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    CHRIST AND CULTURE ~ part 10
    by Roy H. Ryan



    Ethical Issues in Medical Technology - Research and Application

    Advances in medical technology continue to move us into new territory in regard to Medical Ethics. The overriding question in this expanding field of research and discovery is, "Shall we make use of new technologies in the treatment of all types of diseases simply because they are available?" In other words, has our scientific research moved faster than our ability to make good ethical decisions?

    Stem Cell Research

    One of those areas in which ethical issues are still unresolved is with stem cell research. The ethical dimension has been made more complicated because of the breakthroughs in "cloning." Most persons of faith would most likely oppose any form of human cloning. But stem cell research is not technically involved with cloning.

    Few people are opposed to the use of "adult stem cells." These can be derived from bone marrow, skin, blood, umbilical cord and other types of tissue. The controversy is joined when we deal with embryonic stem cell research. So far the research has been largely limited to the "spare embryos created by in-vitro fertilization," those that have been left over after women have the fertilized egg is implanted in the uterus. This procedure has allowed numerous couples to have their own biological children, who otherwise would not have been able to have children.

    One person arguing against embryonic stem cell research has written, "Proponents for embryonic stem cell research argue that these spare embryos created for in-vitro fertilization sitting in freezers in fertility clinics will only be washed down the drain. Therefore, since they will be "killed" anyway, why not use them for the benefit of mankind? One answer is that these spare embryos could be placed for adoption with other infertile couples, something that is already a widespread practice. The other is for fertility clinics and couples to exercise a moral responsibility not to create more embryos than they can reasonably expect to transfer to the mother's uterus." (The practice of in-vitro fertilization usually would require no more than three fertilized eggs.) [From an unpublished paper by Richard Wood titled "Argument Against Stem Cell Research."]

    Churches speak to this issue from a variety of perspectives. Those who oppose legal abortion on the grounds that abortion is always murder would oppose embryonic stem cell research on the grounds that "life begins at conception," ie. when the male sperm reaches the female egg. Other churches see this issue, along with other medical research, in a slightly different way.

    Some experiments with mice offer the possibility of overcoming this religious objection. It will be interesting to see what the future holds.

    This issue was politicized when it was brought into "the public square," rather than kept under wraps in laboratories. Many scientists would much prefer not to have governmental interference in such basic research, believing that it becomes an ethical or political issue only when the application of such research is made available. Somewhat like drug research that goes through a long and carefully defined process before it can be approved for public use. But the debate has been joined and thus the research itself is called into question.

    Bills are making their way through Congress and, in many state legislatures, defining restrictions on the research itself. While medical professionals see great possibilities for treatment of a number of debilitating diseases, eg. Parkinson's, diabetes, spinal cord injuries, etc., we are not sure what we can expect. But it offers great promise.

    Like most scientific advances, the field of medical technology has its share of detractors. We would not argue that no ethical issues are involved, but as people of faith we should support medical research that could help to heal troubling diseases. Stem cell research certainly has that potential.

    One medical ethicist refers to the dilemmas faced in this new field of inquiry as "the slippery slope." This phrase is used by those who are afraid an apparently beneficial act will open the door to less acceptable acts. Dr. Hilton goes on to write, "This scary vision happened with the announcement that brain cells from an aborted fetus were implanted into two Britons suffering from Parkinson's disease. The doctor told the press that both patients had been sent home so much better that they were able to stop the medicine they'd been taking before the operation. Their recovery was dramatic." He goes on to say that "Tissue from a fetus is used because its immune system has not developed enough before death to cause the usual transplant rejection in the recipient." (This was written in 1991) [Bruce Hilton, FIRST DO NO HARM, wrestling with the new medicine's life and death dilemmas, pp 35-36]

    For additional information on this issue: "Guidelines for Human Embryonic Stem Cell Research is a project of the National Academies' Medical Research Council and Institute of Medicine, with additional funding from the Ellison Medical Foundation and the Greenwall Foundation. The report is available for a fee through the National Academies Press at (800) 624-6242, or it can be read online at www.nap.edu.

    What are some of the ethical and social questions around this issue that persons of faith need to ponder? Should the Federal Government help to fund research into embryonic stem cell research? Does life begin at conception (or when the sperm fertilizes the egg, whether inside or outside the woman's womb)?

    If embryos are being destroyed in fertility clinics around the country, why should these not be put to use in a way that might alleviate suffering of certain types of disease? Since sincere Christians disagree on this and other ethical issues, how are we to behave toward one another in the Koinonia (Christian Community)?


    Assisted Suicide or Active Euthanasia

    What part should a terminally ill patient be allowed to play in deciding how and when to die? Usually the questions that doctors struggle with include, "How long shall we continue to use heroic measures to keep a patient alive? Should we use all the life support mechanisms available or should we make the patient as comfortable as possible and give up the fight? Most of the time when the situation gets to this stage, the patient may not be capable of having any input in the matter.

    As medical professionals deal with life and death issues, they often seek the counsel of the patient and/or close family members. It is important for family members to know the kinds of questions to ask if they are confronted with making such grave decisions about the life and death of a loved one. Such questions might include, "How much chance is there that the patient can get better? How much improvement is it reasonable to expect? How much pain is there? Is there suffering - emotional pain, despair? Can the pain be fully relieved? Is the treatment truly therapeutic, serving to cure or heal or preserve health?" [Bruce Hilton, FIRST DO NO HARM, pp. 100-101]

    Clergy persons, hospital chaplains, and other counselors may be especially helpful to patients, physicians and family members as these life and death questions are faced.

