By / Jun 8

“At around twelve weeks, we’ll do a blood test to screen for any chromosomal abnormalities, and you’ll be able to find out the sex if you choose to do so.” This is now a routine statement, a version of which can be heard around the world in consultations between pregnant women and their obstetric care providers. When a woman goes to the clinic for an early pregnancy check-up, she will most likely be offered noninvasive prenatal testing (NIPT), sometimes called cell-free DNA (cfDNA) screening. 

For many women, the opportunity to find out the sex of their preborn child earlier than the ultrasound anatomy scan is reason enough to have the screening. But what exactly does NIPT screen for? And why are some ethicists concerned about it?

What does NIPT do? 

Noninvasive prenatal testing (NIPT) analyzes DNA in a pregnant woman’s blood to screen for chromosomal disorders caused by the presence of an extra or missing copy of a chromosome. NIPT primarily looks for Down syndrome (trisomy 21), trisomy 18, trisomy 13, and extra or missing copies of the X and Y chromosomes. The testing is considered noninvasive because the blood is drawn only from the pregnant woman, unlike diagnostic testing such as amniocentesis, which involves inserting a needle into the womb to collect a sample of amniotic fluid, a procedure which carries a risk of miscarriage. 

NIPT can give both false positives and false negatives, and one study revealed a 10% rate of false positivity. Because it is a screening test, any positive result requires invasive diagnostic testing like amniocentesis to confirm the result. 

While NIPT is a relatively new testing method, it is being used at rapidly increasing rates. While it was previously covered only for those of advanced maternal age, more insurance companies are now covering it for all women. But there are some concerns.

Ethical concerns 

The ethical problems that arise from this kind of screening are extensive. Some ethicists are concerned that the growing prevalence of NIPT will lead to an increase in abortions following a screening that reveals an increased risk for Down syndrome or other chromosomal abnormalities. A study published in 2020 found that the growth of prenatal screening in Europe has reduced the number of babies being born per year with Down syndrome by an average of 54%, and that study was conducted before many European countries offered NIPT. The screening and abortion rates in Iceland have led to only one or two babies with Down syndrome being born each year on average (the population of Iceland is 330,000).  

A reduction in the number of people born with these conditions could directly affect the care and research available for those who are living with such conditions, as well as the possibility for increased discrimination. NIPT could also lead to sex-selective abortions, since the sex can be revealed within the first trimester when abortion is more readily available.1Tom Shakespeare et al., “Non-invasive prenatal testing: ethical issues,” Nuffield Council on Bioethics, March 2017, https://www.nuffieldbioethics.org/wp-content/uploads/NIPT-ethical-issues-full-report.pdf.

Some ethicists are also concerned that NIPT will eventually be used to screen for more conditions, including adult onset conditions or carrier status, meaning it could give some indication of issues that might affect the preborn child later in life or be passed on to the child’s future children. And, unfortunately, there is the potential that a mother would be pressured to have an abortion because of a possible condition that could affect the baby decades after he or she is born.

Preparedness or worry 

For many parents, NIPT offers the opportunity to be prepared mentally and emotionally for any chromosomal disorder their baby may have. While the screening cannot give them the certainty of a diagnosis, it can give an indication of probability. For some, this probability is helpful in considering the possible needs of their child and even the possibility that he or she will not live long after birth. Knowing a child has an increased likelihood of a chromosomal disorder allows community to come around and support a mother or couple through the pregnancy.

But for some parents, false positives can lead to increased worry, which could have a negative effect on the pregnancy. When a test result comes back with an increased probability of a chromosomal disorder, the couple is normally referred for genetic counseling. Unfortunately, this counseling can increase worry or come with pressure to abort the child. 

To test or not to test

While researching NIPT, I heard from many women who chose to have the test, but made it clear to their providers that it would not change anything about their pregnancies. For others, given the concerns and the possibility of false positivity, they chose not to have the screening. For them, the potential for increased worry was not worth the risk. 

