Brave new world: Scott Rae talks to Peter Hastie

Recently, Peter Hastie spoke with Dr Scott Rae, Professor of Philosophy of Religion and Ethics at Talbot Theological Seminary, Biola University, Los Angeles, on the subject of bioethics. Dr Rae holds an MA and PhD in Social Ethics from the University of Southern California, and a ThM from Dallas Theological Seminary. His major interest is in how Scripture applies to current social issues. He specializes in the subjects of medical and bioethics and business ethics.

He is the author of a number of books: The Ethics of Commercial Surrogate Motherhood: Brave New Families? (1994), Moral Choices: An Introduction to Ethics (2000), Brave New Families: Biblical Ethics and Reproductive Technologies (1996), Beyond Integrity: A Judeo-Christian Approach to Business Ethics with Kenman L Wong (1996), Embryo Research and Experimentation (1997), Bioethics: A Christian Approach in a Pluralistic Age co-authored with Paul M Cox (1999), Body and Soul: Human Nature and the Crisis in Ethics co-authored with JP Moreland, (2000). He is also a consultant ethicist for a number of hospitals in Southern California.

Dr Rae is married and has three boys. He lives in Irvine, California, and when he is not teaching ethics and philosophy, he is coaching his boys’ sports teams in soccer, basketball and athletics.

Scott, do you agree with Francis Schaeffer’s claim that every culture will be judged ultimately on the basis of how it treats its people?

Yes, I think Schaeffer is essentially correct. However, I would go a little bit further and say that every culture will be judged on the way that it treats its most vulnerable people. The ‘vulnerable’ are not just the sick and disabled; it includes them, of course, but I am thinking particularly of children and the elderly. Although the elderly have always been vulnerable, they are becoming more vulnerable than before.

I think that there is also a case to be made that newborns are becoming more vulnerable too. While we don’t have laws that would allow broad scale infanticide, there has been some discussion in the United States about overturning the ‘born alive’ rule that would allow physicians to finish off botched abortions. Currently this is illegal in America. If a child survives an abortion, then you have to support it; the child cannot be abandoned.

Why are you so worried about the elderly at the moment?

I’m worried about the care of the elderly because of the escalating cost of health care. I have a friend who is a physician who said to me some time ago that “There is nothing cheaper than dead” when it comes to caring for people. There was a case just recently in Oregon where a woman with terminal cancer was denied treatment but was offered the funding to pay for suicide. I think there’s no doubt, at least in the United States, that there will be record numbers of the elderly in the next 20 years as the baby boomers hit retirement and then have to face old age.

Do you think that this is going to become the main ethical crisis facing us over the next few decades?

I’m not so sure about that. It’s certainly one of the major issues that we will need to deal with. However, there’s another one lurking in the not-too-distant future that’s already setting off alarm bells.

What’s that?

A growing number of scientists are talking about the remaking of humanity through biotechnology. I believe this is going to be the most pressing issue for some time. Nevertheless, we can’t duck the problem that caring for a rapidly growing number of elderly people is a demographic challenge that we are completely unprepared for.

What’s going on in biotechnology at the moment that’s causing you such concern?

As you know, there have been some rather amazing developments in biotechnology that have enabled researchers to discover new ways to treat diseases. Some of these developments are now being considered, not simply as a form of treatment for disease, but as a means enhance a person’s natural traits and gifts. We are now on the verge of altering a person’s genes to prolong life or to create some form of artificial intelligence that will possibly expand mental function. There are all sorts of possibilities just over the horizon.

So are you talking about enhancement of a person’s natural characteristics?

Yes, that’s the ultimate goal for some of these scientists. Some of them want to experiment with drugs and genetic engineering with the aim of re-making a human being. The people who are working to this end are called trans-humanists. I know that what I am talking about probably sounds like science fiction, but some of these enhancements are now becoming more mainstream.

Does this enhancement include boosting physical performance and improving intelligence?

