Codes and Epiphanies (Jan-Feb 2005)

By Matt Dabbs

by Jerry Collins
January – February, 2005

I have had several epiphanies. One occurred some time after the famous “I Have a Dream” speech by Dr. Martin Luther King, Jr. As an intern in Washington that summer, I had considered attending the rally out of curiosity, but had been dissuaded by family members fearful for my safety. “There’ll be trouble,” they said. Replays of the speech convicted me of its rightness and chastised me for not having had the courage or mindset to attend.

The week that Dr. King was assassinated, our church was hosting a preacher’s lectureship, the first integrated one in churches of Christ in the history of the Carolinas. Martial law after riots forced us to remain in our upstairs apartment one night: my wife, me, five hungry preacher guests, one of them African-American, and a meager supply of spaghetti. After the meal, we gathered in the little living room of our upstairs apartment. Military vehicles patrolled the dark streets outside.

Something began to happen to us that night. We were drawn together in worship and common regret for the despicable, cowardly killing and ensuing violence. The next night, we planned and looked forward to our house church. Our African-American brother rocked in our rocker as he led our singing and announced page numbers for each hymn, although there were no books. I thought of another upper room, also a presage to violence, and felt some of the frustration and anger I was beginning to realize that African-Americans had felt throughout their history.

In that “upper room” was my first ethical epiphany. Principles of ethical behavior, however, are not communicated only through epiphany. Ethical content has traditionally been recognized as residing and being transmitted in codes of conduct. The Ten Commandments, for example, were delivered by fiat on Sinai. Understanding and internalizing the code, however, often comes about as a result of human experience, frequently negative. As the old joke states, “Good judgment comes from experience, which comes from bad judgment.”

The ethical lists of the New Testament writers exhibit a different dimension. “Be subject to one another out of reverence for Christ. Love one another as I have loved you. Accept one another as Christ has accepted you. Forgive one another as Christ has forgiven you.” In one instance after another, the Christian is called to ethical behavior patterned after the example of Christ and empowered by the Holy Spirit. For Dietrich Bonhoeffer, Christian ethical behavior was grounded in the will of God, which is not “a system of rules which is established form the outset; it is something new and different in each different situation in life, and for this reason a man must ever anew examine what the will of God may be. The heart, the understanding, observation and experience must all collaborate in this task. It is no longer a matter of a man’s own knowledge of good and evil, but solely of the living will of God; our knowledge of God’s will is not something over which we ourselves dispose, but it depends solely upon the grace of God, and this grace is and requires to be new every morning.”[1]

“Proving” the will of God, the basis of ethical behavior, is a gift of God which comes through the exercise of all of one’s faculties. “Intelligence, discernment, attentive observation of the given facts, all these now come into lively operation, all will be embraced and pervaded by prayer.”[2] Bonhoeffer might have said: All have missed the mark. All stand before Him solely by His mercy. But He is merciful. And so we stand “new every morning.”

Amir, a recent graduate of our department, and I were enjoying coffee in the NIH Clinical Center commissary with his mentor Viktor. We talked about Viktor’s nine years in an Israeli kibbutz and his bitter, painful divorce. Our conversation turned to Kevin, another biomedical engineer, who had also trained at Vanderbilt and been called from a post-doc at Harvard to a tour of duty in Afghanistan. In his off-duty hours, he had organized a relief effort for the children near Kabul. Ravaged by disease and exploited by Pashtun tribesmen, one of five die before the age of five. Amir is Pashtun, the nephew of Afghan President Hamid Karsai. He had told his uncle about Kevin’s access to medicines and food, and the Afghan leader had facilitated the effort to get relief to these children. Viktor and I had applauded Amir’s efforts.

Then these words from Amir: “Here we are, a Jew, a Muslim and a Christian, agreeing.” The words flooded my soul; I was suffused with the realization of what we shared. Each of us could have said with Thomas Merton “ … my being itself contains in its specific nature a whole code of laws, ways of behaving, that are willed for me by the God Who has willed me to be.”[3]

Martin Luther King, Jr.So three bioengineers from different religious backgrounds had found common ground that afternoon. Later that Spring, I asked my Biomedical Engineering class, “Is there a common morality?” A team of five, an evangelical Christian, a Buddhist, a Hindu, a Muslim, and a self-proclaimed hybrid agnostic (one parent Catholic, the other Deist), tried to construct a list of principles of common morality. They culled non-common principles from their individual lists, leaving them with five. The first four were from our class text: beneficence (do good), nonmalificence (do no harm), justice (treat everyone the same), autonomy (keep everyone informed). To these principles they added personal responsibility. Discarded were most of the Ten Commandments and the exhortation “Brush your teeth every night.” I wished they had also focused on principles of common morality, such as compassion, discussed in our text.[4] But like Amir, Viktor and me, the five walked together in common agreement on a code of conduct that appealed to the best in each of them.

