Fighting drug resistance to the glory of God

June 20, 2016

Midway through the last century, a prominent scientist named F.M. Burnet stated: “If one looks around the medical scene in North America or Australia, the most important current change he sees is the rapidly diminishing importance of infectious diseases. . . . With full use of the knowledge we already possess, the effective control of every important infectious disease . . . is possible.”

On the contrary, the wholesale control of infectious diseases—once presumed to be just around the corner—has yet to materialize. To be sure, remarkable progress has been made in our understanding, prevention and management of infections in the years since Dr. Burnet’s unrealized prediction. Advances in sanitation, hygiene, nutrition, diagnostic capabilities, antimicrobial therapies and immunization programs (to name but a few) have reshaped the world we live in and saved countless lives. But the assumption that civilization will one day marshal these medical resources to once-and-for-all regain an Edenic dominion over the whole realm of pathogenic microbes appears to be more hubris than anything else. Even as medical advancements are made and old foes are put in check, new challenges continue to arise.

Take for instance the concerning trend of antibiotic resistance[1]. The advent of affordable and effective antibiotics during the previous century was a major boon and understandably led to a high confidence in the medical community. But almost as soon as widespread use of these wonderdrugs began, reports of infections caused by resistant bacteria began to emerge. The incidence and clinical significance of antibiotic resistance have risen sharply ever since.

The Centers for Disease Control and Prevention currently estimates that two million people per year in the United States have serious illnesses due to drug-resistant bacteria, with nearly 23,000 deaths annually. Global surveillance has shown a steady trend of emerging antibiotic resistance, with new types of resistance to last-resort drugs appearing and spreading predictably. A recent report of a patient in Pennsylvania with a bacterial infection harboring a specific type of resistance not previously seen in the United States—the presence of the mcr-1 gene in E. coli, which causes it to be resistant to a last-resort antibiotic called colistin—has raised further concern. Many media outlets erroneously reported that the patient’s infection was resistant to all known antibiotics, but the difficult reality remains that the discovery of this new resistance mechanism (the last puzzle piece, so to speak) means that such pan-resistant infections are right around the corner.

It’s important to understand that these ever-encroaching public health threats have not come out of left field. This is the trajectory we have been on for quite some time. The emergence of resistance is a simple matter of natural adaptation for any bacteria exposed to the selective pressure of antibiotics. Even as an antibiotic is mowing down infectious pathogens (along with a host of innocent bystanders), small populations of bacteria seek to survive and adapt. If someone were trying to kill you, you’d try to squirm out of it too. In a sense, this is all that antibiotic resistance is—bacteria figuring out how to dodge or block the bullets being sent their way.

But just because it’s a natural process doesn’t mean we’re not partly responsible for the escalating problem. Inappropriate use of antibiotics fuels the engine that drives resistance and increases the number of difficult-to-treat infections. Common examples of inappropriate antibiotic use include taking antibiotics when they are not indicated (e.g., when you have a viral illness), treating bacterial infections with antibiotics that have an unnecessarily broad spectrum of activity (using a shotgun approach when you need the sharpshooter), and the overuse of antibiotics in food-producing animals.

Healthcare providers often talk about judicious use of antibiotics, though we are admittedly better at talking about it than practicing it. Even so, an encouraging emphasis has been placed on antibiotic stewardship, which is a commitment to use antibiotics appropriately and responsibly. In addition to getting healthcare providers committed to this, good stewardship also involves educating the community so that their expectations are well informed and they’re not tempted to pressure providers into bad prescribing practices.

The concept of stewardship brings us back to Eden. While we have no cause to think we can usher our world back to a paradisiacal state free from infectious diseases, neither should we adopt a slash-and-burn mentality. As God has intended from the beginning, we are called to be good stewards of the resources he provides. He put us here and told us to care for his creation, to toil and tend it, to thrive and flourish with it. If we do not live up to this calling, there are real consequences we must deal with. Most of us can see the sense in this when it comes to environmental resources, such as a rainforest, but it applies to his gifts of common grace as well. Inasmuch as it plays a role in helping human society thrive, medicine should be seen as a gift from God, a common grace which at times can offer a temporal restraint on sickness, suffering, and even death. Appropriate and responsible use of the medical resources God has put within our reach is a matter of good stewardship. If we abuse these gifts, we threaten our own well-being.

If we think of ourselves as conquerors of God’s creation rather than stewards of it, we will tend toward irresponsible and overreaching use of the good gifts he provides. Sometimes that means felling a rainforest, thinking we can just grow more. Sometimes it means using antibiotics injudiciously, thinking we’re in control of our infectious destiny. Hubris such as this has consequences. In this particular case, I’m finding the consequences increasingly difficult to treat with my dwindling repertoire of effective antibiotics.


