For those who haven’t been following the issue, here are the basics: Twenty-five years ago a reproductive technology was forged called in vitro fertilization (IVF) that works by harvesting a bunch of ovaries from the mother (anywhere from 5 to 15) and then fertilizing each egg in the laboratory using sperm from the father. These eggs are allowed to grow to be five to eight days old, at which point they are frozen. At this point the blastocyst (it’s not technically an embryo until it’s a couple of weeks old) is roughly a 60 cell “ball” and consists of an inner mass of stem cells (which would become the fetus) surrounded by an outer layer of cells (which would become the placenta). Anywhere from from 2 to ?? blastocysts are then implanted at a time (at $12,000 a go there’s certainly some pressure to implant several at a time) into the mother in hopes that one (or more) will attach itself to the wall of the uterus and start growing. If none of the blastocysts take to the uterus another round is done. However, often after a couple of rounds the parents have the one or two children they want but they have yet to implant all of the blastocysts. The couple then has five options for what to do with these remaining blastocysts (implant all the rest, try and get someone to adopt them, donate them to science [not many clinics in America can currently accept them, though], keep them frozen indefinitely, or let them lapse [basically let them thaw]). It’s from this procedure that America winds up with a half of a million blastocysts resting in frozen test tubes.

What’s this got to do with stem cell research? The cells at the center of the blastocyst are like gold to many scientists because they are totipotent stem cells, meaning they have the potential to become any type of cell in the body. Thus, theoretically, you could grow a new heart or a new liver or antibodies to combat any number of diseases. This is all presuming, of course, that scientists can figure out how to control the genetic process of directing these cells, which is very complex. Science-fiction scenes of self-generating replacement body parts are still a thing of the distant (if not completely fictional) future. However, you can see the appeal. We would be moving from preventative and restorative medicine to regenerative medicine. That’s a huge leap. It would basically do for medicine what the computer did for technology.

Before getting too far along I should point out that there are proponents (and Bush is one of them) of doing stem cell research using adult stem cells (we all have them—that’s how a cut is able to heal itself). However, according to the NIH, “so far adult stem cells that could give rise to all cell and tissue types have not yet been found.” Plus, they are just a lot harder to identify and extract in their pure form. However, these type of cells do have one very big benefit: they are already adapted to your body. Meaning that even if we did manage to create a heart out of a blastocyst we would still have the problem of the body rejecting it (in the same way that a heart from a heart transplant can only function with a constant stream of rejection-inhibiting drugs), but a heart made from your own cells wouldn’t have that problem.

Well, that’s more history than I intended, but it is a complex issue. Let me cut to the chase and put down some thoughts on this most recent debate centering on using the blastocysts sitting frozen around the country for stem cell research. First, the reasons why I’m reluctant to use the stem cells from blastocysts:

• As many have discovered, if not human life, they are at least potential human life. I’m still not sure how much stock I put in potentiality, but it’s at least a factor.


• Who’s going to benefit from this technology? Most likely it will be the rich and insured for quite some time—and they’re the ones who already have one of the most advanced medical industries at their disposal. It’s certainly not going to be the 45 million uninsured we have in this nation. Why are we spending millions when we still haven’t figured out a system of basic health care for the least of these?


• Not many people are asking a more basic question of “Why do we have 500,000 blastocysts sitting around?” Well, here’s at least part of the reason: reproductive technology is big money which means that fertility clinics compete for business. And how do you win customers? By promising results. You want a baby? Our clinic gives you the highest chance for getting pregnant! How do you get such a good rate? By harvesting enough eggs that the chances of one of those eggs taking goes way up. Meanwhile, you conveniently move the ethical dilemma of what to do with those extra blastocysts to the bottom of the page and make the decision sound as easy as deciding what you want for breakfast. No matter what happens with this bill legislation needs to be enacted that at least ensures potential parents are fully aware of the ethical quandry they are entering into (or, if not that, would churches please say something to their congregants?!).


• As Lee points out, why should federal tax dollars be spent on something some people find morally objectionable? However, my guess is some people find nearly every aspect of America’s budget morally objectionable, be it war or the environment. So that’s a tough argument to make.

Given those hesitations, and they are serious hesitations, I still think Bush should have passed the bill for a few reasons:

• We need some sort of laws governing stem-cell research in this country. Anything is better than nothing! At this point a privately funded stem-cell research firm (like we’re trying to set up in California) can do just about anything it wants because there are no laws governing what is ethical and what is not in this field. That means a private company could potentially do grossly inethical things at this point. A couple ideas off the top of my head: start exploiting financially strapped women in poor countries to have their eggs harvested or letting stem cells grow into mutative forms of human life.


