Lutheran Contributions to Bioethics: Threads from a Conversation

 

[1] The 2004 Gathering of Lutheran Ethicists on January 7-8 in Chicago focused on the topic "Lutheran Contributions to Bioethics."  Discussion papers from that gathering are posted elsewhere in this issue of JLE.  This report aims to pull together threads from the conversation at the gathering around this topic so that not only the papers but also the discussion itself may have a wider audience.  As Roger Willer wrote about a similar occasion, "The fact that discussion developed along the threads highlighted below suggests their merit for attention in further deliberation."[1]   

[2] Due to limited space, my report from the conversation necessarily must be selective from among the threads in the discussion rather than exhaustive.  I have used two kinds of filters in making these selections.  The first is my sense of the threads that were more important to the participants themselves as indicated by the depth and intensity of the discussion about them.  The second is their relevance to the announced purposes of the gathering by the planning committee.

[3] The committee posed the following sets of questions to orient the discussion papers and the conversation about them:

  • What are the distinctive contributions of a Lutheran bioethic for dealing with current and emerging bioethical issues? (We assume that these issues range from mundane health care to cutting-edge areas of human and non-human genetics.)

  • How should a Lutheran bioethic function in the public realm?

  • How might a Lutheran bioethic take account of the social, economic, and political contexts of the issues it addresses as it functions in the public realm?

  • How should a Lutheran bioethic address the various effects, benefits, or burdens resulting from the ways that health care is given or that biotechnology is used? How should a Lutheran bioethic address the dimensions of justice implicit in various bioethical issues or in the use of biotechnology?

[4] Although this report cannot be comprehensive, my hope is that it is faithful to the conversation and also conveys a sense of the lively discussion that took place over several hours.

Distinctive Lutheran Contributions
[5] There was general agreement with Paul Nelson's view[2]  that there is more than one way for ethicists to be characteristically Lutheran in their approach to bioethical issues.  Lutherans use a cluster of theological and ethical themes-the distinction of Law and Gospel, justification by grace through faith, Christian vocation, service to the neighbor, love of the neighbor, and so on-in various ways with results that sometimes differ, as Nelson's brief discussion of the work of Ted Peters and Gilbert Meilaender in bioethics shows.

[6] At the same time, participants realized that themes that are characteristically Lutheran are not exclusively so.  What then makes Lutheran ethical arguments distinctive?  Can one now approach Lutheran distinctiveness in Christian ethics by asking whether there are any claims Lutherans would not make, for example in bioethics?

[7] Some participants asked whether there might there be a distinctive Lutheran sense of tragedy that might inform discussion of bioethical issues by Lutherans?  As there are several understandings of tragedy, what particular sense of tragedy is characteristically Lutheran?

Human Agency and Vocation in the Natural Realm
[8] Human agency in the world is affirmed in Lutheran ethics, sometimes in discussions of the vocation of Christians in their daily life and work.  Yet some argued that "vocation" is an under-used concept that is little understood or appreciated by lay people.  Can it or should it be reinvigorated in Lutheran ethics so that it might be of more use in bioethics? 

[9] How shall we characterize the human vocation and agency in the world for healing and other realms of activity?  One contemporary Lutheran proposal about human vocation and agency mentioned was Philip Hefner's view of humans as "created co-creators."  Some participants raised questions about both the theological and the anthropological adequacy of this concept.  Others affirmed the intent and adequacy of its content but preferred instead to talk of humans as "co-creative" or "co-creating creatures."  For them, this alternative terminology more accurately identifies humans as creatures while still expressing the human creative abilities and activities within Creation which Hefner wants to emphasize.  For examples, participants noted that human activity has added elements to the periodic table, has altered living species, and has created new forms of life. 