  1. ^ In this article, I use the word ‘antibiotic’ to mean drugs intended to target bacterial pathogens (as opposed to other categories of anti-infective drugs such as antiviral, antifungal, and antiparasitic)

Scott James

Scott James serves as an elder at The Church at Brook Hills. He and his wife, Jaime, have four children and live in Birmingham, Alabama, where he works as a pediatric physician. He is the author of The Expected One: Anticipating All of Jesus in the Advent, and Mission Accomplished: A Two-Week Family … Read More

Article 12: The Future of AI

We affirm that AI will continue to be developed in ways that we cannot currently imagine or understand, including AI that will far surpass many human abilities. God alone has the power to create life, and no future advancements in AI will usurp Him as the Creator of life. The church has a unique role in proclaiming human dignity for all and calling for the humane use of AI in all aspects of society.

We deny that AI will make us more or less human, or that AI will ever obtain a coequal level of worth, dignity, or value to image-bearers. Future advancements in AI will not ultimately fulfill our longings for a perfect world. While we are not able to comprehend or know the future, we do not fear what is to come because we know that God is omniscient and that nothing we create will be able to thwart His redemptive plan for creation or to supplant humanity as His image-bearers.

Genesis 1; Isaiah 42:8; Romans 1:20-21; 5:2; Ephesians 1:4-6; 2 Timothy 1:7-9; Revelation 5:9-10

Article 11: Public Policy

We affirm that the fundamental purposes of government are to protect human beings from harm, punish those who do evil, uphold civil liberties, and to commend those who do good. The public has a role in shaping and crafting policies concerning the use of AI in society, and these decisions should not be left to those who develop these technologies or to governments to set norms.

We deny that AI should be used by governments, corporations, or any entity to infringe upon God-given human rights. AI, even in a highly advanced state, should never be delegated the governing authority that has been granted by an all-sovereign God to human beings alone. 

Romans 13:1-7; Acts 10:35; 1 Peter 2:13-14

Article 10: War

We affirm that the use of AI in warfare should be governed by love of neighbor and the principles of just war. The use of AI may mitigate the loss of human life, provide greater protection of non-combatants, and inform better policymaking. Any lethal action conducted or substantially enabled by AI must employ 5 human oversight or review. All defense-related AI applications, such as underlying data and decision-making processes, must be subject to continual review by legitimate authorities. When these systems are deployed, human agents bear full moral responsibility for any actions taken by the system.

We deny that human agency or moral culpability in war can be delegated to AI. No nation or group has the right to use AI to carry out genocide, terrorism, torture, or other war crimes.

Genesis 4:10; Isaiah 1:16-17; Psalm 37:28; Matthew 5:44; 22:37-39; Romans 13:4

Article 9: Security

We affirm that AI has legitimate applications in policing, intelligence, surveillance, investigation, and other uses supporting the government’s responsibility to respect human rights, to protect and preserve human life, and to pursue justice in a flourishing society.

We deny that AI should be employed for safety and security applications in ways that seek to dehumanize, depersonalize, or harm our fellow human beings. We condemn the use of AI to suppress free expression or other basic human rights granted by God to all human beings.

Romans 13:1-7; 1 Peter 2:13-14

Article 8: Data & Privacy

We affirm that privacy and personal property are intertwined individual rights and choices that should not be violated by governments, corporations, nation-states, and other groups, even in the pursuit of the common good. While God knows all things, it is neither wise nor obligatory to have every detail of one’s life open to society.

We deny the manipulative and coercive uses of data and AI in ways that are inconsistent with the love of God and love of neighbor. Data collection practices should conform to ethical guidelines that uphold the dignity of all people. We further deny that consent, even informed consent, although requisite, is the only necessary ethical standard for the collection, manipulation, or exploitation of personal data—individually or in the aggregate. AI should not be employed in ways that distort truth through the use of generative applications. Data should not be mishandled, misused, or abused for sinful purposes to reinforce bias, strengthen the powerful, or demean the weak.

Exodus 20:15, Psalm 147:5; Isaiah 40:13-14; Matthew 10:16 Galatians 6:2; Hebrews 4:12-13; 1 John 1:7 

Article 7: Work

We affirm that work is part of God’s plan for human beings participating in the cultivation and stewardship of creation. The divine pattern is one of labor and rest in healthy proportion to each other. Our view of work should not be confined to commercial activity; it must also include the many ways that human beings serve each other through their efforts. AI can be used in ways that aid our work or allow us to make fuller use of our gifts. The church has a Spirit-empowered responsibility to help care for those who lose jobs and to encourage individuals, communities, employers, and governments to find ways to invest in the development of human beings and continue making vocational contributions to our lives together.