Our class explored cases of ethical misconduct later in the spring as we continued to seek common ground. “Biomedical ethics has developed from mistakes of the past,” said Katie, voicing the reaction of many class members to the graphic pictures and descriptions of the Nazi medical experiments. Realization that the United States had also racially profiled and selectively sterilized weighed heavily on us. We had looked earlier in the year at the Tuskegee study, in which hundreds of African-American men with syphilis were observed, not treated, even after penicillin had been discovered.[5] President Bill Clinton apologized for the study in 1997, sixty five years after the study began.

Ethical issues permeate our world and especially our bioengineering profession. The two hot-button issues of biotechnology, according to Patrick Kelly of the Biotechnology Industry Organization, are genomically modified food and stem cell research. I have less trouble with the first issue, even though the political path to consensus continues to be tortuous.[6] I believe it’s a matter of education. According to a recent poll, sixty-five percent of Americans in a recent survey thought that only genetically modified tomatoes, not ordinary tomatoes, contained genes.[7] Under the leadership of such pioneers as Luther Burbank, many of our common foods such as apples, potatoes, red grapefruit, wheat and soybeans, have undergone extensive hybridization and modification through cross-pollination and other methods, having their genetic structure modified in the process. We need carefully documented processes of modification and tests of modified foods to make sure that what is developed is safe and nutritious. But most of all, we need public discussion and education to inform and allay fears. A hungry world deserves no less.

The issue of stem cell research is more problematic. The world’s religions and Christians disagree over when life begins. The issue is complicated by a number of other factors. The legality of abortion, the existence of excess embryos from in vitro fertilization clinics, the hope of medical breakthroughs in treatment of genetically-related disorders, and the variation in availability of funds for embryonic stem cell research from public to private sectors and from one country to another are a few. A recent publication by the President’s Council of Bioethics calls into question the concepts of genetic modification for the purpose of influencing the gender and performance of children and lengthening the life and altering the mood of adults.[8] These issues also need to be thought about and publicly discussed in forums in which there is more light and less heat for a change.

One of the attitudes we stress in our course is tentativeness, or conditionality—the effort to see situations from the perspectives of others. An open discussion of this sort occurred in Singapore in 2001. A government bioethics committee began a dialogue with lawyers, teachers, engineers and religious groups—Catholics, Buddhists, Jews, Taoists, Sikhs—on the propriety and efficacy of stem cell research. It was observed: “The letters written to Singapore’s ethics committee, which can be read on the Internet, render a moving portrayal of religious leaders searching through their ancient books, and their souls, in making the right decision. Several remarked that nowhere does it say what to do in this case (italics mine).”[9] The high cost of medical technology contributes to the high cost of medical care. However, initial costs are higher than ultimate costs; drugs become generic and medical devices and supplies decrease in cost over time. Nevertheless, skyrocketing health care costs compromise the availability of health care worldwide.

Ethical issues lie at the heart of the controversy. Much recent attention has been focused on the pharmaceutical industry. Marcia Angell, former editor-in-chief of the New England Journal of Medicine, accuses the pharmaceutical industry of inflating the reported costs of drug development, spending more on marketing than research, and controlling US legislation through intense marketing efforts.[10]

Pharmaceutical profits are high, and intense lobbying efforts control legislative action. Research universities, under increasing financial pressure, must adjust to pressures to commercialize their research efforts and capitalize on their intellectual property. These tasks must be undertaken with great care, according to Derek Bok, former president of Harvard.[11]

Last year I was part of a committee that put together a Code of Ethics for members of the Biomedical Engineering Society. The preamble to the Code reads,

Biomedical engineering is a learned profession that combines expertise and responsibilities in engineering, science, technology, and medicine. Mindful that public health and welfare are paramount considerations in each of these areas, the Society identifies in this Code principles of ethical conduct in professional practice, health care, research, and training. This Code reflects voluntary standards of professional and personal practice recommended for biomedical engineers.[12]

Personally and professionally, as health care givers, researchers and mentors, we are called to a high plane of ethical conduct. As a Christian biomedical engineer and educator, I participate in the coming of the Kingdom of God. “The blind receive sight, the lame walk, the lepers are cleansed, and the deaf hear, the dead are raised up, the poor have the gospel preached to them,” (Luke 7:22, NASV).

Are the ethical issues of biotechnology and bioengineering kingdom of Christ issues? Most certainly they are, for the following three reasons.

First, God has given us the ability to understand, care for, protect and enhance the creation, all to be undertaken humbly and judiciously, but vigorously and boldly, “dressing and keeping the garden” in the twenty-first century. Stated another way, work of this sort is a ministry for the Christian.

Second, Christian witness is needed in the marketplace. Kingdom values of justice and righteousness, not those of the Enrons, the Adelphias, the World.coms, must prevail.

