Playing God sample chapter
Chapter 1: Rethinking Life and Death
Nick Pollard
This sample chapter is taken from Playing God: Talking about ethics in medicine and technology, edited by Tony Watkins and published by Damaris Books (an imprint of Authentic), May 2006.
President George Bush cut short his Easter holiday because he felt so strongly about the issue and he wanted to sign an unprecedented Emergency Bill. Almost every other American had an opinion on the matter. The subject dominated the newspapers, the radio and the television. It was discussed in lecture halls, churches and bars. And what were they all talking about? It was the fact that the courts had ruled that food and water should be withdrawn from a desperately ill young woman so that she would die.
Terri Schiavo was 26 when she fell into what doctors call a Persistent Vegitative State (PVS). In this case it was apparently as the result of brain damage due to her heart stopping temporarily. For the next fifteen years she was unable to speak, move or feed herself. There was no doubt that she was now living in a very sick body. But there was a lot of dispute about whether she was at peace or in torment, and whether it was her wish to be kept alive by the food and water tubes connected to her body, or whether she would rather have them removed so that she could die.
The two different views were championed by her parents – who wanted to keep her alive – and her husband – who wanted her to die. During the spring of 2005, much of the world joined in the debate. Eventually, the legal process ruled in favour of the husband and, on 18 March 2005, the feeding tubes were finally removed. Over the next thirteen days the world watched as she died. No one viewed Terri as closely as her parents who sat by her bedside and later said:
Watching someone being starved and dehydrated to death, let alone your own daughter, is something so cruel that it can never be forgotten. . . . Witnessing her life ebbing away as she desperately struggled for a breath of air is beyond the realm of human comprehension.[1]
As desperate as one feels for Terri's parents, and for Terri herself, we must recognise that there is another group of people who were also there and will also have felt a huge amount of anguish and pain: the doctors and nurses. They trained for years to help and heal sick people; their desire is always to do the best for their patients. But now they find themselves being asked to ‘play God'. It is the doctors and nurses who removed Terri's tubes. And, as we saw in the introduction, it is the doctors and nurses who will not resuscitate baby Charlotte when she stops breathing.
A Fork in the Road
The incidence of such situations is increasing relentlessly, mainly because of continual advances in medical science. Not many years ago, medics would have been unable to keep Terri or Charlotte alive. But now things have changed – and they keep on changing. What is more, these changes are not restricted only to improvements in the delivery of traditional medical techniques. They also seem to offer entirely new ways of understanding and dealing with human beings. Indeed, they seem to promise a brave new world free from sickness, pain and even death. This is evidently the ultimate goal of research into such areas as cloning, genetic modification, stem cell research, nano-technology, and genetic selection.
There are those who argue that we should embrace such developments with open arms and move as fast as we can into this wonderful new world. Gregory Stock, Director of the Program on Medicine, Technology, and Society at UCLA's School of Public Health, is one of those. His book Redesigning Humans [2] argues that we should use technology to develop the human race. He believes that the continued progress of medical technology is inevitable, and the sooner we get on with using it, the better it will be for all of us.
On the other hand there are others, such as Francis Fukuyama from John Hopkins University, who urge much more caution. His book Our Posthuman Future: Consequences of the Biotechnology Revolution [3] argues that human genetic engineering is not inevitable and that we should take steps to prevent the possible ‘abolition of man'.
Creating Life and Death
While this debate rages at an academic level, it also does so at a much more popular level. As with all great questions in life, the creative writers and producers of novels, films, music and television programmes contribute to the discussion. They have a lot of influence on many people's thinking about the issues. Indeed, most people are influenced more directly by the ideas expressed in popular media than they are by the arguments taking place in academia (although, of course, that academic work trickles down through its influence on writers and producers). Therefore, as we seek to consider how as Christians we are going to engage meaningfully with others about these questions, we must consider the ideas being explored in popular culture. Here are a few examples:
The film Godsend [4] tells the story of Paul and Jessie Duncan (Greg Kinnear and Rebecca Romijn-Stamos) who are the devoted parents of Adam (Cameron Bright). When he is eight years old, Adam is killed in a car accident. This devastates his parents, not least because Jessie is unable to have any more children. However, help is offered by Dr Richard Wells (Robert De Niro), a prominent fertility expert now working secretly on cloning technology. Taking material from Adam's body, he makes an exact biological replica. For the first eight years of his life, this second Adam grows up without any problems. However, when he passes the age at which the first Adam died, he starts to change. He has nightmares – and his dreams seem to belong to another boy.
