Cosmology as the
Context for Bioethics
GEORGE L. MURPHY
St. Mark Lutheran Church
From Perspectives on Science and Christian Faith 42.
(June 1990): 94-99.
© 1990 Americian Scientific Affiliation
The development of biomedical technology has introduced new ethical questions and has sharpened some old ones. It is not obvious that old ways of formulating Christian ethics are adequate to deal with these questions. I first sketch two approaches: (1) "code ethics," and (2) "situation ethics," and point out some of their limitations. My main purpose is to consider bioethics in the context of chiasmic cosmology , which views the universe in terms of Luther's theology of the cross. This emphasizes the biblical understanding that God's work is characteristically done with the appearance of weakness, hidden under the form of its opposite.
Chiasmic cosmology is presented, and some of its general implications are drawn out. In this setting, I then look briefly at abortion, the use of life support systems, and genetic engineering as representative issues of bioethics.
The development of science and technology almost automatically carries with it new ethical questions and challenges to some traditional ethical presuppositions. This is because such development creates new possibilities for human action. In the biological-medical area, such things as genetic engineering, organ transplants, or maintenance of bodily life for those who are brain-dead simply were not possible when traditional ethical systems were formulated, and it is not obvious a priori that those systems will be able to deal easily with the questions which new practices raise.
Perhaps traditional ethical concepts will be found adequate, but in a time of rapid change and new concepts it is wise to examine our foundations. The purpose of this paper is to look at the fundamental ideas which should undergird Christian ethics, especially with regard to bioethics.
I will look briefly at two broad approaches, "code ethics" and "situation ethics," and will note some of the difficulties they have in dealing with questions introduced by modern biology. As one solution to the problem, I suggest adoption of a view of the universe which sees the Creator present first of all as the crucified One - chiasmic cosmology. With this approach, bioethics can also be kept closely in touch with other areas of the science-theology dialogue.
Approaches to Ethics
Of course the literature on ethics in general, and on Christian ethics in particular, is vast.1 Here we will only look quickly at two other approaches before focusing on that associated explicitly with the theology of the cross.
The oldest and simplest approach refers ethical questions to an authoritative moral code, so that we may speak of code ethics . In the Judeo-Christian tradition the Ten Commandments would form the core of such a code. Any serious type of Christianity has seen the Ten Commandments as an important part of divine revelation, though different parts of the Christian Church have often been in disagreement over the role of this code, from Paul and the Judaizers in Galatia to the present day.
Ethics based on the Ten Commandments can be simple and straightforward. "Thou shalt not kill" - no ifs, ands, or buts. We have an unambiguous apodictic law.
But application of the commandments is not always straightforward, as has long been recognized. What am I do to if I can save one person's life only by killing another? What if I can keep one commandment only if I violate another? "Thou shalt not kill" is not regarded in the Bible as an absolute prohibition against all taking of human life, for killing in war and self-defense is sometimes seen as legitimate.
What do the Ten Commandments tell us in the case of a pregnant woman with uterine cancer whose life can be saved only by the removal of the uterus, with consequent death of the fetus? If one believes that the fetus receives some protection from the Fifth Commandment2 then there is no way to avoid violating this precept.
This is simply a modern version of an old ethical dilemma, and could be dealt with by various types of argument. But modern biology raises other issues to which it is hard to see even how to apply the moral code. It does not answer such questions as:
When does the fetus become a person?
When does death occur?
Should we alter the genetic makeup of a human being?
And this is hardly surprising. Such things as genetic engineering were not even imagined by ancient Israel. Noting this fact involves no denigration of the authority of the Ten Commandments, but we do have to recognize that the ethical codes of the Bible do not give explicit answers to all the questions which face us.
Not all the laws in the Pentateuch are apodictic. There are many casuistic "If - then " formulations, such as those found in Exodus 21-23. But while these refer to particular situations, they still apply a code to those situations. It is a much more radical departure from code ethics that has come to be called situation ethics .3 With this approach there is no appeal to an authoritative code like the Ten Commandments. What is wrong in one situation - ending a human life, sexual intercourse, etc. - may be right in another. One must decide how to act in each concrete setting, guided by the need to show loving concern in that situation.
