On January 23-24, 2015, the Academy of Fellows of The Center for Bioethics & Human Dignity (CBHD) met for its fourth consultation. The two previous consultations focused on specific topics: justice and bioethics in 2013, and synthetic gametes in 2012 (video from these events is available on CBHD’s YouTube channel at youtube. com/bioethicscenter). This year’s consultation took a different approach. The overall purpose of the Academy of Fellows is to “engage in thoughtful discussion, charitable debate, and mutual support.” To facilitate this, most of the recent consultation involved Fellows presenting ‘works in progress’ in order to help Fellows develop their ideas and move them towards publication or other public dissemination. A significant emphasis of the Academy of Fellows is the desire to mentor future Christian bioethicists. To explore tangible possibilities of academic mentoring with the Academy of Fellows, the consultation began with a presentation by Donald Guthrie, professor of educational ministries and director of the doctoral program in educational studies at Trinity Evangelical Divinity School. Guthrie outlined current scholarship on academic mentoring and described the importance of providing both challenge and nurture within the same environment. One key aspect is that mentors allow their mentees to attempt assignments that stretch their skills while providing constructive feedback. The presentation led to an engaging discussion about the practicalities of promoting such mentorship within the Fellows’ various academic settings.
Saturday began with Distinguished Fellow Gilbert Meilaender presenting his on-going research on a theological response to biomedical enhancement. Meilaender was on the President’s Council on Bioethics when it published Beyond Therapy. For his theological analysis, Meilaender examined ideas proposed, but not developed, by Karl Barth in his unfinished Dogmatics. In particular he explored how the perfection of our bodies, which enhancement imagines, can fruitfully be examined through the theological lens of redemption and how this lies in the future. Given the engaging discussion stimulated by Meilaender’s work in progress, we look forward to reading his completed work. Other Fellows gave shorter presentations, beginning with William Cheshire. As Chair of the Ethics Committee of the Christian Medical & Dental Associations (CMDA), Cheshire also has grappled with the difficult ethical decisions that enhancement raises.
These include considering the proper ends and means of medicine, distinguishing between healing and enhancement, evaluating the just distribution of medical resources, and, in partnership with patients, deciding how best to honor the patients’ wishes when societal pressures may diminish their autonomy. The Ethics Committee has developed recommendations for healthcare professionals facing ethical challenges with enhancement technologies. Cheshire discussed the status of these recommendations, and acknowledged the expert input provided to the Ethics Committee by CBHD and several members of the Academy of Fellows.
Fabrice Jotterand continued the focus on enhancement through examining issues raised by neurotechnologies, such as brain imaging. Claims are made that damage to specific regions of the brain correlate with predispositions to bad or criminal behavior (psychopathy). The suggestion that material factors are responsible for bad or criminal behavior seems to challenge commonly held understandings of the nature of morality and the basis of moral and criminal responsibility. Jotterand explored some of the implications of neuroscientific conceptions of self for our understanding of moral agency in psychopathy, critically evaluated some of the arguments attempting to establish the neural correlates of morality, and explored the implications of such arguments for forensic psychiatry and moral (and criminal) responsibility.
The final presentation of the morning was made by Chris Ralston. He described his ongoing work at Joni and Friends International Disability Center and the Christian Institute on Disability. These activities included a “Call for Papers” for an upcoming thematic issue on disability and bioethics for the Journal of the Christian Institute on Disability, and the launch of the course “Beyond Suffering Advanced Studies: A Christian Perspective on Healthcare Humanities.” This online course addresses practical reasoning, self-knowledge, and action in the care of the sick and the marginalized, with a special emphasis on people with disabilities. Finally, Joni and Friends is partnering with Tyndale House Publishers to create the Beyond Suffering Bible, forthcoming in 2016. This aims to help readers love, reach, serve, and disciple people with disabilities through understanding what the Bible says about suffering and disability.
In the afternoon session, Henk Jochemsen presented ongoing work on potential social problems if synthetic biology is successful. He described the importance of symbolic order for society. Symbolic order is a set of widely shared and strongly entrenched concepts that cultures use to categorise reality. Society uses such powerful metaphors to draw boundaries in terms of dichotomies like life-death and natural-artificial. Synthetic biology uses many metaphors (like biobricks or cellchassis) that challenge symbolic order and therefore strongly, but subtly, influence society. Yet some synthetic biologists will admit that such metaphors are invalid, even scientifically (e.g., that living cells are like machines). The impact of such metaphors needs careful analysis and may provide fruitful ways to critique the claims of synthetic biology.
