Abstract:
This is a book
review on “Matters of Life & Death: Human dilemmas in the light of the
Christian faith” by John Wyatt. The subject is medical ethics. The purpose is
to help Christians respond to the central ethical dilemmas raised by modern
medical practice in accordance with the Christian faith. Wyatt’s thesis is that
each human is made in the image of God and that alone is the reason for the
sanctity of life. Wyatt has argued well for his thesis as he covered a broad
range of ethical scenarios and backs his response with Scripture. Wyatt
achieved his purpose because this book really gets the reader thinking through
life and death issues. It also helped me on a personal level by changing some
of my mindsets. Wyatt gave some suggestions on appropriate practical responses
but these must be lived out by the readers for it to be practical.
This is a book
review on “Matters of Life & Death: Human dilemmas in the light of the
Christian faith” by John Wyatt. The title already gives clue that the subject
of this book is medical ethics, because the field of medicine often deals with
the matters of life and death, and a dilemma is a situation where we have to
make difficult choices in accordance with our ethical values. “In the light of
the Christian faith” means the target audience includes all Christians. Wyatt’s
purpose is to help Christians respond to the central ethical dilemmas raised by
modern medical practice in accordance with the Christian faith.[1]
Wyatt’s thesis is that each human is made in the image of God and that alone is
the reason for the sanctity of life. Therefore, the value of each human life is
not calculated in materialistic or functional terms, and the weak and
vulnerable should be protected, not eliminated. However, humanity’s desire for
control over its own destiny is one of the main fuels driving these dilemmas.
The structure
consists of twelve chapters. The first chapter identifies five fundamental
themes in health care and society which influences on the development of
bioethical thinking: biological reductionism, technology, consumerism, limited
resources and ethical diversity.[2]
Chapter two talks about the biblical perspectives on humanness and how
important it is to look at the four epochs of human history: creation, fall,
redemption and future consummation, so that we do not get a distorted idea of
the Christian truth.[3]
Chapter three examines the history of reproductive technology and Christian
perspectives on it. Chapter four looks at the implications of antenatal
screening today. Chapter five looks at biotechnology and stem cells, including
the selection of embryos with desirable characteristics, cloning for
therapeutic research and reproductive purposes, and stem cells.
Chapter six looks
at the history of abortion and infanticide. Chapter seven explores Christian
perspectives on the beginning of life looking at passages such as Psalm 139.
Chapter eight talks about dilemmas in neonatal care, such as in the case of
premature babies, neonatal euthanasia and the dying baby. Chapter nine talks
about how euthanasia and assisted suicide are heading down a slippery slope.
Chapter ten discusses the Christian view of dying and some practical responses.
Chapter eleven looks at the history of medicine. The final chapter analyses the
possible paths which humanity will head in the future in the light of the
Enlightenment project and New Age spirituality, and contrasts that with a
biblical understanding of the future hope.
Wyatt uses a
catalogue of relevant topics for the arguments in this book. He opens the book
with discussion on the main themes in the central ethical dilemmas today. He observes
a trend towards scientific reductionism, where our body is viewed by scientists
such as Dawkins as simply survival machines, built by the DNA to create more
copies of the same DNA.[4]
This leads to the temptation to transcend ourselves, eg. observe our brain
function and learn to conquer it. Paradoxically, it also leads to pessimistic
fatalism, where we can predict when malfunction will struck. As technology
advances, science aims not merely to describe the world but also to control it.
