Matters of Life and Death

Human Dilemmas in the Light of the Christian Faith (2nd Edition)

John Wyatt

• Publisher: IVP
• Year: 2012
• Print ISBN: 9781844743674
• eBook ISBN: 9781844747696
• Topic: Theology & Religion
• Subtopic: Christianity

Conjoined twins dilemma...
Suicide of terminally ill patient...
Designer baby transplant success...
Woman gives birth at sixty-six...Rarely are human dilemmas out of the news. And what medical science can do and ought to do - or ought not to do - impinges on our personal lives, families and societies.John Wyatt examines the issues surrounding the beginning and end of life against the background of current medical-ethical thought. Writing out of a deep conviction that the Bible's view of our humanness points a way forward, he suggests how Christian healthcare professionals, churches and individuals can respond to today's challenges and opportunities

1. What’s going on? Fundamental themes in health care and society

In this chapter I shall highlight five fundamental themes, or trends, which seem to lie behind the controversies and developments of the last few years. Although the list is not exhaustive, these seem to me to be some of the most significant trends of the last three decades which have brought us to our current position. This chapter may seem rather academic, theoretical and hard-going to some, and you may wish to jump to the next chapter and come back to this one at a later stage, but I believe these themes are significant and important.

Theme 1: Progress in human biology and the triumph of scientific reductionism

The period from the 1980s onwards has seen the spectacular and unparalleled success of a scientific reductionist methodology applied to human biology. ‘Reductionism’ is a term that is frequently bandied around, often as a term of abuse. But what does it actually mean?

As a scientific method, reductionism can be seen as a way of investigating and understanding processes from the bottom up. As I type this sentence on my computer, I am watching words appear on the monitor screen in front of me. I can analyse the sentence in terms of language, vocabulary and grammar. But those images, which appear to be words that I can recognize, are in fact constructed from a screen display which is generated and regenerated many times per second. The screen display is produced by thousands of tiny semiconductor devices which are emitting photons according to the fundamental physical laws of quantum mechanics. The images on my screen can be analysed at a number of different levels, each more fundamental than the previous one. Reductionism is the name for a description of processes at the most fundamental level possible, in order to provide the most detailed and comprehensive understanding of which we are capable.

This analogy may be helpful because it illustrates the fact that the appropriate level of analysis depends on the question being asked. If I ask, ‘Why are the words at the edge of my screen distorted?’, the answer may well depend upon a detailed understanding of the processes of photon emission. But if I ask, ‘Why is this sentence written in English and not in Chinese?’, an answer in terms of photons is not going to be helpful. The level of explanation required is completely different.

Much of modern biological science is reductionist in the sense that it depends on the progressive breakdown of awesome complexity into relatively simple fundamental cellular and molecular mechanisms. As a way of tackling scientific and medical problems, reductionism applied to biology has been remarkably successful.

The area of molecular genetics is just one example of the success of reductionist biology and the resultant growth in scientific knowledge about ourselves. The sequencing of the entire human genome, recently completed following a massive coordinated research enterprise, has led to a mass of new information about our genetic make-up. We now know much more about the variations in DNA between different human beings, and we are able to compare our genetic code with that of other species. We have learnt more about the genetic make-up of Homo sapiens in the last ten years than in the whole of the preceding thousands of years of human existence.

By comparing DNA samples, it is possible to identify the degree of physical relatedness between any two individuals. And by taking samples from different geographical and racial groups, geneticists have a new and powerful tool to investigate our human history and the racial migrations which have taken place since we first appeared on the planet. This is because our DNA has been passed down to us from our ancestors, accumulating mutations on the way. Modern techniques for DNA analysis have led to an upsurge of scientific interest in human diversity and evolution.

Terrible, disabling conditions such as thalassaemia, sickle-cell disease and Huntington’s disease all stem from ‘point mutations’, minute changes in our genetic code – a single misprint in an encyclopedia of millions of words. Many more common diseases, such as insulin-dependent diabetes and many forms of cancer, result from an interaction between genetic variants (polymorphisms) and environmental factors. Disturbingly, serious abnormalities are surprisingly common in our genetic code. In fact, all of us harbour within our DNA abnormal genes which carry the possibility of serious diseases for ourselves and for our children. ‘For his birthday Daddy gave him a time bomb’ reads the slogan of a poster campaign about hereditary heart disease. By detailed analysis of an individual’s DNA, it is increasingly possible to calculate the risk of future diseases, and before long it may be possible to give increasingly accurate risk estimates for any one of hundreds of conditions, from coronary artery blockage to Alzheimer’s disease.

