DALLAS (BP)–Even unbelievers have the law of God written on their hearts and can perceive the value of a human life — even if they can’t identify the source of such value, an Oxford bioethicist told a bioethics conference in Dallas.
“Conscience is there and we can use that conscience, we can appeal to that conscience,” E. David Cook, director of Oxford’s Whitefield Institute, said during the “Cutting-Edge Bioethics: Human Life on the Line” conference at Criswell College.
“We can work with people who do not share our God, do not share our faith, do not share all that we hold dear but have God’s law written on their hearts. Now maybe [their understanding] is twisted. It may be fallen, but it’s there. And we can use that and build on it.”
Cook’s lecture, “Who Lives, Who Dies? Allocating Healthcare Resource,” covered various factors healthcare professionals use in deciding who gets care and how far care should be extended.
Every country in the world, from second- and third-world nations to technologically advanced countries, has some level of healthcare crisis, Cook said. How they deal with it depends on the worldview of the decision-makers, he said.
Improved medical technology has expanded physicians’ ability to sustain life, creating an allocation-of-resources dilemma compounded by patients who are surviving longer, Cook said.
“It’s a problem today because of the very success of medical science.”
In a nationalized healthcare system such as Britain’s, economists have entered the debate, providing formulas for determining healthcare allocation.
“Healthcare economics has become a major opportunity for our failed economics professors,” Cook quipped.
During a healthcare conference that included leading British economists, healthcare professionals and politicians, and at which Cook was the lone ethicist, the term “quality-adjusted life years” was discussed to describe a formula for determining a numerical value for patients. Cook said the economists considered it an objective factor in making allocation decisions.
“You’ll discover if you are very young you will do very well under a quota system. If you are old, you won’t do so well. If you are well, you will do very well under a quota system. If you are sick, you will not do very well under a quota system.”
Various factors can affect one’s healthcare, including the perception that a patient has family members who monitor his care. Other factors include a perceived value to society, the ability to pay, age and gender bias and the worldview of healthcare providers.
“I tell elderly people, If you go to the hospital, tell them, ‘I’ve got lots of relatives and they’ll create lots of trouble if you don’t look after me well,’” Cook said. “because the single, elderly person is very vulnerable in a hospital setting.”
He told of one teaching hospital where a heart patient was removed from a machine to make room for a college history professor who suffered a heart attack. “Is the professor of European history worth more than someone who works in garbage disposal, who drives a bus, who’s at home looking after the family? We can have bias or we can have merit. He deserves or she doesn’t deserve. How do you decide who is worthy of treatment?”
In reality, rationed healthcare works on a first-come, first-served basis, Cook said.
“I know if I go on the first, second or third of the month, I am likely to get my flu vaccine. But if I go on the 25th, 26th, 27th of the month, ‘Sorry, no vaccine left.’ Because that’s the way they allocate — first come, first served.”
Several European countries are pushing equal healthcare allocation as a human rights issue, and Christians can use this trend to appeal to the inherent value all people recognize in human beings, Cook said.
Regardless of what people claim, everyone has a worldview — a lens through which they make value judgments, Cook said. “People will tell you they don’t have a worldview. They’re telling lies. Everybody has a point to see the world. Everybody has a regulative principle. It’s hard to find, but it is there.”
From a Christian context, Cook said he has identified three dangers in allocating healthcare: reductionism, materialism and determinism:
— Reductionism, he explained, treats people as subjects of disease or illness and often overlooks the person for the symptoms. “The danger is that we depersonalize people.”
— Materialism views the person mechanically and not holistically. The trailblazing work in genetics, for example, has begun to thrive on competition over new breakthroughs without regard to moral boundaries — contrary to early genetics work done to combat diseases, Cook noted. “We need holistic medicine … seeing the whole person … and we need to be concerned with spiritual well-being.”
— Determinism despiritualizes and dehumanizes people by identifying genetic risk factors and forecasting their health status.
Cook said Christians must contend for a biblical ethic in the marketplace of ideas, appealing to humans’ innate sense of morality.
“Genesis begins at the beginning,” he said. “When Jesus is asked moral questions, He goes back to the beginning. And we need to start at the beginning. But the beginning is not about us; the beginning is about God. It’s about who takes the initiative. It’s about God who reveals Himself … He is the one who gives us that moral basis.”
Cook said he’s a regular guest on a television debate program called “The Moral Maze” with a conservative, a liberal and a gay activist. Often, one of them will apologize for using foul language.
“You see, conscience still makes them aware that there are things you should say and some things you ought not say. There are some ways you should treat people and some ways you ought not treat people. God has written His law on their hearts and minds.”
The Terri Schiavo case, for instance, has raised awareness of people worldwide about vulnerability at the end of life, Cook said.
“We can use that and build on it. It’s not just Christians who have dignity. Every person has dignity. And in our evangelism, and in our care in the hospital setting, we need to make sure that we give people the dignity and worth and value that they have because they are made in the image of God.”
The Old Testament abounds with commands to practice justice and mercy, Cook said, noting that “God is the perfect balance of justice and mercy and we are to be like Him” especially to the vulnerable.
“In healthcare we are vulnerable. We have family who are vulnerable. And at the point of vulnerability we are ministers of grace and love.”
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Jerry Pierce is managing editor of the Southern Baptist Texan, newsjournal of the Southern Baptists of Texas Convention, online at www.sbtexas.com.
