How health care ethics need to be ingrained in the fabric of the evangelical mindset.
Technology has introduced great breakthroughs on issues of life and death but has also naturally brought about new ethical issues that the traditional faith has not been prepared to engage in.
Most evangelicals are left with making life or death decisions, not on the basis of religious piety, but the insistence of economics or social convenience. They are game time decisions made in hospitals and doctors offices. These decisions are not considered the role of the church or faith. It is just what has to be done. Faith comes later.
When to pull the plug, is nowhere to found in the Scriptures. Neither is in-vitro fertilization, surrogate motherhood, or the question, does life begin at birth, conception or when the fertilized egg implants on the uterus? Then there is the other difficult question — when is someone really dead? Families are often forced to make life decisions for their members based on statistical chances of recovery. Others are compelled by insurance or economic costs. Sometimes medical advances have allowed suffering to go beyond normal expectations. What framework are Christians to have to make the numerous and difficult decisions on the grey areas of life and death?
The contemporary dilemmas brought on by modern technology have no immediate parallel in the Scriptures. Readings from the ancients like Tertullian and Augustine could easily be used to strengthen the concept of life from beginning to end but they are moralistic more than technically descriptive.
There is no be-all-to-end-all solution to any of this either. The new technologies are always creating new ethical problems. Evangelicals feel morally strong about the equality of all human life but have little know-how in applying this in the health-care arena.
The problems confronting evangelicals on such new territories are not going away by simply ignoring them.
Evangelicals, along with everyone else, are personally confronted with ethical dilemmas on numerous occasions in their lives. For example, a Christian nurse sees a patient’s health chart has a yellow star on it, which means that the patient is not to be resuscitated if there is a health emergency. On some occasions this may be OK, on others, this could be murder. If an emergency does arise, there is no time to think about it. How does the nurse know what is the right move in God’s eyes? What if it goes against the policy and procedure of the hospital?
Or the husband being tasked a life or death decision about his very sick wife, who is hospitalized, overweight, has diabetes, and is need of open heart surgery. The hospital business administrator asks the spouse to make a life ending decision based on statistical chances of survival and advises that surgery is an unnecessary cost. A decision is required now, or within the next few days. He has to go it alone with what his conscience dictates. If he should say that he wants the treatment to continue, he has to convince a thoroughly skeptical administrator who will push hard to achieve the hospital’s objectives. What should he do?
Most evangelicals assume that conception means the fertilizing of the egg but that is no longer correct. It has changed in the last 60 years from the sperm fertilizing the egg to the successful implantation of the blastocyst into the lining of the womb. This is a very controversial subject and a primary concern from a life perspective to look into. Yet, this has never been the subject of popular scrutiny in the evangelical realm.
Evangelical belief holds surgical abortion is wrong, but the use of a chemical pill, such as misoprostol, to immediately dispel a fetus, seems to be in a grey zone. As one blog commenter noted on using it, “It was private, effective, and relatively painless. It is more “moral” (from my Christian perspective anyway).”1
Ethical problems can be found in some types of pregnancy testing. For example older women are routinely advised by doctors to get testing so that a prognosis can be made whether the fetus has down’s syndrome. It is statistically known that there is a greater chance for older women to have a child with this. If a woman is discovered to be carrying a defective child, the medical system allows the woman to choose to carry or abort. I suspect many Christian women have not considered the ethics of such a practice. They simply do the test on the doctor’s advice whom they implicitly trust.
Physician assisted suicide has recently been opened up for discussion in the Canadian political realm. I have not seen or witnessed any feedback from the grassroots Christian community. The silence and lack of action on such subjects always are concerning.
There are many more examples that could be used but this is sufficient to show that Christians are confronted with these difficult deliberations throughout life.
This is the very battlefield that is thrust upon the church; how to get the conscience of the grassroots members of the church body in tune with these issues from a Christian perspective so when the moment comes to make these life or death decisions, they are made correctly.
Prior education from a Christian perspective is required before these moments occur. It cannot be done at the moment of crisis.
Medical ethics has to be an inherent part of the church curriculum that repeatedly needs to be communicated in both public and private occasions. It cannot be simply a yearly symposium, or two sermons a year. It has to become part of the fabric of the church. This is the only way it can fully enter into the grassroots conscience. The ethics have to be viewed as temporary absolutes and has to change as new medical advances arrive.■