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East Asia School of Theology

THS 552 Biomedical Ethics & the Contemporary Church                                  Instructor: Dr Alex Tang

THS 552: Biomedical Ethics and the Contemporary Church

CLASS SYLLABUS

Class Description

Advances in medical treatment modalities, biotechnological innovations, and genetic-molecular manipulations have brought about a set of unique challenges to issues not faced by the Church before. In this class, a pastoral-theological approach will be used to examine, reflect and develop responses to these difficult moral and ethical issues – test tube and designer babies, facts and fallacies of stem cell therapies, cloning, reproductive issues, abortion, mercy-killing, allocation of scarce healthcare resources, living will, gene therapy, prenatal diagnosis, aesthetic surgery- facing the contemporary Church.  This class is relevant to students who will be engaging personally with these issues and also in helping others to engage in these issues.  A rationale engagement is essential to all Christians who are committed to living ethically in these changing times.

Class Objectives

The desired outcome of this class is that participants will demonstrate analytical and evaluative skills in their approach to biomedical ethical issues in their own ecclesiastical and cultural context.

By the end of this class, the students will

1. have an enlarged knowledge base of
   1. the foundations of bioethics
   2. pastoral-theological decision making
   3. bioethical issues at the beginning of life, and reproductive medicine
   4. bioethical issues of genetics; stem cells, cloning, and gene therapy
   5. bioethical issues at end of life, death and dying, and organ transplantation
2. have improved their ability to critically reflect on the continuing dialogue of theology, culture and bioethics
3. be able to offer pastoral help and counsel on biomedical ethical issues

Class Textbooks

• Tang, Alex (2005). A Good Day to Die: A Christian Perspective on  Mercy Killing. Singapore: Genesis Books.
• Tang, Alex (2006). Live and Let Live: A Christian Perspective on Biotechnology. Petaling Jaya: Kairos Research Centre Sdn Bhd.

It is highly recommended that this book be read before the first (18 & 19 June 2010) block classes; and the following book before the next (25 & 26 June 2010) block classes.

Additional Class Reading

Recommended that the relevant articles be read before these topics are covered in the classes. (see Class Schedule)

• Biomedical Ethics Reader 2010              

available online here http://www.kairos2.com/EAST2010_reader.htm

Class Assignments

1. Reflection Papers (20%)

1. Each student is to write one A4 page (one side only) of a reflection journal of their thoughts and reflections on the day’s sessions, to be submitted to the lecturer the next morning for the class held on Friday (18 & 25 June 2010), and the next day for the classes held on Saturday (19 & 26 June 2010). Reflection papers submitted one week after the class was held will not be marked.
2. Reflection is an important part of theological study- taking time to think through and process the information received through a Christian worldview. In his/her reflections, the student is expected to:

                                                              i.      Specify the sources which have informed his/her thinking e.g. insight from the sessions, interaction with others, books read (give title, page)

                                                            ii.      Identify new ideas, thoughts, discoveries, agreement and disagreement. Interact with sources (more discussion, less description)

                                                          iii.      Relate the comments to their own context.

3. Aim for honesty and integrity.

2. Case Study and Presentation (35%)

1. Students will be divided into groups and given different case studies.
2. The students are expected to meet together to discuss the case studies, research the topic, come to some consensus on the issues and present to the rest of the class their conclusions during one of the class sessions.
3. Case study presentations will be held during class on 26 June 2010.
4. During presentation:

                                                              i.      A handout on the topic/issue with relevant references/citation (to be given to lecturer and rest of the class).

                                                            ii.      A 10 minutes presentation followed by questions and discussion.

3. Reading (10%)

All students must read the two class text books. This will constitute approximately 200 pages of reading. Additional reading of the Biomedical Ethics Reader 2010 will give better depth and insight.

4. Research Paper (30%)

1. Complete a research project on a topic, theory, issue, concept or practice related to this course. The student should decide on their topic by the end of the classes and discuss with the lecturer.
2. This research process is developed in the following way:

-identify a problem/topic/issue. It must be related to biomedical ethics

-read up on the problem/topic/issue

-develop a thesis/abstract/outline/solution and framework

-read more and reflect on readings

-start writing

3. This research paper should be between 2000-3000 words (about 4-5 pages) excluding the reference list.
4. It is expected that the student will follow the Turabian format.
5. Date due for this paper will be informed during class.

Class Grading

            Students should submit all assignments on time. Late assignments will receive grade reduction.