Many scientists dream of using technology to improve the capacities of the
human body, thereby transforming the nature of humanity itself.[5]
Furthermore, biotechnology can be used for ‘quality control,’ eg. in prenatal
testing.[6]
With increasing advancements, consumer expectations rise, leading to increasing
expenditures to meet these expectations, thereby increasing economic burdens in
the setting of limited resources.[7]
In response to these dilemmas, the academic discipline of bioethics grew
rapidly since the late 1970s.[8]
Some bioethicists hold anti-biblical views, eg. Peter Singer, who proposes that
the worth of life varies depending on the functioning of the cerebral cortex
and recommends “mercy killing” for a life that is “not worth living”. Wyatt coins the term “corticalism” to describe
Singer’s discrimination of people according to their cortex.[9]
Wyatt then logically
moves on to the biblical perspectives on humanness, covering the theological
themes of the image of God in the human, sin, soteriology and eschatology. Using
the creation narrative, he demonstrates that human life is sacred because we
are created in the image of God. Using the Fall narrative, he describes how human
disobedience led to death and decay, and hence all the futility and sufferings
humanity has to endure. The Tower of Babel narrative describes humanity’s
tendency towards using technology to usurp God. There are multiple promises for
redemption and commands to defend the defenceless. God became flesh to redeem
us, revealing himself as a human being. Wyatt reminds us not to stop at the
cross, as the Gospel emphasise the physical reality of Christ’s restored body
and its continuity with his old physical body.[10]
Our physical bodies will also be transformed in the same way that Christ’s body
was transformed. We can make sense of the present only in the light of the
future.[11]
Chapters three to
seven focus on the beginning of life issues. Wyatt believes “the ethics of art
restoration” can be practiced, where the restorer is not free to change or
improve the masterpiece they are trying to restore, but to follow the artist’s
(ie. God’s) original intention.[12]
In reproductive technology, Wyatt thinks using IVF to assist an infertile
couple to have their own genetically related child is a form of restorative
technology. However, no spare embryos are to be created, and the genetic link
between the married couple and their children is not to be broken, ie. no sperm
or egg donation.[13]
Wyatt suggests
that antenatal screening is fine, so long as the “treatment” for the condition
being screened for is not abortion.[14]
Furthermore, screening is a form of discrimination, implying that the lives of
disabled people are of less value than those of the healthy.[15]
Therefore, biotechnology should not be used to select embryos with desirable
characteristics,[16]
as this turns the child into a commodity[17]
and takes away the loving unconditional welcome.[18]
Embryo cloning should not be done for research or reproductive purposes as this
leads to destruction of large numbers of human embryos and allow people to
reproduce asexually.[19]
Wyatt sees enhancing therapy as crossing the line and cautions that the
distinction between restorative and enhancing therapy is not always clear cut.[20]
Wyatt believes
abortion and infanticide are essentially the same on ethical grounds.[21]
He then discusses “when is a person” in the next chapter using Psalm 139, which
tells us God already knew us when we were still unformed. He concludes that the
distinction between the formed and unformed is not a biblical concept,[22]
and to ‘play it safe’ whenever there is uncertainty.[23]
There are also hard cases such as rape victims, but Wyatt believes that there
are always better alternative than abortions for unwanted or abnormal
pregnancies,[24]
and that it is often the failure of practical caring which drives people to
consider unethical solutions.[25]
Wyatt states that if Christians are not in the forefront of providing practical
care for these people, “our supposed commitment to the sanctity of life is
deeply suspect.”[26]
Wyatt moves on to
the topic of dying in chapters eight to ten. He does not approve of neonatal
euthanasia because if it is legal to end the life of a newborn on the basis of
their own best interests, then it is illogical not to kill an incompetent child
or adult under similar circumstances.[27]
There is a slippery slope with legalising euthanasia, where some people are now
giving ‘tiredness of life’ as the reason to request euthanasia in the
Netherlands.[28]
Wrong diagnosis is also an issue, especially when people are in the vegetative
state.[29]
Furthermore, the ethos of the medical profession is to preserve and protect
life wherever possible, so allowing doctors to kill people would weaken the
level of trust in the profession.[30]
Wyatt also argues that even though the cortex is not functioning properly in
people with dementia, the real person is still there.[31]
Wyatt believes high quality palliative care is needed for all dying people.[32]
He thinks respect for life and prohibition of suicide is part of the glue which
binds society together.[33]
Death may be seen as God’s “severe mercy” for his fallen creatures.[34]
Suffering is “a mystery which demands a presence,” to be there for those who
are ill, suffering, and dying.[35]
Good medicine knows its limits, and the difference between intention and foresight.[36]
Chapter eleven
discusses the Hippocratic tradition, how much it shared in common with
Christian values, how they became the unlikely allies with the early
Christians, how Christianity influenced the development of medicine, how the
Hippocratic-Christian consensus eroded in modern days, and that we should
defend the Christian worldview today. Wyatt’s final chapter ends on a note of
hope for the future, that “unlike the secular humanist, who can never be spared
form the crushing responsibility of fashioning the future, Christians can dare
to rest, and celebrate the goodness of the creation…”[37]
Furthermore, “we are treating someone now in the light of what they are going
to be… This is why we can still respect and treat with dignity even the most
tragically damaged of human beings.”[38]
I believe Wyatt
argued for his thesis well, because he used many different dilemmas, yet his thesis
still applied to each. It is backed up well by the Scriptures, which he quotes
a lot of in Chapters two and seven. However, one needs to think through all the
issues Wyatt raised intentionally before things start linking up. In terms of
the sanctity of life, he describes how we need to be able to protect the
vulnerable ones, including embryos, fetuses, infants, the disabled, people with
dementia and people in the vegetative state, because no matter how unformed or
dysfunctional, they are all humans made in the image of God, and that alone is
the reason for the sanctity of life. Furthermore, the fact that God revealed
himself to us in the flesh and still has a physical body in his resurrection
tells us how important the human body is, and how we should see each person in
the light of what they will be in the final consummation. The world is fallen
and it is reasonable to practice the ethics of art restoration to restore people
as closely to God’s original intention as possible. Wyatt emphasises the
importance of practical care as the way we demonstrate our commitment to the
sanctity of life.