Dr. Kenneth Singleton, an OB-GYN in Little Rock, Arkansas, shared how he counsels patients who are deciding whether to have NIPT. He advises them that one of the reasons the tests exist is to terminate pregnancies if there is a problem. He goes on:

Counseled correctly, our patients hear the “sanctity of life” bent, and the ones that choose to test are foremost excited about early gender discovery and then are wanting to be mentally prepared if there are other genetic issues that are discovered. I tend to share about my cousin with Down syndrome and also about my granddaughter Sage with trisomy 13. I know patients are getting pushed into testing and then counseled on termination. That is very sad. I have turned that around and use the test as a way to prepare patients mentally, emotionally, and spiritually for the life that God is giving them.

A role we all play

We may not be the ones making decisions about prenatal testing, but as a community of believers, we all have a role to play. As followers of Christ, we recognize the inherent value of every person, even the tiniest preborn baby. At times, prenatal screening will reveal health issues ranging from minor to life-threatening. Whether these issues are revealed early in pregnancy or after birth, we have the opportunity to support families caring for children with a variety of needs. In some cases, our willingness to do so could be the difference for a mother deciding whether to choose life after a difficult diagnosis. 

Receiving this hard news can lead to grief and a drastic change in expectations, even for families committed to life. Practical care like meals, a listening ear, and childcare for other children in the family are simple ways to show we are committed to walking with them on what may be a difficult path. Reaching out via text to ask for specific ways we can pray is a simple but powerful way to show someone they are not forgotten. 

Deciding whether to have DNA screening may be complicated, but deciding to support and care for expectant mothers and families around us is simple. We follow the example of our Savior when we welcome children into our lives, seeing their value and loving them sacrificially.

  • 1
    Tom Shakespeare et al., “Non-invasive prenatal testing: ethical issues,” Nuffield Council on Bioethics, March 2017, https://www.nuffieldbioethics.org/wp-content/uploads/NIPT-ethical-issues-full-report.pdf.
By / Mar 22

In October 2019, my family’s life changed forever. My wife was diagnosed with Hodgkin’s lymphoma, which is a cancer of the lymphatic system. We were both in shock when we heard the news because she was so young and healthy. Recently, after two rounds of chemotherapy, with a recurrence in between, she underwent a stem cell transplant and high-dose chemotherapy that we pray God will use to heal her completely. We have been in and out of hospitals for a few years now and were quarantining even before the COVID-19 pandemic hit our shores. Needless to say, it has been a difficult few years, but throughout the process we have been reminded of God’s mercy and of the amazing power of medical technologies.

Medicine as a technological development 

When our society talks about technology, we often revert to visions of the latest gadgets, smartphones, robots, and even artificial intelligence. But we often fail to comprehend that medicine is a form of technological development. My family has seen the power of medical technology firsthand and how it can be harnessed for good in our society. We are thankful for the countless doctors, nurses, and administrators who have served our family so far and for the life-saving innovations and treatments that have been pioneered in cancer research over the last century.

In the early 1900s, a German chemist named Paul Ehrlich set out to develop drugs that could be used to combat infectious diseases. He coined the term “chemotherapy,” even though he was not overly optimistic about the use of these drugs to fight cancer. Yet in the last 50 years, we have seen astronomical growth in the use of chemotherapy and other treatments to combat the devastating effects of cancer, including my wife’s. But for all of the good of these innovations, there has been a flip side, just as there is with any technological progress in society.

More than a technical problem

As the french philosopher of technology Jacques Ellul writes in his well-known work, The Technological Society, the surge in technique over the last century has been a force that has radically altered every segment of our society and shaped our social fabric toward a pursuit of ever greater efficiency and mechanization in every area of life, including medicine. As a result, one of the tendencies that we must be aware of in our technological society is the way that these tools can cause us to gloss over the fullness of human life and focus on other people as merely technical problems to be solved or bodies to be fixed.

This same technical force is picked up by Jeffrey P. Bishop in his work The Anticipatory Corpse, where he speaks of the trajectory of medical innovations in the 1950s-1960s toward defining life not in a meaningful sense but by the measure of physiological function (119). For Bishop, this meant that “the power of technology renders the practitioner forgetful of meaning and purpose” because we begin to define life solely on physiological traits and as a technical problem, rather than as a holistic account of the entire person—body, mind, and spirit.

