more stuff for you-just added it to not a wiki
Not sure where its from (here I think??)
anyway
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STUDIES OF RELIGION
Definition of Bioethics
Bioethics is only 30 years old; it is descended from medical ethics and other areas of scientific ethics. It pays attention to the growing array of moral issues associated with contemporary medical care and biological and medical research.
Bioethics remains thoroughly interdisciplinary: it is not the preserve of doctors or philosophers or theologians, All hospitals now have Bioethics Committees that prepare policies and provide advice on hard cases; these are made up of representatives of doctors, nurses, administrators and professional ethicists, who may be trained in philosophical or theological ethics.
The key questions that arise in bioethics are:
• Allocation of limited resources
• Management of terminal and chronic illnesses
• Regulation of health care
• Use of human subjects in research
• Defining the authority of health care workers to make decisions.
• Genetic research and information
• Regulating technological intervention in human reproduction
Reproductive Technologies
• There are five categories of Reproductive Technologies.
• Helping conception in couples who cannot conceive normally (IVF, hormonal treatments, any embryo transfer such as GIFT).
• Providing a gamete when one is missing (AI with heterogeneous donor, donor sperm or ova in IVF, and surrogacy)
• The manipulation of an egg or embryo in the lab to determine sex, disease or characteristics, or for genetic engineering.
• The correction of defects in the foetus
• The detection of genetic defects in babies and adults in procedures (screening, fingerprinting, mapping).
Issues raised by these technologies (particularly according to the Vatican) fall into the following categories:
• Objections on the grounds of the ‘unnatural’ character of the intervention
• Objections on the grounds that the embryo has moral status (usually from conception or implantation)
• Objections because these technologies represent a ‘slippery slope” which will ultimately devalue life itself
• Objections because these technologies involve a loss of autonomy on the part of the patient and the embryo
• Objections on the ground that there is no absolute right to reproduce.
• Objections on the grounds that medical intervention in this area if not consonant with the purposes of medicine (eg, IVF does not treat the disease of infertility, it rather avoids the problem without treating the cause or the symptoms). This is the ‘technological fix’ response.
• Objections on the grounds that the costs and risks outweigh the benefits.
• Objections on the grounds of lack of informed consent.
• Objections because most of these technologies are experimental and involve experiments on humans
• Objections on the grounds that these procedures represent the objectification of the human person: children become considered as products that are manufactures by some medical-commercial process.
JEWISH APPROACHES TO BIOETHICS
Essential Principals
It is a cardinal principal in Judaism that life is of infinite value that each moment of life is equal to seventy years thereof. All commandments are set aside for the saving of life (all 613 mitzvah!). The potential of the life being saved does not come into it. A second principle is that life is sacred: being created in the image of God, human beings are holy and must be treated with respect in life and death. Only God gives and takes life. A third principle follows: nature was created for the advantage and benefit of the human person, allowing animal experimentation on the condition that the animal does not suffer unduly.
Abortion
An unborn person is Jewish law is not considered a person (nefesh) until it has been born. The foetus is regarded as part of the mother’s body and not a separate being until born. Until forty days after conception, the embryo is considered as ‘fluid’.
Intentional abortion is not mentioned in the Tenach, but accidental abortion is covered by Exodus 21:22-23. The commentator Rashi regards this as meaning that miscarriage is equated with an injury to another part of the woman’s body. None of the commentators raises the possibility of manslaughter being involved.
Moses Maimonides (‘from Moses to Moses, there was none like Moses) worked out the scale of payments without regard to the foetus, because a non-person is not covered by Ex. 21:12, the teaching on murder.
In the Mishnah, abortion is allowed under certain circumstances: ‘If a woman is having difficulty in giving birth and her life is in danger, one cuts up the foetus within her womb and extracts it limb by limb, because her life takes precedence over the foetus. But if the greater part was already born, one may not touch it, for one may no set aside one person’s life for that of another.’
Elsewhere, it says: ‘If a pregnant woman is taken out to be executed, one does no wait for her to give birth; but f her pains of parturition have already begun [literally, she has sat upon the birthing stool], one waits for her to give birth before competing the sentence.’
In the Talmud, it goes further: ‘Rab Judah said in the name of Samuel: If a pregnant woman is about to be executed, one strikes against her womb so that the child may die first, to avoid her being disgraced.’ This is to avoid a situation where the violence of a death by strangulation might cause spontaneous abortion and the bleeding of the woman would cause her disgrace.