Yes, we are talking about both. Everything is on the table. There are all kinds of possibilities—physiological and mental. Theoretically, it should be possible to develop better athletes and give people sharper minds. Recent scientific discoveries are opening the door to longer lives, happier souls and more balanced emotions. All the science is there. The biggest problem we face is a moral one. Our culture is so driven by the idea of personal autonomy that, for the most part, we don’t even think about the moral and philosophical issues involved. The average person says, “Well, if it’s going to improve someone’s life and prospects, then let’s go for it!” It is all about the individual. Naturally, as Christians, we approach the issue from an entirely different world view. We are principally concerned with God’s will rather than human preferences.

Once we believe, as some scientists do, that our lives are genetically determined, do we have any meaningful basis for ascribing value to things like love, friendship, sacrifice and moral values?

Among evolutionists, there is an attempt to establish a naturalistic basis for morality. Personally, I don’t believe that their attempts to construct a system of ethics will explain a lot of the values that we hold dear. For example, I don’t think naturalism offers a plausible explanation for self-sacrifice or compassion, and it certainly doesn’t explain why we should forgive. So while they may be well-intentioned, I think they are going to come up short on a system that has a strong foundation for providing moral values.

Where do we get the notion of the sanctity of life? Is it the result of a Christian world view or can it be grounded on naturalistic assumptions?

I don’t think that you can explain the ‘sanctity of life’ successfully on purely naturalistic assumptions. The only reason that the notion is widely accepted today is that it enjoys widespread cultural acceptance. I don’t believe that such an idea can be sustained properly if it is isolated from our Christian intellectual and cultural heritage. For instance, I don’t think you can argue that life is intrinsically valuable on evolutionary assumptions. It’s hard to see how you could justify that there is something about human life that is particularly valuable over against other life forms. At best, I think that we can only say that human life is valuable on a utilitarian basis. Of course, grounding it on such a basis doesn’t get us very far because it then depends on whether it serves a useful purpose to save the person concerned. That could be very bad news at the moment if you happened to be an unborn child or an elderly person with chronic illness. You see, it’s possible to make a good utilitarian argument that keeping the elderly alive as long as we do is a bad idea. Certainly, there is no reason to keep an unborn child alive on utilitarian grounds if he or she is not going to be loved.

Can you help us understand why there has been such a dramatic shift in attitudes away from the sanctity of human life in the last 50 years or so? What has led our society to accept things like abortion, embryo experimentation and euthanasia?

These issues have been forced upon us by new developments in science and technology. Ever since the early 1960s when it became relatively safe to perform abortions, we have been forced to ask questions about the moral status of the unborn. Before the 1950s, no-one really doubted that unborn children were valuable. It was just a common sense view.

Again, from the 1970s onwards, a number of medical advances have made it possible to keep people alive who ordinarily would have died. Again, this has forced us to confront questions about when life really ends. It has also put us in a position where we are forced to define personhood. For example, does the fact that someone has advanced dementia and is perpetually curled up in the foetal position in a nursing home still mean that they are human? Is it possible through sickness or disability to forfeit our humanity? The unusual circumstances today in which we sometimes find ourselves have forced us to re-examine our definition of a human being. And what has happened is that we have moved from an ‘essential’ view of a person to a more ‘functional’ one. We are seeing a disturbing trend developing where it’s becoming more normal to consider someone as a person by virtue of what they can do rather than by what they are. This is a major shift.

To what extent are these changes being driven by ideology?

People’s outlook on life is certainly changing. As secular views of life such as naturalism have become more influential, we find that people tend to think in these newer categories. Now for naturalists, there are no real categories for things like ‘essences’, ‘natures’ and ‘souls’. The typical naturalist really doesn’t have much else besides a functional view of human beings. I think this is a big shift from the traditional view in the West that has always seen a spiritual dimension to human identity. However, naturalists tend to reduce our humanity to an ability to perform certain critical functions. It is a very thin and one-dimensional approach to human existence.

