What is the Christian stance on today's ethical questions? I've collected these videos based on Norman Geisler's work and statements from the Christian Medical and Dental Association to give us some guidance.
Topics include:
- Euthanasia and Suicide
- Abortion, Beginning of Life, Use of Fetal Tissue for Experimentation
- Homosexuality and Transgenderism
- Bio-Ethics - Genetics, Cloning, Vaccination
- Capital Punishment
- Marriage and Divorce
- Ecology
- War
- Civil Disobedience and Protests
Intro to Christian Ethics
Conflicting Morals
Unqualified Absolutism
Conflicting Absolutism
Graded Absolutism
Euthanasia and Suicide
CMDA Position Statement on Euthanasia:
We, as Christian physicians and dentists, believe that human life is a gift from God and is sacred because it bears His image.
The role of the physician is to affirm human life, relieve suffering, and give compassionate, competent care as long as the patient lives. The physician as well as the patient will be held accountable by God, the giver and taker of life.
We oppose active intervention with the intent to produce death for the relief of suffering, economic considerations or convenience of patient, family, or society.
We do not oppose withdrawal or failure to institute artificial means of life support in patients who are clearly and irreversibly deteriorating, in whom death appears imminent beyond reasonable hope of recovery.
The physician's decisions regarding the life and death of a human being should be made with careful consideration of the wishes and beliefs of the patient or his/her advocates (including the family, the church, and the community). The Christian physician, above all, should be obedient to biblical teaching and sensitive to the counsel of the Christian community. We recognize the right and responsibility of all physicians to refuse to participate in modes of care that violate their moral beliefs or conscience.
While rejecting euthanasia, we encourage the development and use of alternatives to relieve suffering, provide human companionship, and give opportunity for spiritual support and counseling.
Abortion
CMDA Position Statement on Abortion:
- We oppose the practice of abortion and urge the active development and employment of alternatives.
- The practice of abortion is contrary to:
- Respect for the sanctity of human life, as taught in the revealed, written Word of God.
- Traditional, historical, and Judeo-Christian medical ethics.
- We believe that biblical Christianity affirms certain basic
principles which dictate against interruption of human gestation;
namely:
- The ultimate sovereignty of a loving God, the Creator of all life.
- The great value of human life transcending that of the quality of life.
- The moral responsibility of human sexuality.
- While we recognize the right of physicians and patients to follow the dictates of individual conscience before God, we affirm the final authority of Scripture, which teaches the sanctity of human life.
CMDA Position Statement on the Beginning of Human Life:
The Bible affirms that God is the Lord and giver of all life. Human beings are uniquely made in God’s image, and each individual human being is infinitely precious to God and made for an eternal destiny. The Christian attitude toward human life is thus one of reverence from the moment of fertilization to death.
Definition of Human Life
- A living human being is a self-directed, integrated organism that possesses the genetic endowment of the species Homo sapiens who has the inherent active biological disposition (active capacity and potency) for ordered growth and development in a continuous and seamless maturation process, with the potential to express secondary characteristics such as rationality, self-awareness, communication, and relationship with God, other human beings, and the environment.
- Thus, a human being, despite the expression of different and more mature secondary characteristics, has genetic and ontological identity and continuity throughout all stages of development from fertilization until death.
- A human embryo is not a potential human being, but a human being with potential.
Biological Basis for the Beginning of Human Life
- The life of a human being begins at the moment of fertilization (fusion of sperm and egg). “Conception” is a term used for the beginning of biological human life and has been variously defined in the medical and scientific literature as the moment of fertilization (union or fusion of sperm and egg), syngamy (the last crossing-over of the maternal and paternal chromosomes at the end of fertilization), full embryonic gene expression between the fourth and eighth cellular division, implantation, or development of the primitive streak. Scientifically and biblically, conception is most appropriately defined as fertilization. The activation of an egg by the penetration of a sperm triggers the transition to active organismal existence.
- It is artificial and arbitrary to use other proposed biological “markers” (such as implantation, development of a primitive streak, absence of potential for twinning, brain activity, heartbeat, quickening, viability, or birth and beyond) to define the beginning of human life.
Biblical Basis for the Beginning of Human Life
- Procreation is acknowledged in the Bible to be the gift of God.
- The mandate for human procreation in Genesis 1:27-28 and 9:1,7 implies that the God-ordained means of filling the earth with human beings made in His image is the proper reproductive expression of human sexuality in marriage. Human beings do not merely reproduce “after their kind”; they beget or procreate beings that, like themselves, are in the image of God. (see CMDA Statement on Reproductive Technology)
- Human beings are created as ensouled bodies or embodied souls (Genesis 2:7). Together the physical and spiritual aspects of human beings bear the single image of God and constitute the single essential nature of human life. A biological view of human life beginning at fertilization is therefore consistent with the Biblical view of human life.
- From fertilization on, God relates to the unborn in a personal manner. Between fertilization and birth, which are regularly linked in Biblical language God continues His activity in the unfolding and continuous development of the fetus.
- The Bible assumes a personal and moral continuity through fertilization, birth, and maturation.
- The Bible, the Church in all its formative Creeds and Ecumenical Councils, and the witness of the Holy Spirit attest to the beginning of the incarnation, wherein the second person of the Trinity took upon himself human nature, being conceived (“conceived” is to be understood as “fertilization;” see The Beginning of Human Life, Addendum II: Conception and Fertilization: Defining Ethically Relevant Terms) by the power of the Holy Spirit in the womb of the Virgin Mary. The uniqueness of the event and its mode does not affect its relevance to the question of the beginning of human life. From conception the Son of God is incarnate, his human nature made like us in every way. It follows that authentic human existence begins at conception or fertilization.
