Medical Ethics: Choosing Life and Health or Disease and DeathReader, suppose someone were to ask you this question, “What would you do with your life to promote the greatest health for the greatest number of people?” Before reading further, please pause and reflect on this question. It would be a good exercise even to write down 2-3 answers.
Here is the Biblical answer, “To achieve the greatest health for the greatest number of people, one should become a Biblical preacher or a evangelical missionary!” Was that answer among what you wrote down?
This answer introduces you to a Biblical ethic of medicine, no matter what country of the world in which you live. Any Biblical ethic always starts with the Biblical view of man, anywhere, at any time in history. The first man and woman (Adam and Eve) were created in a perfect state. Had they not sinned, they would have lived eternally with complete health. Because of their Fall, disease and death were introduced. “The LORD God commanded the man, saying, ‘From any tree of the garden you may eat freely; but from the tree of the knowledge of good and evil you shall not eat, for in the day that you eat from it you will surely die’ ” (Genesis 2:16-17).
David Livingstone, the great missionary to Africa, had this Biblical understanding when he gave up the practice of medicine to concentrate on evangelism, discipling, and church planting. His time was best spent in evangelization and preaching, rather than in medical care that, at best, would give only temporary relief.
The practice of medicine is inherently religious. If it is practiced on the ground that man is basically good and makes choices consistent with that understanding and that he is only a collection of molecules, every answer to any problem is biochemical or surgical.
Or, by contrast, medicine can be practiced by the believing Christian with the Biblical view that man has a soul, responsible to God for his thinking and behavior.
What is normal? What is health?
The World Health Organization (WHO) states that "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Biblically, health by this definition, exists only in the Garden of Eden (pre-Fall) and in heaven for believers. No matter what advances in medical and scientific technology, because of the Fall, disease is going to be prevalent and death will always occur (until Christ returns). So, the WHO definition, while it may be a noble goal, will never be achieved on planet earth.
What, then, would be a Biblical definition of health? I propose this definition: health is that physical and mental state of a person in which he or she is born-again, obedient to God’s commandments , and makes maximal use of the best medical science that can be discerned within a Biblical understanding. Let’s explore this definition in detail for it is basis to a biblical, medical ethic.
1) A person. Health is always an individual matter, relative to one person only. It ranges from a body like an Olympic athlete and a mind like Einstein to the severely retarded and physically incapacitated child or adult with a severe genetic disorder. Thus, exercise, diet, intellectual development, medications, physical therapies, and other modalities maximize one individual’s capabilities according to one‘s inherent physical and mental abilities. Those who are basically “healthy” of body and mind require, perhaps, only basic diet and exercise. Those with severe genetic disorders may require a wide range of frequent physical and medical interventions.
2) Born-again. This chapter is not the place to present the different Christian beliefs about what being “born-again” means. I refer here simply to the fact that the Bible divides all mankind into two groups, the saved and the unsaved (for example, Matthew 25:32-33). How can a man or woman who is rebellious towards God (Romans 5:10) be considered healthy in mind, if not in body? How can an unbeliever be motivated to make his body a temple of the Holy Spirit (I Corinthians 6:19-20)?
3) Obedience to God’s commandments. “If you love me, you will keep my commandments” (John 14:15).” Commandments” mean all of God’s instructions to His people, not just the Ten Commandments or those that are called commandments. If you read Psalm 119, you will see the many different nouns that are synonyms for “commandment.”Moses instructed the Hebrews, as they were to enter Canaan and after they had received the entire book of the law (from Genesis to Deuteronomy), “See, I have set before you today life and prosperity, and death and adversity,” (Deuteronomy 30:15. Also read verses 11-20). My paraphrase of that choice for medical ethics is “Choose life and health or disease and death.” (See also, Exodus 15:26.) One example of Moses’s choice is HIV/AIDS and all sexually transmitted diseases (STDs). Spouses who are chaste before marriage and sexually faithful after marriage never have to worry about contracting HIV/AIDS or any of the other worldwide epidemic of STDs. Thus, a major fear among the earth’s populations is erased by simply following God’s directives!
4) Makes maximal use of the best medical science that can be discerned within a Biblical understanding. There are some subtleties here of which the reader should be aware. “Best medical science” means a Biblical and statistical discernment that is careful and thorough. An example of Biblical discernment is that the law in every state in the United States allows any physician to treat any age girl for birth control, pregnancy, or sexually transmitted diseases without parental consent or knowledge. Such law is unbiblical, striking at the health that is the unity of the family.
An example of statistical discernment is screening for prostate cancer which does not alter morbidity (experience of disease) or mortality (increasing life expectancy). Even the U.S. government’s own position in its “Report of the U. S. Preventive Services Task Force does not recommend screening for prostate cancer.
There are numerous examples of other conflicts between the Bible and modern medical “science,” a few of which we will explore here. There are hundreds of examples of statistically irrelevant practices that are commonly accepted by health care workers. Biblical discernment includes scientific, as well as, biblical ethics because God is Sovereign over both the spiritual and physical universe. Most medical ethics spoken and written by Christians fail the Biblical standard at many points. Scientific analysis is almost non-existent. On our website, we have many articles that cover both these issues (http://www.bmei.org/).
Governments and Health
Government has a great deal of influence on the health of its people. We have already addressed the issue of treating girls without parental permission and a policy on prostate cancer. The official promotion of condoms, non-intercourse sex practices, and other non-statistical recommendations, rather than sexual fidelity before and after marriage, as answers to the HIV/AIDS epidemic is another heinous example. Countries that pass laws to allow same-sex marriages will also be severely hurting the health of their peoples, striking at the health that true families provide and increasing sexual promiscuity. Public health measures, or the lack of them, may affect the health of hundreds of thousands of people. So, Biblical ethics is necessary for governments, as well as, individuals. We will see this necessity in this next section.