If we reduce humanity down to physiological functions, we not only overly simplify our existence but also dehumanize each other and ultimately ourselves in the process. We are not simply bodies to be fixed but embodied souls created with a specific telos, or end, by God’s design. As bioethicist and theologian Brent Waters has written in his excellent volume This Mortal Flesh, our finitude and the devastating effects of sicknesses and diseases—like my wife’s cancer—are to remind us that “our lives are not our own; they belong to God. Life is not a product we produce or own, but a gift that is entrusted to us, and we are to care for and use this gift in accordance with God’s expectations and commands” (143).

As we begin this next season of our journey with cancer, I would ask that you pray for my wife and family. We long for healing and restoration, but regardless of what comes, we also pray that God would use this season to remind us that our lives are not our own and that we were bought with a price by Christ, who will one day redeem these fallen bodies and resurrect us to newness of life with himself for eternity (1 Cor. 6:20). As Christians, we must reject the mechanized view of human life that is so prevalent in this age of technology and embrace the wholeness of humanity as embodied souls, created for the purpose of loving God and loving others as ourselves (Matt. 22:37-39).

This article originally appeared in the WeeklyTech newsletter. Sign up here to receive more resources on technology and ethics.

By / Jul 9

In the midst of a pandemic, medical providers around the world need believers to approach the throne of grace on their behalf. Below are just a few of the ways you can pray for us.  

1. Wisdom

Many of us are in the position of having to make significant, timely decisions based on incomplete and rapidly evolving data. For medical professionals who are trained to be evidence-based, this can be a nerve-wracking situation leading to uncertainty and fear. Please pray that we would be wise in how we respond to the evidence at hand, and discerning as we move forward to implement best practices for our patients and our communities. 

2. Clarity

With so many incoming streams of information and with the need to adapt to new evidence as it arises, there is a very real danger that muddled and conflicting messages may confuse those we are trying to inform. Pray that medical providers would seek to be clear, balanced, and unified in the guidance we provide.

3. Compassion

In high-stress situations, compassion and empathy are often the first casualties. Emotional distancing and task-oriented interactions are common coping mechanisms for those of us who are consistently close to grief, distress, and crisis. They are also deadly to the soul. Pray that God would give grace to medical providers; pray that we would extend Christlike compassion as we care for hurting souls, not just broken bodies.  

Pray that God would give grace to medical providers; pray that we
would extend Christlike compassion as we care for hurting souls, not just broken bodies.  

4. Stamina

We are tired. Even if we are not currently in an epicenter, this is exhausting work—physically, mentally, and emotionally. Many of us are working extended hours with skeleton crews. This pace is difficult to maintain, yet any semblance of a finish line is still a ways off on the horizon. Please beg the Lord to grant healthcare workers uncanny stamina for the days ahead. Pray that he would help us find new rhythms of work and rest that will sustain us and prevent burnout.

5. Family

As we press further into this important work, many of us entertain fearful thoughts about how it will affect our family, friends, and loved ones. Most acutely, we are worried about infecting them. For those of us who continue to encounter significant exposures, many have proactively self-quarantined for their protection. Even if we’re not physically isolating ourselves from our families, the stress of the workload itself is pulling many of us away from them. This separation just adds another level of emotional turmoil to an already difficult situation. Pray for our families.

6. Dependence

If it is not already abundantly clear, none of us can do this on our own. As determined and resilient as healthcare workers are, if we think we’ll be able to roll our sleeves up and muscle through this on our own we are sorely mistaken. We need you. We need your support, your encouragement, and your responsible choices. Pray that we can depend on you. More importantly, we need God. We need his grace to sustain us and to enable us to share his love as we tend to his people. Pray that we would depend on God.

Thank you for carrying us in prayer as we seek to care for patients with an ability and insight that only he can provide. May he bring this pandemic to a quick end and draw many to himself.

By / Jun 25

The COVID-19 pandemic has forced many hospitals and medical facilities to change visitation policies in order to ensure the health and safety of staff and patients. But in so doing, the needs of one group of people have sometimes been overlooked—adults with disabilities who rely on a care partner or family member to assist them in communicating their needs.  

A complaint filed last month with the United States Office of Civil Rights (OCR) in the Department of Health and Human Services (HHS) alleges that is exactly what happened in Connecticut when the state issued guidance on a “no visitor” policy for hospitals. 