No assignment that is more than 10 days late will be accepted.

Assignments may be submitted by email to draltang@yahoo.com. Class grades will be determined as follows:

Reflection-Assessment

Name:_________________________________  Date _______________

                                                  High extent                                              Low extent

Grade:

Comments:

Research Paper Assessment

Name__________________________________________ Date___________

Topic_________________________________________________________

                                                    High extant                                              Low extant

Grade:

General Comments:

Class Schedule

Resources and Recommended Reading

An annotated reading list

Bioethics-General

Beauchamp, T. and J. Childress (2009). Principles of Biomedical Ethics. Oxford, Oxford University Press.

            Tom Beaucamp is from the Kennedy of Ethics and Department of Philosophy, Georgetown University, Washington D.C. and James Childress, Department of religious Studies of the University of Virginia. This book is essential reading for students of bioethics in many universities. It is 'supposedly secular' in that it draws its foundational principles of moral norms from the philosophies of utilitarianism, Kantianism, rights theory and communitarianism. The principles of biomedical ethics are distilled into four principles:

(1) Respect for Autonomy

(2) Nonmaleficence

(3) Beneficence

(4) Justice.

They recognised that there are two way to do biomedical ethics. One is using top-down models (theory and application) and the other is bottom-up models (cases and analogy). They suggest an integrated model using reflective equilibrium.

Chia, Roland (2010) Biomedical Ethics and The Church - An Introduction. Singapore, Armour Publishing

Roland Chia is Chew Hock Hin Professor of Christian Doctrine and Dean of the School of Postgraduate Studies at Trinity Theological College (TTC) in Singapore. In this book, Chia develops his theological anthropological approach to biomedical ethics in this book. Chia has been instrumental in the writing of many of the National Council of Churches of Singapore's positional papers on biomedical ethics including organ trading and euthanasia. It is good that he now consolidate his thinking together in one book on biomedical ethics for the church.

This book is divided into three parts which is helpful in the way he develops his theological anthropology. The first parts deals with the theological foundations which he then applies in some current issues in bioethics in the second part. The third part is his suggestions for the role of the church in dealing with these complex problems. It is in the final section of the book that this book that Chia gives us our money worth. It is his call to the church to action in being missional, teaching, counselling and being involved in public theology. Public theology is based on the assumption that the creedal symbols and statements of Christianity have public meaning. Public theology therefore has to do with how the faith that Christian profess is linked with how they live and conduct themselves in society (p.200-204). Chia argues that the church has a role in public policy.

Kuhse, H. and P. Singer, Eds. (2001). A Companion to Bioethics. Blackwell Companions to Philosophy. Oxford, Blackwell Publishing.

Kuhse, H. and P. Singer, Eds. (2006). Bioethics: An Anthology. Blackwell Philosophy Anthologies. Oxford, Blackwell Publishing.

            This is another anthology on bioethics, slightly slimmer than the one I reviewed yesterday- only 738 pages. Helga Kuhse was the Director of the Centre for Human Bioethics at Monash University and Peter Singer is the Ira W. DeCamp Professor of Bioethics at the University Center for Human Values, Princeton University. Peter Singer is a man with 'a dangerous mind' which is what a television documentary on him and his work was entitled. I would like to meet him. I have never met anyone with a 'dangerous mind.' Most people I have met have 'harmless minds.' The 81 contributors which include individuals and organisations are mainly philosophers, ethicists, and counsellors. I am only able to identify one doctor and one medical organisation (American Medical Association). The articles are written from a distinctly non-Judaeo-Christian viewpoint and offer an interesting contrast to the previous book, On Moral Medicine. Many articles have raised many points that Christian theologians have yet to identify, let alone address.

Lammers, S. E. and A. Verley (1998). On Moral Medicine: Theological Perspectives in Medical Ethics. Grand Rapids, MI, William B. Eerdmans Publishing Company.

            This massive tome of 1004 pages is a collection of essays written by Christian theologians and philosophers concerning the issues of biomedical ethics. This is an excellent selection with contributions from leading bioethicists for the last 30 years. Bioethics is a new science. The writing is mixed as some write as theologians and philosophers who are Christians, while others write as Christians who are theologians and philosophers. What is surprising is the absence of medical doctors writing. One would have thought that Christian medical doctors will have more to contribute in this area. There is also a noticeable absence of Orthodox theologians and philosophers' contributions. It is still a good book to give a broad Christian perspective on biomedical ethics.