The Moral Worth of Human Life
- The moral worth of a human being is absolute and does not consist in possessing certain capacities or qualities—e.g., self-consciousness, self-awareness, autonomy, rationality, ability to feel pain or pleasure, level of development, relational ability—that confer a socially-defined status of “personhood” (a quality added to being). A human being consists in the entire natural history of the embodied self. A human being is a person.
- The moral worth of a human being at all stages of development consists not merely in a) the possession of human chromosomes nor b) the fact that he or she may someday grow and develop into a more mature human individual. In fact, he or she already is the same individual being who may gradually develop into a more mature human individual.
Conclusions
- Every individual from fertilization is known by God, is under His providential care, is morally accountable, and possesses the very image of God the creator.
- Since human life begins at fertilization, the full moral worth afforded to every human being is equally afforded from fertilization onward throughout development. Vague notions of “personhood” or social utility have no place in decisions regarding the worth, dignity, or rights of any human being.
- Because all human beings derive their inherent worth and the right to life from being made in the image of God, standing in relation to God as their personal Creator, a human being’s value and worth is constant, whether strong or weak, conscious or unconscious, healthy or handicapped, socially “useful” or “useless,” wanted or unwanted.
- A human beings life may not be sacrificed for the economic or political welfare or convenience of other individuals or society. Indeed, society itself is to be judged by its protection of and the solicitude it shows for the weakest of its members.
- Human life, grounded in its divine origin and in the image of God, is the basis of all other human rights, natural and legal, and the foundation of civilized society.
CMDA Position Statement on Fetal Tissue for Experimentation and Transplantation:
We affirm that human life warrants protection from the time of fertilization because it bears the image of God. Medical interventions that involve the unborn child should be permitted only with the intent of providing diagnostic information or fetal therapy, and only when the potential benefits clearly outweigh the potential risks to both child and mother.
The use of fetal tissue for experimentation and transplantation introduces the opportunity for the gross abuse of human life, such as conception and abortion for the sole purpose of obtaining fetal tissue.
Also, the use of fetal tissue from elective abortions could be interpreted as further justification for abortion.
CMDA does not oppose the use of the tissues of spontaneously aborted, non-viable fetuses, with parental consent, for research or transplantation.
Homosexuality
CMDA Position Statement on Homosexuality:
CMDA affirms the long-accepted and widely held Christian teaching that the appropriate context for sexual relations is solely within marriage, defined as a consensual, exclusive and lifelong commitment between one man and one woman. This is the view reflected throughout the Bible and in Christian texts of all denominations—Protestant, Catholic, and Orthodox—throughout their history and, until recently, a view that was universal and uncontested among Christians. Commitment to this historic Christian view of sexuality benefits individuals, families, and all society.
CMDA recognizes that many individuals experience or struggle with same-sex attraction. In these matters CMDA distinguishes homosexual thoughts and desires from willful homosexual behaviors.
CMDA also recognizes that, in recent years, there has been a sea change in cultural acceptance and legal recognition of homosexuality, including voices that celebrate it and seek to make it conventional. These factors have placed Christian healthcare professionals in the position of being at variance with evolving views of sexual choices and behaviors that may be socially approved but which are contrary to a Christian worldview. Whereas the shift in cultural mores has been rationalized by a strong emphasis on the freedom of personal choice, CMDA believes that personal autonomy is not an absolute principle but one that must be weighed alongside other relevant moral principles. In matters of sexuality the broader impact of individual choices should be considered.
Because we are guided by Christ, who assisted all who sought his help regardless of sexual or social status, CMDA affirms the obligation of Christian healthcare professionals to care for all patients in need, regardless of sexual orientation, gender identification, or family makeup, with sensitivity and compassion, even when we cannot validate their choices.
Recognizing that sexuality has not only bodily but also moral and spiritual significance, CMDA views homosexuality within the following framework:
A. Biblical
- All people are loved by God (John 3:16-17).
- All struggle with moral failure and fall short of God’s standards (Romans 3:10-12) and, therefore, need the forgiveness that God provides through Christ alone (John 3:36; Romans 3:22-24; Colossians 1:15-23; 1 Timothy 2:5-6).
- The moral authority of the Bible in matters of sexuality rests in God, who inspired and reliably guided its human authors (Joshua 1:8; Matthew 5:18, 24:35; Luke 16:17; 1 Thessalonians 2:13; 2 Timothy 3:16; Hebrews 4:12; 2 Peter 1:21). The moral teachings of the Scriptures are trustworthy (Psalm 119:86a; John 17:17b), beneficial (Deuteronomy 30:19; Psalm 119:105,133; Luke 11:28), and true for all times (Psalm 119:89; Isaiah 40:8; Hebrews 13:8).
- We live in a fallen world (Genesis 3), and we are all fallen creatures with a sinful nature (Romans 3:9-12). The fall is expressed in nature and in humanity in many ways, including sexuality. Same-sex attraction is but one example of the fall, as are also extramarital sexual attractions among heterosexuals, all of which, if indulged, lead to adverse consequences (Romans 1:24-32; Ephesians 5:3).
- Having homosexual thoughts or desires is not itself sinful, but by acting on them one assumes moral responsibility. A lifestyle that is directed by pursuing sexual desires or governed by personal sexual fulfillment misses the divinely ordained purpose of sex, which is for procreation and for facilitating unity in the lifelong commitment of marriage between one man and one woman, which fosters a secure and nurturing environment for children and which reflects the unity of Christ and the church (Exodus 20:1-18; Leviticus 20:10-21; Romans 1; Ephesians 5:23-33).