• I’m not convinced these blastocysts are mini-Americans. If you do think they are full human beings then proportionate action to such a conviction should be taken. By that I mean a belief that there are thousands of mini-people sitting in freezers should compel us to start doing everything we can to get them adopted, including giving up the idea of having children of our own. But like I said, my take is that an eight-day old bundle of human cells that is yet to be implanted in it’s mother is deserving of respect and dignity, but I’m not ready to say it’s a full human being. Bush has vetoed a bill that would have allowed these blastocysts to be used for the worthy goal of alleviating human suffering. Is letting them sit in suspended animation until the money runs out and we let them lapse really treating them with respect and dignity?

That last point is really the one that this argument hinges on for me. These blastocysts are potential humans and as such should be treated with dignity. If the only other option is for them to eventually thaw and die (which seems to be the case) then allowing the scientific community to work with them for the benefit of humanity seems like a decent solution to this mess we’ve gotten ourselves into.

1. I knew next to nothing about the state of health care in America (I’m a spoiled twenty something who’s never really had to worry about it)


2. I had no clue how Scripture should inform a large-scale public policy issue such as this one.


3. I wanted to know the truth about why health care prices continue to skyrocket (abuse, immigration, fraud, technology, etc.)

It was one of my favorite papers for the class.  You can read it here.

Death and the process of dying were once a common reality in the lives of all but the most elite in society. However, with the creation of advanced medical technology over the last century death became medicalized and largely removed from the everyday-life in the West. The silence and denial this caused in our society led many to believe that in relegating death to the medical world, something vital and human was being lost in death. A revival of interest in death and dying began to occur in the 1970s in what has been termed the “death awareness movement.” It has fueled thousands of books, seminars, how-to guides, and discussion groups by religious and secular people alike (Bregman, 1). This brief history on the death awareness movement is important for it has played a large part in defining what constitutes a good death, both for the Church and larger society.

One dominant image in our society of what makes a good death is that death is to be accepted as a natural part of life. This is contrasted with those who insist that death should not happen and that it is an illusion to think life is death-free. Death is natural in the same sense that birth is natural. As Qohelet, the writer of Ecclesiastes says, “there is a time be born and a time to die” (Ecc. 3:2). To bitterly resist this fact of life can only lead to a bad death (Bregman, 47).

Often when we speak of death being “natural” we mean that it is fitting, or that it happens according to our expectations of how life should be. To this end, death at a ripe old age is a good death, while dying as a child, before our children grow up, or before our parents die is “not the way it is supposed to be.”

A good death in our culture is also one in which the dying person does not lose control over their fate. This is one of the concerns that has spawned such interest in hot issues like physician assisted suicide and Terri Schiavo’s death. A bad death is one in which others are burdened with making decisions for us, or, even worse, they make decisions about our death that we ourselves would not have chosen. In a good death, then, one’s autonomy and last wishes are honored (Bregman, 80).

Another common feature of a good death is that it is not in isolation from those we love. One of the results of medical technology is that often the dying become “stuck” on medical devices such as a respirator or feeding tube which may mean their last days are not spent in their home surrounded by friends and family, but in a hospital bed attended to by strangers (Bregman, 80).

Finally, a good death is often associated with a quick and painless death. To die in one’s sleep, at peace, and free from debilitating or overwhelming pain constitutes a good death. Thus, a lingering death, a violent death, or a death where one endures acute emotional pain (such as fear or a broken relationship) or suffers physically makes for a bad death.

What are Scriptural resources for informing what is a good death?

Jesus’ Death in Mark 14:32-15:41. What are the contrasts and similarities between Jesus’ death and the “good death” of our culture and the death awareness movement? In what ways is Jesus’ death a model for our own? Note how Jesus is willing to die a violent and painful death even though he had a legion of angels who could have rescued him (Matt. 26:53). At the least, this reminds us that while death is an evil, it is not the greatest evil and that while life is a good, it is not the greatest good (Verhey, 321). What do you make of Jesus’ unwillingness to take the wine mixed with myrrh (v. 23)? Does he do this because he wants to die with a clear head, fully suffer the pain, be sure he goes through with God’s plan, or for some other reason? Finally, what do Jesus’ pleas to God in Gethsemane (14:34-36) and on the cross (15:34) tell us about feeling fear, anger, and despair in the midst of our dying?