What part does the new discipline of socio-biology play in this change of values, and what have been its underlying assumptions about humanity?

This is a huge area. But in a nutshell, socio-biology and the neurosciences are an extension of a naturalistic worldview into areas that traditionally have been the domain of theology. Scientists who work in these areas commonly ascribe to the brain the sorts of things that Christians would normally ascribe to the soul. Obviously you don’t have to go very far down this route to challenge the biblical and theistic view of a person. I have noticed in recent times that some Christian scholars are arguing that you be a Christian and yet have a naturalistic view of the person. They don’t see any real incompatibility between the two positions because they are teaching that the Bible doesn’t demand souls.

Are these scholars evangelicals?

Some of them would probably claim to be. Some of the top folks at Fuller Seminary would fall into this category. People like Nancy Murphy and Joel Green come to mind. In fact, Joel Green has just written a new book, Body, Soul and Human Life. He is just one of many theologians who are trying to make a serious attempt at integrating the sciences into their view of theology. Personally, I think they have sacrificed too many of the essentials in their drive to integrate science with theology. I mean, does it follow logically that we can discount the existence of the soul simply because neuroscientists can explain through brain function what happens when people pray, or how religious services lift someone’s mood? I don’t see how it follows that their observations on brain function capture the whole transaction that’s taking place between God and man. They can’t rule out the spiritual presence of God in a person anymore than religious sociologists can explain the prevalence of religious belief in a community by certain social factors.

Why do many of today’s scientists feel that they are free to manipulate human nature?

Well, many of them are obviously imbued with the idea of Francis Bacon that man is the master of nature. Then again, there is the strong cultural drive towards personal autonomy. The combination of these ideas has led people to think that we have the capability to master not only the world, but also our own nature and destiny.

I would also add that genetic technologies have encouraged the idea that the core of human identity is to be found in our genome. This is clearly a naturalistic manipulation of genetic formation. Nothing of the sort follows from our observation of the genome. Ultimately we are not reducible to anything that is physical.

So I would be very careful about anyone who thinks that he can put all your genetic information on a CD and say, “Hey, this is you!” That’s ludicrous.

How is this new approach to human life affecting our approach to death and sickness?

Now that people are starting to look at our humanity in a utilitarian or functional way, this has a serious effect on the way they approach the end of life. Many people now believe that they have the right to determine when and how they shall end their lives. It is the ultimate act of self-autonomy. Some states in the USA are making it possible for people to make these choices. For example, the State of Washington passed an assisted suicide initiative last November. The State of Oregon has one too. Florida is likely to follow because it has a large population of elderly people. A lot of people seem to think that assisted suicide is a win-win situation. Patients think that they are put out of their suffering while society believes that it has saved itself some money on useless medical care. What is there not to love about that?

Well, what is not to love about this is that there is a steady trend from voluntary to non-voluntary assistance for suicide. This is now well-documented in places in Europe where euthanasia has been legalized for some time. What really worries me about this type of legislation is that once it gets enacted, it is very difficult to police. I mean, how will you know that the procedures were followed if there is some collusion in bringing about a person’s death?

The pressure to introduce euthanasia shows no sign of abating. What do you think is going to happen in the future?

I think that there are likely to be increasing calls for its legalization. There are enormous demographic pressures building as a result of a significant increase of elderly people. The one encouraging sign as the push to legalize euthanasia gains ground is that we are finding that the better we are at treating pain, the less the incidence of requests for euthanasia or assisted suicide. It is a self-evident thing. If we control people’s pain, then they want to live. What a surprise that turns out to be! The reason people want assisted suicide is that they are afraid of dying in pain. The good news is that we are capable today of controlling virtually everyone’s pain. It is interesting that the proponents of euthanasia never claim that suicide is the more merciful or compassionate approach to suffering. They always argue from the right to die and autonomy. They have to do this because, apart from a very small number of cases, it is possible to control most people’s pain. So there is just no need for euthanasia. In one sense, it is a case of ‘burning down the barn to roast the pig’, as we would say in Texas. Euthanasia is a draconian solution for a real problem. There is no doubt that many people who are facing death are in real pain. That is a major problem. However, the answer is to control people’s pain, not to put them to death.