- The Scriptures prescribe and promise God’s blessing on life-long heterosexual union in marriage, and chastity in all other circumstances (Genesis 39:7-9; Exodus 20:14; Job 31:1; Proverbs 2:16-22, 5; Song of Songs 8:6; 1 Corinthians 7).
- The Scriptures are uniform throughout in forbidding as sinful the practice of homosexuality (Leviticus 18:22, 20:13; 1 Kings 14:24; Mark 10:6; Romans 1:26-27; 1 Corinthians 6:9; Jude 1:7). Same-sex attraction cannot be consummated within God’s design for human sexuality and procreation (Genesis 2:24; Ephesians 5). The Scriptures affirm, however, the value of non-erotic same-sex friendships (1 Samuel 20:17).
- It is possible by God’s grace for those with same-sex attraction to live a chaste life (Psalm 51:10, 119:9-16; Romans 6:11-14, 12:1-2; 1 Corinthians 6:18, 10:13; 2 Corinthians 7:1; 1 Thessalonians 4:3-5, 5:23-24; Galatians 2:20, 5:16,22-25; Colossians 3:5).
B. Social
- In our current culture, which is saturated with sexual references, there is a prevailing view that personal fulfillment is to be found through abolishing traditional sexual boundaries and following desires and passions that transgress those boundaries. One outcome of this trend is the view that same-sex relationships should be regarded as equivalent to opposite-sex relationships. In our current culture some hold to the erroneous belief that to embrace diversity means to enforce acceptance and affirmation of same-sex relationships while suppressing other viewpoints.
- CMDA believes that, in contrast to the current culture, living out one’s sexuality within God’s design will result in a healthier and more fulfilled life. CMDA recognizes that this traditional view has become counter-cultural; however, CMDA affirms that God’s design transcends culture.
- CMDA recognizes that the causes of same-sex attraction are multifactorial and may include biological, developmental, psychosocial, environmental, and cultural factors that are not of the individual’s choosing. Deciding on a same-sex lifestyle and pursuing same-sex fantasies and encounters, however, are voluntary and involve moral responsibility.
- CMDA recognizes that, for individuals who struggle with same-sex attraction, choosing not to act on same-sex erotic desires may be difficult. Similarly, many individuals who are sexually oriented to the opposite sex also struggle with erotic desires that are contrary to the teachings of Scripture.
- Approval of same-sex marriage is harmful to the stability of society, the rearing of children, and the institution of marriage. If the only criterion for marriage were mutual consent or commitment, then there would be no logical grounds to prohibit polygamy, polyandry, or incestuous unions.
- Adoption into homosexual environments puts children at risk. Children need both male and female influences in their social development. Children should not be exposed to the promiscuity that the gay culture promotes, just as they should not be exposed to heterosexual promiscuity. Homosexual relationships are typically brief and successive. Children reared by same-sex couples are at increased risk of later engaging in homosexual activity.
C. Medical
- Among individuals who engage in homosexual acts, there is an increased incidence of drug or alcohol dependence, compulsive sexual behavior, anxiety, depression, and suicide. These consequences are harmful to the health of same-sex patients and are associated with increased medical costs to society.
- Some homosexual acts are physically harmful because they disregard normal human anatomy and function. These acts are associated with increased risks of tissue injury and transmission of infectious diseases.
- Homosexual behavior can be changed, even when desire persists. There is valid evidence that many individuals who chose to abstain from homosexual acts have been able to do so.
CMDA Recommendations for the Christian Community
- A person struggling with same-sex attraction should evoke neither scorn nor enmity, but rather our concern, compassion, help, and understanding. Christians must respond to the complex issues surrounding same-sex attraction with grace, civility, and love.
- Christians should welcome inclusion of same-sex-attracted individuals, affirming them as equal without condoning their sexual choices and behaviors.
- The Christian community and especially the family must resist stereotyping and rejecting individuals who do not fit the popular norms of masculinity and femininity. Parents should guide their children in appropriate gender identity development. For children who are experiencing gender identity confusion, the Christian community should provide appropriate role models and informed guidance.
- The Christian community must help society understand that traditional marriage is good and a part of the natural order. CMDA is concerned that to redefine marriage in a way that includes same-sex relationships will have detrimental spiritual, emotional, cultural, and medical repercussions.
- The Christian community must condemn hatred and violence directed against those involved in homosexual behavior. Love for the person does not equate with support of the decision to engage in a gay or lesbian lifestyle.
- The Christian community must encourage and strongly support those who wish to abandon homosexual behavior.
- CMDA affirms family life in the paradigm of fathers and mothers rearing their own children as well as adoption of children by a married mother and father. However, CMDA cannot affirm the adoption of children by same-sex couples, because such placement deliberately excludes the parental role model of one sex and is thus detrimental to the best interests of the child.
- Christian communities must seek for ways to minister to children in families of same-sex couples in ways that offer them the love of Christ.
- The Christian community is to be a refuge of love for all who are broken – including sexually broken – not to affirm their sin, nor to condemn or castigate, but to shepherd them to Jesus, who alone can forgive, heal, restore, and redirect to a Godly, honorable, and virtuous way of life. God provides the remedy for all moral failure through faith in Jesus Christ and the life-changing power of the Holy Spirit.
