Based on “Case Study: Fetal Abnormality” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:
What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?
How does the theory determine or influence each of their recommendations for action?
What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?
Case Study: Fetal Abnormality
Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in
the United States for the last three years and have finally earned enough money to move out of
their Aunt Marias home and into an apartment of their own. They are both hard workers. Jessica
works 50 hours a week at a local restaurant and Marco has been contracting side jobs in
construction. Six months before their move to an apartment, Jessica finds out she is pregnant.
Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching
hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans
are conducted, and it is determined that the fetus has a rare condition in which it has not
developed any arms and will not likely develop them. There is also a 25% chance that the fetus
may have Down syndrome.
Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and
Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr.
Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself
when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another
room, Aunt Maria walks into the room with a distressed look on her face. She can tell that
something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of
the room wailing loudly and praying aloud.
Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation
to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He
furthermore is intent on discussing all relevant factors and options regarding the next step,
including abortion. Marco insists on taking some time to think of how to break the news to
Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband
that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks
in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr.
Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as
a responsible medical alternative, given the quality of life such a child would have. Jessica looks
at him and struggles to hold back her tears.
Jessica is torn between her hopes of a better socioeconomic position and increased independence,
along with her conviction that all life is sacred. Marco will support Jessica in whatever decision
she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled
child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the
options but clearly makes his view known that abortion is scientifically and medically a wise
choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and
allow what God intends to take place and urges Jessica to think of her responsibility as a
mother.
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PHI-413V Topic 2 Overview
God, Humanity, and Human Dignity
Introduction
Although there has recently been an explosion of scientific knowledge regarding Homo
sapiens (i.e., human beings) such as the Human Genome Project (National Human
Genome Research Institute, 2015) there is much more to what it means to be human
than what science alone can tell us. The question about what it means to be a human
person is fundamentally a philosophical and theological question that has been a topic
of debate for millennia (“Personal Identity,” 2014). We will focus on two aspects of this
question: (1) what kind of a thing is a human person? and (2) what (if anything) makes
human beings valuable and worthy of dignity and respect? The Christian worldview
claims that human beings are the kind of creature that is created by God and that is
both a physical and spiritual being capable of relationship with God. In this view, human
beings are intrinsically valuable and worthy of dignity and respect because they are
created in the “image of God.” This discussion will address different views of what a
human person is and focus on the distinctives of the Christian view regarding the value
of persons.
Moral Status
A term commonly used by ethicists in medical field to talk about a human person’s
worth or value is moral status (see Beauchamp & Childress, 2013, pp. 62-94). Moral
status explains which sorts of beings or entities are valuable and have rights to be
treated in certain ways. You might begin by asking, “Why is it that my neighbor has a
certain kind of value and a rock does not?” Any answer one gives will describe certain
characteristics or capacities that differentiate the neighbor from a rock. These
characteristics or capacities explain why the entity has the value it does. For example,
we might say that my neighbor has moral status (i.e., value or worth) because he or she
is a rational being, or because he or she has the capacity to feel pain and pleasure, etc.
Thus, to talk about a being’s moral status is to talk about a being’s value, as well as why
it has that value. The focus here is the moral status of human persons. Does moral
status differ among persons? It will be clear below that according to the Christian
worldview, moral status does not differ from person to person.
It is nevertheless common for people (including health care professionals) to think and
act in ways that assign higher or lower moral status to human persons based on certain
characteristics and capacities. The following five theories of moral status are different
views regarding what makes human persons valuable. Each of these theories will pick a
certain set of characteristics or capacities and claim that a human person is valuable
(i.e., has moral status) only if he or she possesses the relevant characteristic or capacity.
Consider carefully each of the following theories: (1) a theory based on human
properties, (2) a theory based on cognitive properties, (3) a theory based on moral
agency, (4) a theory based on sentience, and (5) a theory based on relationships.
1. The theory based on human properties holds that it is only and distinctively
human properties that confer moral status upon a human being. It follows that
all and only human beings, or Homo sapiens, have full moral status. Some of the
characteristics that would endow a human being with moral status would
include being conceived from human parents, or having a human genetic code.
In this view, one only needs to be a human being to count as having full moral
status.
2. The theory based on cognitive properties holds that it is not any sort of
biological criteria or species membership (such as the theory based on human
properties) that endows a human being with moral status. Rather, it is cognitive
properties that confer moral status upon a human being. In this context
“cognition refers to processes or awareness such as perception, memory,
understanding, and thinking
[and] does not assume that only humans have such
properties, although the starting model for these properties is again the
competent human adult” (Beauchamp & Childress, 2013, p. 69). Notice carefully
this is claiming that if a human being does not have these properties, it follows
that such a human being does not have moral status or value.
3. The theory based on moral agency holds that “moral status derives from the
capacity to act as a moral agent”; in this view a human being is considered a
moral agent if they “are capable of making judgments about the rightness or
wrongness of actions and has motives that can be judged morally” (Beauchamp
& Childress, 2013, p. 72).
4. The theory based on sentience holds that having sentience confers moral status
on a being. Sentience in this context is “consciousness in the form of feeling,
especially the capacity to feel pain and pleasure, as distinguished from
consciousness as perception or thought.” (Beauchamp & Childress, 2013, p. 73).
According to this theory the capacity of sentience is sufficient for moral status
(i.e., the ability to feel pain and pleasure confer moral status to a human being).