Lovin, R. W. (2000). Christian Ethics: An Essential Guide. Nashville, TN, Abingdon Press.

            Robin Lovin is Dean of Perkins School of Theology, Southern Baptist University in Dallas, Texas. This is a short and concise book on Christian ethics. It is a useful introductory text because Lovin shows from the Scripture and church history how the principles of Christian ethics are being developed as it interacts with the times and culture of each age. Christian ethic is a living developing discipline as it is being called upon by Christians to face new issues produced by science, technology and culture in every era.

Majeed, A. B. A., Ed. (2002). Bioethics: Ethics in the Biotechnology Century. Kuala Lumpur, Institute of Islamic Understanding Malaysia.

            The contributors to this book offer ideas and perspectives on the rise and challenges of biotechnology in the 21st century. The contributors include philosophers, ethicists, scientists, doctors, religious scholars and policy makers from Malaysia, Japan, Germany, South Africa, Saudi Arabia, Bangladesh, Philippines, and Indonesia.

Meilaender, G. (1996, 2005). Bioethics: A Prime for Christians. Grand Rapids, MI, William B. Eerdmans Publishing Company.

            Gilbert Meilander is the Phyllis and Richard Dussenberg Professor of Christian Ethics at Valparaiso University in Indiana and a member of the President's Council on Bioethics. The first edition of this book (1996) was chosen by World magazine as one of the top 100 books of the twentieth century. Where Lovin's book was on the principles of Christian bioethics, Meileander's book focused on issues of biomedical ethics. He writes on procreation versus reproduction, abortion, genetic advance, prenatal screening, suicide and euthanasia, refusing treatment, organ donations and human experimentation. As in theology and applied theology (how theology is to be lived out in daily lives, not in the ivory towers of the academia), there is bioethics and applied bioethics. Meilander deals with applied bioethics. Things are often different in conceptualisation, and in what is actually happening in the daily life of Christians living in a fallen world. As Martin Luther once commented on theology, theology is living out our troubles and sinfulness in our daily lives (my paraphrase). Meilander has expanded our understanding of bioethics but my personal opinion is that he was too dogmatic in too many things. Many things are so not black and white in our daily lives.

Pence, G. E. (2008). Classic Cases in Medical Ethics: accounts of the cases and issues that define medical ethics. New York, McGraw-Hill.

            Professor Pence is the professor of Philosophy, School of Medicine and Department of Philosophy, University of Alabama at Birmingham, United States of America. This is an excellent book because it documents the various cases that produced the court decisions that are affecting biomedical ethics today in the United States. Written in an easy non academic style, it nevertheless give a background to the who, why and what to the various thinking on death and dying, beginnings of human life, ethical theory, research, and individual versus public good.

Shelly, J. A. (1980). Dilemma: A Nurse's Guide for Making Ethical Decisions. Downers Groove, IL, InterVarsity Press.

            Judith Allen Shelly was a nurse and was with the Nurses Christian Fellowship. In this book, she outlines a step-by-step Christian decision making process that is very useful.

Singapore, National Council of Churches (2002). A Christian Response to the Life Sciences. Singapore, Genesis Books.

            Bishop Dr Robert Solomon was asked by the National Council of Churches of Singapore to form a Life Sciences Study Group to study the rapid development of life sciences in 2000. There are 14 members in the Study Group; comprising of doctors, scientists, theologians, ethicists and pastors. The Study Group identified three areas of study:

(1) the human genome project

(2) cloning and stem cell

(3) genetically modified food

This book is good reading with contributions from members of the Study Group (Dr Roland Chia, Rev Dr Tom Harvey, Dr Mark Chan, Rev Dr Daniel Koh, Dr Anthony Ang, Prof Kon Oi Lian and Dr Soong Tuck Wah). It shows a high level of scholarship and engagement with current issues. However IMHO there should be a more contextualised approach. I am interested to know what Singaporeans Christians will do.

Philosophy

MacIntyre, A. (1998). A Short History of Ethics. Abingdon, Oxon, Routledge.

            It will be difficult to understand bioethics if one does not have any idea about the development of ethics. Bioethics is a new branch of ethics, barely thirty years old. It is also known as applied ethics to differentiate it from the theological ethics. In this book, which is highly recommended, MacIntyre has managed to condense the often dense history of ethics into one small volume (only 264 pages).

Singer, P. (1994). Rethinking Life and Death: The Collapse of our Traditional Ethics. New York, St. Martin’s Griffin.