Several families came forward for the report to explain how the “no visitor” policy affected their loved ones. One mother of a son with cerebral palsy relayed that she was only allowed to speak to a doctor via an iPad while her son was wheeled away screaming before emergency surgery.  When he awoke, confused and afraid, with no one to explain to him what was going on, the hospital physically and pharmaceutically restrained him for days. His mother said he had never needed such drastic interventions in previous surgeries when she had been there to explain what was happening to him. 

The complaint also alleged that a private hospital in Connecticut “unlawfully failed to provide a reasonable modification to the hospital’s no-visitor policy” for a 73-year-old patient with short-term memory loss who is mostly nonverbal. The patient’s family has developed a sophisticated system to communicate with her but was not allowed to be with her when she needed them most. The woman was ultimately tied down and sedated because she became agitated when the hospital staff could not communicate with her. 

The complaint with OCR was filed by several disability rights organizations alleging that an executive order by the governor and a private hospital violated the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, and Section 1557 of the Affordable Care Act. The complaint explained “that without support persons, specific patients with disabilities in Connecticut facilities were being denied equal access to medical treatment, effective communication, the ability to make informed decisions and provide consent, and that they were being unnecessarily subjected to physical and pharmacological restraints.”

Thankfully this week OCR reached an Early Case Resolution (ECR) with the State of Connecticut and the private hospital ensuring that “people with disabilities are not denied reasonable access to needed support persons.” In resolution, the governor of Connecticut issued a new executive order allowing patients with disabilities to have a support person with them when they would experience “barriers to obtaining the care they require as well as inconvenience and distress” without that extra support. The executive order also outlines safety protocols to follow to ensure that support partners are properly screened for signs of COVID-19 and maintain safe practices at all times they are assisting the patient.  

The resolution out of Connecticut shows that it is possible to balance the need to protect health and safety during the COVID-19 crisis, while simultaneously respecting the rights and dignity of persons with disabilities and their families.  

The gospel tells us that every human being—no matter his or her abilities—has inherent God-given dignity. Each person is imprinted with the imago Dei and reflects the glory of our Creator God. 

Part of upholding the dignity of our brothers and sisters with disabilities is ensuring that they are able to understand to the best of their ability what is being done to them and for them and empowering them to help make those decisions. The ADA and other laws and regulations have been established to defend the dignity of those with disabilities and other special needs. Simple accommodations allow these individuals to have a voice and help when they find themselves in the vulnerable positions of being hospitalized or needing medical treatment. 

The HHS Office of Civil Rights has helped ensure that our brothers and sisters, neighbors and friends have the help and support they need during the global pandemic we all face. Their dignity is upheld, and it can serve as a reminder to all of us that we need one another during these anxious and uncertain times.

By / Apr 2

As the coronavirus pandemic rages across the world, Christians are on the front lines offering medical care to those in need. Jeff Pickering welcomes Edward Graham of Samaritan's Purse to the show talk about how their worldwide aid organization is mobilizing medical volunteers to join local hospitals and government authorities in Italy and New York City to respond to the pandemic.

This episode is sponsored by The Good Book Company, publisher of Where is God in a Coronavirus World? by John Lennox  

Guest Biography

Edward Graham is Assistant to the Vice President of Programs and Government Relations at Samaritan's Purse. He is the youngest son of Franklin and Jane Graham, and the grandson of Billy Graham. Edward graduated from the United States Military Academy where he went on to serve 16 years in the US Army. After multiple combat deployments within Special Operations and serving in various leadership positions, he felt called by the Lord to return home and serve in the ministry starting in the winter of 2018. Edward and Kristy have been married for 14 years, and have one daughter and three sons. They are raising their four children in the mountains of North Carolina.

Resources from the Conversation

By / Mar 30

Today is National Doctors’ Day, and in the midst of a pandemic, it’s a timely reminder to approach the throne of grace on behalf of medical providers around the world. Below are just a few of the ways you can pray for us.  