Certainly love is to be a fundamental element in Christian behavior. Jesus gave the "new commandment" to love one another (John 13:34), and St. Paul says that love of neighbor is the fulfillment of the law (Galatians 5:14). But who are all the people to whom love is to be shown? How is love to be put into practice? (Our concern for another person's welfare will, for example, be shown in different ways depending on whether or not we believe that there is any hope for life after death.) There must be something to guide the application of love in different situations. Without such guidance, situation ethics could degenerate into a disconnected series of arbitrary responses.
My purpose here is neither to try to eliminate the Ten Commandments as authoritative guides nor to deny that responsible behavior must to some extent be situational. We do want to look in a different way at the basic Christian understanding of God's relationship with the world in order to see how we are to relate to God and to the rest of the world. The picture of God as the divine lawgiver is neither the most general nor the most profound Christian image of the way in which God deals with the universe, and it does not give the clearest answers to some of our basic questions. If our questions are, "What does it mean to be human?" and "How are we to treat other human beings and the rest of creation?" then our answers must be informed by the Christian understanding of who the human par excellence is ( Ecce homo ), and by the way in which God deals with the creation.
How does God deal with the world? God's typical manner of working is hidden or disguised . God's good work is done under the form of its opposite. God Almighty says, "My strength is made perfect in weakness" (II Corinthians 12:9). This takes place throughout the biblical story, which comes to a head in the cross of Christ. The cross is the characteristic sign of God's work.4
Only God's revelation is able to show us that God is active in this cruciform work, for sinners, cut off from God, assume that God Almighty must work in ways which they consider appropriate for omnipotence. Luther summarized this fundamental distinction by speaking of "the theology of the cross" and "the theology of glory.5
That person does not deserve to be called a theologian who looks upon the invisible things of God as though they were clearly perceptible in those things which have actually happened. (Romans 1:20)
He deserves to be called a theologian, however, who comprehends the visible and manifest things of God seen through suffering and the cross.
A theologian of glory calls evil good and good evil. A theologian of the cross calls the thing what it actually is.
This fundamental insight which comes from the cross and resurrection of Christ is especially important for us today as our understanding and control of the universe continue to grow. It tells us how we are to discern God's presence in that universe which we explore, and thus provides a distinctive answer to the problem of natural theology. Using imagery from Plato and St. Justin Martyr, I have called this approach, which sees God "placed crosswise in the universe," chiasmic cosmology .6And it is chiasmic cosmology which, I believe, should be the context for our considerations about bioethics.
Before examining some specific illustrations, I will spell out a few general implications of the theology of the cross. These will be helpful in our later discussion.
First, it should be emphasized that God generally acts in this crosslike way, and not only in the death of Jesus of Nazareth. That is the focus of God's work, to which all else is connected. Creation "in the beginning," biological evolution through natural selection, the Exodus, virginal conception, the justification of sinners, and the hope of resurrection all bear the mark of the cross. Romans 4 is especially relevant here.
This shows that God can and does bring good out of evil, life out of death, and joy out of suffering, because God is the One who creates ex nihilo . God's work is accomplished in spite of the lack of creaturely possibility.
God identifies with the weak and the helpless. This is quite literally the case in the Incarnation. The Son of God takes on existence as an embryo, as a refugee, as one who is persecuted. He is identified with sinners, suffers, and dies. In recounting the healing ministry of Jesus, the Gospel of Matthew interprets it as part of the fulfillment of the Suffering Servant prophecies of II Isaiah: "He took our infirmities and bore our diseases" (Matthew 8:17; cf. Isaiah 53:4). The healer is not described as one who stands outside the process of suffering, but as one who is effective through participation in it.
There is one more point which is important in decision making. God's justification of the ungodly is the same type of creatio ex nihilo which is seen in the cross and resurrection of Christ (cf. Romans 4:5 & 17). A theology of glory is likely to assume that a person's value depends upon that person acting according to certain ethical standards, so that status before God would depend upon behaving virtuously. That is, of course, the basic idea of "works righteousness," standing in antithesis to the doctrine that one's status depends entirely on being forgiven by God and clothed with the "alien righteousness" which comes through Christ and is received by faith.
Before we make any moral decisions at all, we are accepted by God. When confronted with hard choices, it is necessary to pray and study for guidance to decide wisely. In the medical field such decisions cannot be taken lightly, for they are often literally life and death decisions. But Christians are free to finally go ahead and make decisions without having the assurance that they are right. They need not be paralyzed and rendered helpless by a need to be right. Christians can be confident that they are God's people whether they made the right decision in a given case or not. We are not justified by our correct choices, but by the death and resurrection of Christ.