            This book, together with his earlier Practical Ethics is his best works. Here Singer outlines his consequentialist theories about human life and death. His theories stand only if one is a true atheist and a fully detached human person living outside of human society.

Preece, G., Ed. (2002). Rethinking Peter Singer: A Christian Critique. Downers Groove, IL, InterVarsity Press.

            Four fellow Australians of Peter Singer set out to critique his theories and work: Gordon Preece, director of the Centre for Applied Christian Ethics, Ridley College in Australia; Graham Cole, principal of Ridley College and teaches theology and ethics; Lindsay Wilson, vice principal of Ridley College and has degrees in law and Old Testament studies; and Andrew Sloane is a medical doctor and teaches Old Testament, theology and ethics at Ridley College. They claim to be the first group of Christians to publicly critique Peter Singer's theories. Looking from a Christian perspective, I agree fully with their critique on Singer's views on abortion, animal experimentation, euthanasia, allocation of healthcare resources and Christianity. Peter Singer is a non-practicing Jew and an atheist. However I am uncomfortable in the way these Christians do their critique. Peter Singer is likened to Herod, killer of children in the New Testament. And they question why Peter did not euthanize his mother when she was diagnosed with Alzheimer's disease. Along the way, their critique of Peter Singer has become personal attacks and lack grace. The greatest lesson I learned from this book is how to be graceful with people who holds different viewpoints from me.

Kuhse, H., Ed. (2002). Peter Singer: Unsanctifying Human Life, Essays on Ethics. Oxford, Blackwell Publishing.

            Peter Singer is the Ira W. DeCamp professor of bioethics at the University Center for Human Values, Princeton University. Helga Kuhse is Honorary Research Fellow at Monash University and Senior Visiting Fellow at the University of Melbourne. Peter Singer is regarded as one of the world's most famous or infamous philosophers with huge followings of people who loved his teachings or hated them. He advocates animal rights, infanticide, euthanasia, fair allocation of scarce healthcare resources, embryo experimentation, environmental responsibilities, and reflections on how we should live. This book is a collection some of Singer's best and most challenging articles from 1971-2002. As the man is a prolific writer and speaker, I find it helpful to have some of his more diverse work in one volume.

Theology

Rolnick, P. A. (2007). Person, Grace, and God. Grand Rapids, MI, William B. Eerdmans.

            This is a book that need to be slowly chewed, meditate upon and digested. Philip Rolnick is professor of theology at the University of St. Thomas, St. Paul, Minnesota. This is not an easy book to read but a great book to understand. Rolnick takes on the tremendous task of investigating the concept of personhood, developing his investigation from the etymological and historical development of the concept of personhood. Then he takes on the challenges to the concept of personhood from neo-Darwinism, polemical deconstruction and from the critical stance. He concludes "(u)ltimately, to be a human person means that the totality of who we are is open-textured to the presence and power of God." This is a remarkable work of scholarship of a theologian and philosopher whose methodical use of exegesis and analysis gives us a good idea of the concept of what it means to be a person.

Lazareth, W. H., Ed. (2004). Persons in Community: Theological Voices from the Pastorate. Grand Rapids, MI, William B. Eerdmans Publishing Company.

            While Philip Rolnick in Person, Grace and God deals with the theological and philosophical concept of personhood, this book deals with the pastoral aspects of persons. Its main thesis is that persons can only be understood in community. This community is God's people who are faithful stewards and prudent managers of the world. William Lazareth, the editor is the Jerald C. Brauer Distinguished Professor of Lutheran Studies at Carthage College, Kenosha in Wisconsin. He is also a program associate of the Pastor-Theologian Program at the Center of Theological Inquiry. This program is supported by an endowment by the Lilly Foundation. The program is set up because some Christians have perceived that there is a separation of theology and the church. "A significant part of the current crisis in the church is the hiatus between academic theology as an intellectual discipline and ecclesial theology as a confessional stance" notes Wallace M. Aston, Jr. the director of the Center of theological Inquiry (p.ix). The Pastor-Theologian Program "would seek to focus attention on the ordained ministry as a theological vocation and on the church as a theological community' (p.xiii). Sixty pastors were involved in the program and discussion. Twenty of these contributed articles to this volume. The articles are easy to read and give a significant pastoral perspective on many of the issues dealing with personhood. It is a ground up theological investigation on what it means to be human.

Waters, B. and R. Cole-Turner (2003). God and the Embryo: Religious Voices on Stem Cells and Cloning. Washington D.C., Georgetown University Press.