CMDA Recommendations for Christian Healthcare Professionals
- CMDA advocates culturally competent medical care of patients who identify as gay or lesbian. Such care requires our compassion, an open and trusting dialogue, a genuine effort to understand and respond to the patient’s psychological distress, and acceptance of the person without necessarily agreeing with the person’s sexual views.
- CMDA believes that the appropriate medical response to patients who identify as gay or lesbian should be to support and encourage them in areas we can affirm and to help them understand themselves as people God loves and who are made in his image, even when we cannot validate their lifestyle choices or sexual behaviors.
- A patient’s wishes regarding hospital visitation rights and surrogate medical decision-making by a committed same-sex partner should be respected.
- CMDA believes that Christian healthcare professionals should avoid participating in any reproductive technology procedures in which children are brought into a family other than that of a married husband and wife, or in which children at any stage of biological development are marketed as products. This would include surrogacy-for-hire or in vitro procedures for non-married heterosexual couples or same-sex couples.
CMDA Recommendations Regarding Nondiscrimination
- Christian healthcare professionals, in particular, must care for their same-sex-attracted patients in a non-judgmental and compassionate manner, consistent with the humility Jesus modeled and the love Jesus commanded us to show all people.
- Christian healthcare professionals who hold to a biblical or traditional view of human sexuality and marriage should be tolerated in a diverse society and permitted to express their views in civil discourse free from exclusion, oppression, or unjust discrimination. Healthcare professionals who hold the position that same-sex relationships are harmful and inconsistent with the will of God must not be stigmatized or accused of being bigoted, phobic, unprofessional, or discriminatory because of this sincerely held and widely shared belief.
- Healthcare professionals must not be prevented from providing support and counseling to patients who request assistance with abstaining from homosexual behavior.
CMDA Position Statement on Transgender Identification:
Preamble to the CMDA Statement on Transgender Identification
A novel way of thinking about one's body has entered into popular culture. "Transgender" individuals refer to their "gender" as a sexual identity that may be male or female, something in between, or neither. This self-identification differs from, and takes priority over, their biological sex as recognized in their chromosomal DNA and innate physical sexual characteristics. The naming of gender as a category set apart from sex is an idea foreign to the holistic view of the person as understood within Christianity. Christians affirm the biblical understanding of humankind as having been created male and female, with the two sexes having equal dignity and a complementary relationship to each other.
At the heart of disagreement over transgenderism is a difference in worldviews. If the human body is nothing more than the product of mindless, random, purposeless physical forces, then one may do with it what one wishes, even to demand medical and surgical cooperation in projects to alter, amputate, or reconstruct normal tissue to conform to the patient's revised psychological sense of identity. If, on the other hand, our bodies are an inseparable aspect of our true selves and are a good gift from God, who has designed the sexes to be wonderfully paired, and who has a purpose for humanity, then respecting the gift of given sexual identity and the ensuing moral obligations to our neighbors is the surest path to human flourishing.
Both worldviews share the recognition that humanity is broken and in need of renewal, but they look to different answers for healing. Christians seek not a reconfiguring of the body, but a spiritual transformation of the mind to become more like Christ; not rejecting the gifts of God, but welcoming God's purposes and demonstrating God's love by loving our neighbors. This love of neighbors includes loving our transgender neighbors as persons who, like all people, are created in God's image. However, loving them and validating them as people does not mean agreeing with their ideologies or use of language.
The Christian Medical & Dental Associations (CMDA) believes that healthcare professionals should not be forced to violate their conscientious commitment to their patients' health and welfare by being required to accept and participate in harmful gender-transition interventions, especially on the young and vulnerable. CMDA affirms the obligation of Christian healthcare professionals caring for patients struggling with gender identity to do so with sensitivity and compassion, consistent with the humility and love that Jesus modeled and commanded us to show all people.
CMDA affirms the historic and enduring Christian understanding of humankind as having been created male and female. CMDA has concerns about recent usage of the term “gender” to emphasize an identity other than one’s biological sex, that is, a sense of self based on subjective feelings or desires of identifying more strongly with the opposite sex or with some combination of male and female.
CMDA affirms the obligation of Christian healthcare professionals to care for patients struggling with gender identity with sensitivity and compassion. CMDA holds that attempts to alter gender surgically or hormonally for psychological indications, however, are medically inappropriate, as they repudiate nature, are unsupported by the witness of Scripture, and are inconsistent with Christian thinking on gender in every prior age. Accordingly, CMDA opposes medical assistance with gender transition on the following grounds.
A. Biblical
- God created humanity as male and female (Genesis 1:27, 5:2; Matthew 19:4; Mark 10:6). God’s directives – to have dominion over the earth and to fulfill his goals of procreation, union, fellowship, and worship – are given to men and women together (Genesis 1:26-28, 2:18-24).
- Men and women are morally and spiritually equal (Galatians 3:28) and are created to have roles that are in some respects alike and in other respects wonderfully complementary (Ephesians 5). (See CMDA statement on Human Sexuality)
- All people are loved by God (John 3:16-17). All struggle with moral failure and fall short of God’s standards (Romans 3:10-12) and, therefore, need the forgiveness that God provides through Christ alone (John 3:36; Romans 3:22-24; Colossians 1:15-22; 1 Timothy 2:5-6).
- We live in a fallen world (Genesis 3), and we are all fallen creatures with a sinful nature (Romans 3:9-12). The fall is expressed in nature and in humanity in many ways, including sexuality. Confusion of gender identity is but one example of the fall, as are also marital breakdown and sexual immorality (Romans 1:24-32; Ephesians 5:3).