1. Wisdom: Many of us are in the position of having to make significant, timely decisions based on incomplete and rapidly evolving data. For medical professionals who are trained to be evidence-based, this can be a nerve-wracking situation leading to uncertainty and fear. Please pray that we would be wise in how we respond to the evidence at hand, and discerning as we move forward to implement best practices for our patients and our communities. 

2. Clarity: With so many incoming streams of information and with the need to adapt to new evidence as it arises, there is a very real danger that muddled and conflicting messages may confuse those we are trying to inform. Pray that medical providers would seek to be clear, balanced, and unified in the guidance we provide. 

3. Compassion: In high-stress situations, compassion and empathy are often the first casualties. Emotional distancing and task-oriented interactions are common coping mechanisms for those of us who are consistently close to grief, distress, and crisis. They are also deadly to the soul. Pray that God would give grace to medical providers; pray that we would extend Christlike compassion as we care for hurting souls, not just broken bodies.  

4. Stamina: We are tired. Even if we are not currently in an epicenter, this is exhausting work—physically, mentally, and emotionally. Many of us are working extended ours with skeleton crews. This pace is difficult to maintain, yet any semblance of a finish line is still a ways off on the horizon. Please beg the Lord to grant healthcare workers uncanny stamina for the days ahead. Pray that he would help us find new rhythms of work and rest that will sustain us and prevent burnout. 

Pray that God would give grace to medical providers; pray that we would extend Christlike compassion as we care for hurting souls, not just broken bodies.  

5. Family: As we press further into this important work, many of us entertain fearful thoughts about how it will affect our family, friends, and loved ones. Most acutely, we are worried about infecting them. For those of us who continue to encounter significant exposures, many have proactively self-quarantined for their protection. Even if we’re not physically isolating ourselves from our families, the stress of the workload itself is pulling many of us away from them. This separation just adds another level of emotional turmoil to an already difficult situation. Pray for our families.   

6. Dependence: If it is not already abundantly clear, none of us can do this on our own. As determined and resilient as healthcare workers are, if we think we’ll be able to roll our sleeves up and muscle through this on our own we are sorely mistaken. We need you. We need your support, your encouragement, and your responsible choices. Pray that we can depend on you. More importantly, we need God. We need his grace to sustain us and to enable us to share his love as we tend to his people. Pray that we would depend on God.  

Thank you for carrying us in prayer as we seek to care for patients with an ability and insight that only he can provide. May he bring this pandemic to a quick end and draw many to himself.  

By / Mar 20

In this episode, Josh, Lindsay, and Brent talk about coronavirus and quarantines, the latest in the Democratic primary, and some good news to end your week. Lindsay also gives a rundown of this week’s ERLC content including a piece from Joe Carter on reading the news with discernment, Dane Hays on talking to your kids about COVID-19, and the ERLC’s reading recommendations during social distancing. Also in this episode, the hosts are joined by Dr. Scott James, an infectious disease specialist, for a conversation about coronavirus and his new children’s book.

About Dr. 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, Ala, where he works as a pediatric physician. He is the author of two family worship books (The Expected One: Anticipating All of Jesus in the AdventMission Accomplished: A Two-Week Family Easter Devotional), as well as illustrated children's books, including The Littlest Watchman (The Good Book Company, 2017) and his latest book, Where Is Wisdom? (B&H).

ERLC Content

Culture

  • This week marked the first day of Spring!

Politics

Coronavirus

  • Widespread alarm and misinformation, we recommend you follow live updates on COVID-19 from The Washington Post
  • Pulling out all the stops to stem the tide, churches, schools, and major events across the nation are delayed, cancelled, or moving online.
  • CoronaChaos leads to CoronaQuiet across the globe: France, Spain, Germany join Italy on lockdown; Sources expect UK to join this weekend.
  • San Francisco locking down 
  • Widespread testing finally here . . . with issues.
  • Big companies hiring right now: 
    • Amazon
      • “We are opening 100,000 new full and part-time positions across the U.S. in our fulfillment centers and delivery network to meet the surge in demand from people relying on Amazon’s service during this stressful time, particularly those most vulnerable to being out in public. 
    • Kroger
      • “Kroger plans to hire 10,000 additional workers in the coming weeks to help stock and clean stores. 
      • “Applicants can visit jobs.kroger.com to apply. 
    • Wal-Mart
      • “Walmart (NYSE:WMT) plans to hire 500 more truck drivers for its private fleet, primarily on the East and West Coasts, to help meet the increased demand from its growing e-commerce business.
  • Ford and General Motors are looking into making medical equipment including ventilators that could help combat the novel coronavirus outbreak.
  • Economic projections don’t look so good; Fed moves
    • Economic forecasts look really dire.
  • Bailouts likely coming for industries
    • Phase II – passed on Wednesday
    • Phase III coming"Phase 3" deal that would pump an additional $1 trillion into the economy.
  • Movies go online instead of theater
  • The SEC cancelled all spring sports(!)