Thus the film does not only explore the ethical questions raised by the development of cloning technology (and whether this could or should be applied to humans), it also digs much deeper into the spiritual questions of human existence, and what it means to be a human person.
Such questions are considered from a different angle by Jodi Picoult in her book My Sister's Keeper .[5] This tells the story of sisters Anna and Kate. Kate is sixteen and had suffered from leukaemia for most of her life. Anna is thirteen and is the means by which her parents seek to provide the medical solution to Kate's disease – she was conceived through IVF so that she would be able to serve her sister as a donor. But now Anna is not so happy with her role. She wants to be free from the control of her parents and the needs of her sister. Can she do this? Should she do this? Who has the right to decide what happens to anyone's body? These are just some of the questions raised by this book.
Spare Parts
Then, in 2005, came a film that took the issues raised by Godsend and My Sister's Keeper onto a whole new level. The Island [6] tells the story of a medical establishment that uses cloning to create bodies as replacement parts for those who might need them. Like Godsend, the film is about cloning enabling people to avoid the consequences of accidents and disease. But unlike in Godsend , the cloning takes place before someone dies so that replacement parts are prepared in advance, ready for when they are needed. Like My Sister's Keeper, the technology in The Island is used to provide transplant resources in order to save the life of someone who is sick. But unlike in My Sister's Keeper , removing those resources means that the clone must be killed in order for the required organs to be ‘harvested'.
The whole drama of The Island centres around the expectation that we, the viewers, will identify with the clones that are soon to be killed rather than with the original people whose lives are to be saved. Thus we follow the story of Lincoln Six Echo (Ewan McGregor) and Jordan Two Delta (Scarlett Johansson) as they begin to realise that something is wrong, and as they escape from the laboratory, track down the people from whom they were cloned, and eventually confront the scientist behind the technology, Doctor Merrick (Sean Bean).
It is possible to feel some sympathy for Doctor Merrick. It seems that he began as a compassionate doctor with good motives who wanted to do the best for his patients. He thought that he would achieve this by using the most advanced technology, and at one point in the film he describes how he had reluctantly found himself moving step-by-step to what he was doing now. Perhaps this glimpse of the situation from the doctor's perspective makes us think more deeply about the seductive power of continually advancing medical technology – and the need to think carefully about what we are doing.
Do No Harm
We may think that an equivalent of Dr Merrick's slide into a barbaric treatment of human life would never happen in the real world. Surely we have checks and balances that will prevent such abuses. But can we actually be so sure? Is it possible to have a set of logical and reasonable rules that will protect us from potential harm? That was an idea that was considered in another film , I Robot .[7] Like many other recent films, it explores the possible impact of advancing technology on life as we know it, but this time it focuses on robotics and artificial intelligence.
I, Robot is set in a future where robots are a part of everyone's life. They do the work that no one else wants to do – they shop, they clean, they serve the food and drink, and then clean up the rubbish afterwards.
This sounds wonderful, and wonderfully safe because of the so-called First Law of Robotics that: ‘A robot may not harm a human nor, through inactivity, allow a human to come to harm.' But it is that law which the film seeks to explore. The question I, Robot poses is, will this entirely logical and reasonable law protect us from the adverse impact of developing technology? It is interesting that this fictional law[8] parallels an actual fundamental principle in real life medical ethics. This is the rule that dates back to Hippocrates, is accepted by every doctor, and is usually expressed as primum non nocere or ‘first do no harm'. This may seem a perfectly good safeguard for today's doctors and tomorrow's robots. And such reasonable logic appeals to those who are using logic and reason to advance medical technology. But, I, Robot seeks to highlight some limitations of apparently reasonable logic.
