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Biomedical subjects

H Tristram Engelhardt

Publications and source records attributed to H Tristram Engelhardt.

At least 19 recordsLinked to original sources
PubMed2002

Germline engineering: the moral challenges.

Not only is the use of germline genetic engineering likely in the long run to be inevitable, there are also no convincing secular moral grounds to forbid this technology in principle. Instead, the general secular moral constraints on the use of germline genetic engineering are either procedural or without predetermined content. Nor can one develop a coherent distinction between eliminating disease and enhancing human abilities. At best, in secular morality one can establish the principle to proceed with care, though the invocation of the precautionary principle argues as much in favor of the development of germline genetic engineering as against its use. Because germline genetic engineering, by eliminating certain genetic defects, offers the prospect of decreasing human suffering and decreasing the use of prenatal diagnosis and abortion, there is an obligation, all else being equal, to change the human genome. In a post-modern world, humans face the challenge of directing their own evolution, although they share no common understanding of human destiny and purpose. Such understandings, though available within religious contexts, are not available to secular bioethics.

Bioethics↗
PubMed1999

Genetic enhancement and theosis: two models of therapy.

The author argues that to think theologically about genetic enhancement is to think prayerfully about how to locate all one's uses of medicine, recognizing that they must all be lodged in the Christian struggle to holiness. He is critical of the essays in this issue because they often appear to take on a scholastic life of their own outside of the all-consuming struggle to salvation of Christians across the millennia.

Christianity↗
PubMed1999

Bioethics in the third millennium: some critical anticipations.

Its promises to the contrary notwithstanding, bioethics is plural. There is a diversity of content-full moral undertandings of the good and the right. Moreover, there is no secular means in principle to set this diversity aside without begging the question. This moral diversity exists both as a sociological condition and as a moral epistemological constraint. Without succumbing to a metaphysical scepticism or moral relativism, the bioethics of the future, if it is to be honest, should learn how to live with robust moral diversity.

Advisory Committees↗
PubMed1998

Physician-assisted death: doctrinal develoment vs. Christian tradition.

Physician-assisted suicide offers a moral and theological Rorschach test. Foundational commitments regarding morality and theology are disclosed by how the issue is perceived and by what moral problems it is seen to present. One of the cardinal differences disclosed is that between Western and Orthodox Christian approaches to theology in general, and the theology of dying and suicide in particular. Confrontation with the issue of suicide is likely to bring further doctrinal development in many of the Western Christian religions, so as to be able to accept physician-assisted suicide and euthanasia.

Attitude to Death↗
PubMed1998

Physician-assisted suicide reconsidered: dying as a Christian in a post-Christian age.

The traditional Christian focus concerning dying is on repentance, not dignity. The goal of a traditional Christian death is not a pleasing, final chapter to life, but union with God: holiness. The pursuit of holiness requires putting on Christ and accepting His cross. In contrast, post-traditional Christian and secular concerns with self-determination, control, dignity, and self-esteem make physician-assisted suicide and voluntary active euthanasia plausible moral choices. Such is not the case within the context of the traditional Christian experience of God, which throughout its 2000 years has sternly condemned suicide and assisted suicide. The wrongness of such actions cannot adequately be appreciated outside the experience of that Christian life. Traditional Christian appreciations of death involve an epistemology and metaphysics of values in discordance with those of secular morality. This difference in the appreciation of the meaning of dying and death, as well as in the appreciation of the moral significance of suicide, discloses a new battle in the culture wars separating traditional Christian morality from that of the surrounding society.

Attitude to Death↗
PubMed1997

Holiness, virtue, and social justice: contrasting understandings of the moral life.

Being a Christian involves metaphysical, epistemological, and social commitments that set Christians at variance with the dominant secular culture. Because Christianity is not syncretical, but proclaims the unique truth of its revelations, Christians will inevitably be placed in some degree of conflict with secular health care institutions. Because being Christian involves a life of holiness, not merely living justly or morally, Christians will also be in conflict with the ethos of many contemporary Christian health care institutions which have abandoned a commitment to Christian spirituality. In this regard, managed care raises the special question of how Christian institutions can act morally under financial constraints and maintain their character while under the control of secular managers. This question itself raises the further question as to why health care institutions need even pose this query when there are Christian physicians and nurses who could work for less, or Christian men and women who could become sisters and brothers and work for nothing. Contemporary challenges to Christians to maintain their integrity in a post-Christian world have much of their force because Christians have failed to maintain traditional Christian sprituality. In the face of that failure, Christian physicans and nurses will find themselves in greater conflict with health care institutions, because few will any longer understand the requirements of traditional Christianity. In its place, they will have put a generic spirituality, a value-neutral understanding of the role of the health professional, and an anonymous commitment to social justice.

Abortion, Induced↗
PubMed1996

Suffering, meaning, and bioethics.

