Gilbert Meilaender, Bioethics: A Primer for Christians, 4th ed. (Grand Rapids, MI: Eerdmans, 2020).
With his book, Bioethics: A Primer for Christians, Gilbert Meilaender has given to the church a great gift. As a pastor of a church within an evangelical denomination who gets to walk beside members of my congregation as they wrestle with the ever-changing issues pertaining to real life bioethical questions, I am grateful to have access to a book like Meilaender’s.
Now in an updated fourth edition, Bioethics accomplishes what the subtitle, A Primer for Christians, claims. Meilaender does not say everything that could be said regarding each of the bioethical subjects discussed. Instead, with clarity, brevity, and faithful application of the dignity of life and reality of death, he identifies and explains the primary concerns in each bioethical arena. Meilaender’s approach could best be summarized as wanting to instruct his readers how to think about the inherent difficulties within bioethics broadly rather than what to think exhaustively for each particular subject.
Meilaender notes in his “Introduction” that the difficulties of bioethics for Christians are at least twofold. First, the field of bioethics remains a recent one—only “over the past half century at most has a discipline of bioethics developed, and only in these years have bioethical concerns become commonplace in our everyday lives” (xiv). Because of this newness, many Christians may not yet be aware of or may not have been given the opportunity to consider the ethical issues related to bioethical questions. Second, the field of bioethics has largely “become the specialized possession of ‘bioethicists,’” moving, as a subset of ethics, from the domain of theology to one that has become “increasingly secularized—driven by the view that public consensus must exclude the larger questions about human nature and destiny that religious belief raises” (xiv). Public policy, he argues, largely powers the concerns and rhetoric—a reality that can leave many faithful Christ-followers ill prepared and confused. Accordingly, Meilaender sets forth in his opening chapter, “Christian Vision,” the broad categories that Christians seeking to think and live well in a bioethically complex world should have readily available in their lexicons. The rest of the book is the application of these categories to specific bioethical arenas.
Meilaender presents the categories of “Christian Vision” through pairings that frame the complex nature of bioethical consideration. There is, first, the pairing of the individual and the community. The reality of our living in the enlightened age of the individual, wrestling with our individuality within community (horizontal)—and especially our being “in community with God” (vertical)—bears heavily upon how we will approach bioethical questions (2). Meilaender writes: “We should not suppose that any individual’s dignity can be satisfactorily described by the language of autonomy alone—as if we were most fully human when we acted on our own, chose the course of our ‘life plan,’ or were capable and powerful enough to burden no one” (3). Properly understanding the tension of being an individual within community (horizontal and vertical) should transform how we approach questions of our rights related to everything from procreative to end-of-life choices. In several chapters addressing such questions, Meilaender works to show how the tension of this pairing can apply for believers.
Second, Meilaender discusses the paired ideas of freedom and finitude. By our very nature, the human person is both “finite being” and “free spirit,” and “the person simply is the place where freedom and finitude are united” (4). Why Meilaender believes this two-sided nature of humans matters for bioethics is worth quoting at length:
It cannot be acceptable simply to oppose the forward thrust of scientific medicine. That zealous desire to know, to probe the secrets of nature, to combat disease—all that is an expression of our created freedom from the limits of the ‘given,’ the freedom by which we step forth as God’s representatives in the world. But a moral vision shaped by this Christian understanding of the person will also be prepared to say no to some exercises of human freedom. The never-ending project of human self-creation runs up against the limit that is God. It will always be hard to state in advance the precise boundaries that ought to limit our freedom, but we must be prepared to look for them. We must be prepared to acknowledge that there may be suffering we are free to end but ought not, that there are children who might be produced through technological means but ought not, that there is valuable knowledge that might be gained through use of unconsenting research subjects but ought not (5, emphasis mine).
It is regarding this pairing of freedom and finitude that the complex tension of many bioethical questions really comes to bear. As one specific application of this pairing, Meilaender writes in the chapter “Suicide and Euthanasia” that “suicide as a rational project expresses a desire to be only free and not also finite—a desire to be more like Creator than creature” (71). When we fail to consider a person from both sides of their nature, we run the risk of doing or approving of that which we ought not as Christians.
Third, Meilaender presents the pairing of healing and wholeness. Because of the reality of suffering resulting from a fallen world, he suggests that not every case of healing equates to the bringing of wholeness. When these two ideas are inseparably conflated, we run the risk of falling into the tempting thought he discusses in his chapter “Gifts of the Body: Human Experimentation.” He writes: “Fearing death and running from it, we find no good reason ever to accept it in our own life or that of others. Placing our hope in the forward march of medical research, we deceive ourselves into imagining that it could be redemptive, that it might overcome the sting of death” (130). Accordingly, any and every medical advancement that serves to alleviate mankind’s fear of dying—bringing healing to every subsequent health problem—is conflated with the wholeness for which we really and truly long. When this occurs, we are left blind to the real stakes of our medical choices. That which might heal may not always bring wholeness. The field of bioethics invites us to consider that the choices before us are more complex than we are perhaps led to believe and that “the way we live toward death in a world marked by illness and suffering” matters for obtaining the wholeness to be found only in and through the gospel of Christ (149).
With these categories woven like threads throughout the book, Meilaender sets forth to discuss the issues and concerns regarding procreation, advances in genetic testing, organ donation, embryos, suicide and euthanasia, and other end-of-life questions. Because of the brevity of Meilaender’s Bioethics, there will no doubt be places where the reader wants him to say more than he does. Helping matters here, he does offer in his footnotes an ample supply of resources accessible to the person whose appetite has been whet for more. These resources include books and articles related to each of the topics that he discusses.
Overall, Meilaender offers a clearly articulated wealth of insights for those new to the study of bioethics. In this way, what Meilaender has given to the church is of immense benefit. If Christians are to take seriously Paul’s words in Ephesians 5:15–16 (“Look carefully then how you walk, not as unwise but as wise, making the best use of the time, because the days are evil”), then pursuing wisdom in the field of bioethics should be of no small concern. Toward this end, Meilaender casts a vision of bioethics that is deeply informed by a Scriptural understanding of human dependence, God’s transcendence, the dignity of life, the hope of death, and the satisfaction of the work of Christ applied to all of life.
Bioethics is deserving of a place on the shelf of every pastor, Christian medical worker, Christian counselor, and church member in the pews. It is food for thoughtful engagement and fodder for beneficial conversations.