Moral Aspects of Medical Technology (1)

Herman Hanko is professor in the Church History and New Testament departments at the Protestant Reformed Seminary.

John Jefferson Davis, in his book, Evangelical Ethics, begins Chapter 1 with a story, which goes this way:

“In some of this research,” noted Dr. Robert Foote of Cornell, “I am reminded of a story where the pilot came on and said, “This is your captain speaking. We are flying at an altitude of 35,000 feet and the speed of 700 miles an hour. We have some good news and some bad news. The bad news is that we are lost. The good news is that we are making excellent time.'”

To this story Dr. Davis adds:

This story, told by Professor Foote in testimony on in vitro fertilization before the federal Ethics Advisory Board on October of 1978, expresses in a humorous way the very serious dilemmas facing modern man in the closing decades of the twentieth century. Technologically we are making “excellent time;” morally we at times appear to be lost.

It is our intention in a series of articles to examine the moral and ethical questions which confront the child of God because of the rapid and astounding advances in the fields of medicine, biology, and the combination of both in bio-medicine. Before we enter into specific problem areas however, we do well to give an overall picture of the problem and discuss in a general way some of the questions which these advances have raised.

That the advances have been rapid and sometimes astounding hardly needs saying in a time when almost every day the media speak of new discoveries, new methods of treatment, new ideas for increasing the quality of life and new techniques to enable man to do things in his life which only a few decades ago were unheard of.

We are, e.g., all acquainted with the newest techniques in the area of contraception which, when used according to instructions, can guarantee with almost complete certainty that no conception will follow intercourse. We are also aware of the fact that abortion has become, through the development of a child; and that because of these new techniques, abortion had been legalized in this country and abroad and has resulted in the grim murder of thousands and thousands of unborn infants.

Paradoxically, not only do many women who become pregnant not want their unborn child, but many women who would like to have children cannot for one reason or another have them. Medical science has also come to their rescue. Fertility drugs, in vitroconception, artificial insemination, surrogate mothers, and other means have been invented to give women who want to become mothers their hearts’ desires.

It is interesting in this connection to observe how the opinion of scientists changes almost from year to year. Just a short time ago scientist were speaking in terms of gloom and doom of a population explosion which would not only deplete the natural resources of our planet, but would also lower the quality of life as more and more people struggled to get into their possession the limited natural resources which were available. One could hear the prophets of doom speaking of mass starvation and bitter social struggle as these problems were faced and attempts made to resolve them. Now, suddenly, apparently the thinking is quite different. In the December 16, 1985 issue ofU.S. News and World Report an article appears which speaks of all the horrendous things which are going to happen in the near future because of the sharp decline in birth rates in this country and Europe. With the decline in babies born the work force will grow smaller so that an insufficient number of people will be available to operate industry and provide services. The U.S., now a major world power, will become a second-rate power because the available man-pool for the armed forces will be too small to maintain a standing army, navy, and air force. The ratio between those working and those depending upon social security could go as low as one in three so that three workers are supporting one person retired. The medical cost of supporting an aging population will be staggering. And so, on and on. The government is said to be seriously considering various ways to provide incentives for people to have more babies.

Perhaps the most startling advance in the area of medical science has been the invention of genetic engineering, which can alter the genetic structure of living organisms. While for the present this biomedical technique has been limited in its practical application to the prevention of various diseases, scientists speak of the time when its use will be applied to the area of conception and birth. Not only will parents be able to have a child of whatever sex they prefer, but through genetic engineering combined with other techniques the IQ of a child will be able to be increased, hereditary diseases will be prevented, various bodily characteristics such as color of the eyes, pigmentation of the skin, etc. will be able to be controlled according to the wishes of parents.

Combine all this with sperm banks and surrogate mothers and you have complexities in procreation which seem almost to be endless.

At the same time that thousands of babies are murdered every day, scientists are putting forth their best efforts to prolong life so that the average age people can expect to live is constantly extended. Not only through sophisticated methods of testing, but through new treatment of diseases, life is prolonged beyond what could be expected but a few decades ago. But this in its own way creates medical problems not only, such as those which face the many people filling nursing homes, but also ethical questions. When is a person really dead? Is it the calling of believers to make use of life-support equipment? If so, when? and for what length of time? Is it right to withhold life-support equipment? Or, after making use of it, is it right to discontinue its use? These problems face God’s people every day, and they are not always easy problems to answer.

