Last November, a Chinese scientist announced the birth of twin babies whose DNA had been modified. Gene editing of human embryos is expressly forbidden in federally-funded research in the United States. The announcement was denounced by many scientists around the world and by the Chinese government. Why?
For one, gene-editing has unknown risks — do we know all the consequences of changing even one gene? More critically, gene-editing of embryos introduces changes not just to these babies but to all their descendants. And if this were to become routine, we could have a society where parents design their children to be taller, smarter, and stronger. In light of this technology, how do we preserve what it means to be human? Are we wise enough to edit ourselves? Francis Collins, founder of BioLogos and current director of the National Institutes of Health, said the recent work in China flouted ethical norms and was “profoundly unfortunate;” he is calling for strict oversight in the U.S. and around the world.
Yet this doesn’t mean we should simply ban all use of gene-editing. CRISPR technology is used in many areas besides editing embryos. It has tremendous promise to treat patients today who suffer from genetic diseases. Trials are already beginning for the treatment of sickle-cell anemia, and the initial results look promising. Watch Francis Collins give an overview of the peril and promise of gene-editing from a Christian perspective.
How should Christians respond to today’s challenges in bioethics and medical research? We need the wisdom that grows from three commitments:
- biblical faith – we hold to the revealed truths of Scripture, remembering that all people bear God’s image
- scientific understanding – we delve into the science, learning the potential for both use and misuse
- humble dialogue – we remember that complex questions don’t have easy answers, listening to and learning from others
And that’s what we are about at BioLogos — biblical faith, scientific understanding, and humble dialogue. While the majority of our content has been on evolution and origins, we have also discussed medicine and bioethics. Over the years we have discussed gene-editing several times; see reflections from biologist Jeff Hardin, biologist Kathryn Applegate, theologian Michael Burdett, and biologist Darrel Falk. Because bioethical issues are urgent and important, we decided to focus our attention on this topic in February 2019. We want to do more to equip you, our readers, to understand what is at stake. We won’t be providing easy answers and certainly won’t be addressing every question, but we want to raise awareness among our readers, point to resources, and provide a forum for conversation.
Humankind is made in God’s Image
What does the Bible say about human identity? In the first pages of Scripture, we learn that God created humankind in his image (Genesis 1:27). We are not just biological machines, but created in the image of God. We are made of atoms and genes, but Scripture teaches we are more than what we are made of. Individually and together, we are called to reflect and represent a holy and loving God (see our Common Question on image of God). In Genesis 9:5-6, we are commanded to protect the lives of fellow image bearers. That includes everyone God created — the poor and the powerless, those soon to be born and those soon to die, the weak and the sick. We are called to reflect Christ by loving our neighbors, however powerless. Bioethics for Christians is not just a legalistic set of rules. It flows out of our imitation of Christ and our call to promote human flourishing. Thus, we mourn the times when science and medicine has been misused to promote racism and injustice (see more from pastor Claude Alexander, the son of African American physicians).
A sampling of bioethical issues
How does image bearing play out in modern medicine? Gene-editing is not the only biomedical issue Christians need to be thinking of. As science advances, whole new categories of issues arise. How should we think about the genes that cause disease? Physician Jon Pohl explains cystic fibrosis. Do our genes determine our behavior? Geneticist Denis Alexander discusses reports of a purported “gene for kindness”.
Some bioethical issues are already here. Prenatal testing of the developing fetus is becoming easier and more common, including a new non-invasive blood test for Down syndrome. In the U.K., when parents learn their fetus has Down syndrome, 90% choose abortion. This is an appalling statistic in light of the Christian commitment to care for the disabled and powerless. If you’ve befriended someone with Downs, you know that they bear the image of God as much as anyone and have much to teach us about reflecting God’s love. Genetic testing, however, can be an important tool for preparing for the birth of a disabled child; see our upcoming piece by genetic counselor Kelli Swan.
