The Pastor and Difficult Bioethical Decision Making

I wrote about bioethics several years ago:

https://www.christianbook.com/time-biblical-look-life-issues-ebook/wally-morris/9781620203446/pd/50816EB?event=ESRCG

In a booklet for ministers regarding end of life decisions, C. Everett Koop once said something like, “You mus to decide whether you are extending a life or extending a death.”

That principle has guided me over the years.

But that other stuff — embryos and surrogates — those are the things I find particularly messy.

How would you handle the case study of a mother of three (not that this comes into play in the decision) who has a brain tumor that will kill her if she doesn’t get chemo, but the chemo would kill the baby in her womb? We might need more particulars to address that one, but do any of you have advice as to how you would deal with that one?

1. Doctors are sometimes wrong in how treatment will affect a person or an unborn baby.

2. Treatments can sometimes be localized to minimize risk to the rest of the body and/or baby.

3. The mother may wish to sacrifice herself for her unborn baby, but the husband should be part of the decision too because someone will have to raise the children if she dies.

4. Sometimes these decisions can have a degree of pride and/or selfishness: “Look at what I am doing for my baby” and they can ignore the consequences for the rest of the family.

5. Possibly delay treatment until closer to birth time in order to minimize potential effects on baby. This will increase risk to mother.

6. Unborn babies are not necessarily the highest moral focus. Those who are alive have just as much a right to life as unborn children.

More could be said, but this is a start.

I remember the pastor who did my wedding walked us through the issues of IV fertilization—more or less that to get one to “hatch”, you’ve got to have a whole bunch to implant, which sometimes results in a bunch of successes that lead doctors to say “it’s some of them, or it’s you.”. Seemed to me that the best way of handling that is simply not to make so many embryos and take the risk that you won’t get “your own” child—and if health insurance (etc.) won’t work with that, we need to remember that the heritage of Christ is as great as that of children, and quite frankly as well that there are an awful lot of kids out there waiting to be adopted. We wouldn’t need to worry as much about unworthy parents adopting if the worthy couples did, no?

The chemo issue is tougher, and quite frankly, I can see Christians of good faith making either decision. It’s a matter of odds, really; you’ve got an x% chance of remission with chemo, y% without, you’ve got z other kids for Mom to care for, and you’ve got a% odds of the unborn child surviving. I think you simply say “this is one of those cases where somebody is going to be hurt no matter what. Let’s ask God, understand His forgiveness, and make our best choice.” I’m inspired by those who do sacrifice themselves for their preborn babies, but I understand why not everyone can make that choice.

Regarding the in vitro fertilization, since I hold that life begins at conception, then the onus falls on those choosing to use in vitro fertilization as the means to conceive. Now the scenario shows some attempt at their responsibility in that they are asking for an adoption of embryos, but in my mind, the better choice is to demand that only the number of embryos planning to be put in the original mother’s womb ought to be created (there ought to not be “extra” ones). I realize this is against medical practices, as additional ones tend to be created at the same time in case of failure to bring about success. But this is where the client should take control of the process, and demand that only the number of embryos intended to be implanted in the mother ought to be created (and then as best as possible, follow through on the commitment to see those embryos so implanted, whether one at a time over the course of time, or two or three at once, with possibility of fraternal twins/triplets possible).

For the couple asked to adopt, they are under no obligation to say yes (it is not a moral failure on their part to not save the embryo, only the original couple’s part). If they desire to say yes, and make that sacrifice for the life of the embryo, then kudos to them.

Regarding the brain cancer with baby in womb, which assumes there are no alternative treatment methods that might save both mother and child, it is never morally wrong for a mother to sacrifice her life for the life of her child; but it is always morally wrong to intentionally do something that you know will kill your child when a non-fatal possibility exists. Might this leave the husband alone to raise four children? Yes, but there is nothing morally wrong with that result, only inconvenient/trying. Might both mother and child die, if she dies too soon from the cancer? Yes, but that is not an intentional choice for death. There is always trusting God to keep the mother alive, even to the point that (assuming God does not miraculously remove the tumor, which there are countless testimonies of His doing) she might survive to have chemo after the birth and still survive.