On the Lighter Side

 Lunchroom

  • Brent: A Hidden Life (Movie)
    • The film depicts the life of Franz Jägerstätter, an Austrian farmer and devout Catholic who refused to fight for the Nazis in World War II. The film's title was taken from George Eliot's book Middlemarch.
  • Lindsay: 
  • Josh:

 ERLC Inbox

  • Q: How worried should I be about extra screen time for my kids while we are spending more time indoors during isolation?

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By / Apr 30

The ERLC affirms that every human life is endowed by God with immeasurable dignity. Scripture illustrates the truth that every man, woman, and child is created in the image of God. We believe His knowledge of each person’s life precedes the creative act of conception.

Abortion is not healthcare. If human dignity is given to each person when created in the womb, then abortion is not only an assault on the image of God but also irreparable harm on a vulnerable life. We believe abortion denies precious human lives both personhood and protection, and therefore cannot be considered as healthcare.

The federal government should not use taxpayer dollars to pay for abortions. Americans are divided over the issue of abortion, and many strongly object to their taxpayer dollars being used for what they believe to be a great moral wrong. The Medicare for All Act of 2019 would remove critical Hyde Amendment protections. For over forty years, the Hyde Amendment passed each Congress and prevented taxpayer dollars from funding abortions.

Medical professionals with conscience objections to performing abortions must be protected. The Medicare for All Act of 2019 would eliminate these foundational Constitutional protections. If a medical professional refused to perform an abortion, their employment could be at risk with the only medical provider left in the country—the state.

The Medicare for All Act of 2019 would also codify sexual orientation and gender identity in federal law. This legislation would require medical professionals to provide puberty blockers, transitioning hormones, and gender reassignment surgery even against their best medical judgement. This is harmful and unethical, especially in pediatric care.

The ERLC urges Congress not to adopt the Medicare for All Act of 2019. The legislation presents a grave threat to decades of conscience protection laws that ensured equal protection for millions of Americans, especially the most vulnerable. As ERLC president Russell Moore often notes, “A government that can pave over the consciences of some can steamroll over dissent everywhere.”

By / May 3

The case of Alfie Evans, a terminally ill British infant who died several days after being taken off ventilation, has raised troubling concerns about the state’s authority to intervene in parental rights. But it also has caused some to wonder what they would have done if they were Alfie’s parents.

We often aren’t prepared for the questions that arise in such situations. For example, when should life-sustaining treatment be withdrawn? Do Christians have an obligation to delay death as long as humanly possible? What should we do if we disagree with medical providers about continued treatment of a dying relative?

Such questions are complicated, and the answers often depend on the individual context. But there are certain principles and considerations that can help guide our decisions about withdrawing life-sustaining medical intervention.

Withdrawal is allowable when the fatal condition is irreversible

A primary consideration when determining whether treatment should be withheld or withdrawn is whether the fatal condition is reversible or irreversible.

When a person suffers a potentially fatal threat to their health (e.g., disease, injury), their impaired condition may be either reversible or irreversible. If the condition is reversible, appropriate medical intervention and treatment exists that may possibly restore a person to a state where they are no longer in imminent danger of dying. Medical intervention that restores health and reverses the dying process is known as curative care and should be the first option.

However, if no effective intervention or treatment is possible, the condition is irreversible (i.e., terminal) and the impaired condition will lead to death. This is what is meant when we say that a person is dying, or has entered the dying process.

We can’t always know whether a person’s condition is reversible or irreversible. In most cases, the best we can do is rely on expertise that is based on the collective experience of the medical community. But when the probability is that the condition is irreversible, we are under no moral obligation to continue life-sustaining interventions we believe will be futile.