The story of Judas’ suicide in Matthew 27:3-10. Judas’ death is an example of “bad death” in Scripture; it is an infamous death which we do want to be our own. What makes Judas’ suicide a bad death? Note how he is isolated from God, the other disciples, and even himself in some sense (seen in his desire to undo what he has done). How does this isolation contribute to a ignoble death? What virtues did Judas lack that compelled him to commit suicide (Verhey, 313)? Patience? Courage? Faith? Does this connection between having certain virtues and dying well lend weight to the notion that holy living and holy dying are inexorably linked?
What is the Christian vision of a good death?

Given the above passages of Scripture and our knowledge of the larger story of the Christian faith what can we say makes for a good death?

To begin, we must acknowledge that the threats of death are real. At its core death is frightening because it threatens to alienate us from our bodies, our communities, and our God (Verhey, 337). Death is a journey that must be entered alone; others can accompany us to its bank, but we must cross the river by ourselves, without the companionship of our earthly sojourners.

As we die our bodies begin to fall apart and become an enemy whom we resist instead of cherish. As Christians we are embodied beings. This means that we believe our body is as necessary to our being as our soul. I cannot be fully and wholly me if the two are broken asunder (this is why the resurrection is such good news!). Thus, when death makes our bodies weak, sick, and wracked with pain we begin to experience our bodies not as “us” but as “the enemy” (Verhey, 337). A good death, then, is one where our bodies are cared for. The threat of death to alienate us from our bodies is mitigated when our pain is reduced (even if it risks death in doing so), our bodies nursed and touched by loving hands, or our eyes delighted by seeing the flowers we love (Verhey, 341).

Dying also threatens to separate us from our communities, something the death awareness movement has long realized. We are made for community with others and when our community abandons us to a hospital or, worse, we have no community to accompany us in our dying, death makes its power felt. Thus, a good death is one where we are surrounded by a community who is willing to be present in this final stage of life and so witness to the hope that, in the Church, death does not mean abandonment or devastating loneliness. A death surrounded by those we love may mean death is inadvertently hastened if we expend our energy in reconciling with those from whom we are estranged, but this is not a bad thing for death is neither the greatest evil or the final word.

Finally, death threatens our relationship with God. Faith is not knowledge; it is “the assurance of things hoped for, the conviction of things not seen” (Heb. 11:1). It is no wonder that our trust in God becomes shaken as our bodies and communities become alienated from us. In death we not only worry that our faith will prove unfounded, but also that it may be found wanting when we come into the presence of the Living God. A good death, then, will be one in which we are assured of the presence and goodness of God as we pray, hear the Scriptures read, receive the Eucharist, and are loved by those who surround us with God’s love (Verhey, 343).

We now have a rough outline of what how our faith might inform what it means to die a good death. Before concluding, however, we must note what has not been said about a good death. As Christians, a good death does not mean we are in full control as we die. We do not need to control how or when we die for we trust that God is faithful to give us the courage and patience we need to die well. Also, a good death is not one which burdens no one. In fact, a large part of what it means to belong to a community of those who love each other is “to burden each other – and to find, almost miraculously that others are willing, even happy, to carry such burdens” (Gilbert Meilander in Neuhaus, 118). This subtle implication of this, and which is made clearer in the story of Judas, is that suicide, whether done by others or ourselves, is not an option. While we may indirectly hasten our death, such as by increasing our pain medication, we ought not do something where the intended goal is death (Verhey, 341). Finally, a good death does not mean we accept it as our “natural” end or as an act of defeat in regard to death. Death, in the Christian worldview, is not natural, it is a result of a fallen world. Neither is death an enemy to be defeated, for death was one of the “powers and authorities” triumphed over on the cross (Col. 2:15). This does not mean we do not acknowledge the realit of death or mourn an untimely death (c.f. Isa. 65:20). However, death should primarily be an act of yielding our spirits to God as an act of trust in the Father (Bregman, 76).

References

• Beyond Silence & Denial: Death and Dying Reconsidered, Lucy Bregman (Westminster John Knox Press, 1999).
• Reading the Bible in the Strange World of Medicine, Allen Verhey (Eerdmans, 2003).
• The Eternal Pity: Reflections on and Dying, edited by Richard John Neuhaus (University of Notre Dame, 2000)

The two most obvious ways the issue has been framed is as a debate between those who are pro-life and those who are pro-choice. The advocates of the pro-life stance frame the issue as a refusal to “justify the deliberate killing of an innocent human being” (O’Rourke et al., Medical Ethics: Sources of Catholic Teachings, 1999, 32). At the moment of conception a unique human life is formed which is inherently worthy of respect and dignity because it is made in the image of God. Although there are obvious scientific and philosophical difficulties with determining the moment of “personhood” we must always err on the side of life, especially the life of the weak and vulnerable, lest we participate in a “culture of death” (Ibid.) that denies the dignity of all the life God creates.