In the film, a supercomputer accepts the first law of robotics, as it is programmed to do, and seeks to do everything it can to protect humans. But then it looks at the fact that, left to themselves, humans have a tendency to be violent towards one another. Through the choices they make, these humans are causing each other harm. So, the supercomputer concludes that the best way to protect humans is to stop them from hurting each other by taking away their freedom. Indeed, it has a sense of urgency since it knows that it must not allow humans to come to harm by its inactivity: it has to do something quickly. Therefore, this computer establishes control over a new series of robots and seeks to use them to take over the world so that they can make it a safer place for humans. Claiming to have flawless logic, the computer also concludes that it is acceptable to kill certain humans during the take-over since this will save more lives in the future.
Meanwhile, The Stepford Wives [9] explores the same question from a different angle. The geeky men of Stepford have created perfect robotic replacements for their wives and now enjoy an idyllic life where their ‘wives' serve them in every possible way. When a new man arrives in Stepford, the other men try to persuade him of the logical value of replacing his troubled and troublesome wife. He can see how attractive this solution is. Indeed, the logic for replacing his wife with a perfect robot is very compelling. But he refuses to follow this logic and he eventually exposes the deception. Why does he do this? The film makes it clear: it is because he loves her, with all her faults and failings. It is such a love that also provides the resolution to the I, Robot story. In the final scene we watch the hero argue for the importance of compassion over and above logical reasoning.
Dare to be Wise
The use of logical reasoning in ethics has a long philosophical history. It became particularly influential through the period of the seventeenth and eighteenth century (which is known as the Age of Reason or the Enlightenment). This was a time when many philosophers encouraged people to think for themselves rather than just blindly following church dogma. For example, Immanuel Kant, one of the key thinkers of the period, had a catch-phrase which he thought summed up what was needed. ‘Sapere aude,' he said. This means literally ‘dare to be wise' and was taken to mean ‘dare to think it out for yourself'. And so it was that the culture that was built upon these enlightenment principles (a culture that is sometimes referred to as Modernism) came to prize logic and reason.
In the twentieth century, there has been a gradual move from Modernism to Postmodernism for many people, which has led some of them away from a confidence in logic and reason. However, many more continue to recognise the value of logic. This is especially the case for those working in technology because it is logic and reason that enables them to advance their technology. And so it is logic and reason that they seek to apply when considering the ethical issues raised by the advance of that technology.
Perhaps the clearest example of this is Peter Singer. Whilst he is a philosopher rather than a technologist, his particular interest is in working through the ethical implications of advances in biotechnology. He is the founding co-editor of the journal Bioethics and is a professor at the Princeton University Center for Human Values. Singer has written at length on what he sees as the logical and reasonable decisions we should make in response to the ethical dilemmas of today – and he is not afraid to set aside traditional beliefs and values in order to seek new ways of responding to new challenges. For example, his book Rethinking Life and Death [10] is subtitled ‘the collapse of our traditional ethics'. In it he argues that our traditional ways of thinking about life and death cannot cope with the strain of extremely complex and painful medical dilemmas which have arisen in recent years as medical technology has vastly enhanced the ability of doctors to save and prolong life.
The Unimportance of Being Human
Singer claims that it is no longer possible to take the sanctity of life as the cornerstone of our ethical outlook. We must sweep away the old ethic and construct something new in its place. Building something new requires a foundation – a set of principles from which to begin. And so, one of the major principles Singer adopts is the modern secular humanist distinction between a ‘human being' and a ‘human person'. Specifically, Singer argues that a human being is a biological member of the species Homo Sapiens , but a human person is someone who is far more than that. A person, according to Singer, is conscious, aware of itself as the same being in different times and places, and capable of anticipating the future as well as of having wants and desires for that future.
This distinction is very important for Singer because he then seeks to argue logically that the fact that someone is a human being does not give them the same right to life as a human person. So, he argues that those who are in a Persistent Vegitative State and those with severe intellectual disabilities may be human beings but they are not human persons. Therefore, he says, killing them would not always be wrong – and, indeed, in many cases would be the very best thing to do.
However, he does not stop there. He then applies his relentless logic to the case of newborn babies. He points out that all newborn babies are actually in that same category. He says that in the first few weeks of life these newborn babies have no sense of their existence over time – they are not capable of anticipating the future nor of having wants and desires for that future. Therefore, he argues that ‘killing a newborn baby is never equivalent to killing a person.' And, in case of any doubt, he does mean actively killing the baby, not just letting them die. He adds, ‘if a decision is taken, by the parents and doctors, that it is better that a baby should die, I believe it should be possible to carry out that decision . . . by taking active steps to end the baby's life swiftly and humanely.'[11]
Singing Another Tune
So how do we respond to such a position? Here are three possible ways:
First, one might agree with him that this is entirely logical and reasonable. Thus, one might accept his belief and look for ways of applying it in every possible situation – in every case like baby Charlotte and Terri Schiavo.