The Rhetorical Tradition of the Lutheran Reformation
[10] Klaus Tanner's introduction of his discussion paper[3]  led to a discussion of how the rhetorical tradition of the Lutheran reformers might be reclaimed for Lutheran ethics and consciously used in bioethics.  Exemplified by Luther's small and large catechisms, the reformers changed the theological and ethical focus from matters of substance to matters of relationships with God and other humans.  So, for example, Luther's explanations of the commandments exhorted Christians not merely to so "fear and love God" that they refrain from acting in certain ways toward the neighbor, but further offer positive help to the neighbor in other ways. 

[11] Participants noted how this tradition emphasizes certain polarities within human beings and the human condition; e.g., we both fear and love, we are simultaneously saint and sinner, etc.  The human reality is not simply one dimension but is complex and full of tensions, as are also human relationships with one another in society and with God.  There was some recognition of how this enriches ethics and makes it more realistic about human beings.

[12] In bioethics, the participants pointed out that reclaiming this tradition fully might mean, for example, developing a Lutheran alternative to ways that Evangelical Christians typically pose and answer such questions as, "When does human life begin?" in the abortion debate by equating the substance human being with the existence of a human zygote.[4]   One contemporary Lutheran emphasis is to view the human being eschatologically, for instance.

Natural Law
[13] Participants discussed at length the relevance of natural law for Lutheran ethics.  Luther's use of natural law was noted, a fact which makes it part of the Lutheran ethical heritage.  Luther saw the golden rule as part of natural law.  But there are questions about how clear his understanding of it was, and some participants claimed that his use of natural law needs more research from church historians and historical theologians.

A Natural Sense of Justice and Multicultural Reality
[14] At the very least, participants agreed that this tradition suggests that there is a natural sense of justice in all consciences which justified Christians are free to make use of in daily life.  If so, natural law has some implications for what it means to act out of love for the neighbor in Lutheran ethics.  Part III of Luther's 1523 essay, Temporal Authority: To What Extent It Should Be Obeyed[5]  was cited as a place where Luther made this connection explicitly. 

[15] Some participants questioned, however, the usefulness of natural law with this implied natural sense of justice in contemporary multicultural societies, where ethical consensus across cultural lines was far from clear.  Participants thought that more work is needed on natural law for Lutheran ethics.  They were unclear about what role it does or should play in contemporary Lutheran ethics and whether it was usable in the public discussion.

Love of the Neighbor
[16] Participants agreed on the importance of this Lutheran theme for bioethics.  They noted that Luther's own views matured over his life time, encompassing both self-sacrifice for the sake of the neighbor and using power on the neighbor's behalf.

Lutheran Bioethics in the Public Realm
[17] Participants saw some tensions and ambiguity in the origins of the Lutheran ethical tradition about the public realm.  Luther affirmed secular life, gave advice to princes as secular rulers responsible for the public good, discussed obedience to secular authority, and both thought about and participated in various kinds of civic reform with the other Lutheran reformers.[6]   But some participants claimed that he also argued that human beings cannot legislate their own laws in a democratic fashion.  A quietistic tradition is a part of Lutheran history.[7]

Public Realm and Health Care
[18] Several participants nevertheless argued that Luther would be bolder than the ELCA social statement, "Caring for Health: Our Shared Endeavor,"[8]  about public responsibility for health care and about claiming that access to health care is a human right.[9]   Participants argued for increased precision about what wasincluded in "basic" health care, which the social statement says all Americans ought to have.[10]   Some also questioned assertions in the statement that contrasted market efficiency with government inefficiency.  Some participants also asked what is the moral status of rights language, and how does this status affect using that language in health care?

Intellectual Property Law and Food Policy
[19] Genetic manipulation of food crops and livestock discussed in Glenna's paper[11]   raised issues for participants about the implications of these practices for human hunger, health, food policy, and economic justice.  Is patenting the best way to utilize genetic research?  How will the benefits and burdens of using genetically modified crops such as corn and soybeans be distributed?  If one of the results of growing such crops is to bankrupt farmers who produce them so that they and others are unable to afford to buy food, does not the raising of these crops or herds contribute to world hunger?  What is a good or just food policy as distinct from a commodity policy?