What is going to be the effect on the care of the elderly if euthanasia is legalized? What do you see happening in terms of current health care?

I am not optimistic about what would happen in society if euthanasia becomes an accepted means of dealing with chronically or acutely sick people. I don’t think people understand fully that one of the reasons why we have such good hospice care and pain management is because assisted suicide is off-limits. At the moment, it seems that in Oregon, the practice of assisted suicide and the proper care of the elderly are coexisting. However, I am just not sure what will happen during the next 20 years as very large numbers of elderly people require a high level of health and hospital care. Frankly, I am not optimistic about maintaining good care.

I don’t think our legislators appreciate how dangerous it will be in the future to have assisted suicide on the table as one of the options. Those in favour of assisted suicide argue, “Why would you possibly object to that?” The answer to their question is that with the projected demographic changes, the pressure to make greater use of assisted suicide will be almost irresistible. I realize that I am speculating here, but so are those who are advocating assisted suicide. In general, I think the jury is still out on what the future holds, but I find no encouragement at all in the fact that I will be one of the elderly in the next 30 years. I’m certainly glad that I don’t live in parts of Europe like the Netherlands where assisted suicide has been legalized.

Is there a possibility that medical staff might conspire to euthanize certain patients who are very sick?

It’s a possibility. Say you and I are part of a medical team, and we are having a conversation about a patient lying in a bed. Who is ever going to find out that we have coerced him? No-one is likely to find out. These laws that are supposed to afford some sort of protection are simply not enforceable; breaches of them are also undetectable. While it would be a felony under the Oregon and Washington statutes to coerce a person to commit suicide, there are really no significant safeguards against abuse. These laws don’t have any teeth at all.

When does an embryo become human? Are there theological and physiological factors that you think are decisive in answering this question?

Well, I think the issue is really only physiological. There is really no theological dispute that embryos are human or that they are alive. An embryo is human as soon as it has finished the process of fertilization, which is a 6-12 hour process. Once that has finished, then an embryo is human. I would argue that from the first hour, an embryo has all the capacities necessary to mature into a foetus and newborn, and then an adult. So after the embryonic stages, there are no capacities added; they are just actualized. If an embryo was not human, then we would not be nearly as interested in stem cells.

Given all the modern forms of contraception available, is abortion still being practised at significant rates?

You know, it is. It’s absolutely tragic. The number of abortions in the USA is currently running around a million each year. It is still used as the birth control of last resort. I don’t know if that is because women can’t afford the pill or guys don’t want to do birth control, but it’s widely available.

Tell me, are live births still occurring as a result of abortions of foetuses in the second trimester?


So there are little babies who are five months old that are being born alive after an abortion?

Yes. There were, at one particular neonatal ICU ward, children as old as 23 weeks. That is four and a half months.

If an abortion takes place and a child is born live, what happens?

You mean what should happen, or what does happen?

What should happen?

What should happen is that all measures should be taken to rescue the child. However, what often happens is that the child is killed when they are out of the womb, or they are abandoned and allowed to die on their own so that the charge of infanticide can be avoided. The law in the United States prescribes very clearly that when abortion fails and the child is born alive, then they have to be given all the treatment necessary for them to be stabilized.

So you are saying that there are instances when that is not happening?

Oh, yes. I think that it’s more common than we would want to believe. Then norm is probably that the children are abandoned.

When you say abandoned, do you mean that they are just put somewhere out of the way and left?

Yes, they are just put in an out-of-the-way place and left to die on their own.

