How Christians Should Think About Economics
Dr. Brian Baugus joins Michael to discuss God’s view of our money and how Christians should approach politics in light of economics.
D. Joy Riley, M.D., M.A. (Bioethics), is Executive Director of The Tennessee Center for Bioethics & Culture in Brentwood, Tennessee, and also serves as ethics consultant for a Nashville, Tennessee, area hospital. Board certified in internal medicine, her writing and lecture topics include medical ethics, organ transplantation ethics, stem cell research, genetics, and assisted reproductive technologies. Dr. Riley has co-authored Christian Bioethics: A Guide for Pastors, Health Care Professionals, and Families, published December 2014.
“Bioethics-just the term tends to make those eyes glaze over and so it’s helpful to remember that it’s a made up word. So there are two components: bio meaning life and ethics meaning doing right. So it’s about making right decisions regarding life issues and no matter what your educational background and no matter what you do, you will have bioethics decisions to make in your life.”
“Actually in college, I had a medical ethics class under Richard Barber at the University of Louisville. Then in Medical school I took an elective in medical ethics. Basically medical ethics wasn’t so much a separate discipline at that time at least in our institution. The primary ethical teachers we had were our attendings, so the Attending Physicians, the professors were the ones that taught you not just about medicine, but about the art and science of medicine and that included ethics as well.”
“Everyone who’s admitted to a hospital will be asked if they have advanced directives. A hospital is required to ask that. You’re not required to have them, but they are required to ask so that will be your first time, and that’s at intro, ok, so that’s when you’re checked in or registered. I remember when my son who was eighteen was admitted for an interior, an ACL tear, and he was going to have that repaired.
The admitting officer asked, “Do you have advanced directives?” He of course had no idea what that was. I was his mother and very in touch and said, “I am his guardian and he is a full code.” So, that obviated further discussion, but at any rate who gets involved with ethics discussions in the hospital? Usually ethics problems in the hospital tend to rise primarily from communication problems. So it can be a patient who can be not pleased with his or her care or their family, or it could be they have not communicated their desires effectively to the staff.
When someone stops breathing, their heart stops beating, do they desire to be resuscitated? And that’s not a no brainer question, because not everyone who has CPR or attempted resuscitation actually is resuscitated. There are other issues that come to the fore regarding that so if someone has rib fractures already, from like metastatic cancer you probably wouldn’t want to have that person resuscitated because it would just be more fractures of ribs.”
“Well, it doesn’t pay to “check your brain at the door” as they say. When you go into a hospital you need to take your reasoning ability with you. You need to in as much as possible be informed and when you’re not, you need to ask questions, so that’s probably the first thing. Nurses are more likely to be interested in education at the bedside than physicians, not so much their lack of interest, but lack of time.
So the nursing staff has often taken the role of educator for the patient and family. But the underlying desire really for the patient should be that they get their information by asking questions. If it’s not explained in terms that you understand then you need to ask them to explain again. Typically, whatever you say as a physician to a patient they cannot repeat that to you later.”
“Infertility is a problem for a good number of couples. The latest CDC information was 15% of reproductive age females have used infertility services. That doesn’t translate clearly or cleanly over. Infertility can be a problem from a variety of issues: anatomy, physiology. It can be either a problem with the male or female in the relationship. Often there is no discernable problem. So everything works, everything seems to work, but there’s still no baby.”
“July 25th, the anniversary, the world’s first test tube baby was Louise Joy Brown. She was born on July 25 in 1978. That really did open a wide variety of infertility practices or possibilities for couples and it’s hard to proceed through all of those, if you will, alphabet soup concoctions, and so it’s important to know for the would be patients as well as their pastors and those who consult with them, their friends, to understand where life begins, because if you don’t understand that then it’s a little difficult when you get further down the road.
For instance, after Louise Joy Brown was born in Britain, Parliament was worried. They said, “We don’t have rules about this sort of thing, that we don’t have laws.” They put together a committee, headed by Mary Warnock and she was an ethicist; she’s now Baroness Warnock. The Warnock Committee advised the Parliament regarding infertility and in vitro fertilization. They said in a nutshell, “We can’t tell you what the embryo is.” They knew it was human and they knew it was alive. “We will not tell you what it is, but we can tell you what to do with it.” I would pause at that: One cannot know what to do with something unless you know what it is.”
“Now people are side stepping that because when you have an egg and sperm put together in a petri dish, that’s fertilization. When the egg and sperm come together and the sperm fertilizes the egg it is then called a Zygote. It can be developed in the lab for several, well multiple days, five to seven days it’s called a blastocyst. That’s also an embryo. So an embryo goes up to eight weeks gestation, after that it’s a fetus, then hopefully it’s a newborn.