Suffering evokes moral and metaphysical reflection, the bioethics of suffering concerns the proper ethos of living with suffering. Because empirical and philosophical explorations of suffering are imprisoned in the world of immanent experience, they cannot reach to a transcendent meaning. Even if religious and other narratives concerning the meaning of suffering have no transcendent import, they can have aesthetic and moral significance. This understanding of narratives of suffering and of their custodians has substantial ecumenical implications: chaplains can function as general custodians of narratives and sustainers of a generic religious meaning. This understanding is contrary to traditional Christianity, which discloses a transcendent significance of human suffering found in a very particular history involving particular persons: Christ as the second Adam through the submission of the second Eve has taken on our nature so that we can be united with God. Human suffering is tied to human sin, not simply as a punishment for sin, much less as an opportunity to discharge a supposed temporal punishment due to sin. Human suffering is the result of our rebellious free choices. It provides an opportunity for humility and submission, so that, united to the cross of Christ, sin can be forgiven and suffering set aside in the Resurrection. Knowledge of this framing context for all human suffering is accessible not through rational argument. It is a knowledge garnered through repentance, purification of the heart, illumination by God's grace, and unification with God. Christian bioethics is embedded in the narrative of suffering, which is part of the history of salvation and which encompasses and places all of medicine in its terms.

Bioethics↗
PubMed1996

Equality in health care: Christian engagement with a secular obsession.

A frenetic search for equality lies at the center of much secular and even "Christian" bioethics. In a secular world, if one does not believe in God, if this life is one's whole existence, it would seem that one could not settle for less than equal approbation, especially equality before the risks of suffering and death, which medicine promises to ameliorate. Yet, the concern for equality in health care is puzzling. After a modest level of access to health care there is little difference in average life expectancy. Are concerns for equality in health care even vaguely Christian? The pursuit of Christian perfection has never been correctly equated with state-imposed egalitarianism. Furthermore, an all-encompassing, secular, egalitarian health care system may provide equal access to significantly immoral medical treatments. In contrast to secular thought, the call of Christianity is a call to holiness, not a call to an egalitarianism that superficially resonates with certain elements of Christian thought.

Christianity↗
PubMed1995

Towards a Christian bioethics.

Rather than revealing itself as a single, unified, ecumenical faith, Christianity is sundered with Christians united neither in one communion nor in one baptism. Christian Bioethics seeks to examine the traditional content-full moral commitments which the Christian faiths bring to life, sexuality, suffering, illness and death within the contexts of medicine and health care. Seeking to understand the differences which separate the bioethics of Roman Catholics, Protestants, and the Orthodox, Christian Bioethics explores the manners in which the faiths diverge. The failure of the Enlightenment project to disclose a content-full communality that would bind mankind has left much to be reconsidered by Christians who face new ethical dilemmas in the novel guise of advances in health care technologies.

Bioethics↗
PubMed1995

Moral content, tradition, and grace: rethinking the possibility of a Christian bioethics.

Birth, suffering, disability, disease and death were by medicine's successes placed within a context of seemingly novel challenges that cried out for new responses. Secular bioethics rose in response to the demands of these new biomedical technologies in the context of culture fragmented in moral pluralism. While secular bioethics promised to unite persons separated by diverse religious and moral assumption, this is a promise that could not be fulfilled. Reason alone cannot provide canonical, content-full moral guidance or justify a moral community capable of binding all persons. Christian bioethics, as part of a way of life enbedded in authentic worship, offers content, meaning and understanding where secular bioethics has failed. For Christians, resolution of bioethical controversies will not be found through appeals to foundational rational arguments or isolated scriptural quotations, but only in a Christian community united in authentic faith.

Bioethical Issues↗
PubMed1995

Christian bioethics as non-ecumenical.

A community's morality depends on the moral premises, rules of evidence, and rules of inference it acknowledges, as well as on the social structure of those in authority to rule knowledge claims in or out of a community's set of commitments. For Christians, who is an authority and who is in authority are determined by Holy Tradition, through which in the Mysteries one experiences the Holy Spirit. Because of the requirement of repentance and conversion to the message of Christ preserved in the Tradition, the authority of the community must not only exclude heretical teaching but heretical communities from communion. Understanding Christian bioethics requires a focus on the content of that bioethics in terms of its social context within a right-believing, right-worshipping community. Christian bioethics should be non-ecumenical by recognizing that true moral knowledge has particular moral content, is communal, and is not fully available outside of the community of right worship. The difficulty with Roman Catholicism's understandings of bioethics lies not just in its continued inordinate accent on the role of reason apart from repentance (as well as in its defining novel doctrines), but in Roman Catholicism's not recognizing that the contemporary, post-Christian age is in good measure the consequence of its post-Vatican II failure to call for a return to the traditional pieties and asceticisms of the Fathers so that all might know rightly concerning the requirements of Christian bioethics.

Abortion, Induced↗