Medical practice abounds with impressions of God’s love. Moments when nurses tenderly dress a wound or hold a dying person’s hand reflect our mandate to love our neighbors as ourselves (Luke 10:27). Doctors who toil through the night to save a life embrace the call to lay down our lives for one another (1 John 3:16). Such poignant echoes of the gospel can entice us to equate medicine with Christian thought and to expect bioethics to stand firm with the church against the waves of popular culture.
But sometimes, medicine mirrors little that is good or lovely. Although the capability to heal is a gift from God, medicine is as corruptible as any other sphere of life this side of the fall. As we navigate the hospital hallways we need to practice discernment, with Scripture on our minds and prayer in our hearts.
Definitions of Worth
One example from my training haunts my conscience. A woman arrived at the hospital with an acute illness at nearly 23 weeks pregnant. While doctors tended to her, she asked for an abortion. On learning of her request, her family filed into her room like a throng of mourners, their heads bowed, their faces drawn with grief. Some cried. Others offered to adopt the child. All begged her not to abort the baby who kicked within her, his limbs already fully formed, his heart dancing its vigorous rhythm. While they pleaded she stared into a corner, her eyes occasionally misting with tears.
Modern medicine is a gift from God. But it’s not a Christian institution.
The scene was heartbreaking. It also contrasted sharply with the response of her care team. Rather than sit beside her to explore the dark avenues down which her mind wandered, or to delve into the reasons why an abortion seemed her only answer, they worried she might not recover from her illness in time for an abortion to be legal. State law permitted them to perform the procedure until 23 weeks and 6 days. If she wanted an abortion, they urged, she needed to recover, and quickly, before the child magically became a person at 24 weeks. Before then, her right to self-determination superseded her child’s right to life. Her baby’s rights to live, to love, and to realize his purpose in the world arose not from his inherent dignity as God’s image bearer, but from whether he was wanted. But according to state law, all that would change in a single day. Time was ticking.
This unsettling example hints at the rift between biblical teaching and medical practice. Personhood depends on arbitrary time points. The right for an adult to self-govern holds sway against the unborn’s right to live. Modern bioethics upholds self-determination as an ultimate good, rather than a blessing to wield in service to God. It prizes individual freedom but wrenches it from its godly purposes. The result is a system that in myriad circumstances reflects God’s grace but that can also veer away from scriptural principles.
Modern medicine is a gift from God. But it’s not a Christian institution.
Medicine’s separation from the gospel dates to its beginnings. Although over the centuries churches and monasteries have embraced care for the sick, modern bioethics traces its origins not to Christian thought, but to antiquity and the Enlightenment. Hippocrates, widely lauded as the “father of modern medicine,” began his famous oath with the phrase, “I swear by Apollo the Healer,” followed by a litany of adorations to Greek gods. Medical students still recite his oath today as a rite of passage, their heads lowered in reverence to the profession.
Modern bioethics developed centuries after Hippocrates, when rampant abuse and paternalism in medicine broiled to a zenith. In the 1970s, exposure of the horrific Tuskegee study sparked national outrage as we learned that for four terrible decades, the U.S. Public Health Service funded syphilis research on indigent African Americans without consent. The crisis spurred a movement to define ethical medical practice, culminating in the establishment of four tenets that would become the cornerstones of medical ethics: nonmaleficence, benevolence, respect for autonomy, and justice. Thomas Beauchamp and James Childress, the American philosophers who outlined these principles, drew heavily from Immanuel Kant’s framework for autonomy, as well as from an appeal to common morality—in other words, the philosophy that certain principles are so widely accepted and self-evident as to be universal.
A medical system based on societal consensus rather than firm grounding in the truth will bend to the winds of change.
We can attribute much virtue in medical care to Beauchamp and Childress’s emphasis on human dignity. But Scripture warns us of the limits of human wisdom (1 Cor. 1:25), and advises us to trust in God rather than our own understanding (Prov. 3:5–6). As Beauchamp and Childress’s principles hang on public unanimity rather than divine authority, we expect their manifestations to shift and warp over time. A medical system based on societal consensus rather than firm grounding in the truth will bend to the winds of change.
