Let’s Talk about GLO#1: Christian Faith and Ethics

1. Let’s Talk about GLO#1: Christian Faith and Ethics Kevin E. Voss, M.Div., D.V.M., Ph.D., F.C.A. Professor of Philosophy Director, Concordia Center for Bioethics Concordia University Wisconsin

2. Introduction—Kevin E. Voss • Practicing dairy veterinarian for 14 years • Concordia Seminary St. Louis graduate • Ph.D. in Health Care Ethics from Saint Louis University; Fellow of Christian Apologetics • Unique training in medicine, theology, philosophy, health law, public health, statistical research, and ethics • Chair of CUWAA-IRB (reviews human subject research), serves on IACUC (animal research), member of Committee for Scholarship Integrity

3. Here’s One Reason Why I Quit Being a Veterinarian!!

4. How to Contact Me • Telephone: (262) 243-4398 • Email: kevin.voss@cuw.edu • Office: Heidelberg Hall, H002H • Website of the Concordia Center for Bioethics: www.cuw.edu/bioethics

5. Resources • Commission on Theology and Church Relations of the Lutheran Church Missouri Synod. Many helpful documents are available online at www.lcms.org/ctcr. • Richard Eyer, Holy People, Holy Lives: Law and Gospel in Bioethics,Concordia Publishing House, 2000. • Gilbert Meilaender, Bioethics: A Primer for Christians, 3rd Edition, Eerdmans, 2013. • John Warwick Montgomery, Human Rights and Human Dignity, Probe Books, 1986.

6. Basics in Health Care Ethics: How to Address Ethical Dilemmas • Benefits of an Ethics Course • Six Ethical Perspectives • Features of Christian Ethics • GLO #1: Practical Tips • Questions and Comments

7. A Real Case • “Dr. Voss, can you help me? I am a pharmacist in _______, and I am troubled about being forced to dispense medications I believe cause abortions. I know many of our patients are abusing these abortifacient drugs. My conscience tells me it’s wrong. I can’t sleep at night. What should I do? Should I leave the profession?”

8. Benefits of Taking an Ethics Course • Veterinary School: No ethics course in the 1970s • My Experiences in Practice: Ethics every day, and those issues stay with you! • Studying Ethics Can Help Students To: • Understand moral perspectives of others • Understand their own moral foundations • Take the best possible reasoned course of action in an ethical dilemma • Explain their actions to others more clearly

9. Ethical Theories • What is ethics? • The exploration of why certain actions are deemed right and others are deemed wrong • The study of theories behind our moral pronouncements

10. Various Ethical Perspectives • Existentialism (Choice) • Utilitarianism (Outcome) • Ethical Relativism (No Universal Standards) • Deontology (Duty) • Teleology (Goal) • Virtue Ethics (Character)

11. 1. Existentialism: Jean Paul Sartre (1905-1980) “Existence precedes essence.”

12. Key to Sartre’s Existentialism • Traditional Judeo-Christian Ethics: • Essence precedes existence. • Ephesians 2:10: “For we are God’s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do.” • Existential Ethics: • Existence precedes essence. • Jean Paul Sartre: “ . . . subjectivity must be the starting point. . . . man exists, turns up, appears on the scene, and, only afterwards, defines himself.”

13. The Dominant Principle in Biomedical Ethics • Autonomy: • Is the dominant principle in contemporary medical ethics (i.e., the “default mode”). • “I have the right to say what happens to my own body.” • Emphasizes the right to self-determination. • The basis for informed consent, confidentiality, privacy, and freedom.

14. People Like to Be Their Own Boss (Right of Self-Determination) • NIV Genesis 3:4-5: “You will not surely die," the serpent said to the woman. "For God knows that when you eat of it your eyes will be opened, and you will be like God, knowing good and evil.” • “Autonomy” comes from two Greek words meaning “self rule”

15. 2. Utilitarianism • Utilitarianism is a consequentialist theory of ethics; it focuses on outcomes of an action. • This is one of most dominant foundations for ethics in U.S. society today. • The “right” action is the one that has “good” consequences, or “maximizes” the good. • AKA, “The greatest happiness for the greatest number.” • Accused of: “The ends justifies the means”; any act could be justified to achieve a “good” end.