Does this amount to a conspiracy on the part of staff working there?

It certainly requires their cooperation in not rescuing the child. You need to remember that most of these places where newborns survive abortions are not in neonatal ICUs or high quality care clinics; they are in abortion clinics. The abortion clinic doesn’t have neonatal intensive care facilities on hand; after all, why would they? This means that to obey the law, they have to rush the baby to a neonatal ICU, which may be all the way across town. Of course, that would be a public relations nightmare for them, so there are significant incentives to abandon the child in an abortion clinic, or for an abortion physician to commit infanticide and finish off the botched procedure. That is probably more the norm today, but the law was written specifically to prevent both those events.

Do people ever get apprehended for those sorts of things?

There may be some states where it happens occasionally, but I think it’s very rare. I can’t remember the last time I read about some physician being prosecuted for something like that. In the next few days, we have a guest speaker at Biola University called Gianna Jessen. She is part of our ‘Sanctity of Life’ week celebrations. She is now in her late 20s and she survived a botched abortion. It’s a really remarkable story. She was badly burned with saline solution for 17 hours as part of the abortion process. And by God’s grace, she survived!

What are the after-effects of abortion?

The post-abortion syndrome is very real, and most women feel a significant sense of loss. This is particularly true if an abortion is done for reasons of genetic abnormality or birth defect. Women who don’t want their child still recognize that they have done something deliberate to end their child’s life. The abortion stops a beating heart. That’s the truth. I think women are usually told that “You can come in on Friday and you get this ‘taken care of’, and then go back to your life on Monday and are done with it”. It’s very rare that it works that way.

What are some of the social consequences of widespread acceptance of abortion?

I think society’s acceptance of abortion has generally coarsened our view of the sanctity of life. What I find interesting is that modern technology is allowing us to view the wonder of a developing child within its mother’s uterus, while at the same time, we have a progressive hardening in our view of the unborn. 30 years ago, it would have been almost unthinkable for a woman to have a baby in the ladies’ room and then throw it in a trash can.

Two former Nobel laureates, James Watson and Francis Crick, say that a newborn child should not be called human until it has passed a number of tests with respect to its genetic endowment. They say that if it fails one of those tests, then it cannot be classed as human. What is your response to that?

Well, if we are going to be consistent with this standard, then it seems to me that we have a lot of adults that we need to put to death. There are also a lot of severely disabled and handicapped adults that don’t deserve to live either.

So what they are advocating is really a form of genocide.

Yes, it’s a form of genocide. It is genocide against the disabled. Actually, I wonder whether these people have really thought through the social consequences of what they are advocating. For example, it’s popular today to talk a lot about value and diversity. Well, here’s a classic case of rubbing it out. To say that the disabled and the handicapped do not have valuable contributions to make and ought to be valued really flies in the face of our emphasis on diversity. I am glad to hear these people say it straight out because it is good that they are not just using euphemisms to mask their real intentions.

Some ethicists today are saying that we must take seriously the notions of meaningful life and wrongful life in determining who should live. How would they handle people like Helen Keller and Stephen Hawking?

On their criteria, if they were to be consistent, they would have to dispatch them. If people had known that Stephen Hawking was going to be born with the disabilities he now has, he would never have been allowed to be born. And the world of physics would have been poorer because of it. The same goes for Beethoven, incidentally; he suffered profound deafness.

I would love to take an anecdotal survey of the disabled and ask them if they would have been better off if they had never been born. It would be interesting to see what they say. I suspect that they would look at us like we had come from another planet, and rightly so. I think that the question of meaningful life is a silly question to ask someone who is living and flourishing, albeit in a limited capacity.

If doctors make a decision to allow a baby to die because it is suffering from, say, cardiopulmonary problems, is there any reason why they shouldn’t make the same decision in an adult? If they decide to assist the adult, then what is the basis of making that decision?