- A lifestyle that is directed by pursuing sexual desires or governed by personal sexual fulfillment misses the divinely ordained purpose of sex, which is for procreation and for facilitating unity in the lifelong commitment of marriage between one man and one woman, which fosters a secure and nurturing environment for children and which reflects the unity of Christ and the church (Exodus 20:1-18; Leviticus 20:10-21; Romans 1; Ephesians 5:23-33).
B. Biological
- Sex is an objective biological fact that is determined genetically at conception by the allocation of X and Y chromosomes to one’s genome, immutable throughout one’s lifetime, and not a social construct arbitrarily assigned at birth or changed at will.
- Human beings are sexually dimorphic. Male and female phenotypes are the outworking of sex gene expression, which shapes sex anatomy, determines patterns of sex hormone secretion, and influences sex differences in the development of the central nervous system and other organs.
- Procreation requires genetic contributions from both one man and one woman.
- Anomalies of human biological sex are an outcome of the fall and do not invalidate God’s design in creation.
C. Social
- CMDA recognizes that gender identity issues are complex, and inclination to identify with the opposite gender may have biological, familial, and social origins that are not of the making of particular individuals.
- In our current social context there is a prevailing view that removing traditional definitions and boundaries is a requirement for self-actualization. Thus, Christian healthcare professionals find themselves in the position of being at variance with evolving views of gender identity in which patients seek validation by the medical community of transsexual desires and choices that may be socially approved but which are contrary to a Christian worldview.
- In contrast to the current culture, CMDA believes that finding one’s identity within God’s design will result in a more healthy and fulfilled life. CMDA believes, moreover, that social movements which contend that gender is decided by choice are mistaken in defining gender, not by nature, but according to desire. Authentic personal identity consists in social gender expression that is congruent with one’s natural biological sex. CMDA recognizes that this traditional view has become counter-cultural; however, CMDA affirms that God’s design transcends culture.
- CMDA is concerned that efforts to impose transgender ideology on all society by excluding, suppressing, marginalizing, intimidating, or portraying as hateful those individuals and organizations which, on scientific, moral, or religious grounds, reasonably disagree, are contrary to the freedoms of speech and religious liberty that lie at the very foundation of a just and democratic society.
- CMDA is concerned that efforts to compel healthcare professionals to affirm transgender ideology, provide medical legitimization for transgender psychology, or cooperate with requests for medical or surgical sex reassignment threaten professional integrity.
D. Medical
- Among individuals who identify as transgender, use cross-sex hormones, and undergo sex reassignment surgery, there is well-documented increased incidence of depression, anxiety, suicidal ideation, substance abuse, and risky sexual behaviors. Patients’ gender-altering and sexual encounter choices are among the factors relevant to these health disparities in transgender patients as compared to the general population.
- Hormones prescribed to a previously biologically healthy child for the purpose of blocking puberty inhibit normal growth and fertility. Continuation of cross-sex hormones, such as estrogen and testosterone, during adolescence is associated with increased health risks including, but not limited to, high blood pressure, blood clots, stroke, and some types of cancer.
- Although current medical evidence is incomplete and open to various interpretations, some studies suggest that surgical alteration of sex characteristics has uncertain and potentially harmful psychological effects and can mask or exacerbate deeper psychological problems.
- Transient gender questioning can occur during childhood. There is evidence that gender identity has some degree of malleability and is influenced by psychosocial experiences, including therapeutic interventions.
- CMDA recognizes that exceedingly rare abnormalities exist in which chromosomal and phenotypic sex characteristics are in discord. These disorders of sex development include congenital adrenal hyperplasia, ambiguous genitalia, and androgen insensitivity syndrome. Treatment of these disorders differs categorically from transgender interventions, which are performed on persons whose sex phenotype is in agreement with their chromosomal sex designation.
E. Ethical
- Medicine rests on science and should not be held captive to desires or demands that contradict biological reality. Sex reassignment operations are physically harmful because they disregard normal human anatomy and function. Normal anatomy is not a disease; dissatisfaction with natural anatomical and genetic sexual makeup is not a condition that can be successfully remedied medically or surgically.
- The medical status of gender identity disorder as a mental or psychosocial disorder should not be discarded on the basis of social activism.
- For Christians struggling with transgender inclinations, spiritual, psychological, and social support are needed, as attempts to change gender through hormonal or surgical interventions only lead to further spiritual turmoil and distress.
- CMDA is especially concerned about the increasing phenomenon of parents of children who question their gender intervening hormonally to inhibit normal adolescent development. Children lack the developmental cognitive capacity to assent or request such interventions, which have lifelong physical, psychological, and social consequences.
- The purpose of medicine is to heal the sick, not to collaborate with psychosocial disorders. Whereas treatment of anatomically anomalous sexual phenotypes is restorative, interventions to alter normal sexual anatomy to conform to transgender desires are disruptive to health.
- The inability of men, including men who identify as women, to bear children is not an illness to be remedied by medical or surgical means, such as uterus transplantation.
- Many diseases affect men and women differently, according to biological sex phenotype. Transgender designations may conceal biological sex differences relevant to medical risk factors, recognition of which is important for effective healthcare and disease prevention. As accurate documentation is necessary for good patient care, healthcare professionals should document patients’ biological sex and any alterations of gender characteristics factually in the medical record.
CMDA Recommendations for the Christian Community
- A person struggling with gender identity should evoke neither scorn nor enmity, but rather our concern, compassion, help, and understanding. Christians must respond to the complex issues surrounding gender identity with grace, civility, and love.