16. According to Utilitarianism, When Deciding upon a Course of Action: • Try to foresee the consequences of each action open to us. • Compare the total happiness produced by each. • Choose the one that produces the most happiness overall.

17. Examples of Utilitarianism • Some cases are uncontroversial: • At the level of public services, the government thinks in a “utilitarian” way, because water / power / refuse collection / education / emergency services should be available to all. • Medical treatments (such as adult stem cell research or genetic therapy) are designed to maximize health.

18. Examples of Utilitarianism • But some examples are more problematic: • Embryonic stem cell research; • Heavy use of prescription drugs to control mood, etc.; • The “bottom-line” promoting sales of dangerous or unnecessary products; • Legalized prostitution, drugs, or gambling; • Making medical decisions based on what is the best use of resources versus what is best for each patient, e.g., Charlie Gard and Alfie Evans

19. Problems With Utilitarianism: Buchenwald Concentration Camp

20. SS Motto: “My Honor Is Loyalty”

23. 3. Ethical Relativism • Relativism: values are correct only relative to an individual or culture • We have no basis for saying one moral system is better than another • Ethics is no longer tells us what we ought to do; it only describes what we’re doing • Not a new perspective: Pontius Pilate said to Jesus, “What is truth?” • The illogic of relativism: There are no objective moral standards—but there is one, Tolerance!

24. Ethical View 4: Deontology • From Greek word  meaning “duty” • An act is justified by showing that it is right with little regard to consequences • “Duty ethics” • Appeals to an authority • Appeals to the law when making ethical decisions • The Ten Commandments (God’s Word) • Weakness: legalism—rules matter more than people.

25. Immanuel Kant • Immanuel Kant’s Categorical Imperatives • Treat people as ends and never only as means to an end • Your act can be a rule for all rational agents to follow

26. What Does One Do?

27. Ethical Theory 5: Teleology • From Greek word  (goal) • Appeals to some overriding goal built into human nature or nature in general • Moral principles and behavior fit into some larger purpose • Natural Law Theory: human reason enables us to know (from nature) which acts we ought or ought not perform. • Aristotle, Roman Catholic ethics

28. Romans 2:14-15, NIV • “(Indeed, when Gentiles, who do not have the law, do by nature things required by the law, they are a law for themselves, even though they do not have the law. They show that the requirements of the law are written on their hearts, their consciences also bearing witness, and their thoughts sometimes accusing them and at other times even defending them.)”

29. Ethical Theory 6: Virtue Ethics • Aristotle defined virtue as “a kind of second nature” that disposes us to do the right thing • Excellence not tied to results • Virtues can be sharpened through • Education • Habit • Health care professionals should exhibit several virtues: fidelity, compassion, honesty, wisdom, etc. • The basis for taking oaths.

30. Comparing Ethical Perspectives • Emphases of Secular Ethical Systems • Existentialism: I must make my own choices • Utilitarianism:focus on outcomes • Relativism: all ethical systems are equally valid and acceptable • Emphases of Biblical Ethics • Duty: follow rules; focus on the morality of an act • Goal: All things exist and happen for a purpose; God has a plan. • Virtue: character; the strength to do what’s right.

31. Car Analogy • Virtues are like the motor, giving us proper motivation for ethics • Rules (duty) are like the steering, keeping us from danger • Having an intact car is useless unless we have a purpose for using it, a destination, a goal (telos).

32. Features of Christian Ethics • Community: Focus is on others, not just ourselves. • Clarity: the Bible is prescriptive, i.e., clearly tells us what are our duties. • Power: to change our life, power external to us given to us by the Holy Spirit. • Motive: We want to live moral lives out of gratitude for what Jesus has done for us. • Forgiveness: Jesus has suffered and died in payment for the worst of sins!

33. 1. Community • The Community, the Church • We are not truly autonomous; we are dependent. • See Bioethics: A Primer for Christians by Gilbert Meilaender, 3rd Edition, Eerdmans, 2013. This Photo by Unknown Author is licensed under CC BY-NC-ND

34. St. Paul: Key Biblical Principle 1 Corinthians 6:19-20 (ESV): “Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body.” Our bodies are not ours to do with as we please (as autonomy asserts) 34

35. 2. Clarity • Christian Ethics Is Prescriptive, Not Descriptive • It tells us how we ought to live our lives. • “Do to others as you would have them do to you” (Luke 6:31, NIV). • “Love your neighbor as yourself” (Mark 12:31). • “Do nothing out of selfish ambition or vain conceit, but in humility consider others better than yourselves” (Philippians 2:3).