5. The theory based on relationships holds that relationships between human
beings account for a human being’s moral status. In other words, a human being
has moral status only if he or she has a relationship with others who value him or
her. Usually these are relationships that establish roles and obligations such as a
patient-physician relationship or a parent-child relationship. Of course, there are
many types of relationships (family, genetic, legal, work, etc.), even ones in
which one party in the relationship does not desire or value the other party. In
such a case, a person who holds this theory may be forced to concede that a
being’s moral status may change, depending on the other party.
Each of the theories above have the following logical structure:
“Human being X has full moral status if and only if it exhibits property Y”
X the human being in question (i.e., embryo, fetus, 12-month baby)
Y The property that confers moral status upon that entity (i.e., human properties,
cognitive properties, moral agency, sentience, or a relationship in which someone else
values X).
Notice carefully that different worldviews would apply these theories differently
depending on how they would think about the nature of human persons. It may be that
thinking about the value of human beings according to such theories is not compatible
with a particular worldview. In fact, the only theory above that is compatible with the
Christian worldview is the first theory based on human properties. According to the
Christian worldview all a human being needs to have full moral status or value is to be
human. However, there is much more to the Christian position as will be seen below.
The Nature of Humanity: Divine Image Bearers
One of the most powerful concepts of the Christian worldview is the truth revealed in
Genesis 1:26-27 that humanity was created in the image of God (or imago Dei in
Latin)spirit beings like him. But you were created with both a spirit and a body,
indicating that this is your natural state. This becomes even clearer as you learn in the
New Testament that one day you will be resurrected to new glorified bodies (1 Cor.
15:42-53).
There is some diversity of opinion among Christians about what the Bible means by the
“image of God,” but fundamentally it is what sets human beings apart from all other
creatures and what endows human beings with intrinsic value and dignity. To have
intrinsic value and dignity means that one’s value and dignity do not come from
anything external or extrinsic. For example, money has value that is purely external or
extrinsic because we value it, not for its own sake, but for the things it can get us.
Furthermore, there is not something intrinsically valuable to green paper (in the United
States) that gives it worth. By contrast, a human being’s value and dignity is inherent
such that it is something everyone possess by the very nature of what it means to be
human. Human beings have intrinsic value and dignity because they are the only
creatures that are created in the image of God.
The image of God is equally present in all human beings regardless of one’s worldview
or religion or whether or not one believes in God. Millard Erickson notes
there is no indication that the image is present in one person to a greater degree
than in another. Superior natural endowments, such as high intelligence, are not
evidence of the presence or degree of the image. [Furthermore], the image is
not correlated with any variable
[but is] something in the very nature of
humans, in the way in which they were made. It refers to something a human
being is rather than something a human being has or does. (Erickson, 1998, pp.
557-558)
It follows then that any theory of moral status which equates a human being’s value
with certain external characteristics, or any function a human being must do, is not
compatible with a Christian view of human persons. In addition, the image of God
provides a foundation for the genuine equality of all human beings regardless of race,
color, creed, gender, etc. It should be noted that the well-known bioethical principle of
“respect for persons” (National Commission, 1979) is well supported by the Christian
worldview.
While the image of God is equally present in all, its full expression may be hampered by
disease, disability, or even sin. The image of God also indicates that you also have
remnants of God’s character within you, and when fully expressed may include the
capability to love (even those who seem unlovable), the capability to create for purpose
or simply for beauty, the ability to reason on a very high level, the ability to explore the
universe, the capability to communicate with our Creator and to consciously worship
him, the ability to sacrifice for others, the ability to be fair (a sense of justice), and an
innate ability to sense right and wrong (a sense morality).
But Christians have been called to an even higher purposeto be conformed to the
image of Christ (Rom. 8:29)that is, restored to the perfect image of God; a lifelong
process sometimes called sanctification. The body of a Christian is referred to in 1
Corinthians 6:19-20 as the temple of the Holy Spirit, and as such, Christians are to purify
themselves, being transformed by the renewing of their mind (Rom. 12:2).
Humanity was created to love as God loves, to worship and commune with him as he
does with us, and to work as he works. Adam and Eve were commanded to be fruitful
and multiply, and they were given dominion over all the earth (Gen. 1:28), which is a
high order. They were placed in a beautiful garden to care for it and “work and keep it”
(Gen. 2:15 NIV). Adam was even given the task of naming all the animals, thus becoming
the first biologist, doing a work that continues to this day as new species are still being
discovered. Thus, humanity from the beginning was engaged in good work and given
responsibility and authority over other creatures, to care for them, and to expand God’s
kingdom under his sovereign rule. Unfortunately, as will be seen in the next discussion,
human beings are fallen image bearers.
Conclusion
While most people in our culture happen to believe that human beings are valuable and
worthy of dignity and respect, it is important to stop and actually think about what this
means. The question is whether or not one’s worldview provides an adequate
explanation for these beliefs. Notice carefully how the Christian worldview addresses
human dignity and value, and begin to ask yourself how your worldview would explain
the value and worth of human beings.
References
Beauchamp, T. L., & Childress, J. (2013). Principles of biomedical ethics (7th ed.). New
York, NY: Oxford University Press.
Erickson, M. J. (1998). Christian theology (2nd Ed.). Grand Rapids, MI: Baker Academic.
National Commission for the Protection of Human Subjects of Biomedical and
Behavioral Research. (1979). The Belmont report: Ethical principles and guidelines for
the protection of human subjects of research. Retrieved from
http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html
National Human Genome Research Institute. (2015). All about the human genome
project. Retrieved from http://www.genome.gov/10001772/
Personal identity. (2014). In Stanford encyclopedia of philosophy. Retrieved from
http://plato.stanford.edu/entries/identity-personal/
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