- The Christian community must help society understand that gender complementarity and fixity are both good and a part of the natural order. CMDA is concerned that attempting to reconstruct gender as something that is fluid and changeable through technical means would have grave spiritual, emotional, cultural, and medical repercussions.
- The Christian community and especially the family must resist stereotyping or rejecting individuals who do not fit the popular norms of masculinity and femininity. Parents should guide their children in appropriate gender identity development. For children who are experiencing gender identity confusion, the Christian community should provide appropriate role models and informed guidance.
- The Christian community must condemn hatred and violence directed against those struggling with gender identity. Love for the person does not equate with support of the decision to change sex anatomy or gender identity.
- For the sake of the common good, Christians should welcome inclusion of transgender individuals but oppose claims to grant special rights based solely on transgender identification.
- The Christian community is to be a refuge of love for all who are broken – including sexually broken – not to affirm their sin, nor to condemn or castigate, but to shepherd them to Jesus, who alone can forgive, heal, restore, and redirect to a Godly, honorable, and virtuous way of life. God provides the remedy for all moral failure through faith in Jesus Christ and the life-changing power of the Holy Spirit.
CMDA Recommendations for Christian Healthcare Professionals
- CMDA advocates culturally competent medical care of patients who identify as transgender. Such care requires our compassion, an open and trusting dialogue, a genuine effort to understand and respond to the patient’s psychological distress, and acceptance of the person without necessarily agreeing with the person’s ideology or providing a requested sex-altering intervention.
- CMDA believes that the appropriate medical response to patients with gender confusion should be to support and encourage them in areas we can affirm and to help them understand themselves as people God loves and who are made in his image, even when we cannot validate their choices. We should validate their right as individuals in a free society to make decisions for themselves, while explaining that their right does not extend to obligating the healthcare professional to prescribe medication or perform surgical procedures that we believe to be harmful, such as interventions that deface, disfigure, or mutilate the patient’s biological sex.
- CMDA believes that Christian physicians should not engage in hormonal and surgical interventions that alter natural sex phenotypes, as this contradicts the basic principles of Christian medical ethics, which regards medical treatment as intended to heal and not to harm.
- CMDA believes that prescribing hormonal treatments to children or adolescents to disrupt normal sexual development for the purpose of gender reassignment is ethically impermissible, whether requested by the child or the parent. (See CMDA statements on Limits to Parental Authority in Medical Decision-Making, and Abuse of Human Life)
CMDA Recommendations Regarding Nondiscrimination
- Mutual respect and civil discourse are cornerstones of a free society. The Christian healthcare professional should respect how a patient wishes to be addressed.
- Christian healthcare professionals, in particular, must care for their patients with gender identity disorders in a non-judgmental and compassionate manner, consistent with the humility Jesus modeled and the love Jesus commanded us to show all people.
- Those who hold to a biblical or traditional view of human sexuality should be permitted to question transgender dogma free from exclusion, oppression, or unjust discrimination. Healthcare professionals who hold the position that transgender identification is harmful and inconsistent with the will of God should not be stigmatized or accused of being bigoted, phobic, unprofessional, or discriminatory because of this sincerely held and widely shared belief.
- To decline to provide a requested gender-altering treatment that is harmful or is not medically indicated does not constitute unjust discrimination against persons. CMDA affirms that healthcare professionals should not be coerced or mandated to provide or refer for services that they believe to be morally wrong or harmful to patients. (See CMDA statement on Healthcare Right of Conscience)
- Healthcare professionals must not be prevented from providing
counseling and support to patients who are experiencing confusion in
regard to gender orientation and who request assistance with accepting
and maintaining their biologic sex and gender identity.
Bio-Ethics
CMDA Position Statement on Eugenics and Genetic Enhancement:
Eugenics has historically been the effort to improve the inheritable qualities of a race or species. Traditionally eugenics has been practiced through the use of selective breeding, but it is now moving toward direct manipulation of the genome. Advances in molecular genetics that make this possible are also leading to a resurgence of the eugenics move-ment. This is emerging as the science of directly treating or eliminating undesirable in-heritable characteristics and as the quest for individual human enhancement.
History
The word, eugenics, was coined in 1883 by Charles Darwin’s cousin, Francis Galton, a biologist who used statistical correlations to study the inheritance of intelligence. The term was built out of the Greek Eu (good) and Genics (in birth).
Eugenics has a sordid history. During the late 19th and early 20th centuries in America, and especially in Nazi Germany, eugenics promoted the practice of eliminating human life and races judged to be “inferior.” While eugenics may initially appear attractive, it has by its very nature always led to morally repugnant consequences involving broad facets of society.* Therefore, we are concerned that the modern practices of eugenics will repeat history. The increased power of modern technology demands increased vigilance.
Goals
CMDA affirms the primary goals of medicine – the treatment and prevention of disease and the reduction of suffering, whenever possible, by legitimate and moral means.
- CMDA supports the effort to understand our genetic code for purposes of increasing knowledge, treating disease, and bettering the human condition.
- CMDA opposes the use of any genetic manipulation that has an unacceptable risk of harm to any human being.
Screening
Mapping the human genome has been a significant aid in the identification and possible treatment of genetically determined diseases. Like all powerful information it can be used for good or for ill. **
- CMDA endorses ethical efforts to increase the scope and accuracy of science used to identify, understand, and treat human genetic diseases.
- It should not be mandatory that persons be genetically screened, be made to know their own genetic information, or be required to act upon that knowledge.
- In this context, no person’s genetic information should be used against him or her.
