Everyone would recognise Michelangelo's painting of a naked man (Adam) lounging on the ground, pointing towards a figure sitting in the sky (God) who points back to the man. The painting can be found on the ceiling of the Sistine Chapel in the Vatican City and is called 'Creation of Adam'. Michelangelo paints the moment in which God made humankind:

So God created man in his own image, in the image of God he created him; male and female he created them. (1)

These familiar words have been the subject of much deliberation amongst biblical scholars through the ages. What does it mean to be made in God's image? Far from being a topic only for academics, thinking this through as medics is crucial if we wish to defend the truth about the worth of a human being. The true position and worth of a human being must be the starting place for any discussion about medical ethics. Why should we care for the frail and sick, if this life is just a 'dog-eat-dog' survival of the fittest, or if we are just biological robots, programmed to respond to external stimuli?

who are we? the creation of the image

Let's look again at the creation story. In eloquent poetry, the author of Genesis describes light bursting out of darkness, skies and oceans separating and filling with creatures that swarm and swim and soar, and stars made at God's command. In the beginning everything was fresh and new, untainted by pollution, unspoilt by human folly. And we read that at the close of each new day, God looked at the things he had made and 'saw that it was good'. Again and again, the recurring stanza: 'And God saw that it was good'. (2)

Finally, on the sixth day, God made man 'in his own image'. Out of all the beauty of creation, when we meet a human person we meet the pinnacle of God's creation; God's 'image-bearers'. What was God's conclusion at the close of that day? 'God saw everything he had made and behold, it was very good.' (3) The creation was complete.

So it is 'very good' to be made in God's image. It is to be made like God, a reflection of who he is. We are God's representatives here on earth. What does this mean? If we look at Genesis chapter 2 (a sort of commentary on chapter 1) we note that when God had made Adam, he judged that it was 'not good' (ie not like God) for man to be alone.

If you have ever seen the Walt Disney film 'Lilo and Stitch' you may recall a point in the film when Stitch, an alien from another planet, is looking for his family. He longs to find those who are the same as him, who will love him and look after him, so he sits and waits all night in a dark forest all alone. Sadly he doesn't have a family because he is a genetically created mini-monster, the only one of his kind. The evil scientist who made him suddenly sees how lonely this must be. 'What must it be like' he wonders 'to have nothing, not even memories to visit?'

Adam could not alone represent the God of three persons. God provides him a companion in Eve; another person, unique (and different from Adam), yet one with whom Adam can live and ultimately be united with, just as God is completely united within himself. Therefore reflecting God's image must also be a shared privilege. God created 'male and female', the same but different, and together we are like him. We were made to be in relationship with each other, born into families and communities, because God is a perfectly united, relational God.

what are we doing here? the purpose of the image

Why did God create mankind in his image? Piper suggests it was so he would be seen and enjoyed and honoured through what man does. (4) God describes the sons and daughters from the ends of the earth as those 'whom I created for my glory'. (5) When we use God-like skills and characteristics, we reflect God's glory! We discover true joy, true life if you like, when we know and enjoy the God who made us. We are never more human than when we worship God.

God gives the man and the woman jobs to do (6) because he is a God who works. This is sometimes referred to as the 'cultural commission'. Work is part of what it means to be human! But can you see the difference it makes to know that we are made in his image? It means that the very work we do, whatever it is, is intrinsically valuable because of who we are.

As we are made in God's image, we derive our status from him. Just as an image in a mirror is merely a reflection, so our identity is bound up in who God is; something outside of ourselves. This is hugely humbling. Graham Beynon, in his helpful book 'Mirror Mirror' (7) describes this as 'humble dignity'. Humble because we are only an image, but dignity because of whose image it is. This is the true identity of every human being, of whatever 'standard' of intelligence, whatever age they are, however unwell, whatever their worldly wealth.

Rich and poor have this in common: The LORD is the Maker of them all. (8)

What a difference it would make in treating our patients, if we treated each and every one indiscriminately, not because they have earned the right to our care, but because of their identity as image-bearers of the most high God.

what has gone wrong? the shattered image

It is clear that this glorious depiction of humanhood is not what we see today. We only need to look at one day's worth of news items to know that humans, apparently made to be like God, do not often behave in a very God-like way. What went wrong?

The story in Genesis, which began so well, is soon wrought with tragedy. The first humans, Adam and Eve, fail to grasp the 'humble dignity' of being God's image bearers, and instead aim to become like God by choosing for themselves what is right and wrong. (9) Disaster! God passes a terrible judgment on them; (10) humanity is cursed for their disobedience, for abandoning their true identity.

We feel the effects of that terrible punishment today; we have weak and imperfect bodies that break or get infected; we see nations at war; we are hurt by broken relationships, and we each have failed to love others as we should. We continue to rebel against our good and wise God. Every aspect of the image is distorted and changed, like a house of mirrors at a funfair. It's hard to believe that we were once made to be like God.