Third, the false dichotomy between science and religion has been perpetrated from both sides by well-meaning but mistaken people.

Brian McLaren has one of his characters say “Evolution may be one of God’s neatest gifts.”[13] Is my faith strong enough and well-placed enough that I can walk with both believing and nonbelieving colleagues in a world and spirit of scientific inquiry? Can I be a disciple in both realms, secure in my tentativeness? According to Michael Polanyi, renowned British chemist and philosopher, the scientist/disciple can bring the same spirit of inquiry, of hypothesis testing, to both spheres.[14]

As I descended the escalator in Washington’s magnificent new Convention Center last April to display and defend my poster at a scientific conference, I had another epiphany. On the vast Exhibit Hall floor beneath, I saw thousands of posters and thousands of scientists—themselves preachers at their thousands of pulpits. I determined to practice the same tenets of humble discipleship in my scientific work that the apostles encouraged their listeners to practice. I purposed to work “heartily, as unto the Lord,” to learn, to educate, and to encourage.

“I always thought of myself as a man of science,” Brown and Williamson vice president Jeffrey Wigand, played by Russell Crowe, says in the movie The Insider.[15] “Then you’re in a state of conflict,” CBS 60 Minutes producer Lowell Bergman (Al Pacino) replies. Wigand had signed a non-disclosure agreement with his company. Fired because of an “attitude problem,” he was trying to decide whether to violate that agreement and tell what the tobacco companies knew about the addictiveness and harmfulness of their products.

Jeffrey Wigand did testify. It cost him his marriage and temporary estrangement from his daughters. Wigand continues to be a crusader against tobacco use. He makes a tenth of what he made as a company officer. But he is fulfilled. His daughters admire him greatly.

As he was deciding whether to testify, Jeffrey Wigand says “Nothing in my training ever prepared me for this.” But something in his human experience had. Was it code or epiphany? We don’t know. Perhaps we don’t need to. Perhaps we can recognize ethical conduct when we see it.

(This project was supported in part by the Engineering Research Centers Program of the National Science Foundation under award number EEC-9876363.)

NOTES

1 Bonhoeffer, Dietrich. Ethics. The Macmillan Company, 1955, p. 38.

2 Ibid., p. 40.

3 Merton, Thomas. No Man Is an Island. Harcourt, Inc., 1955, p. 58.

4 Beauchamp, Thomas L. and Childress, James L. Principles of Biomedical Ethics (5th Edition). Oxford University Press, 2001.

5 Jones, James H. Bad Blood: The Tuskegee Syphilis Experiment, The Free Press, New York, 1993.

6 Lambrecht, Bill. Dinner at the New Gene Cafe: How Genetic Engineering is Changing What We Eat, How We live, and the Global Politics of Food. Thomas Dunne Books, St. Martin’s Press, 2001.

7 Federoff, Nina and Nancy Marie Brown. Mendel in the Kitchen. John Henry Press, New York, 2004, p. 155.

8 President’s Council on Bioethics (Leon Kass, chair). Beyond Therapy: Biotechnology and the Pursuit of Happiness. The President’s Council on Bioethics, Washington, DC, 2003.

9 Parson, Ann B. The Proteus Effect: Stem Cells and Their Promise for Medicine. Joseph Henry Press, Washington, DC, 2004, pp. 239-240.

10 Angell, Marcia. The Truth About the Drug Companies: How They Deceive Us and What to Do About It. Random House, New York, 2004.

11 Bok, Derek. Universities in the Marketplace: The Commercialization of Higher Education. Princeton University Press, Princeton, NJ, 2003.

12 www.bmes.org.

13 McLaren, Brian. The Story We Find Ourselves In: Further Advenures of a New Kind of Christian. Jossey-Bass, 2003.

14 Polanyi, Michael. Science, Faith and Society. University of Chicago Press, 1946.

15 The Insider. Walt Disney Home Video, 1999.New Wineskins

Jerry CollinsJerry Collins is a biomedical engineer at Vanderbilt University. He is chair of the Ethics Committee of the Biomedical Engineering Society and is active in several national and state professional bioengineering and biotechnology organizations. Principles of ethics in biomedical product development and delivery, health care, responsible conduct of research, and mentoring are discussed in his course in biomedical engineering ethics at Vanderbilt. He and his wife, Sandra, have children, Leslie and Reid, physicians; and Erin, a teacher. Golden retriever Ginger allows Sandra and Jerry to live with her and grandchildren Isaac and Rachel to stay on Wednesdays and Fridays.

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Profile photo of Matt DabbsThis author published 1577 posts in this site.
Matt is the preaching minister at the Auburn Church of Christ in Auburn, Alabama. He and Missy have been married 12 years and are raising two wonderful boys, Jonah and Elijah. Matt is passionate about reaching and discipling young adults, small groups, and teaching. Matt is currently the editor and co-owner of Wineskins.org.

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