            Brent Waters is the director of the Centre for Ethics and Values and assistant professor of Christian Social Ethics at Garret-Evangelical Theological Seminary. Ronald Cole-Turner is the H. Parker Sharp Professor of theology and ethics at Pittsburgh Theological seminary and an ordained minister in the united Church of Christ. These two collected and edited various denominational positional statements on embryonic cell research. These statements included those from the Pontifical Academy for Life, The Holy Synod of Bishops of the Orthodox Church in America, United Methodist Church, Southern Baptist Convention, United Church of Christ, Presbyterian Church (USA), Union of the Orthodox Congregations of America and Rabbinical Council of America and The President's Council on Bioethics. With statements from such august committees, one will expect a consensus among Christians and Jews about stem cell research and cloning. Unfortunately, what came out is not a symphony but a confusing bubble of voices. While most feel that embryonic stem cell research should not be allowed, very few statements gave convincing evidence for this conclusion. Most appeal to emotions and a sort of pseudo-social theology that involves imputing more into the Bible that what the Bible actually says. One gets the impression that the various denomination study committees are more political and socio-cultural bound than theological.

Cahill, L. S., Ed. (2005). Genetics, theology, and Ethics. New York, The Crossroad Publishing Company.

            This book represents the findings of a group of Catholic theologians and bioethicists from America, Europe and the developing countries who met annually for five years (1996-2001) to study the questions of "Genetics, Theology, and Ethics." A highly readable book, it represents the interactions of Catholic theology and contemporary science.

Hauerwas, S. (1994). God, Medicine and Suffering. Grand Rapids, MI, William B. Eerdmans Publishing Company.

            Stanley Hauerwas, 1990, 1994 , God, Medicine, and Suffering, Grand Rapids, MI: William B. Eerdmans. First published in 1990 as Naming the Silences: God, medicine and the Problem of Pain. Stanley Hauerwas is professor of theological ethics at Duke Divinity School, Durham, North Carolina. In this book which has become a classic, Hauerwas engaged the question of suffering. Drawing from stories of sick and dying children to clarify his discussion of theological issues, Hauerwas shows that medicine is not the answer to the silence cry of suffering and pain. Instead he shows that a God and his caring community "can give a voice to that pain in a manner that at least gives us a way to go on."

Abortion

Gorman, M. J. (1982). Abortion and the Early Church: Christian, Jewish and Pagan attitudes in the Greco-Roman World. Downers Groove, IL, InterVarsity Press.

            Gorman did an interesting study of how Christians, Jews and the Greco-Roman world viewed abortion in the first four hundred years of church history. Abortion was a common practice in the Greco-Roman world; the fetus was not regarded as human and hence not murder. The Jewish community also allowed abortion as the fetus were not considered human until he/she was born. The early Christians however held a consistent stand against abortion. Gorman believed that while greatly influenced by Greek philosophy, the church nevertheless heeled Jesus' teaching in loving their neighbours and the unborn fetus were regarded as a neighbour. The church fathers such as Tertullian, Augustine, Basil the Great, Jerome and Ambrose were all against abortion.

Brown, H. O. J. (1977). Death before Birth. New York, Thomas Nelson Inc, Publishers.

            Harold Brown was professor of Systematic Theology at Trinity Evangelical Divinity School in Deerfield, Illinois. He was one of the few Christians who sounded the alarm and called attention to the increasing rate of abortion in the United States. I remember reading this book and the impact it has on me. It must have been horrifying to Professor Brown to know that in the years to come since his book, abortion was legalised and has become a right in his country. And millions have died before birth.

Hoffmeier, J. K., Ed. (1987). Abortion: A Christian Understanding and Response. Grand Rapids, MI, Baker Book House.

            James Hoffmeier who teaches the Old Testament at Wheaton College has collected an interesting mix of articles on abortion. There is a section on historical, biblical and theological aspects such as "abortion in the ancient near east," "abortion and the Old Testament law," another on ethical aspect, and one on practical concerns.

The section on practical concerns is good with articles on psychological consequences of abortion, crisis-pregnancy ministry and after abortion ("What does a Christian-especially a pastor- say to someone who has had an abortion?).

Reproductive Issues

Hui, E. C. (2002). At the Beginning of Life: Dilemmas in Theological Bioethics. Downes Groove, IL, InterVarsity Press.

