of Asbury Theological Seminary tries to change all this in his book “Health-Care Ethics: A Comprehensive Christian Resource.” He develops an anthropology that can be used as the basis for evaluating health-care decisions.
Unlike many popular Christian writers who focus on isolated issues like abortion or euthanasia, Thobaben takes basic evangelical principles and applies them across the life cycle and to the community’s obligation to care for patients.
“Health-Care Ethics” contributes three things to the current state of bioethics. First, it stands as an evangelical model for making moral decisions in today’s health-care environment. Next, it helps evangelicals understand the language of bioethics. Last, the text can help non-evangelicals understand and appreciate the evangelical perspective.
Those that focus on how Thobaben deals with specific issues, like abortion or the use of stem cells, will miss the book’s brilliance, which is Thobaben’s development of a unifying anthropology for health-care ethics.
Thobaben starts by defining human beings as more than biological objects. “For Christians, the near-neonate and the neonate and those with a severe brain injury are not potential persons, but are humans,” writes Thobaben. “They do not merely possess minds; they are souls.”
There is more to us than simple biology. Human beings are defined by their imago dei and a common brokenness. This gives them equality and eternal worth, but these common elements are often forgotten; clinicians tend to focus on what the patient can or cannot do. There is also a tendency to displace suffering as an intrinsic evil with no value. But this common weakness and brokenness can become the pathway for great spiritual growth.
Many in the ethical community have failed to hold these ideas in balance. They either hold onto a minimal quality of life or they hold onto life at all costs. “One of the great mistakes in contemporary bioethics is to accept the false dichotomy that biological life is to be valued above all or it is to be valued as nothing as soon as it is significantly damaged,” Thobaben writes.
In addition to his anthropology, Thobaben reminds us that one must consider both the American social contract and the exercise of individual autonomy. Our current society often forgets its unstated involvement in health care. It is often involved in preventative health measures as well as future cures, so there is an individual and corporate debt involved in the American social contract.
While this contract must not be forgotten, it still needs to be held in balance with the ideal of autonomy. Evangelicals must remember that their lives don’t belong solely to themselves. They are owned by the Creator, which gave them life, and an integral part of society. In like manner, autonomy cannot be forgotten because only the individual can determine what the Creator wants for that life.
“Health-Care Ethics” will surely become a standard textbook for college ethics students and seminarians, but above all it opens debate about how an evangelical worldview can and should impact contemporary bioethics. It models how to take foundational assumptions about the nature of God and the world and apply them to practical issues faced by people of faith.
Monty M. Self is the oncology chaplain for the Baptist Health Medical Center – Little Rock and a member of the hospital’s ethics committee. He also serves as an adjunct instructor of ethics at the University of Arkansas at Little Rock.
Senior Staff Chaplain and Clinical Ethicist at the Baptist Health Medical Center in Little Rock, Arkansas.