Withdrawal of treatment should not cause or hasten death

Whether death is imminent or non-imminent, our first consideration for dealing with people in the dying process is that we take no action with the intention of hastening the end of their life. As bioethicist Gilbert Meilander explains, “‘Allowing to die’ is permitted; killing is not. Within these limits lies the sphere of our freedom.”

Withdrawal of treatment is not the same as withdrawal of care

If curative care is not possible because the condition is fatal and irreversible, we still have a duty to provide one of three other types of care:

Symptom care – In some situations, a person may be in the non-imminent dying process. They may suffer symptoms such as shortness of breath that requires medical intervention, such as artificial respiration. Out of respect for life and to prevent unnecessary suffering, all necessary symptom care—a form of palliative care—should be provided until death become imminent.

Comfort care – People in the dying process should not suffer needlessly. When death becomes imminent, palliative care should shift from symptom care to comfort care. The main distinction is that comfort care focuses on providing direct relief from the stress and pain of dying. Comfort care is provided to make the last state of dying as comfortable as possible.

Respect care – The dying process often leads to deterioration of the body. Because a person is often unable to care for their own bodies, they may feel a loss of control. Our duty is to provide such care for people unable to take care of themselves in a way that restores their sense of dignity. We should, for example, ensure that their bodies are adequately cleaned and that they afforded a level of decorum and privacy from unnecessary exposure. No matter what stage a person is in the dying—or living—process, respect care should be provided to all who are in need.

Withdrawal of nutrition or hydration should be a last resort

If food and liquids can be administered through oral means and are capable of providing either comfort or nourishment, we have a moral obligation to provide them as a form of care (Matthew 25:31-45). To actively withhold nutrition or hydration to hasten death is evil. However, there may be situations where artificial nutrition and hydration can cause discomfort, pain, or complications and the most loving form of comfort care would entail withholding nutrition or hydration.

Disagreement should be respectful

Health care workers are under no moral obligation to provide treatments they believe are likely to be futile, harmful, or wholly ineffective. While we may disagree with their judgment, the principle of charity requires that—unless we have evidence to the contrary—we assume their refusal to continue treatment is rooted in concern for the patient. As Christians, we must be careful about unfairly maligning health care providers over disagreements about the best methods of treatment.

That does not mean, of course, that we must always submit to a specific expert opinion. Doctors and nurses are fallible, and there is not always a consensus about whether treatments are effective. If another group of health care providers is willing and able to take on the case, transfer of care is a legitimate option.

Parental authority should be respected, but it is not absolute

In a recent article on the Alfie Evans case, Andrew Walker and I argued that the state much respect the rights of parents:

Parental authority over children is explicit in Scripture (Deut. 11:19; Eph. 6:4). The parent-child relationship is one of divine origin and design, accomplished through the one-flesh union of a mother and father. Scripturally speaking, parents are tasked with raising children. For this reason, the mother and father of a child ought to retain primary authority over the child. This is grounded on the basis of an innate link between parent and child—whether biological or adoptive—and right of the parent over the child. This is both commonsensical and appeals intuitively to our sense of justice.

Although children are a gift to parents from God, all children ultimately belong to God. Parental authority is a sub-authority, ordained and limited by what God allows. Just as parents do not have a the authority to abuse or neglect their child, they do not have the authority to hasten their untimely death.

While parents should be given wide latitude in making medical decisions for the child, healthcare workers have an obligation to oppose parental decisions that may significantly harm their children.  

All healing comes from God

Whether God works within the natural laws he has established for health or provides miraculous intervention, we should recognize that all healing comes from God.

“Sometimes it is clear that scientific principles are used to facilitate that healing; sometimes the connection with known science is not so clear,” says the Christian Medical and Dental Association. “We need to give God the credit at all levels of healing, whether we understand the science behind it or not.”

We must also, however, trust God has a purpose for withholding healing and remember that physical death is the expected outcome of human life (Hebrews 9:27). As the Apostle Paul says, “For the wages of sin is death, but the free gift of God is eternal life in Christ Jesus our Lord” (Romans 6:23).