Russell DiSilvestro presented an on-going project that aims to show how the “capabilities approach” to moral and political philosophy, initiated by Martha Nussbaum and Amartya Sen, might best address the debate about the relationship between human rights and sex-selective abortion. This debate predictably migrates through familiar questions about balancing the rights of adult women against the rights (and moral status) of prenatal human life. Although some of Nussbaum’s work suggests that prenatal human life has a low moral status, her recent paper with Rosalind Dixon, “Abortion, Dignity, and a Capabilities Approach,”1 claims that the capabilities approach supports something like a gradualist position. However, they acknowledge the possibility and plausibility that this approach offers to defend a high moral status for prenatal human life. This proposal will receive further careful deliberation by DiSilvestro and colleagues.
Shari Falkenheimer gave an overview of her plans for her doctoral dissertation and ideas for related comprehensive papers on whole person medicine and the continuing professional development of physicians. Her preliminary plans include a qualitative project involving interviews with people who have taken the Partners in International Medical Education (PRIME) course on whole person medicine. This project would explore what attracted participants from multiple cultures and faith groups to take the course, what they valued about it, and whether and how it affected their practice after the course. She received valuable feedback from the Fellows and plans to develop her project further.
John Kilner gave an overview of his new book, Dignity and Destiny: Humanity in the Image of God (Eerdmans, 2015) and his further plans for this material. Dignity and Destiny includes an examination of all biblical passages on the image of God. Kilner’s view is that people, made according to (or in) the image of God, have a special connection with God and are intended to be a meaningful reflection of God. Because of sin, they do not actually reflect God very well, but are still fully in God’s image. Renewal in God’s image entails a more intimate connection with God through Christ and an increasingly actual reflection of God in Christ, to God’s glory. This connection with God is the basis of human dignity. Kilner concluded with a reflection on the tremendously liberating impact that a sound understanding of God’s image can have in the world today, including within bioethics.
Calum MacKellar discussed a current project he is working on in the area of emerging technology and neuroethics. He detailed how current and near-future research suggests the possibility of fusing the human brain with computers, and the human mind with cyberspace. Rudimentary, and current, examples of such technology include Google goggles linking the user to the web, and cochlear implants linking brains with computers. These developments raise challenging ethical questions whose answers are neither obvious nor easy to reach. The proposed book takes an inter-disciplinary approach that blends research from disciplines such as neurobiology, philosophy, sociology, and psychology.
Dónal O’Mathúna gave an overview of recent ethical debates triggered by the Ebola outbreak in West Africa. These include the ethics of quarantine, research ethics during infectious disease outbreaks, and ethical issues with collecting and storing biospecimens for Ebola research. These led to the Presidential Commission for the Study of Bioethical Issues requesting public commentary on Ebola ethics. The Academy discussed setting up a working group to examine ethical issues in Ebola response and research for which a Christian perspective could make a distinct contribution.
After a packed and engaging day and a half, the consultation concluded. Through the consultation, presenters received helpful comments and constructive feedback. The breadth of bioethical issues being addressed by members of the Academy was impressive. On-going projects moved a little further towards completion, and seeds for new projects were sown. New collaborations were forged as Fellows saw areas of common interest. Also important, a sense of camaraderie and common purpose was renewed that will stay with the Fellows as they return to their own bioethical front lines.
The Academy of Fellows expresses its gratitude to all the staff at CBHD for organizing the consultation so well. In addition, the Academy is especially grateful to the anonymous donor whose gift funded this consultation and other Academy activities over the past few years.
1 Rosland Dixon and Martha Nussbaum, “Abortion, Dignity and a Capabilities Approach,” in Feminist Constitutionalism: Global Perspectives, ed. Beverly Baines, Daphne Barak-Erez, and Tsvi Kahana, 64-81 (New York: Cambridge University Press, 2012).
Cite As: Rosland Dixon and Martha Nussbaum, “Abortion, Dignity and a Capabilities Approach,” in Feminist Constitutionalism: Global Perspectives, ed. Beverly Baines, Daphne Barak-Erez, and Tsvi Kahana, 64-81 (New York: Cambridge University Press, 2012).