The Talmudic commentary of the Tosafot states that ‘it is permissible to kill an unborn foetus.’ These words are not universally accepted.
After forty days, the Talmud considers that miscarriage must give rise to ritual uncleanliness (similar to that prescribed for the birth of a child and not for a menstruating woman) and that the woman must make a birth offering. It does not matter that the foetus or embryo may not be identifiable as human: the abortus still has some human status even if it is not nefesh.
In spite of the general consideration that the foetus has little status, then, abortion is generally prohibited except where the mother's life is in danger. This is because most rabbis consider that killing is immoral even if it does not actively attract a penalty. Hence, there must be a strong reason for killing the unborn that will justify the general respect for life in Judaism. The assumption is that the Talmudic teachings allowing abortion are exceptions from an accepted rule.
Babies who are disabled or defective
If a woman gives birth to a child who is significantly deformed, the Talmud does not regard it as an offspring unless it is born alive, in which case it is regarded as a human person. In one of the classic rulings, Rabbi Judah the Pious (13th C.) described what to do with a child who was born with a fish's teeth and tail. The people were worried that it might be a victim of mistaken identity and eaten poached with a white wine sauce; so Rabbi Judah ruled that the teeth and tail should be removed in spite of the risks and the child raised as a normal human being.
In more recent cases, Rabbis have rejected any suggestion that a child should be starved to death if it is born with a severe defective. When thalidomide was causing birth defects in the sixties and seventies, the killing of children who were missing limbs was specifically excluded. Since the advent of amniocentesis and other diagnostic procedures, rabbis have ad to deal with the situation where the defect is known before birth. Some rabbis suggest that couples that both carry defective genes should not marry; others allow abortion for serious congenital diseases like Tay-Sachs disease. However, it is generally considered that the fear of giving birth to a deformed foetus is not in itself a reason for having an abortion.
In Vitro Fertilisation
The three major source in the Talmud dealing with IVF are sourced in rulings on artificial insemination, which seems to present a bigger problem for Jewish ethicists.
Ben Zoma was asked: May a high priest marry a maiden who has become pregnant yet who claims she is still a virgin? Do we take into consideration Samuels’ statement, for Samuel said, I can have repeated sexual connections without bleeding (i.e., causing the loss of virginity)? He replied: The case of Samuel is rarer, but we do consider the possibility that she may have conceived in a bath [accidentally inseminated by the previous occupant].
The tradition is called generation or conception sine concubitio. While not all rabbis agree that this is possible, it does emphasis that not-copulatory conception was considered possible before IVF. In another case [written up in a theological work with the great name of Hagahot Smak], Rabbi Peretz ben Elijah says:
…a woman may lie on her husband’s sheets but should be careful not to lie upon sheets which another man has slept lest she become impregnated from his sperm. Why are we not afraid that she will become pregnant from her husband’s sperm and the child will be conceived of a niddah [menstruating female]? The answer is that there was no forbidden intercourse, and so the child is legitimate. We are concerned about the sperm of another man because the child may eventually marry his sister.
In recent rulings [Jewish ethical and legal rulings by rabbinical courts are called reponsa] the major questions about IVF surround the status of the offspring, and develop from the rulings on AID (Artificial Insemination Donor Sperm and AIH (Artificial Insemination Homologous Sperm). Some of these are: is the woman permitted prohibited to her husband following such a procedure (i.e., donor sperm); is it an act of adultery; is the child of a donation a mamzer [bastard]; does the donor fulfil the commandment of procreation [in Genesis]; is the offspring the child of the donor or the husband of the mother; how should one obtain the sperm; and can the insemination procedure be carried out if the woman is unclean?
Therefore, a major problem in IVF and AID is the potential for adultery. Many rabbis see this as obvious; though rabbis that are more liberal think this is impossible without an act of copulation. Generally, AID would give the husband the right to divorce his wife for adultery; so, IVF using donor sperm would entail the same. The principle of the danger of incest also prohibits this.
The other significant objection lies in the necessary process for obtaining or recovering the sperm. Masturbation is prohibited, though some rabbis allow it when not other procedure is available. Also frowned on is the recovery of sperm after intercourse.
