by Kenneth Vaux
Dr Vaux is professor of theology and ethics at the Institute of Religion, Baylor Medical School, Houston.
This article appeared in The Christian Century, January 30, 1985, pp. 103-104. Copyright by The Christian Century Foundation; used by permission. Current articles and subscription information can be found at www.christiancentury.org. This material was prepared for Religion Online by Ted and Winnie Brock.
Scientific-technological projects go on wildly, fueled only by their own momentum. Only a restored sense of spiritual destiny — and a moral vision derived from it — can now rescue us.
In both cases realism and even honesty were overshadowed by our desire for unbridled movement onward in a quest for success and publicity. Neither Baby Fae’s parents nor the public were adequately informed of the double-barreled danger of host-graft rejection and organ destruction from medication.
Neither Schroeder nor the public were adequately informed of the danger that blood coagulation on the artificial heart might cause stroke-producing clots, or of the danger from bleeding caused by the anticoagulation medication. We the public didn’t want to hear of these tragic side effects of our technological prowess. In both cases we confessed our faith in medical science, health professionals and institutions but at the same time, we betrayed a moral bewilderment grounded in spiritual impoverishment.
At the year’s end we witnessed a curiously parallel event in Bhopal, India. Here in an unprecedented technological tragedy we saw the disastrous effects of an industrial policy contemptuous of life, committed to technological production at any cost.
I think I am beginning to understand why we put ourselves in situations of moral ambiguity where we seek to do good but end up doing evil. We are Puritans gone wild. We pursue the Puritan vision of comprehending and utilizing the earth’s secrets and energies but have lost the Puritan corrective value of ecological justice. We are driven by the Puritan ambition to subdue the earth but have lost the redeeming virtue of stewardly respect. We serve the Puritan virtue of prolonging life but have lost the chastening value of providential death. In sum, we are animated by a desire to enhance life and build the earth, but we do not know why. Orwell’s technical and political nightmare is brought on by a crisis in soul and spirit. Reviewing a volume of essays titled 1984 Revisited, edited by Irving Howe, Arthur Schlesinger, Jr., writes: "Orwell’s vision was of a society absolutely controlled by absolute power using absolute terror to remove the human soul" (New York Times Book Review [September 25, 1983], p. 20). Our crisis reaches from our technical activity to our political policy to our moral commitments and dispositions of soul. Let us describe in some depth the dimensions of our scientific and spiritual crisis and then prescribe a more sensible approach.
Why were these events so provocative? Why has every person (at least in the industrialized, media-saturated world) had to respond to these cases? They are compelling because they speak to us of our births and deaths -- of our assault on circumstances and our acceptance of limitations. The dramas mirror our own critique of or complicity in the principal political project of the waning years of this millennium: scientific technology and biomedicine. Our culture is asking a searching question: Where in our commitment to ameliorate the tragedy of life (Francis Bacon, "Relieving Man’s Estate") to enhance and improve life, to protect and develop our substance -- where do we run amuck and begin to devastate the very purposes we pursue?
Two books are on my table in these early days of 1985. Preparing for his visit to Chicago, I am rereading Ivan Illich’s Medical Nemesis. And, pursuing a promising lead as I try to understand our magnificent yet often misguided sense of national destiny, I am reading The Puritan Origins of the American Self by Sacvan Bercovitch. Illich uses a Greek image to convey a biblical truth:
The Greeks saw gods in the forces of nature. For them, nemesis represented divine vengeance visited upon mortals who infringe on those prerogatives the gods enviously guard for themselves. Nemesis was the inevitable punishment for attempts to be a hero rather than a human being [Medical Nemesis (New York: Pantheon, 1975), p. 35].
The greatest American hero is one who breaks the sound and sight barriers but is always falling on his face. Using terms more easily understood by our technological-industrialized generation, Illich speaks of the "counter intuitive behavior of large systems" and the "self-reinforcing loop of negative feedback." This of course is sociological language for the biblical truth of being unable to avoid doing the harm we know perfectly well we are doing (Rom. 7:15).
Bercovitch quotes Emerson’s version of the Puritan vision:
"The Genius of Destiny of America is a man incessantly advancing, as the shadow on the dial’s face, or the heavenly body by whose light it is marked. . . . Let us realize that this country, the last found, is the great charity of God to the human race" [R. W. Emerson, "Young American," "Divinity School Address" and "Fortune of the Republic," quoted in Puritan Origins (Yale University Press, 1975), p. 136].