[20] Participants also wondered how safe such crops would be.  How do they affect food crops in other parts of the world?[12]   Glenna noted that simply to raise these questions is not to answer them or to prove that these crops are dangerous or their effects unjust.  Careful study is needed of effects of such crops and the contexts in which those effects occur.

[21] Participants tended to be skeptical that putting all matters about genetically modified organisms for food production in the hands of public authorities to decide and regulate would necessarily solve the problems of too much power over these matters being in the hands of corporations.

Need for a Lutheran Political Ethic
[22] Some participants agreed with Svend Andersen[13]  that there is a need for a more robust Lutheran political ethic to address questions about bioethics (and other questions as well) in the public realm at present.  Such an ethic needs to address the organization of political life, how public life makes life together in society possible, and how decisions are made about bioethics and other issues.

Nature of the Public Realm
[23] Participants were divided about what precisely the public realm is where a Lutheran bioethic might function, and what sorts of talk or claims are legitimate there.  Are we talking only about a sphere where political deliberations take place and political decisions are made?  Or, is this realm a space where all sorts of things are discussed, including religion? 

Whether Religious Claims Are Appropriate in It
[24] If so, what is the role of religious rhetoric and claims in this space?[14]   Must Lutherans necessarily make persuasive arguments in so-called common secular languages to people who do not share our religious convictions?  Or, do religious rhetoric and claims have a legitimate place in discussion with a wider public?  Some argued that both a common appeal to natural law and the common good as well as a Christian appeal were appropriate in the public realm or "public space."  Perhaps the kind of argument one uses, some participants observed, depends upon the particular audience which one addresses.

Human Life and Bioethics
[25] Some participants wondered whether, if we must make health care decisions in the face of limited resources, it makes sense to claim that any human life is inviolable if some health care will be denied?  Are we not already in a relational realm where the claims of others to care may take precedence of my own claims because their care may, for example, have a better chance of success, or because their need is more critical, or for other justifiable reasons?

The Moral Status of Blastocysts and Stem Cells
[26] Participants noted a number of unresolved issues about the moral status of living things created or manipulated by the practice of the new genetics.  What sort of dignity do blastocysts have?  And what respect is due them?  What sort of dignity do stem cells have?  Participants noted that there may be a distinction based on the purpose of their creation, i.e., for reproductive or for therapeutic purposes.  But it was also noted that just as a child should be treated with the same dignity regardless of how it originated, perhaps the same treatment should be accorded blastocysts and stem cells regardless of their origination.

 

The Church's Role in Public Discussion of Bioethical Issues
[27] Participants tended to agree that the church had a role in discussion of bioethical issues in the public realm as well as a role in fostering deliberation about those issues within the church.  Internally, the church should organize discussion, should enable Christians to think and act, help broaden perspectives, and help to find ways we can live together in the face of disagreement about some things.  It is important for the Church to deliberate as a community of Christians about what loving the neighbor is.  In discussions, including those beyond the church, it should reject kinds of either/or logic which lead to polarization.  Other aspects of its role beyond the church need thoughtful development.

[1]  Roger A. Willer, "Threads from a Conversation" based on an ELCA consultation on human cloning held October 13-15, 2000 in Chicago, Illinois, in Human Cloning: Papers from a Church Consultation, Roger A. Willer, ed. (Chicago: Evangelical Lutheran Church in America, 2001) 83. Willer's report is my self-consciously chosen model here, although I will depart somewhat from his method of presentation. My thanks to Willer and to John Stumme for their comments on an earlier draft of this report.

[2]  "Can Bioethics Be Lutheran?" posted elsewhere in this issue. Copies of this collection of papers are available by calling 800-638-3522.

[3]  "Some Remarks on the Stem-cell Debate from a Lutheran Theologian in Germany," posted elsewhere in this issue.