            Edwin C. Hui is professor of biomedical ethics and Christianity and Chinese culture at Regent College, Vancouver and adjunct professor of philosophy and religious studies at Peking, Fudan and Sichuen Universities. Hui's original training was as a medical doctor. Hui approach to theological bioethics was through the Christian understanding of personhood and how that applies to the beginning of human life dilemmas.

George, R. P. and C. Tollefsen (2008). Embryo: A Defence of Human Life. New York, Doubleday.

            Robert George is Professor of Jurisprudence and Director of the James Madison Program in American Ideals and Institutions at Princeton University and a member of the President's Council on Bioethics. Christopher Tollefsen is Associate Professor of Philosophy at the University of South Carolina. Questions about abortion and stem-cell research have created seemingly unbridgeable gaps between Americans. Should faith-based views be considered when deciding public policy? Using up-to-date research, George and Tollefsen show that embryos are humans beings from conception; and argue against "moral dualism" and the utilitarian worldview that places society's "greater good" above the life of the fetus. This book differs from others in the sense that the authors argue from the perspective of public policy making in the United States. They argued against embryonic stem cell research and remind the public that the state has an "ethical and moral obligation to protect embryonic human beings in just the same manner that it protects every other human beings..." This is an irony when there is a call by some Americans for the separation of church and state. However, it seems that when it suits some people's purposes, the state should fight for their causes. The King in the musical The King and I would throw his hands up in despair, "It's a puzzlement!" I agree with you, dear king.

Euthanasia

Gula, R. M. (1994). Euthanasia: Moral and Pastoral Perspectives. Mahwah, NJ, Paulist Press.

            Richard M. Gula, S.S. is professor of moral theology at St. Patrick Seminary in Menlo Park, California. He gave the Catholic tradition's reasoning and motivations for opposing physician-assisted suicide. It is interesting to read their well reasoned objections. In Declaration on Euthanasia issued by Vatican Congregation for the Doctrine of the Faith, June 26, 1980, there is a section on suffering. "According to Christian teaching, however, suffering especially suffering during the last moments of life, has a special place in God's saving plan; it is in fact a sharing in Christ's passion and a union with the redeeming sacrifice which he offered in obedience to the Father's will." Gula outlines his pastoral response as "a call for the personal virtues of humility, courage, hope, within a community or parish committed to caring, hospitality, and interdependence."

Larson, E. J. and D. W. Amundsen (1998). A Different death: Euthanasia and the Christian Tradition. Downers Groove, IL, InterVarsity Press.

            Edward Larson is professor of history and law at the University of Georgia. Darrel Amundsen is professor of classics and chair of the department of modern and classical languages at Western Washington University, Bellingham, Washington. This is one of the books that influenced my thinking on euthanasia. These two authors did a historical survey of euthanasia or mercy killing from the early church period until today. Since mercy killing is closely associated to suicide, they also included suicide in their survey. I was fascinated to learn that the ancient Greeks and Romans favoured suicide which they think were honourable. The early church however was counter-cultural and was against suicide in any form. It was Christians who started the hospice movement in the last century. Highly recommended.

Tang, A. (2005). A Good Day to Die: A Christian Perspective on Mercy Killing. Singapore, Genesis Books.

            Euthanasia or mercy killing is an emotive and controversial subject. Tremendous advances in medical sciences and biomechanical technologies have prolonged our lives. Unfortunately, these same knowledge and technologies have prolonged our dying. Many today struggle with the issue of euthanasia or mercy killing, either for themselves or for their loved ones. Alex Tang approaches this issue from different perspectives. He uses examples from patient case histories to illustrate his points. This book will help those who struggle with euthanasia or mercy killing to come to some resolution of death with dignity. God in His sovereignty determines the times of our birth and of our death. If He has chosen that day for us to die, then it is a good day to die. When we bring about our own death, however, the day of dying is not of God's choosing but of ours. Do we have the right to choose when we die? Do we have the right to determine the way we are to die? And do we have the right to ask someone to kill us?

Peck, M. S. (1997). Denial of the Soul: Spiritual and Medical Perspectives on Euthanasia and Morality. London, Simon and Schuster.

            Psychiatrist Scott Peck examines the issues of euthanasia and the culture of fear of our mortality. He makes some interesting points which he illustrates from his medical experience. He writes,” While it is not necessarily our lot in this age that we should suffer physically to the end of our endurance, it is still our lot that we should so suffer emotionally. The denial of this fact of life is the central defect of the age." Death is not just the dead of the physical body. Peck argues that we need to prepare for our deaths emotionally and spiritually. He thinks that euthanasia is not justified. However he pointed out two issues related with the euthanasia debate that need to be resolved: (1) the need for better pain management, and (2) secularism (Americans claim to be religious but are not committed spiritually). Peck provides a different perspective in our dialogue on euthanasia.

