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Introduction (Full Text, then Section Headings)
- Matters of Life and Death examines a range of pressing contemporary ethical concerns raised by advances in medical and scientific technology. It addresses issues at the beginning of life, including reproductive technology, embryo1 research, stem cells, genetic screening, abortion2 and the care of sick newborn infants. It also deals with issues at the end of life, including euthanasia and assisted suicide, dementia and palliative care.
- The book engages with a range of contemporary secular perspectives on these complex subjects and provides Christian responses based on orthodox biblical theology. It illustrates how these principles may be applied in practice, and highlights the roles that Christians, both health professionals and lay people, are playing in finding practical solutions to these complex challenges. The book is intended for medical and scientific professionals, for Christian leaders and teachers, and for lay people who are affected by these matters.
- Orthodox Christian thinking about human existence, birth and death is facing unparalleled challenges from advances in medical and scientific technology and from recent developments in secular liberal thought and in legislation. The book argues that a historic biblical understanding of creation order, of the human person and of the Christian gospel, provides an intellectually coherent and practically relevant framework for engaging with these complex issues at the beginning and end of life. Christians have a unique contribution to make in current debates and in demonstrating practical and effective solutions to current bioethical problems.
- The first edition of Matters of Life and Death was based on the London Lectures in Contemporary Christianity. … The new edition has been extensively revised and updated to address recent developments in science, technology and ethics, and incorporates a range of new material and theological perspectives.
- See Link (Defunct) for extra material: These PDFs contain extra information about specific topics covered in Matters of Life and Death. They are a valuable resource for anyone wanting to read more widely, and include links to relevant websites as well as material by the author.
- When I was a medical student in London in the 1970s, I received just one lecture on medical ethics in my six years of undergraduate professional training. I was taught that all the practising doctor needed to know about the subject could be summarized under five A's: Abortion3, Adultery, Alcoholism, Association (with non-medically qualified physicians or `quacks') and Advertising. Of these evils, which the General Medical Council was dedicated to stamping out, it was widely held that the most objectionable was Advertising.
- But the world has changed. Medical ethics has been transformed from an obscure and unimportant branch of professional practice into a high-profile media activity. `Shock horror' tabloid journalism and highbrow television documentaries have brought the issues to a world audience. A single medical case can now achieve the same media prominence as the latest disclosure about the British royals or a soap opera scandal.
- What are the underlying forces behind the modern transformation in medical ethics? And how can people who wish to be faithful to the historic Christian faith respond to the challenges and the opportunities of recent and dramatic medical progress?
- This book attempts to formulate a Christian perspective on a number of central ethical dilemmas raised by modern medical practice. While writing from my individual perspective as a practising clinician and Anglican layperson, I have tried to reflect a broad theological position of historic or ‘foundational' Trinitarian Christianity, a theological position which takes a high view of Scripture and of the doctrines of the ancient creeds and councils of the Early Church. I am not a professional philosopher or theologian. For most of my professional life I have been a practising paediatrician and a Christian believer who has had to face some of these agonizing dilemmas as part of my daily medical practice. What I do have to offer is a view from the coalface. It is a view which has been created in my personal struggle to understand what is going on in the world of modern medicine and the attempt to develop an authentic Christian response.
- These questions are not just matters for an interesting academic debate, of the sort that philosophers, ethicists and students love to engage in. These dilemmas touch us at the most intimate, painful and vulnerable part of our lives. Many of the people who read this book will be carrying secret sorrows which they cannot share with others. The statistics show that more than one couple in seven will suffer from some form of fertility problem, and many will never be able to have children naturally. Some parents who pick up this book will have watched their child struggle and die, or will have given birth to a stillborn baby. Some will have had an abortion4, although even their closest friends and relatives may not know. Some will have watched a close relative die in pain or emotional distress. A few will know that they suffer from a major genetic disorder which is likely to curtail their life, and they are wondering how they and their families will cope with the future. Many more of us are unknowingly carrying genes which may result in major illness, disability and death later in life: diseases such as Alzheimer's, stroke or breast cancer. Virtually all of us are carrying the genes for devastating illnesses which we might pass on to our children. Many people who pick up this book, for instance, will be carrying the gene for cystic fibrosis, though they are completely unaware of it.
