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IS MODERN MEDICAL TECHNOLOGY
A CHALLENGE
TO CHRISTIAN ETHICS?

Dr. A. K. THARiEN

Dr. A. K. THARIEN MBBS. DLO., E.O.M.S., (Vienna) M.A.M.S..
F.A.C.S. is a founder - member of the Christian Fellowship
Hospital Oddanchatram, Tamil Nadu, INDIA.

A current concern book

Published by
EMFI
March 1989

Printed at
Cosmo Printers
395, Cross-cut Road
Coimb.jtore-641 012

M p " I 2—0
COMMUNITY HEALTH CELL
326. V Main, I Block
Koramanga la

Bangaloro-560034
India

In recent years Medical Science and
Technology have made great strides of
progress. The growth
of technological
medicine raises some moral and ethical
problems. Our understanding of ethical
principles should lead us to find a rational
basis for our medical practice.

CHRISTIAN MEDICAL ETHICS
Christian medical ethics deals with human
behaviour, relationships, biological issues of
health, religious ideals, culture, decisions
regarding when to treat and when to withhold
treatment, dying and death. Christian medical
ethics has now become complex, as it has
medical, legal, theological, moral, social and

personal aspects. Medical and biological
advances in knowledge and technique further
pose new dilemmas in decision making. Many
time honoured principles are being openly
questioned or flouted. New legislative mea­
sures are under consideration, if not already
in existence, particularly in areas like organ
transplant, management of human fertility and
infertility, use of drugs to alter brain function,
genetic engineering to change human genetic
stock, euthanasia, amniocentesis, termination
of pregnancy etc.

THREE DIMENSIONS OF A PERSON

A person may be viewed, biologically,
socially and spiritually.
a)

Biological

We have a physical form to our body and
keeping the body healthy is a biological
activity. Health is therefore our right and we
need to safe-guard it. A doctor's duty is to
preserve and promote health in all its aspects,
physical, mental and spiritual.

b)

Social

Man is a social being. He lives in
relationship with another. The most import­
ant relationship is between husband and
2

wife, each being incomplete without the other.
Out of this partnership, come the children;
then there is the extended family of relatives,
friends and the larger community. Mal-adjustment in relationships or breakdown of relation­
ships will affect healthy living.

c)

Spiritual

Man as a whole person, is responsible to
God, as, life is a gift of God. We are cons­
cious of the sanctity of human life, because
of this relationship with a living God. Human
being created in the image of God has a worth
and is unique. Unless we maintain this right
relationship with our Greater, we are likely to
wonder about our purpose of existence and
lack a sense of direction in our life. Not being
clear about this may lead to frustration in life
and all the consequences of conflict and
confusion in one's life resulting in ill-health.
If we have a biological, social and
spiritual dimension for our life, our conduct
and behaviour would emerge from this net­
work of relationships. How we think and
behave are largely the reflections of our
convictions. As people with convictions, we
are constantly faced with the Biblical under­
standing of issues at stake. Let us look at
some of them.
3

I.

the dilemma of abortion

The debate on abortion is an open ended
issue for most of us. It is a highly emotional
subject as it touches the mysteries of human
sexuality and reproduction. Pro-abortionists
emphasize the rights of the mother, especially
her right to choose. Whereas the Pro-life
advocates, emphasize the right of the unborn
child and his or her right to live. What is not
usually considered in the abortion issue is the
sovereignity of God and sanctity of human life.
"When we debate the rights and wrongs
of induced abortion", wrote Dr. Garetts Jones,
"We are debating a problem of human rela­
tionship much broader and more significant
than that of a woman with an unwanted
foetus. Life starts at conception and it is a
continuous process. This developing human
being requires protection from society through
out his life”.
The liberalised law of medical termination
of pregnancy Act of 1971, permits termination
of pregnancy on the grounds of danger to the
physical or mental health of the mother or in
the event of failure of a family planning

4

measure. This means that almost any one can
demand abortion legally and get it done before
twenty weeks of gestation. Then there are
others who on humanitarian grounds justify
an abortion because of an unplanned
pregnancy, extreme financial or social stress
due to pregnancy, the stigma of a pregnancy
out of wedlock, (unmarried girl, adultery,
incest, rape) and if, the unborn baby is
diagnosed as physically or mentally defective.
As Christians, our convictions are to be
based on Biblical guidelines. Our view of the
status of the fertilised ovum will largely deter­
mine our attitude to abortion. Pro-abortion
campaigners plead that medically and legally
the embryo and foetus are parts of the
mother's body, so she has the right to decide
its'destiny. There are others like the late
Dr. Francis Schaeffer and Dr. Everett Koop
(Surgeon General of U.S.A.) who argue that
though the embryo is carried within the
mothers body, the foetus is a person in the
making with all potentials to grow and
develop. The growing body has a genotypic
distinction from the mother and is "already a
human life, not merely a potential human"
(Pope Pius XII). The Psalmist in the Bible

