No Neutrality–Gilbert Meilaender on Bioethics

Gilbert Meilaender is one of the most intelligent and influential bioethicists of our age, and it is reassuring to know that he is a member of the President’s Council on Bioethics. Meilaender holds the Richard and Phyllis Duesenberg Chair in Theological Ethics at Valparaiso University, and his numerous writings in philosophy and bioethics are must-reads for intelligent Christians.

An essay originally prepared by Meilaender as a discussion paper for the President’s Council on Bioethics has been published in the premiere issue of The New Atlantis: A Journal of Technology and Society, and this essay contains a wealth of wisdom on the issues now confronting humanity in the postmodern age.

In “Bioethics and the Character of Human Life,” Meilaender argues that there “is no neutral ground” when it comes to issues of bioethics. “These topics are not driven simply by concern for public policy regulations; rather, they involve some of the most important aspects of our humanity and raise some of the deepest questions about what it means to be human,” Meilaender insists.

Meilaender’s purpose is to frame a proper approach to issues of biomedical ethics–issues including everything from embryo ethics to human cloning, genetic screening, euthanasia, and population policy. From the outset, Meilaender insists that any response to these challenges must necessarily be rooted in deep worldview commitments.

Meilaender cites a statement made by the Human Embryo Research Panel established in the 1990s by the National Institutes of Health. Introducing the approach the panel had taken, their document made this claim: “Throughout its deliberations, the Panel considered a wide range of views held by American citizens on the moral status of preimplantation embryos. In recommending public policy, the Panel was not called upon to decide which of these views is correct. Rather, its task was to propose guidelines for preimplantation human embryo research that would be acceptable public policy based on reasoning that takes account of generally held public views regarding the beginning and development of human life. The Panel weighed arguments for and against Federal funding of this research in light of the best available information and scientific knowledge and conducted its deliberations in terms that were independent of a particular religious or philosophical perspective.”

Those last words caught Gilbert Meilaender’s attention. “There are no such terms,” he insists, “and the public is not likely to believe such protestations of neutrality.” Questions related to life and death, human dignity, and medical ethics “are inevitably normative, value-laden, metaphysical in nature,” he asserts.

Claims of neutrality in biomedical ethics are, we must know, disguised assertions of one worldview over another. As Meilaender reminds us, human beings “are not philosopher-kings who can adjudicate disputes between conflicting views without ourselves being parties to the argument.” As human beings, we must accept the responsibility to take the controversial issues of biomedical ethics with full seriousness, and we must be honest about our presuppositions, worldviews, and intellectual commitments.

Throughout his essay, Meilaender weaves together moral wisdom and serious intellectual engagement. His worldview is clearly rooted in Christian conviction, and he writes with both passion and persuasiveness. At one point, he performed an experiment in jumbling words, demonstrating that the symmetry of language indicates the presence of an author. Similarly, the nature of humanity cries out for an acknowledgement of “the presence of an authorial hand.” As a theological ethicist, Meilaender resists reductionisms that would redefine humanity as something less than personhood deserving of full dignity. As he acknowledges, “the problems of bioethics force us to ask what a human being really is, and, in doing so, to reflect upon the unity and integrity of the human person. We must think about the moral meaning of the living human body–whether it exists simply as in interchangeable collection of parts, whether it exists merely as a carrier for what really counts (the personal realm of mind or spirit), whether a living human being who lacks cognitive, personal qualities is no longer one of us or is simply the weakest and most needy one of us.”

As human beings, we are able to reflect upon our own nature, an ability that sets us apart from non-human animals. We recognize that human beings have been granted a considerable gift of freedom, but we must acknowledge that this does not extend to a freedom to redefine ourselves. “Understanding our nature in this way, we can appreciate how hard it may be to evaluate advances in medicine, claims about the importance (or even the obligatoriness) of research, attempts to enhance our nature in various ways, or efforts to muster death,” Meilaender acknowledges. “If we simply oppose the forward thrust of scientific medicine, we fail to honor human freedom. The zealous desire to know, to probe the secrets of nature, to combat disease–all that is an expression of our freedom from the limits of the ‘given.’ Yet, of course, if we can never find reason to stop in this restless attempt at mastery, we may fail to honor the finite limits of our wisdom and virtue. In fact, it may trivialize freedom to think of it as limitless.”

In other words, any adequate approach to issues in biomedical ethics must acknowledge necessary limitations upon human freedom. This assertion runs against the grain of the extreme libertarianism that marks so much of our contemporary culture and the modern mind. Yet, any failure to acknowledge these limitations will ensure moral disaster in short order.