Secondly, one might accept that this is an entirely logical position, but then argue that this shows the danger of a narrow view of reason. This was an approach expressed in the famous words of Blaise Pascal who said, ‘The heart has its reasons that reason knows not of.' For Pascal, and others who hold this view, logic is important but requires a broader view of reason which recognises the value of intuition and even the possibility of revelation. If people are prepared to consider those possibilities, perhaps we will want to talk with them about the possibility that there might be a God who could reveal truth to us – maybe directly through scripture or indirectly through the conscience he has given us.
Thirdly, one might question the soundness of his argument. An argument is simply a process that links together two premises (two claims about reality) in order to formulate a conclusion. Thus an argument can be expressed as:
Premise
Premise
Conclusion
Philosophers call this a syllogism . The classic example of this was given by the ancient Greek philosopher Aristotle (which is why it is often referred to as ‘Aristotelian Syllogistic Logic') who gave this example:
Premise: Socrates is a man
Premise: All men will die
Conclusion: Therefore Socrates will die
That is a sound argument. However, there are three ways in which an argument may be unsound. First, it may use invalid logic. That is, the conclusion may not follow logically from the two premises. Second, the terms may be ambiguous. That is, words may be used to mean different things at different times. Third, the premises may be false. That is, one or both of the two premises may actually be untrue claims about the world.
So, looking at the argument that Singer uses, we might ask whether it is sound or whether it falls into the trap of using invalid logic, ambiguous terms or false premises. To consider this we must first express his argument as a syllogism, perhaps as follows:
Premise: Humans do not have an automatic right to life if they have no sense of their existence over time
Premise: Newborn babies have no sense of their existence over time
Conclusion: Therefore newborn babies do not have an automatic right to life
We might then conclude that this argument is logically valid, and does not use ambiguous terms. But are the premises true? We might accept the second premise (although we might question how we could ever know). But is the first premise a true claim about the world? Or is it just an assertion that he makes? Where does he get this from? Why should anyone accept this assertion rather than an alternative such as, ‘Humans have value, significance and rights because they are created by God in his image'?
Thus, we are then back in the same kind of territory where we were in the second response to Singer – considering the possibility that there might be a God who reveals his truth to us. And that is a very good place to be when we are talking with people about these questions. We want to help people to understand the issues; we want to respond to the specific views that are expressed in our culture. But we particularly want people to listen to the Bible which says, ‘When we tell you this, we do not use words of human wisdom. We speak words given to us by the Spirit, using the Spirit's words to explain spiritual truths' (1 Cor. 2:13).
Notes
[2] Gregory Stock, Redesigning Humans (Profile Books, 2002)
[3] Francis Fukuyama , Our Posthuman Future: Consequences of the Biotechnology Revolution (Profile Books, 2002). For an article critiquing Stock's and Fukuyama's books, see Peter S. Williams, ‘Mere Humanity', CultureWatch.org
[4] Directed by Nick Hamm (Lion Gate Films, 2004). For a study guide on Godsend , see Louise Crook, ‘Godsend', CultureWatch.org
[5] Jodi Picoult, My Sister's Keeper (Atria Books, 2004). For a study guide on this book, see chapter seven.
[6] Directed by Michael Bay (DreamWorks, 2005). For a study guide on The Island , see chapter eight.
[7] Directed by Alex Proyas (Twentieth Century Fox, 2004). For more on I, Robot , see chapter five. For a study guide, see Tony Watkins, ‘I, Robot', CultureWatch.org
[8] For more on the Three Laws of Robotics, see chapter five.
[9] Directed by Frank Oz (Paramount, 2004). See also Louise Crook, ‘Flawed Perfection', CultureWatch.org
[10] Peter Singer, Rethinking Life and Death (Oxford University Press, 1995)
[11] Peter Singer, FAQ, III. The Sanctity of Human Life
© Damaris Trust, 2005. All rights reserved. This sample chapter may not be reproduced in any format or medium.