Determinism
We oppose the concept of genetic determinism, that we are our genome or that genes are destiny. Humanity’s prospects for the future will be enormously impoverished if its outlook is limited to its own perceived genetics.
Morals
The application of genetic knowledge for eugenic agendas is unequivocally problematic.
- The goals of modern genetics must be sought within the limits of moral boundaries and qualifications. Medicine, and therefore genetics, must be practiced according to principles of ethical behavior delineated by conscience under the authority of Scripture.
- When an undesired trait or gender is identified by pre-implantation or prenatal screening the discovery is often followed by destruction of the human life exhibiting the undesired trait. CMDA opposes destruction of human life for eugenic purposes. This includes the destruction of embryos, abortion, infanticide and genocide.
Genetic Intolerance
Society, while advocating tolerance, has become increasingly intolerant of any “defective” human life. Our society exerts increasing pressure on parents to neither accept nor bring to birth a child perceived as defective. This intolerance violates the sanctity of human life.
- We must not deem inferior anyone with a “defective” genetic heritage. We recognize that all persons, no matter how normal in appearance, carry defective genetic information within their genome, and that all human physical life is defective to some degree and with certainty becomes more so with aging.
- There are no superior or inferior racial groups. Any efforts to create or eliminate perceived superior or inferior individuals are to be condemned. Similarly, there is no superior or inferior gender. There are no “lives unworthy of life.”***
- Continued improvements in genetic diagnosis sharpen the dichotomy between those who “have” a good genetic endowment and those who “have not.” With the possible advent of genetic enhancement this dichotomy will increase.
- Far more serious and damaging than our genetic deficiencies are our moral deficiencies. Intolerance of those deemed genetically inferior is an example of this moral deficiency.
Safety
Although the use of somatic and germ cell genetic therapy**** has the potential to correct genetically determined disease, there are significant concerns regarding the safety of genetic therapy, particularly germ line therapy.
- Somatic cell therapy: If critical concerns regarding the safety of somatic cell therapy can be resolved, the use of somatic cell therapy may be acceptable for correcting genetically determined diseases.
- Germ cell therapy: CMDA believes that germ cell genetic therapy is unacceptable - at least until safety issues are resolved. The use of germ cell therapy is more problematic due to the transmission of any changes to future generations. Safety issues are magnified in this instance since changes not only affect the patient but future descendants. Even if safety issues are resolved, germ cell therapy still raises significant moral issues, e.g., the impossibility of obtaining consent from those yet to be born.
Genetic Enhancement
The practice of genetic alteration evokes deeper concerns on a more fundamental level. The prospect of using genetic technology to enhance human characteristics is now a theoretical possibility. CMDA recognizes that the distinctions between treatment and enhancement are difficult to discern and are arbitrary in many cases. As Christians, we hold that all humans are made in the image of God. This essential characteristic disting-uishes us as human. The goal to recreate man in man’s image raises profound questions about human nature and man’s relationship with his Creator. The ultimate end of man is to glorify God; the re-creation of man to glorify himself is idolatry.
Conclusion
CMDA considers genetic research and therapy to potentially be of great benefit to humanity. We endorse the effort to make progress in this field. We diminish our own prospects both individually and communally if we refuse to work for scientific advancement. However, we must build moral safeguards around our technology. We must accept, learn from, and care for those who are vulnerable and suffering.
CMDA Position Statement on Genetic Information and Manipulation
As genetic knowledge increases and technologies to manipulate genes become more powerful, our need for wisdom in application intensifies. In regard to human genetics in particular, the conditions that allow for hubris call for an even greater measure of humility.
As Christian healthcare professionals, we affirm that:
- All human beings have been individually created through the providential interest and design of Almighty God. Being created in the image of God, every human being has inestimable worth, regardless of genotype or phenotype (see CMDA statement on the Human Life: Its Moral Worth).
- The diversity of individuals is part of the wonder and strength of God's sovereign design.
- Each human life is a composite of genetic, environmental, historical, social, volitional, and spiritual factors.
- God has endowed humans with minds capable of exploring, but only partially understanding, the magnificence and intricacies of His Creation. Human knowledge and wisdom are limited and may be used for evil or for good.
- God has mandated responsible stewardship of Creation, both of ourselves and of the surrounding world.
Therefore, in regard to genetic technologies in medicine, CMDA believes:
- The presence of a disability, either inherited or acquired, does not detract from a person's intrinsic worth.
- Fallen humanity lacks the wisdom and moral restraint necessary to take control of human genetic destiny.
CMDA supports:
- The use of genetic information in guiding the care of patients.
- Strict confidentiality of an individual's genetic information, as for all personal health information.
- Healthcare professionals informing the patient with a genetic diagnosis of potential familial risk and encouraging the patient to share information about heritability risk with family members.
- Somatic cell manipulation (excluding somatic cell nuclear transfer, i.e., human cloning) to replace absent or defective genes, as this is consistent with the goals of medicine and may be good stewardship of knowledge. Such manipulation should be performed only after extensive study demonstrates the specificity, benefits, and risks of these interventions, or as part of an approved clinical trial.
- The scientific exploration of life, including its genetic foundation, as this is proper and consistent with God's mandate and humanity's created nature, but it must be conducted within the constraints of biblical principles in order to conform with God's design for human flourishing.
- Genetic testing of minors (embryos, fetuses, children), provided the result could potientially benefit them prior to majority. Because a minor is unable to give informed consent, presymptomatic testing of a minor should not be performed for disorders that will not either affect his or her health until after majority or lead to therapeutic intervention before majority.