We deny that human worth and dignity is reducible to an individual’s economic contributions to society alone. Humanity should not use AI and other technological innovations as a reason to move toward lives of pure leisure even if greater social wealth creates such possibilities.

Genesis 1:27; 2:5; 2:15; Isaiah 65:21-24; Romans 12:6-8; Ephesians 4:11-16

Article 6: Sexuality

We affirm the goodness of God’s design for human sexuality which prescribes the sexual union to be an exclusive relationship between a man and a woman in the lifelong covenant of marriage.

We deny that the pursuit of sexual pleasure is a justification for the development or use of AI, and we condemn the objectification of humans that results from employing AI for sexual purposes. AI should not intrude upon or substitute for the biblical expression of sexuality between a husband and wife according to God’s design for human marriage.

Genesis 1:26-29; 2:18-25; Matthew 5:27-30; 1 Thess 4:3-4

Article 5: Bias

We affirm that, as a tool created by humans, AI will be inherently subject to bias and that these biases must be accounted for, minimized, or removed through continual human oversight and discretion. AI should be designed and used in such ways that treat all human beings as having equal worth and dignity. AI should be utilized as a tool to identify and eliminate bias inherent in human decision-making.

We deny that AI should be designed or used in ways that violate the fundamental principle of human dignity for all people. Neither should AI be used in ways that reinforce or further any ideology or agenda, seeking to subjugate human autonomy under the power of the state.

Micah 6:8; John 13:34; Galatians 3:28-29; 5:13-14; Philippians 2:3-4; Romans 12:10

Article 4: Medicine

We affirm that AI-related advances in medical technologies are expressions of God’s common grace through and for people created in His image and that these advances will increase our capacity to provide enhanced medical diagnostics and therapeutic interventions as we seek to care for all people. These advances should be guided by basic principles of medical ethics, including beneficence, non-maleficence, autonomy, and justice, which are all consistent with the biblical principle of loving our neighbor.

We deny that death and disease—effects of the Fall—can ultimately be eradicated apart from Jesus Christ. Utilitarian applications regarding healthcare distribution should not override the dignity of human life. Fur- 3 thermore, we reject the materialist and consequentialist worldview that understands medical applications of AI as a means of improving, changing, or completing human beings.

Matthew 5:45; John 11:25-26; 1 Corinthians 15:55-57; Galatians 6:2; Philippians 2:4

Article 3: Relationship of AI & Humanity

We affirm the use of AI to inform and aid human reasoning and moral decision-making because it is a tool that excels at processing data and making determinations, which often mimics or exceeds human ability. While AI excels in data-based computation, technology is incapable of possessing the capacity for moral agency or responsibility.

We deny that humans can or should cede our moral accountability or responsibilities to any form of AI that will ever be created. Only humanity will be judged by God on the basis of our actions and that of the tools we create. While technology can be created with a moral use in view, it is not a moral agent. Humans alone bear the responsibility for moral decision making.

Romans 2:6-8; Galatians 5:19-21; 2 Peter 1:5-8; 1 John 2:1

Article 2: AI as Technology

We affirm that the development of AI is a demonstration of the unique creative abilities of human beings. When AI is employed in accordance with God’s moral will, it is an example of man’s obedience to the divine command to steward creation and to honor Him. We believe in innovation for the glory of God, the sake of human flourishing, and the love of neighbor. While we acknowledge the reality of the Fall and its consequences on human nature and human innovation, technology can be used in society to uphold human dignity. As a part of our God-given creative nature, human beings should develop and harness technology in ways that lead to greater flourishing and the alleviation of human suffering.

We deny that the use of AI is morally neutral. It is not worthy of man’s hope, worship, or love. Since the Lord Jesus alone can atone for sin and reconcile humanity to its Creator, technology such as AI cannot fulfill humanity’s ultimate needs. We further deny the goodness and benefit of any application of AI that devalues or degrades the dignity and worth of another human being. 

Genesis 2:25; Exodus 20:3; 31:1-11; Proverbs 16:4; Matthew 22:37-40; Romans 3:23

Article 1: Image of God

We affirm that God created each human being in His image with intrinsic and equal worth, dignity, and moral agency, distinct from all creation, and that humanity’s creativity is intended to reflect God’s creative pattern.

We deny that any part of creation, including any form of technology, should ever be used to usurp or subvert the dominion and stewardship which has been entrusted solely to humanity by God; nor should technology be assigned a level of human identity, worth, dignity, or moral agency.

Genesis 1:26-28; 5:1-2; Isaiah 43:6-7; Jeremiah 1:5; John 13:34; Colossians 1:16; 3:10; Ephesians 4:24