Here we see the source of our genius and our crisis. The myth of manifest destiny, when joined to the myth of scientific progress, endangers the spiritual and physical health of individuals and societies. Bluntly put, we must stop thinking of ourselves as God’s chosen people and think more about our opportunities and obligations among the community of nations. We are not an innocent and inspired people; like all the earth’s folk, we are tired and treacherous but also capable of the sublime and sensitive. Only when we grasp the chastisement of divine justice and the guidance of divine will on our work can we hope to participate in redemptive purpose. The materialization of a moral vision is as dangerous as its spiritualization. "Beware the man whose god is in the sky," wrote George Bernard Shaw.
The materialistic degradation is most poignantly seen in the Indian crisis: As lawyers and industry representatives talked with Bhopal residents about compensation, the following insightful comments were heard:
If only I could get 10,000 rupees ($850) I’d be very happy," said one woman who had lost family members.
"India is a spiritual world. We don’t understand millions. Americans started all this talk of compensation," said another.
Mr. Patel, whose wife and 17-year-old son died said, "I am a man not an animal. Money cannot give you satisfaction. Purity of soul is satisfaction. Suppose I would have died, this body would be thrown away." He looks up, eyes tearing. "Reality is God! Do Americans believe in God -- tell me?" [Wall Street Journal, (December l9, 1984), p. 16].
Our technological crisis is at root a moral and therefore a spiritual crisis. What would the shape of a more appropriate ambition be? We should require that technological momentum be carried on carefully and well. A primary stipulation of the Nüremburg code of laws is that our work be good science. A cardinal principle of religious medical ethics is that high-risk, innovative procedures be undertaken only by the highly competent -- those most likely to have knowledge, experience and collegiality of expertise.
Careful research, sensitive prognosis and negative-feedback assessment must accompany our scientific ventures. Such innovative, experimental work as transplants and therapeutic biomedical engineering should occur in the great nonprofit university centers, where there are deep traditions of scientific excellence, clinical rigor and human protections.
Where life and health are concerned, human good must not be subverted by the profit motive. Publicly formulated guidelines from Health and Human Services, the Office for the Protection of Human Subjects in Research, the World Health Organization and World Scientific and Technological Associations should stringently guide all technical endeavor -- especially when there is a temptation to act solely in terms of the profit factor. Indeed, where any extraneous ambition -- whether it be profit, prestige or scientific intrigue -- threatens to contravene the primacy of human benefit, some structure of disinterested advocacy must be set in place.
Also, the procedural value of scientific truthfulness and disinterested advocacy must be enhanced by the normative verifies of justice and mercy. The technological project in general and the biomedical project in particular should be guided by the imperatives of justice -- i.e., equity, simplicity and sensitivity. We should make available to all those rudimentary provisions for particular needs. We should concentrate our technological work much more on basic provisions for the many than on the exotic interests or needs of the few. Simple devices to replant deforested ground might serve human health better than artificial hearts. Recombinant DNA procedures might be better used to attack the global scourge of malaria than to concoct human growth hormones to make the short tall.
Justice ultimately calls us to respond to the personal need of each. Those who succumb to catastrophic medical crises, for example, should be borne up by the community. Our insurance, social security and welfare mechanisms must be rescued from their present for-profit, entrepreneurial captivity and devoted to broader human service.
Finally, just as the meaning of freedom is ultimately found in sacrifice, the deeper meaning of justice is found in mercy. Padwel Sitarz, the 16-year-old son of poor Polish immigrant parents, died just before Christmas. He did not tell anyone about the prostate cancer that had spread to his stomach. He knew his parents "couldn’t afford" treatment. Can our society continue to "afford" this disgrace? The pre-eminent value guiding scientific technology and medicine should be the spirit of gracious benefit to man need and potential. This spirit alone -- not vengeance, anger or even security -- should guide our scientific venture from the macrocosmos of space to the microcosmos of molecular and cellular medicine.
In sum, the scientific project must be guided by truth, disinterest, justice and mercy. Truth is the safeguard against deception; advocacy, against vested interest; justice, against favoritism; and mercy, against resignation. I have argued that spiritual malaise has opened up a moral crisis in our civilization. This crisis in turn has allowed the scientific-technological project to go on wildly, fueled only by its own momentum (if it can be done, it will be done). Only a restored sense of spiritual destiny -- and a moral vision derived from it -- can now rescue us.