Of course, it is not only human genetics that has seen an explosive rate of scientific advance. In virtually all areas of human biology – embryology, neuroscience, cancer medicine – the reductionist scientific methodology has been spectacularly successful, leading to an explosive growth in the basic medical sciences. The importance of this development for the future of medicine is hard to overestimate.

What is our reaction to this explosion of scientific information about our bodies, about the stuff of our humanity, the microscopic mechanisms of which our physical being is constructed? How have these scientific advances affected our view of ourselves and our place on the planet? What does it mean to be a human being in the light of modern biology?

As a number of Christian writers have pointed out, a successful scientific approach, splitting down complex systems into more basic constituents, tends to transform unnoticed into a philosophical view which assumes that any system can be explained wholly by the properties of its component parts. To put it more technically, a reductionist methodology tends to merge imperceptibly into a reductionist ontology. Professor Donald MacKay, a distinguished Christian neuroscientist, christened this attitude ‘nothing buttery’. Nothing buttery is the belief that because we are composed of chemicals, we are ‘nothing but’ chemicals.1

Certainly ‘nothing buttery’ seems to be alive and well in modern biology. The well-known zoologist Professor Richard Dawkins, of Oxford University, writes in his influential book, The Selfish Gene: ‘We are survival machines – robot vehicles blindly programmed to preserve the selfish molecules known as genes. This is a truth which still fills me with astonishment.’2

Dawkins describes his striking vision of the process of Darwinian evolution which proceeds inexorably from the first living, replicating cell all the way to human beings:

Replicators began not merely to exist, but to construct for themselves containers, vehicles for their continued existence. The replicators which survived were the ones which built survival machines for themselves to live in...Survival machines got bigger and more elaborate, and the process was cumulative and progressive...Four thousand million years on, what was to be the fate of the ancient replicators? They did not die out, for they are past masters of the survival arts. But do not look for them floating loose in the sea; they gave up that cavalier freedom long ago. Now they swarm in huge colonies, safe inside gigantic lumbering robots, sealed off from the outside world, communicating with it by tortuous indirect routes, manipulating it by remote control. They are in you and in me; they created us, body and mind; and their preservation is the ultimate rationale for our existence. They have come a long way, those replicators. Now they go by the name of genes, and we are their survival machines.3

Dawkins once asked a little girl what she thought flowers were for. She thought for a moment and said: ‘Two things; to make the world pretty and to help bees make honey for us.’

‘Well, I thought that was a very nice answer,’ said Dawkins, ‘and I was very sorry to tell her it wasn’t true.’

What then is Dawkins’s answer? What are flowers and human beings and everything else for?

He says: ‘We are all machines built by DNA whose purpose is to make more copies of the same DNA. Flowers are for the same thing as everything else in the living kingdoms, for spreading “copy me” programs about. That is exactly what we are for. We are machines for propagating DNA...It is every living object’s sole reason for living.’4

To the consistent reductionist, our bodies are ultimately just survival machines; our brains are, in reality, computers constructed out of flesh and blood rather than silicon and wires. The sole purpose of the human body is to ensure our ability to survive and replicate. Even our most erudite thoughts or passionate emotions are merely the by-products of our neural-computer circuitry. When challenged about the nature of human love in an interview in Third Way magazine, Dawkins replied: ‘Brains being what they are, they have a capacity to invent spurious purposes of the universe...[love] is an emotion which is a manifest­ation of brain stuff.’5

Of course, there are serious problems with thorough-going reductionism as an all-encompassing philosophy. If all our thoughts and beliefs are mere by-products of neural-computer circuitry, there are serious reasons to doubt whether our beliefs actually match with reality, with the way the world is. It could be that some of my thoughts and beliefs merely have survival value but are ultimately faulty, including my beliefs about reductionism. If the structure of my brain has evolved solely to ensure my survival, there are serious questions as to whether its beliefs can be reliable. Dawkins has claimed that religious belief represents an aberrant way of thinking which replicates from mind to mind (a malignant meme or God-virus).6 But the argument is two-edged. A belief in reductionism may also be aberrant and faulty. Thorough-going reductionism raises the question of whether it is possible to generate rational beliefs through a process of discovery and discussion. If our beliefs and convictions are simply an artefact created by the firing of brain cells, then there is no reason to think that they should have any connection with reality. In fact, the very possibility of rational thought is called into question. Yet Dawkins clearly believes most passionately, not only that his view of the world has survival value for his own genes, but also that it is true – that it matches with the way the universe is.