Many bioethical issues are complex and prompt a range of reactions from Christians. One of the hardest issues is fetal tissue research, in which the remains of elective abortions are used in medical research. For many Christians, including me, the initial reaction is deep concern. Yet I learned that Christians who have thought about this deeply, and who share a bedrock commitment to humans as image-bearers, can come to differing conclusions. Francis Collins in his NIH role recently explained his support for fetal tissue research. “Even for somebody who is very supportive of the pro-life position, you can make a strong case for this being an ethical stance. If something can be done with these tissues that might save somebody’s life downstream, perhaps that’s a better choice than discarding them.” As George W. Bush wrote in 2001 on a related issue, “the life & death decision [of abortion] has already been made.” Meanwhile, Paige Cunningham, leader of the Center for Bioethics and Human Dignity, testified before congress in 2016 that fetal tissue research is always unethical, even if it brings health benefits to others. “Rather than being a distinct—and lesser—form of human life, the fetus is a distinct human being at a particular stage of development.” She argues that others should not profit from a wrongful act, even if the benefit is scientific reputation or a wonderful cure. Can this research be done without condoning the initial abortion? These aren’t easy questions! I encourage you to read the links above and chime in on the Forum with your thoughts.
Medicine as a Christian vocation
Most areas of biomedical research are less controversial. Many scientists in our network study the human body, making discoveries and developing cures that will benefit many lives to come. As believing scientists, they know that God’s healing often comes through our hands; medical cures are not an alternative to God’s work but a means of it. You can read profiles of researchers like Doug Lauffenberger, Jimmy Lin, and Georgia Dunston.
For the doctors in our network, practicing medicine is a Christian vocation. Christian doctors remember that each patient bears God’s image and is a whole person, not merely a disease state or biological machine. This vocation is not without its challenges. Surgeon Paul Lange writes of the “Christian physician’s dilemma,” the tension felt between using established medical procedures and the Christian belief that prayers for healing can be answered. At BioLogos we believe God is at work in both natural mechanisms (like surgery and medication) and in miraculous answers to prayer. Watch for an upcoming piece by surgeon Matt Steensma on how this played out at one patient’s bedside.
Christian physicians also use their skills to live out their faith. Francis Collins notably lived out Christ’s command to “love your enemies” when he offered his medical care and friendship to atheist Christopher Hitchens. Other Christian physicians engage in medical missions, using their skills to serve the needy and show Christ’s love around the world (see the Center for Medical Missions).
Where you can learn more
For families and pastors, bioethical questions can hit close to home. In addition to the issues raised above, there are other questions around the beginning of life (infertility, embryo adoption, etc.) and a host of questions around the end of life (chronic pain, quality of life, euthanasia, hospice, life extension technologies, etc.). How do we make decisions for ourselves and our loved ones?
At BioLogos, we know we are only scratching the surface in the area of medicine and bioethics, so let me point you to some great Christian organizations who have been addressing this for many years:
- Everyday Bioethics, a website of “accessible resources to help you understand tomorrow’s bioethical issues today” from the Center for Bioethics and Human Dignity at Trinity International University.
- The Christian Medical and Dental Association, which offers position papers on bioethics, networking for medical practitioners, and connections for medical missions.
- The American Scientific Affiliation, a professional organization for scientist Christians in the U.S.; search the site for video lectures, scholarly papers, etc.
There are also many books available – here are two starting points:
- Gilbert Meilaender Bioethics: A Primer for Christians, Eerdmans 2013 (2nd edition)
- James Peterson. Changing Human Nature: Ecology, Ethics, Genes, and God Eerdmans, 2010
These books and organizations take both the Bible and science seriously. While they don’t all agree, there is much you can learn from their materials as they discuss the ambiguities and propose ways forward.
A voice in the public square
Christians need to bring their voice to the public square on issues of medicine and bioethics. Before speaking however, we need to build our scientific understanding and ponder how biblical faith might contribute to such a critical discussion of our time. Then we need to engage in humble dialogue, as people today are weary of nasty debates—but eager for a thoughtful conversation. Many science-minded people realize that the rush of new technologies raises questions that require more than science to answer. The topic of bioethics is a good opportunity to start conversations about faith with others.
May we live as those created in God’s image. Let’s work to reflect Christ in our love for all people, our courage on behalf of the powerless, our care for the sick and suffering, and our humble spirit. Individually and together, may we reflect Christ.
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