Humphry, D. (1991, 1996). Final Exit: The Practicalities of Self-deliverance and Assisted Suicide for the Dying. New York, Dell Publishing.2nd ed.

Derek Humphry, 1992, Dying with Dignity: Understanding Euthanasia,

Secaucas, NJ: Carol Publishing Group.

Derek Humphry caused a national sensation in the United States when he published Final Exit in which he argues that everyone has a right to die and has a right to ask others to help them to die. Humphry's personal experience when his first wife, Jean, who was suffering from terminal breast cancer and asked him to help her die affected him deeply. After her death in 1975, he started the National Hemlock Society in 1980 which lobbies for legalisation of euthanasia and a 'right to die' movement. Humphry's second book, Dying with Dignity serves as a companion to Final Exit in which he presented a ‘systematic’ consideration for the right-to-die movement.

Humphry writes a blog, Assisted-Suicide Blog www.assistedsuicide.org

Koop, C. E. (1976). The Right to Live; The Right to Die. Wheaton, IL, Tyndale House Publishers, Inc.

            Dr Koop was surgeon-in-chief at Children's Hospital of Philadelphia and professor of paediatric surgery at the University of Pennsylvania. He became famous in 1974 when he and his team successfully separated Siamese twin girls in a pioneering operation. This book was important as Koop looked at the Supreme Court Ruling on abortion and Karen Quinlan from a personal, social, medical, and theological point of view. Though the facts of the cases are dated, his astute observations and predictions on how these two key events will affect our lives are timeless.

Blocher, M. (1999). The Right to Die? Caring Alternatives to Euthanasia. Chicago, Moody Press.

            Mark B. Blocher is Director for the Center for Biblical Ethics. There are a few approaches to bioethics. In 1982 psychologist Carol Gilligan suggests that women and men approach moral issues differently. This is taken up by feminist thinking (I do not mean it in a negative sense). Women are more emphatic and intuitive which Gilligan call the 'ethic of care.' Men on the other hand, then to follow rules and principles which was named 'ethic of right and justice.' However, these approaches are not strictly gender restrictive. Blocher took on the ethic of care in relationship to his work on the dying. However, being a Baptist pastor and bioethicist, he wants to offer more than just what the "death with dignity" movement is offering. "Killing is not caring," he writes,” It may look compassion...even merciful but it is not." In the ethic of care, he finds that he can offer more. Blocher suggests that Christians must be proactive in providing alternatives to assisted suicide and euthanasia while offering at least three promises to the terminally ill:

1. To the best of our ability, we will not allow you to die in pain

2. We will not allow you to be alone

3. You will not be a burden to anyone

Caring for the dying require commitment, sacrifice, and personal involvement.

Organ Transplant

Chia, Roland (2009) The Ethics of Human Organ Trading. Singapore, Armour Publishing

Chia uses a theology of the body to argue against human organ trading. This book offers an important theological perspective to the discussion.

Lock, M. (2002). Twice dead: Organ Transplants and the Reinvention of Death. Berkeley and Los Angeles, University of California Press.

            One of the key debates in organ transplantation is the definition of death. The mostly held definition is the Harvard definition which is brain dead- no EEG, no brain stem activity. There is a need for organs for transplantation and the medical profession is tinkering with the definition of death so as to get more viable organs for transplantation. The definition of death has been modified to either brain dead or cardiac death. Cardiac death occurs if there is proof that when a heart stops, it is irreversible and unlike to resume beating again. The National Institute of Medicine suggests 5 minutes but hospitals have been reducing the time to 2 minutes and even 90 seconds. This means that a potential organ donor is pronounced dead when he or her heart stops for 90 seconds and is prepared for organ harvesting. In 90 seconds, the brain will still be alive. In some hospitals, such patients are given large dose of morphine in case the potential donor feels 'pain'. This is a funny argument because if someone feels pain, that person must still be alive. I suspect the reason is that if allowing the heart to stop doesn't cause brain death, the morphine will, thus sparing the doctors, hospital, and ethics committees the embarrassment of being sued because the heart restarts during organ harvesting.  Margaret Lock did a good job of documenting the shifting definition of death. The interesting title is because an organ donor may die twice. His or her heart stops (cardiac death), then the body is kept living by a machine, the heart restarted and then allowed to stop when the organ harvesting has been done. This is a very thought provoking and frightening book about organs transplantation.

