SCIENCE and ethics are inseparable. Scientific break-throughs, especially in the area of medicine, initiate fresh ethical debates. Public participation in this discourse is only possible with adequate information.
In Life and Morality, David Smith offers us an up-to-date account of medical developments in four areas: abortion, in-vitro fertilisation and embryo experimentation, genetic engineering and euthanasia. It provides essential background knowledge to current debates. Each chapter sets out the present state of research and developments, examines the responses of the Christian churches to the new questions, as well as providing the reader with probing questions for reflection. Different responses from the churches and even within the same church warn us about any rush to judgment.
The churches differ in their consideration of technologically aided reproduction. The Roman Catholic Church teaches that there must be inseparability between intercourse and the possibility of procreation, and therefore rules out all methods, even in-vitro fertilisation where the sperm and the ovum come from a married couple.
Other Christian churches take a different stance. Rather than concentrating on the isolated act of intercourse, they judge IVF as an enrichment of the marriage relationship. David Smith cites respected Catholic theologians such as Lisa Sowle Cahil and Professor Bruno Schuller, SJ, who criticise the Vatican position and suggest that the use of technology in reproduction must be judged in relation to the love and commitment of the spouses and by its effect on their relationships. On surrogacy, or womb leasing, the churches are at one in their rejection.
Ever since the discovery of DNA 30 years ago, the search has been on to tease out and analyse every gene in the human blueprint. This has led to the $3 billion Genome Project in the US. Of our 75,000 human genes, so far we have information on only a third. This project will continue into the early years of the 21st century. All the churches are supportive. If it can liberate people from suffering and enhance human dignity, it is welcomed. But should there be limits to the application of such therapies? Is there a moral distinction between altering a patient's cancer-causing genes and altering their intellectual capacity?
Such information about an individual's personal make-up has enormous implications. Who should have access to such information? Who owns it? Who acts on it? These are questions that we are going to have to face. And even more seriously - who decides the answers?
One issue already hotly debated is euthanasia. Have we a right to die, to refuse medical treatment, to discontinue treatment, to be assisted in. ending our life? Since the 1960s, even the definition of death has changed.
Though the churches make a substantive case against euthanasia in any form and insist that there is a duty to preserve life, they clearly state that there is no obligation to use extraordinary means to preserve life. The Catholic Church accepts that medical procedures that are burdensome or disproportionate to the expected outcome can be legitimately discontinued. This view finds support in other churches.
One of the most creative suggestions coming from the euthanasia debate is the shift from dogmatic absolutist judgment to one that evaluates treatments and procedures in terms such as "beneficial" or "burdensome". There is, at least, a growing awareness that context is a significant element in moral deliberate ions. If moral theology is to have relevance for people's lives, it must recognise the context in which it operates.
David Smith suggests a new role for the theological enterprise it can no longer construct essentialist precepts and strive to implement them in all situations, but should be engaged in facilitating people to make informed moral decisions. A good beginning has been made with Life and Morality
