“In a spiritual understanding of clinical ethics, the basic idea is that the individual who is facing a difficult dilemma is not alone.”[1] Robert D. Orr penned these words in reference to the “priesthood of all believers” (1 Pet 2:4–5) and its role in clinical ethics decision-making. The individual believer need not make difficult ethical decisions alone, but participates with the broader Church, as well as the guiding of the Holy Spirit, to discern what is wise, what is true, and what is good.
Dr. Orr himself contributed greatly to this endeavor. As a beloved doctor, professor, author, and Distinguished Fellow with CBHD, he gave generously of his time and wisdom to work directly with patients and their families on the frontlines of ethical decision-making and to participate with the broader bioethics community. My (Anna Vollema) own position as the Robert D. Orr Fellow for the Center is a testament to his passion for educating the next generation of thinkers and leaders in bioethics.
This issue of Dignitas seeks to honor the important work of mentoring the next generation. Three of the articles in this edition come from current students, their specialties spread across a variety of disciplines. An essential part of the “priesthood of all believers” concept is the integration of the next generation: the passing on of the torch, the wisdom gained from experience, and the inclusion of their necessary voices. As a center, CBHD is committed to providing space for such student voices.
Thus, Justin Chu, winner of the 2021 Student Paper Competition, develops a theology of addiction and applies it to the current opioid epidemic in the United States. He states that a tension must be allowed to remain between the biological realities of addiction and its nature as an idolatrous pull away from one’s Creator. This allows for an approach that considers both the theological reality of moral culpability and a recognition of the biological interplay that comprises one’s ability to make a licit choice. After exploring the neuropsychological effects of opioid-class drugs and the resultant opioid crisis in North America, Chu lays out the various models developed to understand and respond to such addictions. Including a more detailed analysis of both the moral and disease models of addiction, he asserts that an appropriately developed doctrine of sin and Calvin’s understanding of the misplaced sensus divinitatis (“awareness of divinity”) provide an avenue for understanding addiction as a form of idolatry. He thus provides a variety of scholarly perspectives regarding the nature of this idolatrous reality and the sanctification process that must ensue in response. In the end, Chu provides his own exhortation regarding the church’s necessary response to the reality of addiction as “misoriented idolatry in tension with affected agency.”
Bethany Peck writes on the importance of a theology of embodiment for women and how this should affect our response to the ethical viability of abortion. While recognizing the potentially negative consequences for many women if Roe v. Wade were to be reversed, she ultimately asserts that an informed theology of embodiment would better equip the church to both care for potential mothers and yet protect the sanctity of unborn life. Clarifying the theological implications of the fact that women are created in the image of God and their creation as a life that brings forth life is an essential component of that reality, Peck argues that abortion ultimately represents an egregious form of disembodiment. She therefore examines how Gnosticism, in its radical separation between soul and body, is at fault for much of the rhetoric within the current abortion movement. Peck then sets off on the task of reaffirming a theology of embodiment anchored in creation, the incarnation, and the distinctiveness of the female body. Further recognizing that the gravity of the abortion epidemic has diverted the “pro-life” movement away from care of the mother along with that of the child, she reflects that a stance against the “expressive individualism” so prominent in pro-abortion circles should include a “turn inward” within the church so that space is created for the protection of both truth and life holistically.
Continuing on the topic of beginning-of-life issues, Ioan Veres explores partial ectogenesis, otherwise known as artificial womb technologies (AWT), from a Christian perspective. Affirming that partial ectogenesis should be considered morally permissible in cases where a continued pregnancy would pose a serious health risk to the mother, Veres begins by summarizing two differing perspectives regarding the personhood of a fetus. After synthesizing and refuting what he labels “The Secular View,” or that which utilizes a hedonistic utilitarianism to determine morality based on what results in the greatest happiness and pleasure for the most amount of people, Veres ultimately lands in an affirmation that Scripture affirms the full personhood of a fetus from conception, utilizing such passages as Psalm 51:5, Genesis 1: 27, and Exodus 21:22–25. With the personhood of the fetus, and thereby the ectogenetic fetus, established, Veres turns to the development of a theological-ethical framework for understanding partial ectogenesis. Stating that mankind is given dominion to rule at creation, he asserts that ethical scientific developments are included in this function. He further affirms the benefits of saving the lives of potentially at-risk infants and mothers. After exploring some of the challenges that embracing partial ectogenesis would pose, he opines that AWT is not intrinsically morally impermissible. However, he concludes his essay with a word of optimistic caution, exhorting the readers to tread carefully into the world of AWT, yet affirming its limited use in extreme circumstances.
Also essential within the communal aspect of the “priesthood” that Dr. Orr affirms is the perspective that each individual within the community needs the other. As the “Body of Christ” (1 Cor 12:12–27), we not only step into complementary functions as we serve and participate with the Church (vv. 1–11), but we also enter the collective wisdom of fellow believers. Thus, both continued dialogue and charitable critique are a conduit of building and reforming such understanding. Two of our fellows, Calum MacKellar and Russell DiSilvestro, exemplify a commitment to this process as they continue a discussion of the ethical viability of gene editing.
In this issue, MacKellar further develops his argument affirming that a necessary distinction be made between the ethical viability of genome editing on a pre-conception egg or sperm versus a post-conception embryo. Building his argument from the philosophical foundation of Origin Essentialism, he affirms that the circumstances of a person’s origin are essential to the development of that person. Thus, to alter the circumstances of one’s origins is to create a whole new person altogether. The extent of this difference is not what matters. Rather, pertinent is the fact that only one person, in all that makes up his or her essence and form, can exist at a given point in both space and time. With this established, MacKellar clarifies the “Non-Identity Dilemma,” or the reality that when faced with a potential flaw in a human person, to choose to erase that blemish would not alleviate such a person, but would in fact create a dissimilar person. Thus, well-meaning parents, MacKellar argues, who choose genome editing do not allay “Carson’s” potential disease, but in fact create “Donald.” He further states that this in fact displays a hidden preference for a non-disabled child, when the value of both the disabled and non-disabled child is in fact equal before God. However, he also qualifies this by stating that extenuating circumstances, such as a lack of resources, may be the reason behind the choice against a non-disabled child. Yet, if no such circumstances exist, then a “pro-equality” society must choose against genome editing that occurs before conception, while genetic editing that occurs on an embryo or fetus is acceptable. Finally, responding to DiSilvestro’s argument that a moral distinction should be allowed for intentional versus unintentional pre-conception genome editing, MacKellar states that this in fact highlights the need for education, not acceptance, regarding such a practice.
With the recent passing of Dr. Orr, our hope is that the issue before you will honor him in more ways than one. To that end, John Kilner provides a beautiful tribute to the life and work of this beloved man. We also desire that the pieces published here are reflective of the work to which he was committed throughout his life.
As a final note, as we mentioned in the previous Dignitas issue, this edition marks the transition to a fully online, open-access publication. By making this switch, we hope that Dignitas can benefit a wider audience. Members will continue to receive our sister publication, Ethics & Medicine: An International Journal of Bioethics in print format.
[1] Robert D. Orr, Medical Ethics and the Faith Factor: A Handbook for Clergy and Health-Care Professionals (Grand Rapids, MI: Eerdmans, 2009), 473.
F Matthew Eppinette and Anna Vollema, “Editorial,” Dignitas 28, no. 1–2 (2021): 1–2.
