Bioethics: A Primer for Christians

by Gilbert C. Meilaender

In the face of rapid advances in medical research and treatment, bioethics has become a serious social concern. Originally published in 1996 and later chosen by World magazine as one of the top 100 books of the twentieth century, Gilbert Meilaender’s Bioethics covers a wide range of pressing bioethical issues and offers discerning guidance on how Christians ought to think about them.In admirably clear language Meilaender discusses abortion, assisted reproduction, genetic advance and prenatal screening, care for the dying and euthanasia, human experimentation, and more. This new edition of his Bioethics features updated information throughout, a fuller discussion of human embryos — including stem cell research — and a thorough rewrite of the chapter on organ donation.

Genres: Nonfiction, Theology, Philosophy, Religion, Science, Christian, Christianity

138 pages, Paperback

First published November 30, 1995

Reviews

[John Yelverton · Rating 2 out of 5]

The main thing that hampers this book is its brevity. The author raises some good points, points out things that need to be discussed, raises a couple of eyebrows, and then just leaves you hanging without any real solutions.

[Ben Franks · Rating 4 out of 5]

This is a beautifully written book on the complex world of bioethics from the pen of a thinker who is deeply immersed in the Christian tradition. Gilbert Meilaender writes as a conservative Lutheran (LCMS) ethicist but he grounds his ethical reflections in the broad sweep of Christian thought. I don't agree with all of his judgment calls (I think he's a bit too broad on abortion and a bit too narrow on organ donation and prenatal screening, amongst other things) but getting his "take" on the issues is hardly the point. The purpose of the book is to provide a Christian framework for making ethical decisions and then to tease out the implications of that framework in light of the various ethical issues of the day.

In that sense, the first chapter "Christian Vision" is the most important and helpful part of the whole book. In it, Meilaender carefully shows how the assumptions that the Christian brings to the world stand in such stark contrast to the views of modern culture. While contemporary Westerners build many of their ethical decisions on the pillars of individualist autonomy and a conviction that suffering it to be avoided at all costs, Meilaender reminds us that the Bible takes a very different view. While individuality is cherished, individualism is rejected. Man is never autonomous or independent. Indeed, dependence and need are integral aspects of the human experience and so alongside of our stress on freedom must come a corresponding embrace of our creaturely finitude. Perhaps most counter-culturally of all, the Bible views suffering as both lamentable (as a result of the fall) yet also redeemable (through the gift of God's grace). Because God delights to sanctify our suffering we do not accept the idea that suffering is an evil which must be resisted at any cost. These core assumptions have huge implications for how we deal with ethical issues and quandaries - from issues of fertility and conception to questions about organ donation and euthanasia.

While thoughtful Christians will apply these principles differently, it is important to ground our discussion in the basic paradigm of the Bible. Meilaender does a helpful job of reminding us of that foundation and of showing us at least some of the ways it can be worked out in life and death.

[Liesl · Rating 4 out of 5]

On the whole it is a good and helpful book. I had some theological quibbles (the author's Lutheran obsession with baptism) and some scientific quibbles (the chapter on human subjects research equates "randomized" and "placebo-controlled", and I believe misrepresents how clinical trials are done).

[Mikael Hall · Rating 2 out of 5]

En helt okej introduktion till området men ganska svag på flera punkter. I synnerhet när det gäller att grunda vissa axiomer som kanske är självklara för en amerikansk konservativ kristen men som för mig en svensk "icke-konservativ" kristen inte förefaller lika självklara. Dessutom var kapitlet om eutanasi mycket svagt vilket var förvånande eftersom det kanske är en av de mest självklara bioetiska frågorna från ett kristet perspektiv.

[Jon Vos · Rating 5 out of 5]

An excellent resource for Christians to begin thinking about important issues such as IVF, prenatal screening, and living wills. It’s easy for Christians to make an idol of scientific progress and seek to act like God in making good out of every conceivable tragedy. I’d recommend this book.

[Karen Dauer · Rating 5 out of 5]

This is an excellent book. Meilaender provides clear and biblical insight into bioethics, discussing how a Christian should view these different bioethical topics. I highly recommend this book to every single Christian.

[Russell Sigler · Rating 4 out of 5]

I have now completed my ethical training. Let me know if you have any pressing moral quandaries, I am available to assist free of charge as long as I can count the hours towards my field education.

[Will · Rating 2 out of 5]

Meilaender's approach to bioethics is substantially different from my own, and from that of many other Christians. However, I believe that his concerns are still valuable, and should be respected as important parts of the ongoing bioethics debate within the Christian community.