On the other hand pro-choice advocates insist that those who would force a woman to bear her child are in no way acting morally. Instead, pro-lifers are perpetuating abusive patriarchal structures in which women are denied a right to be their own decision-makers about what they want to do with their body. There is no way to prohibit safe, legal abortion without also violating “the conditions of well-being for the vast majority of women…” (Beverly Wildung Harrison with Shirley Cloyes, “Theology and Morality of Procreative Choice” [from Moral Issues and Christian Responses ed. by Patricia Beattie Jung, 2003], 159).

Both of these positions often center the debate on the status of the fetus: is it a full-fledged person with all the rights and dignity we accord to other fullgrown persons? This discussion has proven to be a landmine of problems. Traditionally, humans were thought to be persons because they have souls which are distinguishable from their bodies. However, as science has continued to link areas of the brain with functions that used to be assigned to the soul (i.e. will, emotions, rationality) and as Christian theologians have emphasized the Hebrew notion of our embodiment it has become increasingly harder to use the soul as proof for personhood. In response, some have turned to the genetic uniqueness of a zygote as the criteria for personhood. However, even that line of reasoning is suspect for we are now discovering that an embryo can divide into two separate persons up until 14 days after conception (c.f. Margaret A. Farley, “Roman Catholic Views on Research Involving Human Embryonic Stem Cells” [from Ethical Issues in Human Cloning: Cross-Disciplinary Perspectives ed. by Michael C. Brannigan, 2001], 116). On the other side of the debate pro-choice advocates argue that until a fetus attains the status of “person” (whenever that may be) it can be treated as any other organ of the mother’s body. Both sides belie the futility of the personhood debate by the way they live: advocates of abortion rights are unlikely to treat an abortion as only, say, an appendectomy, and those who would prohibit abortion are “unlikely to to check the menstrual flow each month to see if there is has been a death in the family” (Allen Verhey, Reading the Bible in the Strange World of Medicine, 2003, 195).

Though the debate about abortion has been framed in society as a question of whether pro-choice vs. pro-life there are other questions, perhaps more helpful, that the Church must raise. What is our response as a community to children? Are they a right, an option, a gift, or a burden? How is the church to act towards the marginalized and oppressed of society, which include both the unborn and women? What obligation does the church have towards those women who have an unwanted pregnancy? Is there a difference between what the church does about abortion and what public policy should be on the issue, especially considering we live in a largely post-Christian society? We will seek to answer these difficult questions below, but first we must examine some of the medical details of abortion.

The biggest distinction to make between the different methods of abortion is surgical abortion and chemical abortion. Surgical abortion involves the physician killing the fetus while it is still in the mother and then either manually extracting it or inducing contractions to expel the fetus. The most common method used in the first 15 weeks is suction-aspiration where a hollow tube is inserted into the uterus and fetus is sucked out. A more dangerous procedure is dilation and curettage (D & C) where the woman’s uterus is dilated and a curette (a sharp, hooked, instrument) is used to clean out the lining of the uterus, thus removing the fetus. Dilation and evacuation (D & E) is similar, but is used between weeks 15 and 18. The uterus is dilated and then, using surgical instruments, the fetus is dismembered and extracted. In the third trimester abortion becomes more difficult and dangerous for the woman. Drugs such as prostaglandin can be given to force the fetus to be expelled prematurely. Usually the fetus dies in the labor, though there are cases where it is born alive. To prevent the fetus from being born alive the amniotic fluid can first be injected with saline or urea which poisons and kills the fetus. In very late abortions the fetus is delivered part-way, but it’s skull is crushed before it is fully extracted. This is commonly known as partial-birth abortion, but is also known as dilation and extraction (D & X) (“Abortion, from Wikipedia the free encyclopedia,” en.wikipedia.org/wiki/Abortion).

Chemical abortions (also known as medical abortions) can be done within the first nine weeks of pregnancy. The procedure involves administering methotrexate or mifepristone (RU-486) which cause the lining of the uterus to become inhospitable to the embryo, thus causing it to become disconnected from the uterine wall. Misoprostol is then taken 24-72 hours later causing the fetus to be expelled from the body (Ibid.).