says "You knit me together in my mothers
womb" (Psalm 139:13) obviously referring to
God as the orginator of every life. Arch­
Bishop Ramsay of Canterbury considers the
unborn baby to be reverenced as the embryo
of a life capable of coming to reflect the
Glory of God.
One may want to argue for freedom of
decision or exception to this general rule,
But every exception has to be rigorously and
specifically examined (eg. a serious threat to
the life of the mother or a completely
malformed child as to be incapable of inde­
pendent survival). In no case should termina­
tion of pregnancy be resorted to as an easy
method of family planning.

II.

RECENT GENETIC DISCOVERIES AND
EMBRYO EXPERIMENTS

Recently new knowledge has been
acquired about genetic science, like D. N-A.
genetic engineering,
invitro fertilisation
(I.V.F.), Embryo transfer (E.T), amniocentesis.
I.V.F. has found a revolutionary solution to
the human dilemma of infertility by non­
human technological means.
6

a)

Genetic Engineering

In 1954 Watson and Crick published, the
now famous discovery on the structure of
"deoxy ribo nucleic acid". This has paved
the way for invitro fertilisation and manipula­
tion of the genes.

The fertilised ovum is grown in culture.
The cells thus formed are then separated into
individual cells which with further culture can
form new individuals, identical genetically to
all others. This can be stored frozen for further
development. Thus a women could give birth
to her twin sister if these cells are used at a
later period.
By the selection of genes and it's mani­
pulation one can choose sex, complexion,
height and other such features of the foetus.
Corrective gene therapy can also be done.

It is also possible to produce ailophenes
between species like men and monkey hybrids.
Thus it is reasonable to speculate that, it
should be possible to create novel mutants or
entirely new species. If man, with his scien­
tific curiosity and weak human nature, is given
the knowledge and power of a creator, can
one predict where it will lead him to. He may
7

tresspass into regions outside the laws of
God. So it will be necessary to guard against
potential abuses and avoid human vivisection
b)

In vitro Fertilization

The procedure of invitro fertilization
(I.V.F.) raises the question of the status
of the fertilized ovum before God,whether
in the womb or in the test tube. The fertiliza­
tion of an ovum outside the uterus is a great
break-trough in medical science and an alter­
nate means of conception for many infertile
woman. But some argue that laboratory
production of human beings is no longer
human procreation as it amounts to degrada­
tion of parenthood and deprives procreation
of its human involvement and love. I.V.F.
might undermine values which biological
parenthood give to marriage. But it is argued
by scientists that I.V.F. is a dramatic extension
of the sort of interference found in delivery,
by ceaserean section or in hormonal induction
of labour.
In these experiments there are a few
surplus fertilised embryos which are kept
frozen for future use or are used for further
experiments for researchers to study genetic
8

and developmental abnormalities, intricacies of
tissue and cell differentiation etc., or to be ulti­
mately destroyed. Can we treat the fertilised
ovum as a lump of jelly or blop of tissue which
can be destroyed, like a tumour or tonsil? Is it
right to use human materials for experiments
and if so how far? At present the proposed
law in the U. K., does not permit embryo
experiments beyond 14 days (which is the
implantation stage). Then the question is
raised, do human embryos have any right at
all? If they have rights, at what stage? Can
such embryos be the material possession of
the donors when they do not intend becoming
the parents. The fundamental issue is whether
or not respect should be shown to human
embryo in view of the potential for full
humanness. If embryos are produced with the
expressed purpose of providing scientific
information, that information has already taken
precedence over the significance of human
existence.

In the West, ovum is fertilised from sperm
of unknown parents and children are born
without identity of biological parents. (This
is now changing, as donors have to record
their identity). A child conceived in a test
9

tube can have as many as five parents; the
egg donor, the sperm donor, the surrogate
mother, (who bears the child,) and the couple
who raise the child. The potential emotional
and psychological ramifications of this could
be deep and disturbing.