- So these are not just ethical issues `out there': they touch us at the core of our being. Nobody is immune: we all share in a common humanity, a physical nature which is painfully vulnerable and deeply flawed. As you read the following case histories, you may well find them disturbing and painful, as indeed I have done. A French philosopher of the Enlightenment once said that `death, like the sun, should not be stared at'. Yet that is precisely what we shall be doing in this book: staring at death and at the questions and fears that it raises.
- The vision behind the London Lectures in Contemporary Christianity is the Christian task which John Stott has termed ‘double listening'.' First, our task is to listen to the modern world in order to try to understand the real issues. Next, our task is to listen to the unchanging historic Christian faith in order to develop an authentic Christian perspective. Finally, our task is to build a bridge which spans these two foundations: the modern world and the authentic biblical Christian faith. The task of biblical Christians is to understand the modern -world in the light of the Bible, and to understand the Bible in the light of the modern world. Unless our bridge is securely rooted in both foundations it will be unable to bear the weight demanded of it.
- Of course, bridge-building is a perilous art. My father was a structural engineer, and I have a vivid memory of watching with him as a child while a concrete bridge he had designed was being tested by huge weighted lorries. I embark on my process of bridge construction with due trepidation. I have made no attempt to be exhaustive, as I lack the expertise and the experience to span the vast range of ethical issues raised by modern medical practice. Instead, I have concentrated on the ethical dilemmas surrounding the twin ‘edges of life': the start of life and its end.
- These are not easy matters. I have no simple answers — indeed, there are no simple answers. Yet I do have a deep conviction that the historic Christian faith, the faith of the Bible and of the Church Fathers, gives us a way forward as we approach these agonizing dilemmas. It is a way forward that is intellectually coherent and satisfying, and also immensely practical and down to earth. The historic Christian faith does have something vital to say to the world of the Human Genome Project, the intensive-care unit and the palliative care specialist. As I have researched and written this book, I have had a continuing sense of optimism, hope and confidence in the answers which the Christian faith provides.
- To set the scene, I will outline a number of important and influential medical cases which have hit the headlines. My purpose is to illustrate some of the technical possibilities and human dilemmas which modern medical technology has created, before we attempt to analyse the fundamental trends and social forces which underlie them.
… Mary and Jodie: conjoint twins5
… Dr Anne Turner: a case of assisted suicide
… Joanna Jepson – late abortion6 and the law
… Ms B – the right to refuse medical treatment
… Zain Hashmi – the hope of a saviour sibling
… Diane Pretty – the right to die
… Tony Bland and the persistent vegetative state7Contents
- Foreword by John Stott – 11
Acknowledgments – 13
Introduction – 15
- What's going on? Fundamental themes in health care and society – 25
- Biblical perspectives on humanness – 51
- Reproductive technology and the start of life – 83
- Fetal screening and the quest for a healthy baby – 107
- Brave new world: biotechnology and stem cells – 121
- Abortion8 and infanticide: a historical perspective – 135
- When is a person? Christian perspectives on the beginning of life – 157
- The dying baby: dilemmas of neonatal care – 179
- A good death? Euthanasia and assisted suicide – 191
- A better way to die – 215
- The Hippocratic tradition and the practice of modern medicine – 239
- The future of humanity – 265
Glossary – 277
Notes – 281
Index – 295
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- 2nd Edition, Nov. 2009
- On loan to Julie
Text Colour Conventions (see disclaimer)
- Blue: Text by me; © Theo Todman, 2019
- Mauve: Text by correspondent(s) or other author(s); © the author(s)