It’s hard to say that this person is pregnant if the embryos in a dish, so lots of people have moved that goal post if you will, to say that pregnancy is when the baby implants, when the embryo implants in the uterus. If you understand that the embryos are human and alive and they are children, or grandchildren is it in their best interest to be frozen? Because embryos that are frozen, when they are thawed, a good number of them die. So those are some questions and a RAND study back in the early 2000s found in the US, we had more than four thousand embryos on ice.”
“It has rarely in the history of mankind been the answer to difficulty to get rid of the person with the difficulty. That’s not the same thing, so if you are suffering, I can express sorrow, I can suffer with you, which is the real definition of compassion, but to kill you to get you out of your misery or mine, is a step that we’re not allowed to take.
I would do my best to encourage you that in the midst of this suffering that there is perhaps some time for you to deal with situations near family, that need to be dealt with before you die. I would do my absolute best to treat your pain. Dr. Pellegrino, who died last year was a strong proponent for pain relief and felt that by and large most pain can be relieved or at least diminished, such that there should be no call for either physician assisted suicide or euthanasia.
Physician assisted suicide is basically requiring people who have been trained as healers to become killers. While they may not wield the needle, the syringe, but by writing a prescription for a drug that is life ending and explaining to the patient how to do that, they become culpable in this death.
When you give people a dual responsibility, the blurring of the lines is not the only things that’s blurred. So I find it inappropriate that because you want to kill yourself then you make me want to be responsible for your death. I think that’s unfair, and not only that, it goes against Millennia of Hippocratic Medicine.”
“The first part is swearing to the gods and goddesses. The second part is the responsibility of the Hippocratic Physician to his teachers. The Hippocratic Physician swore that he would teach only his children or the children of his teacher’s medicine.He would protect that art. Finally the third part of the oath is a delineation of his responsibilities to his patients.
A couple of things; they are noteworthy. The Hippocratic Physician swore he would not provide a pessary to cause an abortion for a woman. Another is that he would not prescribe a poison even if asked. A third is that anything he heard would be held confidential.
So now we have twenty five hundred years of Hippocratic Medicine and only a few decades of medical ethics. But we have gotten to the points where the provision, at least in certain states, for not killing your patient no longer applies if you prescribe the medication. No longer is the promise necessarily made regarding abortion.”
“There are boundaries, and yet I think it behooves the young couple to avail themselves of input from people like yourself, from pastors, as well as read themselves. They need to educate themselves in this arena. The Making of Life would include more recently, something that has come on the horizon, it’s through parent embryos. In 2008 there were at that time over forty countries that banned germ line modification.
In the egg and sperm you have your chromosomes. Your chromosomes will compliment who you are. All of your cells have nuclei except egg and sperm you have forty six chromosomes, the normal human person. The egg and sperm each have twenty three chromosomes. When the egg is fertilized by the sperm the twenty three and twenty three come together for forty six chromosomes in a normal child.
There is DNA outside the nucleus. Those chromosomes are inside the nucleus of the cell, the central portion of the cell. The outside of the nucleus is called the cytoplasm and in the cytoplasm are the little powerhouses called the mitochondria.”
“Mitochondria have DNA of their own and if you’re looking at your mitochondria, you would see only your mother’s mitochondria. So some women have mitochondrial disease. The mitochondria have about thirty seven genes and primarily about thirteen of those are of interest. So if a woman has mitochondrial disease, she doesn’t want to pass that along to her child.
These are varied in their expression as well as kind of problem. So the work around has been that you take a normal egg from a donor, lop out that nucleus, take the nucleus from the would be mother, lop that out of her egg, put that in the donor egg, fertilize that with the father’s sperm. But as I said, your mitochondrial DNA come from your mother. In this case, it would come from the egg donor. For the first time, we’re contemplating having DNA from the father and the mother in the nuclear DNA, but then having DNA from a third party.”
“Well you can take penicillin as an example. If your child were very ill from some bacterial process and penicillin will be the right drug for him or her, why would you not give it? The considerations there would apply to these issues as well. Did you kill the druggist in order to get it? Did you get the prescription validly? Was anyone harmed in the middle of that? Did you drive too fast and run over a pedestrian or something?
So all of these issues come to the fore as “Have I harmed someone in the process of attaining my goal?” And is my goal consonant with the fact that I am to be a good steward of what I’ve been given? Is it consonant with the fact that I have a beginning into my life? Is it consonant with the fact that God is in charge of our days? So those are some of the issues.”
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