The Anglican Church of Australia disap­
proved experiments like cloning, genetic
engineering, artificial placenta, surrogate
motherhood, human-animal hybrids and
embryo
freezing. Organisations like the
Order of Christian unity (London) are seeking
to outlaw 'womb leasing' and 'Ovum donation,
to, eliminate legal problems, human tragedies
and to uphold the sanctity of human life. It is
now accepted that no human being is to be
treated as property, as in the days of slavery.
Every one has an inviolable status as regards
life and liberty. It is recognised that every
human being has the right not to be used as
a means to the needsand interests of others
c)

Amniocentesis

The study of amniotic fluid gives a lot of
information including the sex of the foetus and
of possible malformations of the unborn baby.
A study of abortions conducted in Bombay
10

after amniocentesis, revealed that the vast
majority of the babies aborted were females.
This is a small pointer to the way this proce­
dure is being used. It is used for determination
of sex giving a chance for the parents to
choose which baby they should keep. This
attitude to females can have devastating
effects on our social structure.
The real indications for amniocentesis
when ethically used may be for providing
therapeutic support for the unborn baby
(eg. hydrops foetlis) or for diagnostic purpose
to anticipate the special measures needed to
assist the baby at birth. (Respiratory
Distress Syndrome) The decision to resort to
amniocentesis must not be with the bias to
resort to abortion if needed.

III.

ORGAN

TRANSPLANTATION

Organ transplantation is another break­
through in medical technology, overcoming
many technical barriers like vascular anasto­
mosis, immunological rejection problems and
so forth. The process is one of high cost,
prolonged hospitalisation intensive medical
care and follow-upCOMMUMiTY health CELl
1 " P ~

OiCl6'. (l KorarflongaJa
35 V Main'
9-—-O

Bafl9alOfe-560034
India

a)

Organ Procurement

A major obstacle yet to be overcome
is the inadequate supply of donor organs, and
the supply and demand imbalance is increa­
singly widening. Till artificial organs are
designed, an ethical problem will be; establi­
shing a fair and effective policy of allocation
so that the available organs are used as justly
as possible.

b)

Determination of Death

The viability and suitability of certain
organs depend on the time lapsed after death,
and, hence the tendency is to remove the
organ from the donor as early as possible. This
leads to the question of the criteria for death.
The traditional legal view of determining death
used to be the absence of heart beat and
spontaneous respiration. With the advent of
recent life supporting systems, neurological
death is now considered to be the criteria for
death. It would be advisable that brain death
should be certified by a physician who is not
a participant in any phase of the transplant
procedure.
12

c)

Consent for organ donation

Organs may be donated after death by
'living wills' or consent of next of kin. When
an organ is required from a living donor, the
age of the donor and his ability to understand
the nature of the procedure, it's complications
and risks are crucial issues. There have been
many instances in countries like India, where
organ selling was done for monetary gain,
organs procured by using coercive methods,
or by giving false or inadequate information.
The recepient should also be given informa­
tion about the risks involved, especially, if the
procedure is a high risk one or of an experi­
mental nature.
d)

Resources

The question should be raised in situations
where there are limited resources, whether it
is justifiable to spend enormous amount of
money, time and energy for prolonging the life
span of a few, temporarily, while thousands
are denied even the elementary and basic
health needs which might cost very little.
Offering a patient extended life without
reasonable quality of life seems to be cruel.
13

IV.

EUTHANASIA

True meaning of euthanasia, is, the
deliberate bringing about of gentle and easy
death, making the patient's last days as com­
fortable as possible to ensure a calm and
peaceful death, within context of relieving
incurable suffering in terminal illness or disa­
bility. It is voluntary when requested by the
patient; involuntary when resorted to by
those attending on the person. It may be
passive when death is hastened by the delibe­
rate withdrawal of effective therapy or
nourishment.

Euthanasia request may come out of
depression and confusion, or out of a feeling
of worthlessness or due to persuasion of
interested
parties with ulterior motives.
Though one may not prolong the act of dying
in a case of irreversal death and thereby
increase suffering, respect for the person of
the patient and concern for the family should
lead us to use our resources as best as we
can to promote life. We should oppose all
attempts for the elimination of human life or
the manipulation of it to suit personal con­
14

venience. The essence of a Christian approach
to a dying patient is to give ourselves in loving
care to meet his need. A Christian doctor
sees his patients not merely as a biological
unit but as a person before God with family
and social connections.

One of the great achievements of recent
medical technology is the use of artificial life
support systems which can keep a patient
alive by special means, like artificial feeding,
dialysis, controlled respiration, pump circula­
tion etc. But in some cases it may be so
dehumanising, painful, hazardous or costly
that other consideration outweigh the aim to
conserve life.