The End of Life
The biblical principal is 'Whoso sheddeth a man’s blood, by a man shall his blood be shed.' (Gen 9:6) In the Pentateuch, murder is one of the most significant issues for the Mosaic Law, prohibited in every book. A specific reference within the prophetic tradition is the death of Saul, in I Kings. Some commentators see this [Saul falling on his own spear when the battle was lost, and then asking an Amalekite to finish him off] as an example of euthanasia.
In the Talmud, one who is dying is considered a living person
One may not bind his jaws, nor stop his openings, nor place any metallic vessel or cooling object on his navel until such times as he dies, as it is written: Before the silver cord is snapped asunder.
One may not move him, nor place him on sand or salt until he dies.
It also prohibits closing the eyes of the dying before death, in case this may hasten death [cf Rashi]. Jewish martyrs refused to take action to hasten their own deaths because such an action was God’s prerogative alone. Maimonides, who was a physician as well as a rabbi, 'Whoever closes the eyes of the dying while the should is about to depart is shedding blood.' Who knows: perhaps he is only in a swoon.
There are, therefore, very strict prohibitions on he ending of life, and rules regarding the treatment of the dying. Some actually ban some actions, like the chopping of wood, because this may hinder as well as hasten the departure of the soul. [Rabbi Judah ben Samuel the Pious].
Recent rulings emphasize the prohibition on active euthanasia, but sanction the withdrawal of any factor that is extraneous to the natural departure of life. This is only referring to those who are described as goses: that is, in immediate expectation of death. One can shorten the act of dying, but no interrupt life.
Rabbi Yehudah Eliezer Waldenburg restates the obligation to do everything for the patient, even if he or she is suffering and/or beyond cure. Analgesia can be given as long as the drugs are not for the purpose of hastening death. One must resuscitate the drowned or others with cardiac arrest, but is not obligated to initiate life support if the patient is terminally ill with responsibility of recovery. One is also allowed to disconnect the machine if the person is legally dead according to Jewish criteria (independent brain function or spontaneous cardio-respiratory activity).
Christian Teaching on Bioethics
Basic Principals
All Christians agree that life is sacred and a gift from God which cannot be taken away arbitrarily. Pius XII summarise this when he said:
Every human being, even the infant in the mother’s womb, has the right to life immediately from God, not from the parents or from any human society or authority. Therefore there is [no one] that can show or give valid juridical title for the direct, deliberate disposition concerning an innocent life … Thus, for example, to save the life of the mother is a most noble end, but the direct killing of the child as a means to this end is not licit.
All Christians would look to the Commandments: You shall not kill. [Ex 20:13] Jesus expanded on this in the Sermon on the Mount: You have heard it was said to the men of old, ‘You shall not kill: and whoever kills shall be liable to judgement.’ Nevertheless, is say to you that everyone who is angry with his brother shall be liable to judgement. [Mt 5:21-22]
The deliberate killing of human person is contrary to the dignity of the person and breaches the Golden Rule. See Gen 9:5-6; Lev 17:14; Ex 23:7. The human person is sacred from the moment of conception in many traditions [Ps 22:10-11].
Abortion
Christian responses to abortion have become more urgent since Western abortion reforms of the Sixties. The thalidomide and rubella epidemics of the early sixties provided an impetus for abortion law reform I the USA, starting in Colorado in 1967. In 1973, the Supreme Court declared all ant-abortion laws unconstitutional and effectively legalised abortion on demand. In Australia, however, the legal availability of abortion is limited by the fact that it is still prohibited by the Crimes Act (NSW) and its equivalent in other states. The ability of physicians to provide therapeutic abortions relies on a limited number of court decisions where abortion was consider legal if it protected the life of the mother, for reasons which could include social and psychological as well as physical dangers.
Non-Catholic opposition to abortion vary Baptists in the USA consider abortion to be ‘primarily a medical problem’ because there is no specific Biblical teaching, and some Methodists agree. The attitudes of Lutherans and Anglicans is more in keeping with the Catholic views, however: the American Lutheran Conference condemned abortion as ‘the destruction of a living being” and condoned it only where it was necessary to save the mother’s life. Anglicans, Presbyterians and others allow the minister an ‘enlightened conscience’ advising Christians from their tradition.
