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ss nucleus - summer 2002,  Ends and Means

Ends and Means

Does the end ever justify the means? Peter Saunders, tackles a fundamental question in medical ethics

The House of Lords' Select Committee on Stem Cell Research has just granted permission for cloned human embryos to be produced for research on the grounds that they are necessary to develop treatments for degenerative diseases like Parkinson's, Alzheimer's and diabetes. Whether they provide the only potential means of treatment has been vigorously disputed (adult stem cells may provide a viable alternative),[1] but the underlying question is one of ends and means. Does the end of treating serious diseases justify the means of killing human embryos? Does the end ever justify the means? This issue is fundamental to many contemporary debates in medical ethics.

Secular approaches

Secular ethicists classically divide ways of decision-making into two categories: deontological and consequentialist.

The philosopher Immanuel Kant was one of the first advocates of deontological [2] decision-making which judges an action on the basis of whether it conforms to a set of rules or principles. In the 1980s Beauchamp and Childress first enunciated four prima facie principles of ethics in health care, which form the basis of most contemporary secular ethical discussion. They are:

  • Beneficence (doing good)
  • Non-Maleficence (do no harm)
  • Autonomy (respecting free will)
  • Justice (being fair)

Consequentialists, by definition, judge an action by its consequences. John Stuart Mill and Jeremy Bentham are the philosophers usually associated with this school of thought and most popular ethical discussion gives far more weight to the consequences of decisions than the principles underlying them. In practice consequentialism rules OK!

A Christian approach

Christians clearly respect the authority of Christ and Bible above Kant and Bentham, but are biblical ethics deontological or consequentialist? Both, in fact. Take, for example, the question 'Is adultery right? On one hand the seventh commandment states 'you shall not commit adultery'.[3] Why not? Because God commanded it and we have a duty to obey God. This is a rule-based or deontological argument.

However the writer of Proverbs takes a different approach. In effect he says, 'Think about the consequences of adultery: all the shame and disgrace, not to mention the fury and rage of a jealous spouse to contend with. Is it really worth it for a few moments of pleasure? You'll probably end up destroying your marriage and then what about the children? How can that be right?'[4] This is a consequentialist argument.

God is loving, trustworthy and profoundly concerned with our welfare so it makes sense to obey his commands. However, recognising this is not enough. We must also understand that God is a far better developer of deontological principles and judge of consequences than we are:

'Trust in the Lord with all your heart and lean not on your own understanding; in all your ways acknowledge him, and he will make your paths straight.' [5]

This means that even when a course of action seems good to us, we should nonetheless abide by what God commands. This is the way of faith, making Christian ethics so diametrically opposed to those of the secular world.

Examples of faith

Humans are limited and sinful so it follows that we should trust God's word and not our own judgment. The Bible is full of examples of great men and women of faith being commended for obeying God's word, despite the perceived consequences. Take, for example, Abraham: God told him that his son Isaac's progeny would be like the sand on the seashore. Then he told him to go and sacrifice Isaac. How could Abraham have children through Isaac if his son was dead? Yet he went to obey, and was commended for his faith. The writer to the Hebrews tells us that Abraham was confident that God could raise Isaac from the dead if he so chose.[6] This is true faith; obeying God even when obeying seems a foolish thing to do by any human reckoning. Moses' return to Egypt to lead the Exodus is another example.[7] Why go back to the place where you are wanted for murder? Isn't that suicide? But Moses did it because God asked him to.

These men recognised that God was sovereign; that their job was to obey and trust the consequences to God, knowing that he will work things out in the best possible way.[8] The real test of genuine faith is whether we obey God in circumstances where it seems the immediate consequences will be bad for us. If we obey him only when we can see things will work out, then we are really trusting our own judgement rather than his.

Those in the Bible who chose not to obey, but rather trusted their own judgment, are not commended. Saul's sacrifice without waiting for Samuel [9] is a poignant example and resulted in Saul losing his kingship. He panicked rather than being patient, because he trusted his own judgement rather than God's. When he later failed to fulfil God's clear command to destroy the Amalekites, he was finally rejected. 'To obey is better than sacrifice', was Samuel's stern rebuke.

Aaron's crafting of the golden calf was a similar case in point.[10] Aaron was afraid of the people's reaction, and so succumbed to idolatry out of fear. By contrast when Satan offered Jesus all the kingdoms of the world if he would worship him, Jesus chose the path of obedience and not the path of expedience.[11] We know that to rule over the kingdoms of the world was Christ's destiny - but the means to it was not through worshipping Satan but through submitting to God on the cross.

Ends and means

The consequences of actions can sometimes be very difficult to judge, in fact they may not become apparent until years later. The heavy drinker does not have cirrhosis foremost in mind - nor does the promiscuous student consider that his actions may be leading to gonorrhoea or emotional hurt. The Bible is full of stories of entire nations who remained blind to the consequences of their actions until it was too late. This is why it is important to obey God rather than trust our own insight, as he sees the long-term consequences of our actions clearly.

While scientific enquiry is an important source of knowledge, for example, we do not need scientific proof of the harmful consequences of sex outside marriage. God's word is clear that it is wrong and, as we would expect, science is now backing this up by highlighting the damaging results. We do not yet know the long-term consequences of cloning embryos but, as Christians, we should not have to wait for research to come in before deciding on the morality of the procedures involved.

According to the apostle Paul, the attitude that says 'Let us do evil that good may result' [12] deserves condemnation. With God the end never justifies the means. Rather we must do God's work his way and trust the consequences to him.

References
  1. Saunders P. The House of Lords' Select Committee on Stem Cell Research. Triple Helix 2002; 19:3 (Spring)
  2. From the Greek word deon, meaning 'duty'
  3. Ex 20:14
  4. Pr 5:1-14; 6:20-35
  5. Pr 3:5,6
  6. Heb 11:17-19
  7. Ex 3:7-4:31
  8. Rom 8:28
  9. 1 Sa 13:1-14
  10. Ex 32
  11. Mt 4:8-10
  12. Rom 3:8
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