Some Problems of Bioethics
Chiasmic cosmology does not provide a precise calculus for the solution of ethical problems, but we have just made the point that even to expect such a moral calculus would be to lapse into a theology of glory. In any given setting, the guidance of the moral law and the needs of the people involved must be taken into account. But if the situation is viewed in the light of the cross, we may be helped to see the will of God in ways that appeals to the Decalogue or to love might not reveal.
We may begin with the question of abortion. This is not a new issue introduced by modern medicine,7 but it is a major ethical problem today, and modern medicine has greatly expanded our understanding of the character of fetal life.8 The Bible does not explicitly answer such old and basic questions as those concerning the time of "quickening." Thus, it has not been uniformly held in the Christian tradition that life begins at conception.
But we receive a fundamental insight from the classical doctrine of the Incarnation. Against all adoptionist ideas, this holds that there never was an independent human person in Jesus Christ. The personal centering of both his human and his divine nature is the person of the Logos . From the time that he was conceived, the One borne by Mary was the Son of God (Luke 1:26-45, Matthew 1:20-21).
Fetal life is certainly not full, complete human life. It is human life at its weakest and most helpless. And the Incarnation shows that the biblical God who is especially concerned for the poor, for the fatherless and the widow (Psalm 68:5), identifies precisely with human life in its weakest and most helpless state.
This means, at the very least, that we are to be concerned about the life and welfare of the unborn. It does not imply that the fetus has an absolute right to life which overrides concerns about the mother's health. But it does mean that a woman's right to control her body cannot be absolutized at the expense of the fetus.
At the other end of life, concerns about the appropriate use of life-support systems, "death with dignity," "right to die," "quality of life claims," and euthanasia loom large. Medical technology has made it possible to maintain body functions in many cases long after there is any possibility of a return to conscious life. Voices are being raised in the medical community in favor of allowing, or even facilitating, death in some cases when life could be maintained.9 What does the theology of the cross have to tell us about such concerns?
As we might expect of a rather broadly defined theology, it will not always give precise "Yes" or "No" answers in specific cases. But it will suggest some boundaries for ethical practice.
In the light of the cross, suffering is not a pointless evil, even when we are unable to see any hope for health or life. This is precisely the meaning of the resurrection of Christ that the cross, which to ordinary understanding seems foolish, is the way in which God brings hope (I Corinthians 1:18-31, Romans 4:18). The cross is the instrument by which God defeats evil (Colossians 2:15). Suffering is therefore not something to be avoided at all costs. In some cases we are able to see the point in suffering, and we may then speak of discipline or of the building of character. Then there is some commonality between Christian and, for instance, stoic ethics. But the theology of the cross goes deeper. Even when we feel no hope and do not see how anything good could come from suffering, even when suffering is purely evil, God is able to bring forth good.
Of course we are to try to minimize suffering. But any "quality of life" ethic which would end life when suffering and loss of dignity have become too great has failed to grasp the redemptive power of the cross.
That stands as a warning on one side. Our theology also insists that maintenance of physical life for as long as possible is not the highest good: Those who love their life lose it (John 12:25). Such attempts may become ways of denying that ultimate hope comes from the God who raises the dead, just as much as giving up on life because of suffering or apparent pointlessness may be a denial of hope.
This implies a relatively conservative and apparently "common sense" approach: To sustain life, but not take "extraordinary" measures when medicine can foresee no recovery. If there is a strengthening of public and professional opinion in favor of various degrees of euthanasia, such an approach may not remain common sense. It is therefore important that witness to the cross of Christ, which is anything but common sense (I Corinthians 1:18-31), be heard here.
In areas of bioethics, which are still in a more speculative state, it will not be so easy to see implications of the theology of the cross. This is the case with human genetic engineering.10 Again, our comments must be restricted to suggestions of some fairly vague boundaries for deliberate genetic modification of human beings.
The identification of God with the weak and despised, "the form of a slave" (Philippians 2:7), reminds us, as we work to eliminate manifest genetic defects, that we must not be contemptuous of present-day people who have them. It would be a great advancement to be able to correct the problem of the extra chromosome which produces Down's syndrome, but it is wrong in the meantime to imply that those who have this condition should be looked down upon11 We must even be careful of words like "defect." To speak of people as "defective" suggests that they are to be regarded as products of a factory, or as merchandise.
When we speak of genetic modification of humans, we are considering alterations in the evolutionary trajectory of what is now the human race. How is this to be understood theologically?