CMDA opposes:
- The search for and use of genetic information to justify destroying an existing human life, born or unborn, for example, as has occurred with Down syndrome.
- The use of genetic information for positive or negative discriminatory purposes, including sex selection of human embryos, or infringement upon the right to procreate (see CMDA statement on Eugenics and Enhancement).
- The use of a patient's genetic information for societal benefit if such use could potentially harm that individual.
- The reductionist belief that humans and their behavior are simply the product of their genetic destiny.
CMDA is especially concerned about heritable germline or embryo manipulations, as these technologies carry a higher risk of harm and abuse than somatic cell manipulations. First, there is the potential that any errors will be transmitted to future generations. Second, germline manipulations will affect the individual for the remainder of his or her life, whereas some somatic manipulations will be self-limited in duration. Third, the proposed and desired uses of germline technologies are fraught with the strong probability of selfish, narcissistic, and eugenic goals, commodifying offspring, supporting the false concept of genetic reductionism, increasing discrimination and intolerance of the disabled, and increasing the number of early human lives being conceived, then destroyed.
While, in concept, specific single disease-producing mutations could be corrected early in life, which could be consistent with the proper goals of medicine, this process would necessarily alter the germline. Development of germline manipulation technology would irreversibly open the door to proportionately greater harms. This concern is not merely hypothetical. The proven record of maleficence by some scientists, physicians, governments, bioethicists, and social engineers in the historical record and in contemporary experience demonstrates contempt for appropriate ethical boundaries and guidelines.
In conclusion, CMDA opposes:
- All forms of human germline manipulation; these should remain prohibited.
- The use of genetic manipulation to augment human attributes (see CMDA statement on Human Enhancement).
- The deliberate use of genetic manipulation to disable or kill.
In deciding how to apply genetic knowledge in medicine, we should prayerfully seek God’s wisdom and guidance, for He is the Author of the genetic code and the Creator and Redeemer of humankind.
CMDA Position Statement on Cloning:
As Christian physicians and dentists, we believe that human life is sacred because each individual is made by God in His own image. God's design is that each individual is formed by the union of genetic material from a husband and wife. We further believe that the family is the basic social unit designed by God to receive and nurture new human life.
There are moral reasons to refrain from proceeding with human cloning.
First and foremost, the development of this technology will require the deliberate sacrifice of human embryos. We believe this to be immoral. The use of human life merely as a means to an end is likewise morally unacceptable. Another moral concern is the question of the timing and significance of ensoulment. Furthermore, cloning may deviate from the wisdom of God's design for human genetic diversity and therefore may be unwise.
There are scientific reasons to oppose human cloning such as the potential for mutation, transmission of mitochondrial diseases, and the negative effects from the aging genetic material. There are also societal reasons to be hesitant about human cloning such as questions about parentage, lineage, family structure and the uniqueness of the individual.
Therefore, we believe that human cloning should not be pursued given our current understanding and knowledge. We affirm the need for continued moral scrutiny as research on animal cloning proceeds and proposals for the application of this technology to humans are advanced.
CMDA Position Statement on Immunization:
Personal Safety and Public Health
Since the pioneering work of Edward Jenner and others in developing a vaccination for smallpox over 200 years ago, immunization has been of great benefit to individuals as well as the public. Immunization practices have prevented outbreaks of communicable diseases and resultant deaths or disability and continue to prevent an ever-increasing variety of illnesses.
The immunization process is based on safely activating the body’s own defense system against a specific disease. As with other medical treatments, it carries a small but real risk of an adverse reaction.
CMDA agrees with current medical opinion that immunizations are of great benefit to the individual and society. The decision to immunize an individual relies on the similar decision-making process used for that of any other medical treatment.
CMDA recognizes that immunization benefits society by protecting public health and that individual members of society have some reciprocal obligations to the society in which they live.
CMDA acknowledges the right of an individual to refuse immunization except in extraordinary public health circumstances. This decision may be motivated by moral or religious convictions, known risk, misinformation or fear. The Christian community needs to base its decisions on accurate information. Those who model their lives in imitation of Christ should reflect on their obligation to take personal risk for the good of others.
CMDA supports the current scientific literature that validates the general practice of immunization as a safe, effective, and recommended procedure.
Immunization and Potential for Moral Complicity with Evil
The use of medical information and technology obtained through immoral means raises concerns about moral complicity with evil*. Some currently available vaccines were developed using tissue from aborted fetuses, while others use technology or knowledge acquired from the use of aborted fetuses. We need to consider carefully whether it is morally permissible to benefit from knowledge or technology obtained from the intentional destruction of human life.
We attempt to determine whether our participation is appropriately distanced or inappropriately complicit by consideration of the medical facts and of our conscience as informed by the revealed Word of God.
CMDA provides the following examples to help determine whether it is permissible to manufacture, administer or receive a specific vaccine:
- Using technology that was developed without any intentional destruction of human life or other evil is morally ideal. Most vaccines in use to date fall into this category.
- Using technology developed from tissue of an intentionally aborted fetus, but without continuing the cell line from that fetus, may be morally acceptable.
- Continued use of a cell line developed from an intentionally aborted fetus poses moral questions and must be decided as a matter of conscience, weighing the clear moral obligation to protect the health of our families and society against the risk of complicity with evil.
- Using a vaccine that requires the continued destruction of human life is morally unacceptable.
CMDA encourages the use of and endorses the further development of medically effective and ethically permissible alternatives that do not raise the question of moral complicity.
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