Reading this book was an interesting experience. In perhaps 2/3 of the chapters, I found myself in strong agreement with Meilaender and was impressed by the detail and depth of his insights. Such sections included his stances on refusing treatment, assisted suicide, and human experimentation. However, in the remaining 1/3 of the book, it seemed to me that Meilaender was ignoring very significant details. His positions on adoption, prenatal screening, and organ donation do not seem to be grounded in medical fact or Biblical truth.

I believe that some of my differences with Meilaender may arise from different theological backgrounds. My background is Reformed, while Meilaender is a Lutheran. Lutherans generally have a very different approach to culture than Reformed individuals, which may account for some of the oddities that I encountered. This divide is especially significant with respect to adoption. Meilander believes that adoption is a sign of brokenness in the world because it is not a creational norm. I believe that adoption is a sign of redemption and a symbol of the Church's "adoption" into God.

[Glenn Crouch · Rating 2 out of 5]

Whilst this is a good book for introducing many topics in Bioethics, I was expecting more when it comes to “a primer for Christians”. It comes across to me as far too legalistic, in that it is telling us as Christians what viewpoints we should have on various matters. Note that I agree with the Author in many (if not most) of his ethical stands, however I was expecting more Biblical arguments, as well as a wrestling with some of the topics - rather than be told that Christians should not do “this” or support “that”.

There are some fine ethical discussions, especially in the later chapters - and in fact the book comes across a bit more as an apologetic for an already established Christian ethic - as in here is the argument to use for your stand when confronted by others. I would’ve preferred more on, why should I as a 21st Century Christian have this particular stand.

I was also bothered, that many Christians who read this book may “discover” that they had “unknowingly” done unethical (thus sinful) things. The Author seems to say little about the Grace of God, and the Forgiveness achieved through our Lord and Saviour’s death and resurrection :( Given that this book says it is for Christians, to omit the Gospel in this way seems to be a major oversight - just add an appendix on this!

[Luke Stamps · Rating 4 out of 5]

Excellent introduction to a range of bioethical issues, from reproductive technologies and abortion to euthanasia and end-of-life decisions. Meilaender is well-versed in the concepts and categories of Christian theology and brings them to bear on these issues in an unapologetically Christian way. He warns about ethical dilemmas that many Christians have not adequately considered, such as the problems raised by IVF, advance directives, and organ donation.

[Ian · Rating 4 out of 5]

4.2, This book lost me at times, was helpful at times, and had points of extreme precision and eloquence that blew me away.

In many ways it is a primer, not exhaustive both in range of topics or in the depth of certain topics. Regardless, a helpful place to start on a topics Christians find themselves actively or passively participating in.

It really is a blend of bio, ethics and theology. Meaning it at times can feel some what practical and go into the details of certain medical research, procedures, etc. It also has its philosophical moments, and very much is theological throughout.

I will say a couple points I just disagree or at the very least would need more from him to be convinced. I think there are also some times where certain examples were used that just felt odd or off. And a couple points I plead ignorance in not knowing about something that he didn’t flesh out.

The chapters of this books can kind of be read like essays.

I think he is rightfully quite nuanced in the complexity of so many issues but helps the reader along, not leaving them mentally paralyzed. One area he hits on repeatedly while working through topics is our dependence on God, not letting readers forget that very real very important reality that comes into our decision making and lived reality.

“Sickness, suffering, and death are evils that plague human life, but they are not the greatest evil. That would be to lose God, to have reason to doubt his faithfulness to us. Christians affirm God's faithfulness, although they confess that it is demonstrated in a manner that might never have occurred to us had God not simply done it. God defeats and destroys the negative powers of sickness and death, but he does it by claiming even that realm as his own - by entering it and bearing it to its own logical end. The perfection and power of God is displayed in the acceptance of neediness, dependence, and even suffering.”

[Caleb Eissler · Rating 4 out of 5]

This little book is one of the best primers on bioethics I’ve ever read. In a very small number of pages, Meilaender masterfully introduces and walks through biblical implications on a number of important bioethical issues. This is clearly a primer and no topic is covered in great detail. One would need to look elsewhere for that. But for the vast majority of Christians who have never thought in detail about these issues from a biblical perspective, this primer is great. Meilaender helps readers think through the basic logical train of thought that should guide them as they wrestle with various issues. He gives readers logical and theological points to grab hold of to help them get their bearings in individual ethical cases. My criticisms of the book are relatively minor. While being pro-life on the whole, Meilaender makes allows for more wiggle room on exceptions where abortions might be allowed (with surprisingly weak reasoning, I might add). Conversely though, he brought up interesting points about how Christians can think through life’s beginning at conception.

A particularly strong part of the book is the chapter on assisted suicide. Meilaender eviscerates the logic of the pro-assisted suicide movement. He shows that the movement’s logic doesn’t allow for assisted suicide to only apply to those in extreme pain in extreme medical cases. Rather the logic would allow for approved suicide for anyone who seeks it because the primary logic of the movement rests on unhindered human autonomy. This chapter is especially important in light of the prances of a number of countries around the globe who are introducing assisted suicide.