The question arises, how long to sustain
life artificially? A patient might say "I do not
want a vegetative existence by drips, drugs
and machines. I want to die with dignity and
I have a right to die when I choose". Some
time ago, there was a judgement in the
Bombay High Court in which two judges
acquitted a man accused of attemped suicide.
They said that according to Indian constitu­
tion any citizen has the right to life. Corollary
15

of this is that every citizen has also a right to
lay down his own life. When I showed this
news item to Dr. John Wilkinson, a British
medical doctor and a theologian, he reminded
me that according to Christian concept.
Almighty God is the giver and sustainer of
life and He alone has the right to withdraw
breath from life. Life is not a right, but a gift
of God and so we have no right to take away
a human life, even one's own, as it is a divine
prerogative. The famous Arthur's trial of 1981,
where Dr. Arthur had prescribed an overdose
of codeine to a baby born with Downs synd­

rome with the object of hastening his death,
can be considered here. Dr. Arthur was char­
ged with murder. Many eminent withnesses
were tried.
Most of them justified the
procedure. Finally the court acquitted
Dr. Arthur as his motive was compassion.
There is a strong arguement that if a foetus is

found to be abnormal and severely handi­
capped it should besought out and eliminated
before birth, as such children are socially
valueless. Do not the physically handicapped
and mentally retarded have as much right to
life like others, and get the needed care and
treatment?
16

Let me share with you the experience of
two of my friends who faced the issue of
caring for children with disability. One was
a hospital Chaplain. When a child with disa­
bility was born to him, he asked God why this
happened to him, but he could not get an
immediate answer. He loved that child but the
child could not adequately respond to his
love in the normal way. This helped the
pastor to realise how God loves us inspite of
us not being responsive to His love. The other
was a colleague of mine and a highly qualified
Paediatrician. When a child with disability
was born to him and his doctor wife, they
did their very best to sustain her life. The
child became critically ill immediately after
birth, needing exchange blood transfusions.
Though their colleagues questioned the
wisdom of taking such an extreme step for
such a child, they choose to have the exchange
transfusions. The child recovered and subse­
quently brought a new purpose to their life
before she finally died at 4 months of age.
Through this the parents realised that God
had a purpose in bringing her to their home.
This experience was an act of God to make
them aware of the need of caring for many
neglected, children with disability in our
17

society. So they resigned from their busy
clinical work and offered their lives to start a
centre for children with special needs. An
apparent traumatic experience became the
rallying point for a new mission and for
Christian compassion.
OUR GUIDING

PRINCIPLE

Ever since the time of Hipocrates in the
fifth century BC the medical profession has
been guided by the concept of the worth of
each individual human life, which was recently
reaffirmed by the Geneva code in 1948, which
states, "I will show the utmost respect for
human life from the time of conception".
Suffering is evil, and we should take every
step to mitigate or relieve it, but suffering
has also meaning and purpose.

Hitler had a utilitarian philosophy of
life. Any person who had a utilitarian value,
he preserved, and others he eliminated. But
as Christians we respect the unique value of
human life. Man is made in the image of God
(Gen 1:27) This gives human life a unique
dignity and value (Gen 9:6), (Ps 8:4-8).
I he death of Christ on the cross demonstrates
the depth of God's love for mankind, His
creation. Life should be cherished, supported
and cared.
18

LET ME SHARE SOME PRACTICAL S TEPS •'

1.

Doctors should serve and care for their
patients in love based on Christian
motivation.

2.

Deliberate attempt to end or shorten life,
whether by ommission or commission is
wrong and should not be done.

3.

The church should proclaim the way of
righteousness and truth, against taking
innocent lives, and provide compas­
sionate, care.

4.

Education of medical personnel and
people with moral and spiritual values
should be done, which may lead to
sound legislation.

5.

Bring in Christ's principle of love as
the motive and mainspring.

CONCLUSION
Views and ideas and even concepts
of ethics are fast changing in the context
of the progress of science and technology.
The traditional institutions in our society,
which protect human life and spiritual

19

values are gradually being pushed aside or
getting eliminated. Love is the foundation
of Christian ethics. Loving our God with
all our heart, soul and mind and loving our
neighbour as ourselves, are the two found­
ations for our ethical practice. Only a code
of ethics based on the Bible and sound
Christian principles, can lead our society to
lasting happiness, harmony and peace.

20

E. M. F. I.

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Copies are available at :
1.

EMFI Office,
Montauban Christian Guest House,
Ettines Road,
Ootacamund-643 001,
The Nilgiris,
Tamil Nadu,
South India

2.

Christian Fellowship Hospital,
Oddanchatram-624 619,
Anna District,
Tamil Nadu,
South India.

3.

International Christian Medical &
Dental Association,
157, Waterloo Road,
London BEI 8XN,
UNITED KINGDOM.

SOME

ISSUES

RAISED

Has a patient the right to be delivered from incurable
suffering?

«’

If a person has a right to life has he not also a right
to take away his own life?
Abortion, though once considered to be a criminal act
is now often considered to be a benevolent and obligatory
act. Should we not go along with the times?

Is it wrong to find out and eliminate a retarded foetus?
If test tube baby is a breakthrough in medical technology,
why impose restrictions?

Is it wrong to attempt to create super-humans through
genetic engineering?
Is it ethical to sell or

buy organs?

What is our priority - to prolong life of a few or improve

the quality of life of the masses?

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