[4]  For the current official ELCA position on abortion, see "A Social Statement on Abortion" (1993), online at http://www.elca.org/socialstatements/abortion/. For a single complementary copy, call the Division for Church in Society at 773-380-2996.

[5]  J. J. Schindel, tr., rev. by Walther I. Brandt, in Luther's Works, v. 45 (Philadelphia: Fortress, 1962) 126-129.

[6]  For an historical account see John Witte, Jr., Law and Protestantism: The Legal Teachings of the Lutheran Reformation, (Cambridge: Cambridge University Press, 2002).

[7]  These ambiguities and tensions in Lutheran thought about the public realm persisted beyond the Reformation period. Political quietism in 19th century German Lutheranism persisted into the Twentieth Century . The failure of the German Lutheran churches to oppose the rise of Nazism is commonly attributed partly to this quietism. The reaction against the Nazi regime by the Confessing Church is seen as a rejection of this quietistic strain of Lutheran tradition. Reaction to the posture of the German Lutheran churches in the Nazi period was cited by a participant at the gathering as one factor that contributed to the emergence of American Lutheranism into the public sphere after World War II.

[8]  (2003), Online at http://www.elca.org/socialstatements/health/. For a complementary copy call 773-380-2996.

[9]  As the Lutheran Church in America-a predecessor church of the ELCA-once did in its social statement, "Human Rights: Doing Justice in God's World" (1978), p. 7.

[10]  The statement says, "Health care as a shared endeavor entails a comprehensive and coherent set
of services of good quality care throughout one&=javascript:goNote(39s life span. At a minimum, each person should have ready access to basic health care services that include preventive, acute, and chronic physical and mental health care at an affordable cost." (p. 13) In a footnote, the statement explains that "more specifically, such a set of basic services likely will include: primary care services (including a relationship with a provider, routine well-child and well-adult examinations and prevention, age-appropriate screening for disease, treatment for acute problems, coordinated referral for more complex levels of care); dental care; in- and out-patient care for acute and chronic physical and mental illness; emergency care; treatment for substance abuse; and appropriate complementary and supportive services." The drafting task force thought that while each of these elements would need more detailed specification, this was beyond the scope of a social statement. (p. 25, n. 10)

[11]  See Leland Glenna's paper, "Commercial Science and World Hunger: Issues of Social Justice Concerning Genetically Modified Organisms" posted elsewhere in this issue of JLE.

[12]  In the context of the discussion, the concern was for the isolation of native African crop varieties from genetically modified crops imported from elsewhere. But this issue exists for the U.S. as well. Despite efforts to remedy widely reported incidents of mixing modified and non-modified grain in storage elevators, the Union of Concerned Scientists recently reported that fragments of genetically modified seeds of corn and canola were found in several American samples of unmodified seeds tested. See "Modified Seeds Found Amid Unmodified Crops," The New York Times, February 24, 2004, C6.

[13]  See Andersen's discussion paper, "Can Bioethics Be Lutheran?" posted elsewhere in this issue of JLE.

 

[14]  Informal discussion among some participants at lunch revealed a variety of approaches existed in the official contexts of various countries. The President's Council on Bioethics in the U.S. solicited the views of various religious bodies which were expressed in religious terms; Presiding Bishop Mark Hanson responded to this request. Gilbert Meilaender, a Lutheran member of the Commission is presumably free to express his views in religious language. But the Commission will make recommendations to the Administration and to the Congress that need not be acted on directly. In German Parliamentary commissions on stem cells, Klaus Tanner reported that representatives of various religious communities were members along with high-level party delegations across the political spectrum in the Bundestag. Its recommendations will affect legislation introduced for consideration. Religious language was not normally part of the proceedings of these commissions. Svend Andersen reported that national bioethics commissions in Denmark did not directly involve elected representatives from parliament, and did not ordinarily exhibit explicitly religious language in their proceedings. Their recommendations did not necessarily affect legislation directly.

 
© April 2004
Journal of Lutheran Ethics
Volume 4, Issue 5