Wyatt describes
how humanity’s desire for control over our destinies drives many of these
dilemmas. The combination of scientific reductionism and the rapid advances in
biotechnology misleads humanity into thinking we can overcome the human
condition. However, this only gives rise to rising consumer expectations.
Rather than just seeking restorative treatments, people actually seek
enhancement. People try to exert control over the beginnings of life, by
selection of desirable embryos, which is really treating their children as
commodities. People are trying to get around God’s original intention for
marriage by seeking ways to reproduce asexually. People are also trying to
exert control over death through euthanasia. Without the Christian hope, the
secular humanist carries the crushing responsibility of fashioning the future.
I believe Wyatt
achieved his purpose in this book, because in the process of thinking through
these issues, I understand more. Any person can encounter at least one of the
dilemmas described in Wyatt’s book, and everyone can benefit practically from
this book as it helps people think about difficult issues ahead of time. Wyatt’s
use of the Scriptures helps me understand the Christian perspective better and
even changed some of my mindsets. For example, I just realised I am guilty of “corticalism”
as I tend to get agitated when I see myself or others being “non-productive.”[39]
I also did not realise until now how antenatal screening changes the
relationship between the mother and the child from an inseparable attachment to
one that begins with separation and distancing.[40]
However, I am thankful for antenatal screening because I have personally
encountered clinical scenarios where both mother and the baby might have died
if antenatal screening does not exist, and early intervention saved their lives.
So I agree strongly with Wyatt’s that antenatal screening can sometimes give us
the opportunity to give early treatment for certain conditions, and is ok so
long as it does not result in abortion.
One thing I do
not agree with is his statement “God’s ultimate being is found not in glory,
not in power, not in authority, but in self-giving.”[41]
I think God is all of these, and Wyatt seems to be putting God into a box to
support his argument for empathy here. In terms of practical application, Wyatt
attempts to give some practical responses in chapter ten, “a better way to
die.” Although it helps me reorganise my mindset, these are just words on the
paper. I believe that practical caring can only be learned through the
experience of being present for the suffering ones we encounter in our lives,
and learning from the mistakes made in the process. Overall, I find Wyatt’s
book very helpful but need the power of the Holy Spirit to apply these into my
everyday life.
Bibliography:
Wyatt, John. Matters of Life
& Death: Human dilemmas in the light of the Christian faith.
Nottingham: IVP, 2009.
[1] John Wyatt, Matters of Life & Death: Human dilemmas
in the light of the Christian faith (Nottingham: IVP, 2009), 15.
[2] Wyatt, Matters of Life & Death, 48.
[3] Ibid., 52.
[4] Wyatt, Matters of Life & Death, 28.
[5] Ibid., 34.
[6] Ibid., 36-37.
[7] Ibid., 39.
[8] Ibid., 40.
[9] Ibid., 45-46.
[10] Wyatt, Matters of Life & Death, 79.
[11] Ibid., 80.
[12] Ibid., 99.
[13] Ibid., 103.
[14] Ibid., 108. Abortion is eliminating the patient, not
treating the patient.
[15] Ibid., 118.
[16] Ibid., 123.
[17] Ibid., 132.
[18] Ibid., 173.
[19] Wyatt, Matters of Life & Death,
125-126.
[20] Ibid., 132.
[21] Ibid., 135.
[22] Ibid., 165.
[23] Ibid., 167.
[24] Ibid., 177.
[25] Ibid., 133.
[26] Ibid., 177.
[27] Ibid., 181.
[28] Ibid., 203.
[29] Ibid., 205.
[30] Ibid., 181.
[31] Wyatt, Matters of Life & Death,
213.
[32] Ibid., 232.
[33] Ibid., 218.
[34] Ibid., 219.
[35] Ibid., 220.
[36] Ibid., 224.
[37] Ibid., 271.
[38] Ibid., 273.
[39] Wyatt, Matters of Life & Death,
47.
[40] Ibid., 112.
[41] Wyatt, Matters of Life & Death,
260.