Specific Anglican teaching rests on the Natural Law tradition (though evangelical dioceses like Sydney can’t spell Natural Law, let alone employ in ethical reasoning). As Anglicans (and in America the Episcopalians) do not accept papal teaching, the Anglican approach tends to be more prudential: this means that they are not as fixed in their ideas about the beginnings of life, and the fact that they have no history of moral legalism has meant that the prohibition on abortion has occasioned less opposition.
Catholic teaching reaches right back to the 2nd C. Didache (‘you must not kill the embryo by abortion and shall not cause the newborn to perish’) and has been generally consistently held throughout the Church’s history. There has been, however, a considerable tradition of dispute over the beginnings of life (Aquinas accepted that quickening was an appropriate point, and 19th C. opinion allowed a much later time). In the decades before Vatican II, with the contempt for life shown in the Second World War and later, life became a key issue for the Church; and Pius XII strongly held out for life beginning at conception. This was restated in Gaudium et Spes, [the constitution on The Church in the Modern World]:
God, the Lord of life, has entrusted to men the noble mission of safeguarding life, and men must carry it out in a manner worthy of themselves. Life must be protected with the utmost care from the moment of conception: abortion and infanticide are abominable crimes.
Under the influence of Paul VI (Humane Vitae) and John Paul II, the Church has adopted a modern version of Natural Law that stresses the incommensurability of the basic goods (in other words, it is irrational to try and compare the life of the mother with the life of the child, or the life of the child with the careers or social positions of the parents, or even of the ecological or economical demands of the community). As in the 1930s situation where craniotomy was prohibited even to save the life of the mother, so now the doctrine of Double Effect (‘under what situations is it permitted to do evil to achieve good’) is interpreted as meaning that no evil act is permitted. Hence, when a pregnant woman requires a hysterectomy to save her from cancer, this is permitted because the abortion is an ‘unintended secondary side effect’; but where the abortion is intended, it is prohibited even when it is to save the mother. This is stated in the document Declaration on Procured Abortion (1974) [Sacred Congregation for the Defence of the Faith]; in Donum Vitae (1987) [SCDF], and consistently in JP II’s statements and teachings. Recent encyclicals have been designed to prevent theologians from debating the issue.
In Canon Law, it is clear that it is not only a sin to procure an abortion, but also to assist someone to procure an abortion.
In Vitro Fertilisation
All traditions agree on the value of the child and the importance of the child to the marriage. It is generally considered a truism that sexuality is best expressed through marriage. In Orthodoxy, the words of St Chrysostom are remembered:
…young husbands should say to their wives, I have taken, and I love you, and I prefer you to life itself.
The marriage rites of most Christian traditions emphasize the holiness of the state of marriage, even when it is not regarded as a sacrament. Children are an essential part of Christian marriage. Evangelical Christians recall Rachel’s words to Jacob: ‘Give me children, or I shall die.’ Jacob’s reaction is not recorded: he probably had mortgaged the farm twice already and afford the school fees.
In the Catholic tradition, the Church teaches that fecundity is one of the purposes of marriage (i.e., procreative and unitative purposes).’ Conjugal love naturally tends to be fruitful.” [Catechism 2366] ‘Married couples should regard it as their proper mission to transmit human life and to educate their children…’ [Gaudium et Spes 50§2] Hence the frustration of the procreative purpose of conjugal love (marital sex by any other name) in artificial contraception is prohibited (Humanae Vitae 23) and only periodic abstinence is allowed to regulate births. On the other hand, IVF threatens the unitative purpose of marriage, and so is generally opposed.
The spouses have, therefore, a ‘right to become a father and a mother only through each other.’ [Donum Vitae II, 5] ‘ Only respect for the link between the meanings of the conjugal act an respect for the unity of the human being makes possible procreation in conformity with the dignity of the person.’ [DV II, 4]
Couples who are infertile are enjoined to recall that there is no right to a child, and that physical sterility ‘is not an absolute evil’ [Catechism 2379]. Adoption is recommended.
Some of the Catholic and conservative evangelical opposition to IVF is centred in a fear of unfettered technology, but the greatest area of concern lies with the wastage of embryos, which are considered to be alive from the beginning of the conceptory process. In summary, separation of the conjugal act and conception is morally wrong; only procedures like gift can therefore even be considered; and the elements of experimentation, masturbation and wastage make IVF a procedure frowned on by many Catholic and Protestant ethicists.