And yet, although broken and barely recognisable, the image is still there, and sustains its value because of whose image it is. Even after the 'fall', God condemns murder on this basis:

Whoever sheds the blood of man, by man shall his blood be shed; for in the image of God has God made man. (11)

Every human then, however they look or behave, is alike and equal in that they are bearers of God's image. We behold the marred image wherever we look. It is like '...a temple which is now in utter ruins - a temple in which a shattered window here, and a doorway there, and a column there, still give some faint idea of the magnificence of the original design, but a temple which from end to end has lost its glory and fallen from its high estate'. (12)

redemption - the restoration of the image

Wonderfully, despite the brazen disobedience of mankind against the Creator, God did not give up with the world he had made. Even as he banishes them from his presence, he hints at a promise to provide a rescuer, and moreover a redemption. His wrath at human rebellion is real and terrifying, but rather than abandoning the world to destruction and ruin as we deserve, God's amazing love prompts him to come himself, clad in the same feeble flesh, to share in our humanity.

The Word became flesh and made his dwelling among us. We have seen his glory, the glory of the One and Only, who came from the Father... (13)

Think about what this means .... Jesus began life as a tiny zygote... he was born and was a helpless baby ... he grew up in a family with brothers and sisters ... he would have experienced sickness, headaches, diarrhoea ... he worked as a carpenter. Essentially, he joined us in our dirty, sweaty, messy human existence! John Wyatt observes this as another reason to treat the human body with special respect 'because this strange idiosyncratic collection of 35,000 genes, ten billion nerve cells, several miles of wiring, eight metres of intestinal plumbing, five litres of blood, and assorted biochemical engineering - this is the form in which God became flesh!' (14)

But what was the difference between us and Jesus? Not only did Jesus never sin (unlike Adam who sinned and marred God's image) - he is the exact representation of God's being. (15) He was not created, but was with God in the beginning. (16) Yet he 'became flesh and made his dwelling among us'. (17) He was not only human, but as an exact representation of the God in whose image we are made, he was the most human person who ever lived!

Why is this important? It meant that he could die in our place, and bear our sins on our behalf. (18) Jesus rose again as a physical human being, who was seen and touched, he ate and drank, and chatted ... he rose in bodily form! (19) Jesus' resurrection affirms God's total commitment to the significance of physical human bodies.

What happens to my human-ness when I become a Christian? As the Holy Spirit does his transforming work in our lives, and we grow in godliness (that is God-likeness), in effect we become more and more human as we reflect increasingly accurately the One whose image we bear! In trusting in Christ for our full forgiveness, we are able to turn back to be in right relationship with God himself; to have his image restored in us. Think about all the ways humans are made in his image .... all of us are affected by the Fall, all are distorted .... but Jesus came that all can be restored. Often we think about 'growing in godliness' only in terms of the moral aspects of our Godlikeness. But think about all the other aspects of ourselves, our creativity for instance, or our relationships ... the Holy Spirit works in hearts to restore these as well!

This gives us confidence that our study, our families and friendships, modern art, cancer research, our responsibility to look after the planet, charity....these and all other parts of our humanity matter, because Jesus came to redeem them all, to make them whole again.

the great commission - the transformation into his likeness

In the beginning, God made man to be like him. In the end, 'we know that when he appears, we shall be like him, for we shall see him as he is' (20) and the image once restored will never again be broken. We experience something of this transformation as the Holy Spirit lives in us - but should remember that we are not yet at the end. We are still in our earthly bodies, and must continually put to death the sinful nature. (21)

Until the end, as we live our lives for Jesus' glory, we must continue to fulfil our cultural commission; to be good stewards and to cultivate the earth, to work hard, play hard, exercise our brain cells! The Christian is someone with a new identity, who therefore has to put to death whatever belongs to our earthly nature, 22 be that lying or laziness, cruel joking or mean giving; in effect to be more and more truly human.

As Jesus left the earth, he commissioned his followers: 'Go and make disciples of all nations, baptising them in the name of the Father and of the Son and of the Holy Spirit'. (23) Part of this great commission is to live in such a way as to represent him as he really is, to 'image forth God' as John Piper expresses it. (24) And as we are gradually changed to image forth God he uses us to 'adorn the doctrine of our Saviour'. (25) We must speak about Christ for whose glory we are living. Otherwise, for those he has placed around us it would be like 'watching an effective ad on TV that never mentions the product. People may be impressed, but they won't know what to buy'. (26)

What message do we 'adorn' then, with our image bearing lives? It's the knowledge of a great God of grace who longs for people to realise their true identity and come back home to him. As we wait for Jesus' return, let's strive to live lives that make him look good, letting it be known that it is he who has made us, he who will bring us home, and he who will restore us. To God be all the glory!