On the whole, this book is a great place to start for Christians and would make for a great study guide for church groups or those wanting to think through the implications of their faith in more detail.

[Sara Christians · Rating 4 out of 5]

Overall, I thought this was well done. Bioethics is an area where the church is severely lacking, as most people avoid talking about these difficult topics in an effort to not offend. Christians desperately need clarity here and must consider the difficult realities of many of these "medical advances". While at times difficult to read some of the scenarios (the portion on organ donation made me sick to my stomach), it is still important for all Christians to be informed on these issues and make judgements that are Biblically based and that demonstrate a fear of God. Having been written nearly 20 years ago, the medical field has waded into even murkier waters, so parts of this book have become a bit outdated.
My biggest complaint, however, is that the author allows for cases in which he believes a Christian can argue that abortion is justified. This is simply an unacceptable view of anyone who professes Christ, the Savior of the world who came to earth as a vulnerable infant in Mary's womb. If the preborn child is fully human (he is) and if he is innocent of any wrong (he is), intentionally killing him is always wrong, regardless of the circumstances. In the event of a life threatening complication of pregnancy, it is possible to deliver the infant prematurely and do all that is possible to sustain his life as well as save the life of his mother. This is wholly different from dismembering a baby in the womb and removing his corpse due to a life threatening complication of the mother.

[Mikey · Rating 4 out of 5]

Two things are true of the human condition — we are both free and finite. More often than not, these two realities come to a head. When considering procreative technology, are we abusing our freedom to do whatever necessary to “create” life? Is this, perhaps, not an area in which our finitude is showing itself, and should we accept that? When considering end-of-life issues, are we once again more prone to abuse our freedom to do whatever necessary to extend the life we have as if it is our own? Is this also not an attempt to turn a blind eye to our inherent finitude?

Have our attempts to overcome infertility, illness, and death actually have the far worse consequence of neglecting to suffer well in service of the God who suffers with us? Has the rapid development of medical technology caused us to forget the Hope we have — a Hope in the new life promised us in Christ? Or could it be that we are doing whatever we can to consummate that new life on our own?

These are the sorts of questions Meilaender is asking in this book. Life is good, yet death is inevitable. And praise the Lord that both of those are held securely in His hands — that is, until death is no more.

[Hannah · Rating 5 out of 5]

I deeply appreciated the structure and content of the book. Before addressing the big topics in bioethics today (physician assisted suicide, abortion, stem cell research, genetic engineering, and organ donation, among others) Meilaender articulates a Christian vision for the human being, living an embodied existence in community and in the midst of a broken world. Throughout this book Meilaender brings us back to questions of human dignity and purpose. I found his “procreation versus reproduction” chapter very helpful and enlightening in thinking through the ways mankind has understood the purpose and role of children and parenthood. I cried in the section about prenatal screening and organ donation from infants with severe disabilities and limited life, not just because the content was heavy, but because the implications for human life and human meaning are so profound. What are humans for? What makes a life worthy?

[Peter]

Pretty mediocre. Meilaender comes close to outright contradicting himself in the abortion chapter.

On one hand, he holds that the child in the womb is a "human life equal in dignity to ours."

On the other hand, he argues for the permissibility of abortion in cases of rape or incest because "though the fetus is . . . formally innocent, its continued existence within the woman may constitute for her an embodiment of the original attack upon her person."

In other words, Meilaender holds that it is licit to kill an innocent person for the crime of another. By his reasoning, post-birth infanticide would be justified if the continued existence of the child constituted "and embodiment of the original attack."

Perhaps his position is more nuanced in a way that avoids self-contradiction, but he utterly fails to communicate that in this book.

[Sarah · Rating 4 out of 5]