That’s a good question. See, I don’t have an objection to newborns or adults being allowed to die if further treatments are futile. The same is true if additional treatment is more burdensome than beneficial. If you say, “Stop. I’m done. I don’t want to live out the rest of my days with tubes down my throat”, then you ought to be able to say that. It may actually hasten your death, but so be it.

However, it’s different if somebody else starts making those choices for you. I would have a real problem about somebody else saying that for me unless they were representing my wishes and speaking on my behalf.

But I think a person ought to be able to say, “Enough!”, where it is obvious that further procedures are only going to prolong the suffering with no prospects of recovery. I think it’s right and deeply Christian to say “Enough!” when our position is terminal. If our view of eternity is correct, then what business do you have delaying a loved one’s homecoming by hooking him/her up to technologies and tubes that the physicians have deemed are futile? Again, we can put it like this: “What business do we have in increasing another person’s net suffering at the end of his life if the burdens far outweigh the benefits?”

I really think people should be able to say “Enough”. I don’t think ‘sanctity of life’ means that we have to treat everybody at all costs and at all times. That’s making an idol out of earthly life. Theologically, earthly life is not the highest good. If we define the sanctity of life as meaning that we support life even when it is futile to do so over the longer term, then we are obligated to do everything possible at all times and at any cost. When death is inevitable, there is nothing wrong with allowing it to take its natural course. Christian families need to hear that because sometimes they think they are violating the sanctity of life unless they take every measure possible even when it is futile to do so.

How should Christians be viewing developments in stem cell research?

For the most part, very enthusiastically, because the vast majority of clinical applications are coming from stem cells harvested from non-embryonic sources, which is entirely non-controversial. Incidentally, this is where all the action is.

So are you concerned at some of the current decisions that are being made at a political level to promote embryonic stem cell research?

Yes, I am. There are a couple of reasons for my concern. Firstly, I don’t believe that it is ever justifiable to kill one person to benefit another. I don’t think that we should agree with that under any circumstances. A second reason is because so much of the promise of embryonic stem cells lies off in the distant future. In these circumstances, I think we are giving people with debilitating diseases false hope that their cure is right around the corner. The simple fact is that it isn’t. If the cures were right around the corner, then the venture capitalists would be funding this, not the taxpayers.

Is it true that it’s far more effective to use stem cells that come from relatives rather than stem cells from the wider population?

That is right, and the reason is that the donor is a match to the recipient. Using stem cells from leftover embryos is virtually useless for treatments because it’s like doing a bone marrow transplant from some guy off the street. He may not be compatible. The good news on embryonic stem cells is that we will be having new discussions on this subject sometime soon because both in Japan and in two places in the United States, researchers have reprogrammed adult cells back to a stage where they can harvest stem cells. It happened last year, and it was done without using embryos. This discussion about using embryos will be irrelevant in five years.

How important is it for the church to endorse the historicity and integrity of the Genesis record as a means of articulating a defence for the sanctity of life?

That’s a good question. Can you sustain the traditional doctrine that man is made in the image of God and also allow for an evolutionary reading of the text of Genesis? Frankly, I am really reluctant to let the camel get his nose in the tent on this issue. I find it very difficult to see where random selection and providence could coexist. It hard to imagine why, in the providence of God, man, who evinces evidence of the most amazing indications of design, would have been the result of an entirely random process. If it did occur in this way, as William Lane Craig recently said in a debate with Christopher Hitchens, then it would be the most amazing miracle.

As I see it, adopting an evolutionary interpretation of Genesis is an attempt to make two mutually contradictory systems—theism and naturalism—coexist. I know some Christians—especially scientists—are comfortable with this approach. However, as a philosopher I am not sure that it is possible to be entirely consistent in being a theist and also believing in the process of random selection. Of course, I am always open to any new arguments on the subject, but I’m not holding my breath while I’m waiting.

Reproduced with kind permission from Australian Presbyterian, June 2009 (PDF).