In March of 2015, one of my nephews lost his wife of three years to cancer two days short of her 25th birthday.

At age 17, she had a malignant tumor that was surgically removed, underwent chemo, and then appeared to be cancer free.

At age 23, she became pregnant. Early in the pregnancy, the cancer from six years prior suddenly reappeared. She put off any treatment until after the birth. She lived until past her daughter’s 1st birthday.

Today my great-niece, Macey, is five. She has a new mom now; my nephew remarried last June.

I appreciate all the thoughtful comments on some of these difficult dilemas.

I remember Ronald Reagan talking about abortion to save a mother’s life, arguing that self-defense was what would be happening. Any comments on that?

[Ed Vasicek]

I appreciate all the thoughtful comments on some of these difficult dilemas.

I remember Ronald Reagan talking about abortion to save a mother’s life, arguing that self-defense was what would be happening. Any comments on that?

I don’t remember Reagan arguing that, but that was certainly my position when my wife and I were deciding to have children. We both agreed we would try every possible way we knew to avoid any similar decision (and thankfully, we were never faced with one like that), but that when it came down to it, my wife was the one I made vows to, and if I were forced to make a decision, I would choose to save her first.

I’ve had a number of arguments with other Christians about it being similar to “self-defense,” and I understand that others might make a different decision, but my conscience was clear with my choice. I don’t know how often it would actually happen that a choice between saving one or the other would have to be made, but if faced with that choice (i.e. not being able to choose both), I’d have to make it one way or the other. I’m not sure it’s an easy decision which would be more “right.”

We both agreed we would try every possible way we knew to avoid any similar decision (and thankfully, we were never faced with one like that), but that when it came down to it, my wife was the one I made vows to, and if I were forced to make a decision, I would choose to save her first.

I agree with this approach. Yet, with the mom with cancer — like the example Larry pointed out — it becomes tougher. You don’t know that the mom will necessarily live, and the odds are related to so many factors. So if it becomes the baby being very likely to live vs. the mom only possibly likely to live, that makes it more confusing.

None of us want to be involved in a situation that makes us “play God,” and so trying to find out God’s will can be overwhelming.

And I guess that is the point of this article — to reveal the difficulty of finding the best (or least worst) choice in such dilemmas.

[Ed Vasicek]

We both agreed we would try every possible way we knew to avoid any similar decision (and thankfully, we were never faced with one like that), but that when it came down to it, my wife was the one I made vows to, and if I were forced to make a decision, I would choose to save her first.

I agree with this approach. Yet, with the mom with cancer — like the example Larry pointed out — it becomes tougher. You don’t know that the mom will necessarily live, and the odds are related to so many factors. So if it becomes the baby being very likely to live vs. the mom only possibly likely to live, that makes it more confusing.

I agree, but we still don’t know. In 2012, my wife was diagnosed with breast cancer, and it turned out to be a particularly rare and aggressive type. Obviously, we could do nothing but pray, trust God, and hope that the doctors knew what they were doing, confident that God would do what he thought best. 6 years later, she is in remission, and another lady we heard about who was diagnosed with the same type of cancer the same month as my wife was dead by the end of 2015. We still don’t know how much time my wife will have, but that’s true of all of us.

If that had happened while my wife was pregnant, I’m sure there would have been those who said that it was likely she would die anyway, and to therefore favor the unborn child. Obviously, I can’t know what I would have done in a hypothetical situation, but looking back on it, I think I would still have made the decision to try to save my wife, because again, I made my vows to her, and I have no idea how God would work. If the cancer were aggressive enough and untreated, both might have died anyway. I can only make decisions based on information I have, not what I might suspect.

I’m not trying to say my choice was the only right one — far from it, in fact. But as I said, my conscience was clear with what I had previously decided, and what my wife and I had prayed about. I’m really glad that that choice was never forced on me.