“Now (Adam) had relations with his wife Eve, and she conceived and gave birth to Cain” (Genesis 4:1). Very simply, this verse defines when human live begins: with the sexual union of a man and woman that leads to conception. Human life begets human life. The issue is no more complicated than that.
For those who might want more Biblical support, I could cite the following.
John the Baptist leaped in his mother’s womb at the presence of Jesus (Luke 1:41). John has sufficient consciousness, that is, personhood, to react to His Lord’s presence. Now, the exact age of John in the womb of Elizabeth in not precisely known, but drawing the line anywhere during gestation from conception to birth can only be defined by some arbitrary standard that denies the continuity of human life from parents to their children.
David had a sin nature at conception (Psalm 51:5). Only a person can have a sin nature. David (and, therefore, any descendant of other humans) are persons from conception.
In Psalm 139:13, the unborn child is being “knit” together by God Himself. Does he “knit” at certain times before birth and not others? If so, how do we discern when He does not work that we may consider the unborn child non-human in order to abort it?
In Jeremiah 1:5, we are told that God ordained and sanctified Jeremiah before he was born! Thus, persons begin in the plan of God, starting at conception, when the person is first formed a unit of being.
Citing other verses will not convince the person who is unwilling to bow to God’s Word which clearly states that the individual person begins at conception, and that it constitutes murder to intentionally kill that person any time later in life (6th Commandment).
For the most part (at least superficially), Western civilization is a pretty picture. Tall, strong lines of skyscrapers and huge ships, libraries and universities, hospitals and physicians’ offices, asphalt and concrete roads, computers that stagger the imagination in their capabilities, and dozens of other marvels. But, if you go into any nursing home and look at the bodies of the people there and observe the functioning of their minds, you will see the devastating effects of the Fall of Adam and Eve. For all our “advances and technology,” we cannot prevent much of the ravages of disease and the dying process.
These devastating effects cause a great deal of human suffering by the persons themselves and their families. On an emotional level, one can understand the drive to find a “solution” to end this suffering. (It is also costly and a great inconvenience.) No one wants this tragedy for himself, herself, or a member of one’s family. But, God speaks from Mount Sinai, “Thou shalt not kill!” He does not need to say more.
What is most needed in these difficult situations is the presence of tenderness and longsuffering, the “until death do us part” commitment of spouses, the “honoring of father and mothers,” the reconciliation of conflicts (before the opportunity is gone forever), the creativity of care and comfort, and the greater heights that men and women are sometimes called to scale in their love or one another. Unfortunately, Christians are too often no better than non-Christians in these circumstances. Surely, we should strive to fulfill the criteria by which the world may judge our testimonies (John 17:20-25).
You see, dear reader, the reality of Moses’ choice that he gave his people, “choose the way of life or death” is the same choice today. The unbeliever (call him humanist, atheist, agnostic, communist, socialist, spiritualist, or whatever) answers difficult problems with the solution of death: death to the unborn child and death to the aging and diseased ridden person. God’s answer is life, as difficult as it may be under the effects of the Fall.
A Word about Psychology and PsychiatryThe human individual is a unity of both body and mind. Thus, we cannot avoid considering the sciences of the mind (psychology) in a chapter on medicine.
Virtually all professionals in this field trace modern psychology and psychiatry to Sigmund Freud. This man was an atheist who tried to find a solution for the problem of guilt. Voila! We are face to face with the Bible again! There is no solution for guilt other than the forgiveness provided in Jesus Christ and to be born-again.
Some writers who are Christians pose the question, “Is the Bible really a textbook on psychology?” (The only difference between psychiatry and psychology is that psychiatrists are M.D.s and may prescribe medications. Both use the same “psychotherapies.”) You should answer, “It most certainly is!” What is psychology about? Thinking and behavior. What is the Bible about? Thinking and behavior.
Now, there are a couple of differences. The Bible is truth; psychology is science (see the Chapter on Science and Technology), based upon an evolutionary concept of man. The Bible is God’s Word; psychology is man’s word (as theory and experimental knowledge).
One other comment should suffice for a very brief overview here. There are diseases of the brain. Some are obvious, like brain injury: accidents with head injury, strokes, Parkinson’s disease, cerebral palsy, Alzheimer’s, brain tumors, etc. Some are likely due to brain disease: schizophrenia and bipolar disorder. Some are very questionably caused by brain disease (at least in most cases): depression, attention deficit hyperactive disorder, and panic disorders. The borders in many of these areas between disease and behavioral choices is yet to be worked out definitively. Yet, today, a far greater number of these have been labeled “mental disorders” than are truly organic. In all cases, the Bible must be applied to behavior in all areas where choices can be made.
Drug Use and Abuse
We started this chapter with medicine being practiced on the basis that man is a body (biochemicals) only or he is both body and soul (the Biblical view). So, let me ask you this question, “Both legally and illegally, what do most societies believe the answer to their problems is?” The answer is, “Drugs.” People go to physicians to get drugs. (They care little for spiritual answers based upon mine and many others’ experiences.) If they can’t get the drugs that they want there, they get them “on the street” (illegally).
You see, a man’s view of himself will determine his approach to medical care for himself and his family, whether he is the patient or the physician. Medical practice is the reflection of a culture, as is every other area of endeavor.
I have only introduced a number of basic issues here. Another physician (Hilton P. Terrell, Ph.D., M.D.) and I have a website that explores and develops these and many other concepts from a Biblical perspective, for those who have internet access. (http://www.bmei.org/).
All Bible quotes are NASB.
Copyright © 2003 BMEI, Inc.