Feminist Christians from all traditions condemn the objectification of the woman’s body and personhood— first, as a biological mother only, second, as the victim of chemical and medical manipulation of the grossest sort.
Many Protestant ethicists (and some Catholics recognise the injustice inherent in IVF: it is expensive, usually subsidised, and distributes scarce resources away from areas where the funds and facilities would be more usefully employed.
Finally, Medical ethicists recognise that IVF and related procedures create problems for the practitioner. Health care workers are supposed to heal and cure: There is no sense that IVF address the disease at all: it is a technofix.
It is immoral to produce human embryos intended for exploitation as disposable biological material [ Catechism 549; DV I, 5]
Euthanasia
The Christian attitude towards euthanasia mirrors the legal position that was hitherto derived from it. The word is derived from the Greek eu (well, pleasant) and thanatos (death) and is popularly interpreted as meaning the painless inducement of death for the relief of suffering and pain. In spite of the fact that many (including Bill Hayden) see euthanasia as being a liberating process, it raises many problems for the subject as well as the medical practitioner, whose primary purpose is the saving of lives.
Generally, euthanasia is classified in to three categories: eugenic (merciful release of the handicapped, deformed or social and racial undesirables, as practiced by the Nazis); active, where a drug is used to hasten inevitable death; and passive, where treatment is withheld, resulting in death (this is the ‘living will” situation, and is also graphically portrayed in Whose Life is it Anyway, a film or play worth seeing for this course). The latter two can be voluntary or involuntary, depending on the mental state of the subject.
Most doctors have at some stage to wrestle with the problem of the incurable patient who is dying with great suffering (palliative care usually means that pain is usually not a major issue, rather the loss of dignity or self-hood). The increase in the demographic mean age has caused an increase in the number of elderly cancer patients (most cancers are age-related) and a dramatic increase in the incidence of Parkinson’s Syndrome and Alzheimer’s Disease. Doctor’s would admit their involvement in ‘mercy killing, both at the active and passive level; but there is a degree of resistance to having this legally recognised, using a form of the ‘slippery slope’ argument.
Many countries now allow passive euthanasia, through some form of the ‘living will’, where a patient indicate the circumstances where treatment is to be discontinued if they become unable to consent or deny treatment. Such legislation exists in Victoria. Active euthanasia legislation is more rare: the Netherlands and Italy being the most popular examples. In most countries in the West, euthanasia is suicide, and the assisting health care worker or relative is wither an accessory or guilty of homicide. Health care workers may not withdraw treatment until the point of futility (not when death becomes inevitable) and must not do so to hasten death.
The Catholic position is unequivocal: based o n the teaching, Thou shalt not kill. The new Catechism of the Catholic Church says:
…an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator. The error of judgement into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded. [2277]
So there.
On the other hand, Pius XII allowed the discontinuing of medical treatment on the grounds of futility: heroic measures are not called for. Such passive action is not prohibited, although the doctor is enjoined to provide palliative care. Where the patient is able to make an informed decision to discontinue medical treatment because it is ‘over-zealous’, they may do so and the physician should follow their desires.
The Catholic position is based not only on respect for life but also on an understanding of the role of suffering in rasing the Christian person to holiness. Such a position is exemplified in the lives of the saints (even Mary MacKillop). C.S. Lewis, though an Anglican encapsulated the Catholic position when he wrote of pain as ‘God’s megaphone’, not caused by God but used by God to speak to us in our greatest need.
There is no consistent Protestant teaching on Euthanasia. The greatest advocate of legalised euthanasia is Joseph Fletcher, and Anglican priest. His position is based on three grounds: (a) suffering is purposeless and degrading; (b) human personality is the essence of life, not mere biological functioning; (c) the New Testament teaches ‘Blessed are the merciful, for they shall obtain mercy.
Again, as with abortion, there is no consistent position. Generally, because the theologically conservative churches are fundamentalist, they tend to oppose abortion and euthanasia absolutely because they interpret the Fifth Commandment literally. The more centrist Churches (Anglican, the Wesleyan tradition, Church of Scotland, Lutherans) hold to ideals like the Catholic Church, but are very flexible in practice because their moral tradition is more individualistic. The Orthodox have a strong sense of the holiness of life and of the will of the Father: they tend to oppose both abortion and euthanasia under all circumstances as being contrary to the teaching of the Fathers.