Today, our culture esteems fulfillment of individual desires more than the gospel of grace. The idolatry of self-determination in medicine seems inevitable.
Idolatry of Autonomy
Of all Beauchamp and Childress’s four tenets, respect for autonomy has achieved primacy in medical practice. Otherwise described as the right to self-determination, this principle intends to safeguard patients against exploitation, and in the 1970s it represented a crucial divergence from the horrors of paternalism. On the surface, it parallels Christian values. We all have intrinsic worth and dignity as God’s image bearers (Gen. 1:26), and God grants us a measure of freedom as stewards of his creation (Gen. 2:15, 19).
Yet the Bible diverges from secular medical ethics on the purpose of our God-given autonomy. From the biblical standpoint, God gives us freedom so that we may lead lives that point to his character; our freedom comes with the expectation that we exercise it for his glory. “And whatever you do, in word or deed,” Paul writes, “do everything in the name of the Lord Jesus, giving thanks to God the Father through him” (Col. 3:17). While we remain free in Christ, the cross must temper our conduct (1 Cor. 6:19–20).
In contrast, autonomy divested of its biblical context turns away from God and toward the self. The right to choose reigns supreme, regardless of whether our choices reflect our identity in Christ. The chief goal in life shifts from serving God to fulfilling one’s desires. Freedom becomes an ultimate good, an end in itself, rather than a vehicle to glorify the Lord.
While untangling its complexities, the secular roots of medicine warn us to practice discernment.
We’ve seen this before, and we know where it leads. Autonomy without God first bore sinister fruit in the garden, when Adam and Eve prized self-rule over the covenant with their gracious Lord (Gen. 3). It has plagued humankind since, enticing us to idolize the work of our own hands, rather than revere our Creator (Isa. 2:8; Jer. 1:16; Rom. 1:21–22).
The hospital corridors are as prone to this subversiveness as any other corner of the earth. In medicine, unbiblical autonomy weaves threads of popularism and transhumanism into care for the sick. Technical language dehumanizes unborn babies unless they are wanted. Advocates claim assisted suicide is a human right. Cancer patients who express religious concerns receive little support in the hospital, and doctors who do respond conflate humanistic gestures—holding a hand, spending extra time to talk—with spiritual care. So stark is the divide between Christianity and medical practice that in their excellent book Hostility to Hospitality, doctors Michael and Tracy Balboni characterize American medicine as “spiritually sick.”
Discernment in the Hospital Corridor
All this does not mean we should distrust doctors or shy away from the modern remedies with which God has blessed us. Contrary to media depictions of doctors as greedy and power-hungry, most physicians pursue medicine out of a genuine passion for helping others, often at great personal cost. And modern medicine literally saves lives. At its best, it reflects the mercy, and love for our neighbors, to which Christ calls us as his disciples. Medicine is a blessing from the Lord, and we should accept it with heartfelt gratitude.
But the hospital is far from heaven. While untangling its complexities, the secular roots of medicine warn us to practice discernment. We can’t blindly place all our hope in the Western medical system, just as we shouldn’t idolize government or economics. This awareness is especially critical when we consider acute illness, when a threat to life can deprive us of the clarity to unpack ethical dilemmas biblically. The tumult of life may not allow us space and time to ponder medical questions at our own pace. We need to carefully define our values, and the principles that guide Christian discipleship, before calamity strikes.
Thankfully, our paltry hope in the broken systems of this world withers before the glory of our greatest and most steadfast hope. In the cross, we find an assurance of God’s love that surpasses all the meager philosophies of our own minds. And when Christ returns, the debate over medical ethics will fade into irrelevance, as Jesus marches back the hands of death, perfects our feeble bodies, and annuls the need for medicine at all.