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Wednesday, February 22, 2012

Ash Wednesday and Authentic Bioethics

Prayer. Fasting. Almsgiving. What on earth do such thing have to do with the principles of bioethics and bioethical issues? Catholics especially might see that these activities could be ways of combatting the evils of abortion, euthanasia, and other controversial issues, as a general way of combatting evil. But are prayer, fasting, and almsgiving in themselves a concern of bioethics?

I say they are, if bioethics is to be authentic.

There are many who want to cut bioethics out of its larger context, to limit its scope, and thereby have an easier time justifying the things they want to do. So, they limit the concern of bioethics to technologies and procedures that pertain to human bodily life and well being. Spiritual concerns are beyond the scope of bioethics in their mind.

They also tend to stack the deck in their favor, using our pluralistic society as an excuse. They maintain that bioethical issues have to be deliberated on non-religious terms to be valid. But this begins the deliberations on a false foundation. Anthropology drives ethics, and if reality and therefore man are godless, the ethics one employs will be rather different from those who understand man to be spiritual.

Man is created by God in His image. I cannot prove this to an atheist, but then again neither can atheists prove their position to me since it is equally unprovable. So I will not try. I hold that man is the image of God because man has a higher degree of life, a more complete goodness of being, because of his Godlike powers of intellect and will, which are absent from all other earthly creatures. If God exists, He can only be perfectly and purely intellectual and powerful in His designs, perfectly good, attributes setting Him infinitely apart from all other beings. These traits set man apart from other creatures. These traits are how man resembles God.

These traits are manifested bodily. Man is the image of God with his body, not because his body looks like God, but because his Godlike traits are manifested bodily. What man does to and in the body reflect on how well he images God. Either he will do things in a way that resembles what God would do, or he will do things in a way that resemble something (or perhaps someone) else.

Two things need to be said here. First is that if God exists, man’s ultimate and highest good is God Himself. This does not mean that we do nothing to combat suffering and disease and so forth. Indeed, we must use our intellect and will to combat these things as best we can out of charity for our neighbors who are suffering. But we must also keep things in proper order. Suffering needs to be combatted—but it is not the greatest evil because it does not threaten man’s greatest good. In fact, suffering can be a path toward God, Who is man’s greatest good. I will get more into that in a minute, because it is sort of the point of this post. Secular bioethics, however, considers man’s greatest good to be his bodily life.  If that is true, then suffering is a threat to man’s greatest good, and looms as man’s greatest enemy, to be combatted with any means. Pleasure and bodily happiness of various kinds become things to be obtained at any cost and it becomes impolite reprimand anyone for doing what makes him putatively happy. Indeed, you become an inflictor of suffering if you stand in the way of pleasure or relief of suffering. You ask, “What good comes from abortion?” And you get the response, “Who are you to stand in the way of women’s autonomy and happiness and impose your morality on others? You want women barefoot, pregnant, and going in the back alley for coat-hanger abortions that will leave many dead. And it’s all your fault!”

You can see already that secular bioethics depends greatly on relativism. Relativism of course is inherently self-contradictory.  “It's wrong to tell other people what’s right and wrong. You have to let others do what they want. I can tell you what’s right and wrong, but you can’t tell others.” The principle is violated in speaking it. And, usually, it boils down to “I” don’t want “you” telling me what to do. It’s a way of getting you to shut up.

Secondly, if God is man’s greatest good, then bioethics must have concern for this fact in deliberating bioethical issues. Indeed, the very first principle of authentic bioethics is not to harm the image of God, neither in the patient nor the agent. Does IVF aid or impede attainment of man’s greatest good? Does man—the IVF technicians, the prospective parents, the donors of ova or sperm—align his actions and desires with godly principles or with other kinds of principles in using IVF?

Prayer, fasting, almsgiving. These things form man more and more as an image of God. They reveal and refine him. They bring wayward bodily desires into better control of the intellect and will. They order man to his neighbors. They equip us with the capacity to reason well in bioethical issues. To want what is better to want. They are absolutely necessary for bioethics to be authentic, and thus are (or ought to be) a direct concern of bioethics.

Take IVF and contraception. These two stand as extremes against the middle. The main problem with both is a distortion of the proper love people should have for their offspring, not to mention each other, and the proper regard of the physician for the patients. IVF and contraception are both egotistical determinations as to what is a good outcome of sexual intimacy. And they are both means toward ends that have other, more ethical options. 

With contraception, let me say that sometimes it is reasonable to postpone pregnancy. It is a question of mean. This particular means, however, is a deficiency of love for future children, who are seen as an evil to be avoided rather than a gift to be cherished, a wondrous outcome of physical love. People who use contraception believe they know better than God what is a good outcome of sexual intimacy. Instead, people could use natural family planning, which as a method of postponing pregnancy is highly effective. But it does nothing to sexual intimacy to rob it of its intrinsic power of procreation. It requires periodic abstinence and some self-control, but these are virtues and worth having. The world does not revolve around the ability to gratify one’s sexual urges, as vehement as they may be, believe or not. At any rate, contraception puts the ability to gratify that urge ahead of all else, and sees the natural outcome of sexual intimacy—one’s own child—not as a gift, but as a burden, as a suffering, as an evil to be combatted. If God is not part of the equation, then perhaps that is so. Children are just objects, part of the paraphernalia of our lives, and not images of God themselves, a suffering one day, a status symbol the next, a thing to be resented or loved for the value one gets from it.

With IVF, it is just the opposite. (I am speaking here of IVF generally and used by married couples. IVF used by unmarried and especially same-sex couples raises additional ethical issues.) The child is desired to excess, and the prospective parents have a stop-at-nothing attitude to obtain one. In the process, the child becomes less and less a gift and a thing more and more made, acquired, achieved by one’s own efforts. If God does not exist and is not part of the equation, then why should a child not be manufactured? The child is not an image of God, not a gift, but an object, part of our trappings. It’s all about us and our desires. With IVF, lack of a child is an evil to be combatted, but the child is loved inordinately, not for who he is, but for the value we get from him, and that value—status, self-fulfillment, whatever, but not the child himself—is raised above all else. Moreover, IVF leaves the underlying infertility untreated, and the infertility is the real medical issue. By the way, NaPro Technology has a much higher success rate than IVF, because it treats the underlying infertility and helps the couple achieve a pregnancy naturally.

In between contraception and IVF lies virtue. Loving children the right way. Having recourse to sexual intimacy, not without rational concerns for one’s lot, but with trust in God. Working with the way the human body works and healing its diseases rather than working against the body or superseding its needs. Relying on God. Having self-control. Being giving of oneself to one’s spouse and future children.

Prayer. Fasting. Almsgiving.

The heart of authentic bioethics.

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