Speaking of disease, the November 11, 1985 issue ofU.S. News and World Report quoted a professor in a School of Medicine as saying; “We should eventually be able to develop safe, effective tools to combat any organism that causes disease.” And the magazine itself, speaking of genetic engineering, says this:

Now, a second revolution in treating disease is beginning—due in large part to cracking the human genetic code that controls the function of cells in the body. Although the science of genes is in its infancy, it has the potential for unraveling the origins of disease. Doctors may one day treat patients by administering a normal gene to overcome a defective one—thus turning gene therapy into tomorrow’s penicillin for inherited defects such as hemophilia and for illnesses ranging from depression to Alzheimer’s disease.

Notice in this quote the reference to physical diseases not only, but also to depression, a mental state or state of the soul, which, scientists claim, will soon be amenable to medical treatment.

In the June 24, 1985 issue of Christian News, in a rather lengthy article on the moral aspects of modern medical technology, reference was made to some of the boasts of today’s scientists who speak of conquering all evil with the tools of their trade, but also of the problems which are involved.

Nobel Prize-winning scientists claim they will be able to produce live, carbon-copy clones of you in less than ten years. Corporations will have the legal right to own and sell all new forms of life they create in their laboratories. Leading scientists are proposing that only people with certain “superior” genotypes be licensed to have babies. Normal sexual reproduction might be totally replaced by artificial procedures. Genetic engineers are talking about doubling the size of the human brain in order to produce a new super species of human beings. A major American company has experimented with changing the human digestive system so that people could eat and digest hay, like cows, One scientist says there is no reason why humans and plants could not be genetically crossed so that skin, like leaves, would perform photosynthesis . . . .

Evolutionary scientist, George G. Simpson, concluded one of his books by saying that man is “his own master. He can and must decide and manage his own destiny.”

U.S. News and World Report itself recognizes the moral and ethical questions which all these advances bring up. The article quoted above says,

Yet despite these advances, many wonder treatments are raising difficult ethical questions about how lifesaving tools should be used—and who should pay. Living longer does not automatically mean living better. Across the country, doctors and lawyers are pondering what to do with the patient whose body is alive but whose brain no longer functions.

All these things add greatly to the complexity of life and make decisions difficult to reach. While the world, itself recognizing that ethical issues are involved, does not appreciate the true moral implications of many of the things which it does, the child of God who seeks to live a life in obedience to God’s Word finds the way difficult to follow and the decisions hard to make.

D. Gareth Jones, in his book, Brave New People, (a book, by the way, which has stirred up considerable controversy in fundamentalist circles) writes of this.

Underlying all these developments is the promise and the spectre of technology. They would not be serious issues for ordinary people were it not for our enormous technological capabilities in the areas of biology and medicine. It is tempting to compare the sort of genetic engineering scientists are currently engaged in, or the in vitro fertilization which is currently being employed in a number of countries, with the ideas of a science-fiction writer such as Aldous Huxley. How does our brave new world compare with his? How far have we gone along the road to a biologically-controlled and biologically-replicated state? Interesting as such comparisons may be, we dare not overlook one radical difference—his world was a brilliant and perceptive vision, ours is reality. His vision can be either read as entertainment, analyzed as literature, or it can be ignored. Our reality cannot be ignored. No longer is it the province of academics or dilettantes; it is rapidly becoming the everyday experience of us all. We are the characters in the brave new world; we ceased being the audience long ago. It is we who are being changed and who are having to make unpalatable and unrehearsed decisions; it is we, not some interesting figment of the collective imagination, who are having to sort out the priorities.

There is no escape from the ramifications of biomedical technology. Somehow we shall have to learn to live with and to cope with it. Unfortunately we appear to be particularly ill-prepared to do this. For so long have we welcomed every new advance of technology, that it now seems tantamount to heresy to question any aspect of it. In the biomedical realm it has prolonged our life-span, eradicated most serious infectious diseases, ushered in brilliant reconstructive surgery and given us the opportunity to live life to the full. Technology is our ally and we are in its debt.

Unfortunately, this dependence upon technology has a price-tag. Continual improvement in the quality of our physical lives is bought at a cost. Sometimes this is a financial one, because sophisticated technology is now very expensive; on other occasions it is a human cost, as values come into conflict and one life has to be staked against another life. (pp. 4, 5).

What does God’s Word have to say to us in all these difficult problems? That is the question we face as we discuss these matters.