One final pertinent medical issue is when the fetus begins to feel pain. Unfortunately, the medical data here is mixed. Pro-life advocates say that a fetus can experience pain as early as 7 weeks since that is when the pain receptors start developing. Abortion advocates argue that a fetus cannot experience pain until the pain receptors are connected via the spinal column to the thalamus, an egg-shaped structure in the brain, which does not occur until the 26th week of pregnancy. Many argue that a woman having a late-term abortion (about 1% of all abortions) should be notified that the fetus can feel pain and given the option to give the fetus pain control medication (B.A. Robinson, “Can a Fetus Feel Pain? Various Opinions,” religioustolerance.org/abo_pain.htm).

Having examined the pertinent ethical questions and medical data surrounding abortion we can now turn to looking at what Scripture has to say about the issue. Here we quickly discover why the issue is so hotly contested among Christians. There are no Scripture passages which directly mention or discuss abortion, a fact somewhat puzzling since the Assyrian Code, a middle-eastern law code from the 15th century B.C., specifically prohibits abortion (Verhey, 197). However, Scripture’s silence should not be used as a foundation for one’s position since an argument from silence can easily be used to support either side (Verhey, 198). Furthermore, the silence of Scripture did not prevent the early church from taking a strong stand against abortion (c.f. Didache 2.2). Before continuing we should note that there are a few passages that have been used by both sides as arguments for their position. Exodus 21:22-25 seems to differentiate between the legal status of a fetus and its mother – at least, when read in the NRSV. When read in the NIV, which also has strong support for its translation choices, it appears to make no legal distinction between a mother and its fetus (Verhey, 200). Another passage is Psalm 139:13-16 which is a frequently quoted text by the pro-life side to prove that from conception a person is being “knit together” in its mother’s womb, “fearfully and wonderfully made” by God. The most serious problem with this interpretation is that it ignores the context and genre of the psalm. As a psalm, it is poetry that figuratively expresses the nature of God, his intimacy and foreknowledge. It is not a scientific treatise about the legal or moral status of a fetus (Verhey, 205).

If we are going to find Scriptural insight into the issue of abortion, then, we must look at Scripture paradigmatically. In other words, what stories or themes in Scripture might be used to focus our vision regarding abortion? First, we note that in Scripture a sacrifice made by the powerful and privileged is an example of profound love, and this is best exemplified by Jesus who “laid down his life for us” (1 John 3:16). However, when the relatively more powerful and privileged force the less powerful and less privileged to make a sacrifice the story of Christ is not being told (Verhey, 209). We might also look at the parable of the Good Samaritan (Luke 10:25-37). Here we learn that while the rich young ruler wanted a strict definition of who was and was not his neighbor, Jesus emphasized what kind of a neighbor we are to be. Christians are to “become neighbors to those who are helpless” (Richard B. Hayes, The Moral Vision of the New Testament, 1996, 451). This means providing over-the-top aid to those whom we might otherwise treat as strangers . Finally, we can also learn from the early Jerusalem community where “everything they owned was held in common” and thus “[t]here was not a needy person among them” (Acts 4:32-35). From this we learn that the Church should assume the responsibility of caring for the needy in its midst (Hayes, 452).

Where does all of this lead us in terms of concrete conclusions? In terms of public policy, the Church should advocate for policies which serve the interests of women and reduce the number of abortions. This includes, among other things, addressing the failing health-care system and educating boys and men on the moral and financial responsibility they accept whenever they have sex. Additionally, the Church has an obligation to support and raise those children who would otherwise be aborted. A Church that embodies hospitality to “unwanted” children will not only powerfully witness to the watching world, but will also be living out its calling as a community that truly supports the least of these. Certainly a Church that endeavors to do so will quickly find itself stretched financially and emotionally, but this has always been the case when the Church has faithfully lived out its calling to be a counter-culture. If a Church decides it will not or cannot support a mother and her child and thereby chooses an abortion, then the Church corporately shares in the guilt and suffering of the act.

There is one thing evident to anyone who reads much on this issue which is there is a large amount of “bad faith” on both sides which has lead to stalemates and a lack of common ground for advocating for policies like the ones mentioned above. It is with those considerations in mind that I offer one final suggestion for those on both sides of the issue: “Let us all be more hospitable to those who ‘do not count’ for much as the world counts” (Verhey, 252).