Christian Worship
Southwestern Journal of Theology
Volume 66, No. 1 - Fall 2023
Editor: Malcolm B. Yarnell III
By Mark Wesley Foreman and Lindsay C. Leonard. Grand Rapids: Kregel Academic, 2022, 384 pp., $29.99.
This book is co-authored by former philosophy professor at Liberty University, Mark W. Foreman, and his daughter, Lindsay C. Leonard, assistant attorney general for the Commonwealth of Virginia. It updates a previous book, Christianity and Bioethics: Confronting Clinical Issues (Joplin: College Press, 1999). In 23 years, more bioethical issues have risen, so this update includes approximately 100 more pages.
The first of ten chapters, “Modern Medicine in a Moral Fog,” introduces the current state of medical ethics. The authors offer a Christian appraisal and propose a pluralism of three ethical theories—consequentialism, deontology, and virtue ethics—to form a God-honoring Christian perspective for addressing each ethical problem. In chapter 2, “Principles of Bioethics,” they start with Beauchamp and Childress’s four principles: respect for autonomy, beneficence, justice, and non-maleficence. These principles are prima facie but may be superseded by stronger obligations. This chapter concludes with a manifesto covering God as Creator and Redeemer, the dignity of humanity and sanctity of life, individuals in community, freedom and finitude, suffering, and medicine and healing. These manifest truths trump secular moral justifications.
Chapters 3 to 10 are devoted to special issues: abortion, infanticide, euthanasia, physician assisted suicide, procreational ethics, genetic ethics, treatment clinical ethics, and research clinical ethics. In each area, the authors tell a real-life story first, then provide moral arguments for both sides, present the legal cases, and summarize their position. Chapter 3 concerns abortion and concludes that personhood begins at the moment of conception. Abortion is, therefore, the killing of a person. Next come two chapters concerning infanticide and euthanasia. The authors argue against active euthanasia since human life is given by God, thus overriding the autonomy principle. Chapter 6 discusses physician assisted suicide and, upon evaluating the evidence, concludes Christians should reject it. The next chapter is about procreational ethics, while chapter 8 covers genetic ethics. The authors argue the goal of medicine is to cure, not to kill a person. The goal of genetic intervention should therefore be to cure, not to enhance.
The last two chapters relate to ordinary clinical practice and clinical trials in advancing the treatment of diseases. In chapter 9, the authors discuss the doctor-patient relationship and emphasize that doctors should fully inform patients of disease and treatment. Doctors should not exhibit paternalism or practice deception but maintain confidentiality. The last chapter, concerning ethics in clinical trials, is weak. This reviewer was a statistician who worked in the Cancer Treatment Evaluation Program of the National Cancer Institute. It must be noted that randomized controlled clinical trial is the gold standard in establishing treatment efficacy, rather than random clinical trial (RCT; 357). A placebo is only used when there is no current effective treatment, so a new treatment is tested against a placebo. Once there is a good treatment for a disease, the new treatment is tested against a current standard treatment, never a placebo. All clinical trials supported by NIH grants must satisfy very stringent ethical requirements. For instance, during the recent COVID-19 vaccine trial, a statistical procedure stopped the clinical trial early when the new vaccine showed strong evidence of being effective. In a footnote (358), the authors describe a “three-armed” trial, but their definition is incorrect and lacks citation. The authors claim the majority of RCTs are nontherapeutic (360), but that contradicts this reviewer’s experience in cancer clinical trials.
Overall, this book is a good handbook for guiding Christians to deal with biomedical ethical issues. It provides Christian perspectives on many issues and is highly recommended as a reading for a course in biomedical ethics. It does not include a subject index or bibliography.