It’s interesting that Charles Darwin himself was aware of this implication of evolutionary thinking:

But then with me the horrid doubt always arises whether the convictions of man’s mind, which has been developed from the mind of the lower animals, are of any value or at all trustworthy. Would any one trust in the convictions of a monkey’s mind, if there are any convictions in such a mind?7

Despite its philosophical problems, biological reductionism is part of popular culture today. It has penetrated into the foundations of modern people’s thought-forms. It is the unchallenged perspective of the scientific and educated elite. How has this perspective affected our view of ourselves as human beings? I want to spell out four consequences.

Scientific reductionism leads to a ‘machine’ view of humanity

In the history of biology, human beings have always tried to understand the human body by comparison with the most potent forces we observe in the world around us. The ancient physicians conceived of the body as operating according to the four basic elements that philosophers had identified: fire, water, air and earth. The Victorians, in an age when the power of hydraulics was omnipresent, conceived of the body as composed of incompressible fluids which generated powerful pressures and forced their way through microscopic tubes. Even the Freudian conception of psychodynamics can be seen in this way. The libido is an incompressible fluid which is channelled through the structures of the unconscious, but has a tendency to burst out in uncontrollable energy. At heart it’s a hydraulic view of the mind!

Now, as modern society has been transformed by machines of all types, it is perhaps not surprising that the commonest perception of our bodies is as merely another sort of machine, especially an information-processing machine. We understand machines; we operate and control them. We are surrounded by them. So the idea that the human being is merely another form of machine makes sense to modern people. It is a frequent theme in scientific documentaries and high-school and undergraduate courses in biology. We explain the working of the human body by analogy with machines.

An undergraduate textbook of cell biology shows a photomicrograph of a neuron growing on top of a computer microprocessor. The text states: ‘The neuron is the fundamental information-processing unit of the brain, which might be compared to the transistor as the fundamental processing unit in the computer. However, the brain has 15 billion neurons, whereas microprocessors have only millions of transistors.’

In the words of theologian Helmut Thielicke: ‘Instead of man being the measure of things, the things he has made...come to determine the lines along which man himself is to be structured.’8

There is a paradox here. All the machines we know were designed by humans in order to achieve a particular purpose. That is what a machine is – a way for a human designer to achieve a human purpose. Every microprocessor was laboriously created by teams of human designers in order to accomplish a series of complex design objectives set by other humans. Yet in the human body we have a machine which is apparently designed by no-one for no purpose! From a reductionist perspective we can call the human body an extraordinary coincidence, a cosmic accident, but we cannot call it a machine. The analogy begs more questions than it answers.

This ‘machine thinking’ leads inexorably to a sense of alienation from our own bodies. In some sense, the real me is trapped in a frighteningly complex and ultimately alien machine which has its own agenda, its own programme, its own laws, and its own capacity for breakdown. Each person’s future is determined by the mysterious and ultimately incomprehensible laws of science which are controlling the machinery.

The sense of alienation from our own physical structure, and from the lives of other people, strikes deeply in our modern society. It contributes to the modern philosophical concept of the isolated autonomous individual, to which we will return later in this chapter.

Scientific reductionism offers a way to self-mastery or self-transcendence

It may not be very comfortable to discover that we are only survival machines, but it has an advantage for modern people. By understanding how the machine works, we can satisfy a deep drive we all have to understand and hence control ourselves. I think this explains the particular fascination of modern neuroscience: the observation of the living, functioning, thinking, feeling human brain. By observing our own brain function, we can learn to conquer it. By making ourselves an object of study, we assert our own self-mastery; in philosophical terms, we attempt to transcend ourselves.

The managing director of a high-technology Japanese company which devoted large amounts of research money to the development of a new form of brain scanning told me that his ultimate aim was the prevention of war: ‘What causes wars and conflicts between people is the malfunctioning of the human brain. By understanding how the brain works we can bring world peace.’