Human evolution has already been radically redirected by the Incarnation, in which humanity is united with God. Of course this is something which transcends ordinary genetics, but it is not separate from genetics. All human beings are to some extent "infected" with the divine character of the Word. While human nature is not destroyed or swallowed up in this union, it is transformed. What it means to be fully human is not to be understood only in terms of a static concept of human nature, but must take into account the dynamic character of God's re-creative work in the Incarnation. And just as other techniques of science and technology may serve as instruments of God's action, so may genetic modification of the human gene pool.
But the Bible already has something to say about the future of humanity's evolution. That future is what St. Paul calls the Body of Christ, the super-personal organism of Christian believers who have Christ as their head (Romans 12:4-8, I Corinthians 12:12-31, Colossians 1:15-24, Ephesians 1:15-23). J.A.T. Robinson connected Paul's concept with his experience on the Damascus road: When Christians are persecuted, Christ is persecuted (Acts 9:4)12 It was one of the great achievements of Teilhard de Chardin to put this Pauline concept in an evolutionary setting with his argument that the Body of Christ is the next stage of human evolution.13
The direction of humanity's evolution, in this view, is not toward some type of individual superhuman, but toward the organic community of the Body of Christ. It will be appropriate to use our technology to correct genetic damage and perhaps even to work for positive genetic improvements though we always have to ask, "Who decides what is an improvement?" and Quis custodiet ipsos custodes? But this activity can be seen as coherent with God's work as a genuine activity of "co-creation" only if it is in accord with God's will for creation.14 And we have seen that that will of God is revealed most clearly in the cross and resurrection of Christ, leading to a renewed creation centered on the Body of Christ. There are certainly dangers associated with human genetic engineering, but it has the potential to be one instrument of the divine renewal of creation.
A Concluding Comment
We have seen here some examples of how chiasmic cosmology can deal with questions in bioethics. It is appropriate for Christians to have modest aims for their theologies, which at best provide models to express the richness of the Christian faith. It is not necessary that any given theological viewpoint provide a "theory of everything" (if we may borrow a term now popular in physics). It will be enough if a theology can provide a coherent and instructive way of understanding a significant part of our experience in connection with the Christian faith. It seems clear that the theology discussed here is able to do that.
1For a survey of sources see Waldo Beach and H. Richard Niebuhr (eds.), Christian Ethics (New York: Ronald Press, 1955). I would suggest also Dietrich Bonhoeffer, Ethics (New York: Macmillan, 1955).
2I follow the usual Lutheran numbering of the Commandments here.
3Joseph Fletcher, Situation Ethics (Philadelphia: Westminster, 1966), and The Ethics of Genetic Control (Garden City, NY: Doubleday Anchor, 1974).4George L. Murphy, The Trademark of God (Wilton, CT: Morehouse-Barlow, 1986).
5Martin Luther, Theses 19, 20, and 21 for the Heidelberg Disputation in Luther's Works , vol. 31 (Philadelphia: Fortress, 1957), p. 40.
6George L. Murphy, "Chiasmic Cosmology: A Response to Fred Van Dyke," Journal of the American Scientific Affiliation 38 , 1986, p. 124.
7The earliest explicit reference in Christian literature seems to be in The Didache . See Early Christian Writings , trans. Maxwell Staniforth. (Baltimore: Penguin, 1968), p. 228.
8Landrum Shettles and David Rorvik, Rites of Life (Grand Rapids: Zondervan, 1983).
9For a survey of current attitudes see, e.g., Sidney H. Wanzer et al., "The Physician's Responsibility toward Hopelessly Ill Patients," The New England Journal of Medicine 320 , 1989, p. 844.
10See, e.g., Thomas A. Shannon, What are They Saying about Genetic Engineering? (New York: Paulist, 1985).
11Note, e.g., Fletcher's reference to babies with Down's syndrome as "pathetic creatures" in The Ethics of Genetic Control , p. 28.
12John A.T. Robinson, The Body, (Philadelphia: Westminster, 1977), p. 58.
13Pierre Teilhard de Chardin, Christianity and Evolution (New York: Harcourt Brace Jovanovich, 1969).
14Ronald Cole-Turner, "Genetic Engineering: Our Role in Creation," in The New Faith-Science Debate , ed. John M. Mangum. (Minneapolis: Augsburg Fortress, and Geneva: WCC Publications, 1989), pp. 68-75.