Genetics

Peters, T. (2007). The Stem Cell Debate. Minneapolis, MI, Fortress Press.

            Ted Peters teaches systematic theology at Pacific Lutheran Theological Seminary and the Graduate Theological Union in Berkeley, California. He is an associate of the Center for Theology and the Natural Sciences and is the co-editor of the Center's journal Theology and Science. Peters gives a good overview of the stem cell debate by framing the discussion into three frameworks:

(1) The embryo protection framework. The moral status of the ex vivo embryo (not implanted) and the principle of non-maleficience are central

(2) The nature protection framework. The fear that we may cross the line to manipulate genetics as in 'playing God'

(3) The medical benefits framework. Beneficence that puts relief of human suffering as the core of its reasoning

It is out of these three frameworks that a fourth will arise-The research standards framework which will essentially be government policies informed by the other three frameworks.

Wilmut, I., K. Campbell, et al. (2000). The Second creation: Dolly and the Age of Biological Control. Cambridge, MA, Harvard University Press.

            Ian Wilmut was with Roslin Institute in Scotland when he successfully cloned Dolly. I believe he is working in Biopolis in Singapore now. Keith Campbell is a cell biologist and embryologist with the University of Nottingham. Colin Tudge is a science writer. The first part of the book was an account of their work with cloning Dolly from the cell of an adult sheep in 1996. The second part was interesting as they reflected on their breakthrough in genetic engineering, genomics, and cloning using adult cells. They believed there will be tremendous ramification from their experiments and predict great changes in biological experimentation. Biology will the next area of scientific development. It was interesting that they entitled their book, The Second Creation. An interesting insight into how scientists work, think and behave.

Tang, A. (2006). Live and Let Live: A Christian Perspective on Biotechnology. Petaling Jaya, Kairos Research Centre Sdn Bhd.

This is the age of cutting edge biotechnology. With the completion of the mapping of the human genome in 2000, we are poised for a great leap in life-changing biotechnological discoveries and innovations. The Bible does not give specific answers to these questions. Using biblical principles, this book seeks to help Christians to understand and be informed about these issues. Some of these questions may sound like science fiction. We have seen the way the silicon revolution of computers; mobile phones and the Internet have changed our lives within a decade. The biotechnology revolution has already begun. We are just beginning to experience its effect. We are living in ‘interesting times’.

Sociology

Tada, J. E. and N. M. d. D. Cameron (2006). How to be a Christian in a Brave New World. Grand Rapids, MI, Zondervan.

            Joni is a quadriplegic who has spent three decades advocating for the disability community. Nigel M. de Cameron is research professor of bioethics at the Illinois Institute of Technology and president of the Institute on Biotechnology and the Human Future. The book is targeted at the general informed reading public and deals with human cloning, designer babies, redefining human nature and human harvesting. Though they do not offer new arguments, the recommended reading list and the Internet links are worth looking at.

Peters, T. (1996). For the Love of Children: Genetic Technology and the Future of the Family. Louisville, KN, Westminster John Knox Press.

            Ted Peters is professor of systematic theology at pacific Lutheran Seminary. His writing is very precise and logical. In this book he takes on the challenge of looking at biotechnology and molecular genetics from the children's viewpoint. This is a unique approach and Peters' thesis is that all children have claims on their parents and in turn their families. This places the responsibility of guarding the morality and placing boundaries on genetic research and application on the parents and indirectly on society and the church. He proposes an ethic "for the love of children."

Fukuyama, F. (2002). Our Posthuman Future: Consequences of the Biotechnology Revolution. London, Profile Books.

            Francis Fukuyama is Bernard L Schwartz Professor of International Political Economy at the Paul H Nitze School of Advanced International Studies, John Hopkins University. A social scientist, Fukuyama published The End of History and the Last Man in 1989 which  he proclaimed that due to the exhaustion of alternatives to liberal democracy, history as we know it has come to an end. Ten years later and we are still here; he revised his theories to that history has not ended yet because we have not reached the end of science. Fukuyama asks an important question: How does the ability to modify human nature affect liberal democracy? Fukuyama examines how the changing understanding of human nature -from Plato and Aristotle to the present- has affected society. Then he extrapolates into the future on how the consequences of genetic manipulation will affect society especially liberal democracy. The foundation of liberal democracy is based on the concept that all humans are created equal.

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