Take all the forms of human behaviour which threaten our future: violence, drug addiction, inter-racial conflict, religious fanaticism, paedophilia, selfish squandering of the world’s resources. At heart these can all be seen as due to a malfunctioning of the human brain. If we can only understand how to prevent brain malfunctioning, we will be able to usher in a new dawn of social harmony and global peace. By making our own human functioning an object of scientific study – by objectifying ourselves – we hope to control ourselves, to achieve self-mastery.

Since the attacks on New York on 9/11, politicians and policy makers have been particularly concerned about violence linked with so-called ‘religious fundamentalism’. It is not surprising that there is an active area of scientific research into the brain mechanisms that underlie religious beliefs and experiences. MRI and PET brain scans have identified brain regions which are activated during meditation and ‘out of body’ experiences, and neuroscientists like V. S. Ramachandran have performed studies indicating that the brain has specialized circuits which mediate belief and which are central to religious behaviour.9

Of course, brain scans can never conclusively prove whether a belief is founded in reality or is delusional. We may observe the brain regions which are activated when a young man thinks of his girlfriend, but this will never tell us what she is really like, or indeed whether she exists or is just a figment of his fevered imagination!

A United States ‘consumer consultancy’ company has promoted the idea that the ‘next important evolution in marketing’ will be based on brain imaging. The consultancy performs brain scans on subjects while they are observing advertisements, to investigate ‘what drives consumer behaviour at a conscious and subconscious level’, with the aim of helping clients establish ‘loyal, long-lasting’ relationships with those who buy their products.10

A research group at Dartmouth College in New Hampshire investigated brain activity while subjects looked at photographs of people from different racial groups. The scientists found that when white volunteers looked at faces of Afro-Caribbean people, there was a strong link between activity in the right dorsolateral prefrontal cortex and scores on a previously performed word association test of racial attitudes. Professor Richeson, the leader of the group, concluded that the brain activity arose because the volunteers were concentrating on not doing or saying anything offensive.11 Not surprisingly, the research provoked controversy, with some experts arguing the conclusions were mis­placed. At its most far-reaching, the study raised the possibility that the minds of people, including police recruits, could be screened for racist attitudes. It is clear that neuroscience is providing new insights into the way our brains work, but our desire for self-mastery will lead to troubling and profound dilemmas in the future.

■ Read more: Brain mechanisms underlying religious and moral beliefs

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Table of contents

• Matters of Life and Death
• Contents
• Foreword
• Acknowledgments
• Introduction
• 1. What’s going on? Fundamental themes in health care and society
• 2. Biblical perspectives on humanness
• 3. Reproductive technology and the start of life
• 4. Fetal screening and the quest for a healthy baby
• 5. Brave new world: biotechnology and stem cells
• 6. Abortion and infanticide: a historical perspective
• 7. When is a person? Christian perspectives on the beginning of life
• 8. The dying baby: dilemmas of neonatal care
• 9. A good death? Euthanasia and assisted suicide
• 10. A better way to die
• 11. The Hippocratic tradition and the practice of modern medicine
• 12. The future of humanity
• Glossary
• NOTES
• Brain mechanisms underlying religious and moral beliefs
• Genetic evidence on the origin of Homo sapiens
• Human Fertilisation and Embryology Act 2008
• Gamete donation and sharing
• Embryo freezing
• Reproductive tourism
• ‘Natural’ fertility treatments
• Free fetal DNA
• Psychological effects of antenatal screening
• Attitudes of disabled people to antenatal screening
• Advances in biotechnology
• Sex selection for social reasons
• Embryo selection
• Therapeutic or research cloning
• Regenerative medicine and embryonic stem cells
• Gene therapy and human-animal hybrids
• Abortion statistics
• Late abortion or 'feticide'
• Using the human embryo in medical research
• Practical alternatives to abortion
• Neonatal euthanasia
• Withdrawal of intensive treatment in neonatal care
• Euthanasia and physician–assisted suicide
• Social pressures in favour of euthanasia
• The Remmelink Report
• Brain stem death
• The persistent vegetative state
• Advance Directives, Statements and Decisions
• Advance Statements
• Caring for people with dementia
• Defending a Christian worldview
• Conscientious objection in medicine
• Transhumanism and posthumanism