36. The Fifth Commandment: • Every human life has inherent value, value given to us by God. • “You shall not murder.” • What does this mean? We should fear and love God so that we do not hurt or harm our neighbor in his body, but help and support him in every physical need” (Luther’s Small Catechism with Explanation, CPH, 2005, p. 77).

37. 3. Power • Christian Ethics is a type of Virtue Ethics. • Concerned with the character of people, the “new man” and not actions alone. • The Holy Spirit helps us to lead a life patterned after that of Christ Himself. • Is the best way to make a lasting change in our lives (the power to live a moral life).

38. Virtue: I Corinthians 13:4-7 • “Love is patient and kind; love does not envy or boast; it is not arrogant or rude. It does not insist on its own way; it is not irritable or resentful; it does not rejoice at wrongdoing, but rejoices with the truth. Love bears all things, believes all things, hopes all things, endures all things” (English Standard Version).

39. 4. Motive: Law and Gospel • While Christian ethics is informed by both Law and Gospel, “we must sharply distinguish between the Law and the Gospel in the Bible” (LC, 2005, Q 6, p. 51). • Law: “In the Law God commands good works of thought, word, and deed and condemns and punishes sin” (LC, Q7). See Mark 12:30-31. • Gospel: “In the Gospel, the good news of our salvation in Jesus Christ, God gives forgiveness, faith, life, and the power to please Him with good works” (LC, Q8). See John 3:16. This is the chief motivation for Christian ethics.

40. 4. Gospel Motive • Christian Ethics is founded on the Gospel • Because of what our Lord has done for us, we want to do our best to serve our Lord and our neighbors to the best of our ability. • A Christian’s motive for doing the right thing is not a “have to” (the Law) but a “want to” (The Gospel). • Our actions are not based on earning something for ourselves (e.g., praise by others). • Hope: because of what Jesus has done for us, we look forward to the hope of eternal life in heaven because events are not random even though they appear to be (e.g., vocation).

41. Vocation • Vocation means “calling.” Work is much more than a job. Every work or social function is a distinct calling from God. • Each person is a “mask of God” because God works silently through people who contribute according to their God-given talents and abilities. • God has a plan which we are eager to help fulfill. This Photo by Unknown Author is licensed under CC BY-SA-NC

42. 5. Forgiveness • We will fall short of our expectations or those of our loved ones, employers, or those of our profession. • “If we say that we have no sin, we deceive ourselves, and the truth is not in us. If we confess our sins, he is faithful and just to forgive us our sins, and to cleanse us from all unrighteousness” (1 John 1:8-9, King James Version).

43. How Then Do We Decide? Check out the facts to the best of our ability, discover truths, and reject untruths Bring pertinent biblical truths and other ethical standards to bear on the situation Carry out the best God-pleasing option as guided by the Holy Spirit and informed by God’s Word Trusting that God will forgive us if we repent of a decision made incorrectly (a reliance on the cross of Christ) From Dietrich Bonhoeffer’s Ethics

44. Difficult Ethical Issues in Health Care • Emergency Contraception • Abortifacient Medications Like RU-486 • Physician-Assisted Suicide • Honesty in Record Keeping • Conflicts of interest—the desire to make a good living versus the welfare of patients • Conscience Clauses • Adhering to Unfair/Unsafe Rules by Employer • Many others!!!

45. Helpful Tips: For the Classroom • Present major views of a moral issue. • Explain the traditional Christian perspective about an issue (use CTCR docs for help). • Stress forgiveness. • Don’t grade on the student’s views, but on how well their views are supported. This Photo by Unknown Author is licensed under CC BY-SA-NC

46. Other Tips • We can’t force our students to adopt a Christian ethical framework, all we can do is present it to them and model that framework in our conduct. • Don’t be afraid of saying “the wrong thing!” • Feel free to seek out help! This Photo by Unknown Author is licensed under CC BY-SA-NC