    Assisted suicide is already a lively and controversial issue for many. One writer has suggested that "by 2040, an increasing proportion of the population in developed countries will be more than 75 years old and thinking about how their lives will end. The political pressure for allowing terminally or chronically ill patients to choose when to die will be irresistible. When the traditional ethic of the sanctity of human life is proved indefensible at both the beginning and the end of life, a new ethic will replace it." [From an article titled "Sanctity of Life" by Peter Singer in The Dallas Morning News, November 27, 2005]

    Whether we agree with Mr. Singer or not, there will no doubt be continued social/political pressure to give more choices to persons in the way they want to die.

    The state of Oregon now has a law that allows physicians to prescribe a potential lethal does of medication to terminally ill patients under certain carefully defined rules. The Supreme Court has refused to overturn the law, based primarily upon States's Rights, rather than on the ethical grounds (as this layman understands it). This, again, is seen as a "Slippery Slope" by many physicians and ethicists. In fact, the number of physicians who are willing to assist those in Oregon who choose to end their life, is a relatively small number. Physicians are in the business of saving life wherever and whenever possible, and do not like the idea of helping a person end his life. The law in Oregon, of course, applies only to terminally ill patients who have no hope of recovery and who seek to end their struggle of pain and suffering.

    "A recent Gallop Poll shows that 58% of Americans agree that physicians should be allowed to help patients with incurable illnesses and suffering acute pain to commit suicide. The U.S. administration (President Bush) asserts that because Oregon is the only state to have legalized physician-assisted suicide, there is no broad based consensus against it." [U.S. News and World Report, October 10, 2005. p. 33]

    "Not Dead Yet, along with the United States Conference of Catholic Bishops, antiabortion groups, the lawyer-evangelist Jay Sekulow (who has played a key role in helping the administration appoint conservative jurists to the bench) has filed a friend of the court brief supporting the administration." (This article was written before the Court made its decision in the Oregon Case.) [LOC. CIT.]

    The United Methodist Church makes this statement as its official position on the Faithful care of the dying:

    "We applaud medical science for efforts to prevent disease and illness and for advances in treatment that extends the meaningful life of human beings. At the same time, care for the dying is part of our stewardship of the divine gift of life. The use of medical technologies to prolong terminal illnesses requires responsible judgment about when life-sustaining treatments truly support the goals of life, and when they have reached their limits." The statement goes on to say, "We believe that suicide is not the way human life should end. We encourage the church to address the biblical, theological, social and ethical issues related to suicide, including United Methodist theological seminary courses focusing on affirmation of faith that nothing, including suicide, separates us from the love of God (Romans 8:38-39). Therefore, we deplore the condemnation of people who take their own lives, and we consider unjust the stigma that so often falls on surviving family and friends. We encourage pastors to address this issue through preaching and teaching." [THE DISCIPLINE OF THE UNITED METHODIST CHURCH, SOCIAL PRINCIPLES 161-L -- 162-M]

    One would expect this or a similar view to be held by many main line Protestant Churches in America. There are many denominations and sect groups who would not support such a statement. One has to decide which "camp" one is going to be in on this and other controversial issues.

    Regardless of one's age, it would be well to exercise your right and freedom to have a part in your final treatment as death comes. No one is immune from death, no matter how young and healthy one may be. Some of the most tragic situations in regard to end-of-life issues and decisions involve victims of serious accidents or even "stroke" and other debilitating illnesses.

    Every adult person, regardless of age, should execute two documents that help family members and physicians make decisions about medical treatment when one is no longer able to help makes those decisions. They are; (1) A Durable Power of Attorney for Health Care, and (2) A Living Will. Each person needs to have these documents drawn up, preferable by an attorney, and made available to one's primary physician and to members of the family who are designated to make those crucial decisions about treatment and care. Because laws vary from state to state, it is wise to know what the laws are in your state -- that is why it is important to engage a trusted Attorney to draw up the documents.

    You should also discuss this with your primary care physician and make sure he/she knows your wishes and instructions. And, of course, it is vital to discuss this with the family members who will be designated in your Durable Power of Attorney for Health Care.

    We can expect great advances in medical research during the next few years. We should not let medical research and practice get ahead of our ethics. That is why it is essential for well-informed people of faith to learn what scripture teaches about these issues we have been considering over these last several weeks (in some cases the scripture is silent), but the Will of God is best discerned by a faithful study of Scripture, the Christian Tradition (and our own denominational traditions), Experience and Reason.

    I trust that our journey together through these essays has been helpful. This officially ends the course on Christ and Culture. But I may, from time to time, write other essays on other subjects of interest. Stay tuned to www.usadeepsouth.com. Thanks.



    For further study:


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    BIO ~ ROY RYAN
    A United Methodist Minister, now retired, and a native Mississippian, Roy Ryan lives in Tupelo, Mississippi. He is a graduate of Millsaps College, BA in Sociology-Anthropology and of Emory University (Theology), M. Div focus on New Testament studies. He is also a graduate of Southern Methodist University (Theology) STM in Adult Christian Education and Vanderbilt University (Theology) D. Min in Theological Ethics. Roy has written eight books on Christian education and numerous articles for church and secular journals. He is presently teaching this course on "Christ and Culture" in First United Methodist Church in Tupelo.


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    Click these links to access essays in this series:
    Part I... Part II... Part III... Part IV... Part V... Part VI... Part VII... Part VIII... Part IX... Part X


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