Human personhood is also inescapably relational and chronological. We are deeply embedded in a generational pattern, and human reproduction properly focuses upon parent and offspring. “It is, I think, fair to say that several different aspects of medical advance–in reproductive technologies, in psychopharmacology, in genetic screening, and one day perhaps in techniques for genetic enhancement or cloning–have made it more difficult for both parents and children simply to honor and affirm the bond between the generations and accept as a gift the lines of kinship that locate and identify them,” Meilaender warns.

The image of children as gifts who are “the fruition not of an act of rational will but an act of love” is contrasted with the image of a child “as the parents’ project or product.” With issues in reproductive ethics presenting urgent challenges for ethical attention, Meilaender argues, “Human cloning, were it possible, would from one angle bring to completion this image of the next generation as a product of rational will, undertaken to fulfill our desires. From another angle, of course, cloning might be thought to break entirely the bond between the generations, since in the instance of cloning we do not even know how to name the relation between progenitor and offspring.”

The rise of new eugenic ideologies and the reemergence of dark strains from the past should amplify our ethical concern. As Meilaender remembers, “The twentieth century began with considerable confidence in the possibility for eugenic control of the relation between the generations. That confidence suffered eclipse in the face of revelations of Nazi eugenic experiments, but it has reemerged in quite different ways. Today, any state-sponsored eugenic ideology would surely face considerable opposition, but instead we have (to use the barbarous locution now common) ‘privatized’ eugenic decisions.”

Thus, the human ambition to redefine ourselves and our offspring is now combined with the market-driven and choice-laden context of a consumer society. Persons who would be quick to identify government-sponsored eugenic efforts as immoral and diabolical might decide to employ eugenic technologies for their own self justified purposes.

Beyond this, surveys indicate that a growing number of Americans would gladly employ genetic screening in order to choose the characteristics, gender, and capacities of their offspring.

Furthermore, Meilaender knows that the emergence of human germline therapies would allow even further destruction of the bond between generations. Germline therapies would alter, not only the first generation to bear the therapeutically-designed genetic code, but all generations to follow.

One of the biggest challenges to clear thinking in the realm of biomedical ethics is the argument that whatever can be done, should be done. Added to this is a culturally-driven belief that medical experimentation should be authorized if there is virtually any hope for the emergence of a usable medical treatment. This research imperative drives what Meilaender identifies as “the great quest of modern research medicine.”

Behind all this, Meilaender sees an effort to deny the function of human suffering and the reality of human vulnerability. In an all-out effort to eliminate suffering, we may inadvertently redefine humanity itself, and lose a precious knowledge that is known only through struggle, suffering, and even pain. Meilaender cites moral sources ranging from the Stoics to St. Augustine who understood that suffering was an inescapable part of life. “In the modern world we may admire such views,” Meilaender allows, “but we tend to keep our distance from them. The quest for health . . . the attempt to master nature in service of human need and to refuse to accept the body’s vulnerability to suffering, has characterized the modern period.”

Make no mistake–Meilaender celebrates the fact that much suffering and pain has been eliminated or alleviated through modern medical research. Nevertheless, he warns that the total elimination of suffering may be both impossible and undesirable.

When it comes to research, Meilaender insists that “we must also ask ourselves whether there might be research that is neither imperative nor desirable.” A responsible and mature approach to biomedical ethics would require an awareness of such limitations. “We cannot simply give our children the happiness that comes from finding a vocation, a spouse, or inner strength,” Meilaender reminds. “Trying to give such goods would, in effect, subvert and undermine them. So too we have to ask whether there might be research aims which, however well-intentioned, would seek to bestow traits of character and skill that have no value apart from the process whereby they are developed and achieved. We are, that is, forced to ask hard questions about any project aimed at ‘enhancing’ human nature.”

Decisions and debates about issues of biomedical concern are not limited to professional ethicists, medical doctors, or philosophers. To the contrary, every family will eventually face these questions, and the ethical challenges posed by the biomedical revolution will touch almost every relationship, every congregation, and every individual. We must not fail to take these questions with proper seriousness, and to pursue an adequate ethical understanding that recognizes the sanctity and dignity of human life, and refuses to negotiate on questions of human personhood.

Without doubt, these questions are excruciatingly difficult precisely because we are faced with competing goods. As Gilbert Meilaender understands, “Our finitude and freedom are not easily reconciled. The goods of life compete with each other, and if we do evil it may be done with great dignity and appeal–done even in the service of some good. The wisdom bioethics seeks is the wisdom to discern right order among such competing goods.”

This responsibility will demand our intelligence, our courage, and our acknowledged dependence upon a moral wisdom that is deeply rooted in serious Christian thinking. Gilbert Meilaender’s profound essay is a good place to start this process. The Christian church had better assume this responsibility without delay. The issues simply will not wait.