Our love ones have no reason to fear either death or the eternal consequences of their sin, though, when they believe in Jesus (John 3:16). That is why the most important step an individual can take when preparing their loved one for death is to ensure they know Jesus as their Lord and Savior.

By / Aug 22

Pharmacists in Washington state must now provide abortion-causing drugs to customers even if it violates their consciences to do so. After a legal battle that went all the way to the Supreme Court, the state’s requirement that all pharmacists must make Ella and Plan B available is in full force. As a result, any pharmacists whose consciences will not allow them to participate in abortion by providing these drugs will not be able to lawfully practice their professions in Washington state.

The state of Washington has decided that its interest in making these abortion drugs available is a higher priority than the consciences of some of its citizens. The state’s imposition of its requirement on the Stormans family illustrates the extremes to which it has decided to go in order to enforce its abortion agenda. The family has been in the pharmacy profession for more than 60 years. Until the state decided universal access to abortion-causing drugs was its priority, the family routinely, and willingly, referred customers who sought these drugs to one of more than 30 other pharmacies within a five mile radius of their business. During this time, no one, not one person, was ever denied access to these drugs, and the Stormans continued to fulfill their calling to serve their community with clear consciences.

The state no longer considers this successful compromise to be good enough, despite the fact that this referral process is even approved by the American Pharmacists Association. Under the governor’s direction, the Washington State Pharmacy Commission adopted a new regulation in 2005 that required every pharmacist and pharmacy in the state to sell Ella and Plan B drugs, regardless of their religious and conscience claims. No other impediment was targeted. Pharmacies could still refer customers to other stores for a wide range of other business, economic, and convenience reasons. They just couldn’t claim a conscience objection.

The place of the greater burden is clear. Those seeking these drugs can easily find another pharmacy, but the faithful cannot find another conscience. Washington state should acknowledge that they are crushing people of faith in order to solve a problem that doesn’t exist.

The state’s total lack of concern for conscience in this matter is distressing. Scripture describes the human conscience as an independent, inner voice that acts as a counselor and judge to instruct us to act according to God’s moral law (Rom. 2:12-16). It is God’s gift to help us to discern right from wrong and to choose to do right. As we all have experienced, its voice of condemnation or commendation is inescapable. Those whose conscience has been shaped by God’s truth understand that they must answer to God Himself if they act contrary to what His word teaches (James 4:17). Unless a person’s actions are clearly contrary to God’s revealed moral law, no external force or authority should require that person to violate the guidance of his or her conscience. It is, quite simply, intended by God to be inviolable.  

The state of Washington has clearly chosen to violate this space, however. It has made access to abortion not only a universal right, but the provision of access a universal requirement. By doing so, it has set itself up as a higher authority than God himself. What’s a person of conscience to do when government cannot discern between right and wrong and dictates that he or she must engage in what is wrong? The first Christian disciples answered that question when they declared, “We must obey God rather than men” (Acts 5:29). The Stormans family and many other committed Christian pharmacists in Washington state are now being forced into the position of either violating the law or giving up their calling as pharmacists.

It doesn’t have to come to this, however. There is a solution. It is the Conscience Protection Act. This bill prevents the federal government and state and local governments that receive federal financial assistance for health-related activities from penalizing or discriminating against a health care provider based on the provider's refusal to be involved in, or provide coverage for, abortion. The bill doesn’t deny access to the abortion drugs in question to anyone who wants them. It simply prevents government from punishing people whose consciences will not allow them to provide them. It will protect the consciences of the Stormans and other people of faith from the kind of heavy-handed, ideological tyranny being waged against them in Washington state right now.

This bill is worthy of our support. It has already been passed in the House of Representatives, by an overwhelming vote of 245-182. It must still be passed by the Senate and signed into law by the president. This may seem like a daunting task, but we must try. We can begin by praying that God will intervene on behalf of His people. With God involved, what at first seems unlikely becomes very possible. In addition, we can contact our senators and insist that they pass the Conscience Protection Act this year.

The Stormans family and thousands of other faithful Christians are depending on us. Their very ability to fulfill their calling from God is at risk. In coming to their aid, we will find ourselves working in defense of God’s amazing gift to all humanity—the inviolable human conscience.