This volume was smaller than some of the other Christian bioethics texts I read recently, but its content is rich and deep. The writing was clear and fluid, the arguments scriptural and didn’t simply skim the surface but grappled with the tough questions.
The first chapter, titles “Christian Vision”, was an excellent overview of the general approach Christians take to life, death, suffering and medicine. I appreciated the segment on suffering, which began with the phrase, “At the heart of Christian belief lies a suffering, crucified God.”(pg 7) His approach to suffering was as an evil thing and yet a thing that does not lack purpose, and he pointed out that to make the alleviation of suffering the highest goal of life would be to ignore that it does serve a purpose.
The second chapter, “Procreation versus Reproduction,” contained a discussion of the new technologies involved in assisted reproductions, with a description of the change in thinking that has occurred even among Christians in the shift from viewing children as a gift verses a product to be tinkered with and produced. He discussed the significance of the biological bond, and I loved his description of the child as “God’s ‘yes’ to… mutual self-giving.” His contrast of this with the assisted reproduction using third parties in which “the lines of kinship are confused” was clear, and his reasons for Christians to reject the participant of a third party in assisted reproduction were reasonable. However it seemed his arguments against the use of assisted reproduction without third parties seemed to lack weight, resting mainly on the vague idea that “instrumentation” of the body is questionable morally. The last section in the chapter dealt with how Christians ought to approach having children in general, which can be well summarized with “Without in any way undervaluing the presence of children, we should also be free of the idolatrous desire to have them at any cost—as our project rather than God’s gift.” (p 23)
The discussion in the “Abortion” chapter surrounding the beginning of life and personhood was one I found to be well-rounded and informative. The only point at which I was hesitant to agree was on page 34, where the author discussed pregnancy resulting from cases of incest or force. He extended grace to these situations where pregnancy could be considered to be a continuation of the initial attack upon the woman involved, but I would have appreciated a more balanced approach to this complex and difficult scenario. It seems that there are times when the birth of a child can for the victim of violence be a way of redemption of the crime committed against her. Even in cases where she does not have the resources, emotionally or otherwise, to raise the child, there are so many waiting would-be parents it would be a loss to end this life in the womb.
The discussion of prenatal screening seemed to be an exception to the rest of the book, in that it was medically dated and simplistic. First, the use of amniocentesis is certainly not the routine way pregnancies are screened—they are the exception rather than the rule. Usually blood tests are performed initially and only followed by an amniocentesis if needed for positive blood test results. The number of false positives for such tests is high, leading many couples to panic needlessly and probably other couples to choose abortion. But if the Christian uses prenatal diagnosis in a prayerful and thoughtful manner, in the setting of risk factors such as advanced maternal age, the Christian family can both prepare themselves for the arrival of a child with special needs and also consider whether prenatal treatments/surgery or special delivery plans necessary. The author didn’t discuss these possibilities at all.
The discussion regarding the Christian and autonomy and suffering in later chapters was excellent. The culture of medicine has so profoundly tempered public thinking as to assume the priority of autonomy and self-determination over the life of surrender (i.e. that of a Christian to his God).
In the chapter on “Refusing Treatment” I was initially somewhat disappointed. This issue of when to stop treatment is so complex and difficult to answer that some level of medical knowledge is needed to be able to give the discussion value. It was clear to me on page 67 that the author did not know the evidence surrounding the use of opiates during the end of life. I have done literature reviews in the past on this subject and read a good portion of the medical literature on this topic, and studies that actually suggest that appropriate management with opiates at the end of life actually extends the life longer than if pain goes undertreated. Also it is known that the body requires rapidly increasing doses of opiates to control pain during those final days and hours. But I appreciated the author’s note that “Life is not our god, but a gift from God; death is a great evil, but not the ultimate evil.” (p68). I also appreciated the way that the author distinguished rejecting a burdensome treatment versus rejecting a burdensome life (as in the case of a patient in a vegetative state). And in the end the section of the chapter on “Truth-telling” was worth its weight in gold for the way in which, particularly in the way in which he cautioned against suggesting to a patient that his condition is hopeless.
The remainder of the book contained thought-provoking discussions about organ donation, human experimentation, embryo research, and concluded with a discussion of the providence of God at work in health and in sickness.

[Kevin V. · Rating 4 out of 5]

The word, “primer,” should be remembered when considering the impact and importance of this book. Meilaender is clear what he is and is not attempting to accomplish here. He is not trying to say all that needs to be said on each of the bioethical topics covered. He is attempting to lay sufficient groundwork for informing his readers of the main lines of argument from a Christian perspective. With this in mind, Meilaender offers to his intended audience—Christians—a good starting point for thinking through vital issues facing our world. I am grateful for his clarity, brevity, and faithful application of the dignity of life and reality of death.

[Tanner Howard · Rating 3 out of 5]

If this book is a “primer,” I fear it may prime believers into more confusion at times than understanding. I was disappointed in Meilander’s ability to speak in spiritual terms while not aligning himself with the clear witness of Scripture. His intention in writing was not to create a black and white ethical standard, I understand that, but the lack of conclusions was silly.

And yet, if the book primes people into thinking more about cloning, IVF, organ donation, and assisted suicide; I can consider that a win.

Pretty okay book that would benefit from another update because of the nature of medical advancements.

[Paul · Rating 5 out of 5]

This book is an excellent introduction to multiple bioethical (medical) issues that our societies will increasingly face in the 21st century. Meilaender's writing is insightful and concise, biblically and philosophically informed. There was only one issue where I found him inconsistent (and wrong). Pastors, thoughtful Christians, and especially those working in the medical field, will benefit from the contents of this book.

[Josiah Richardson · Rating 3 out of 5]

A short primer on bioethics from a Christian perspective. Even though this is the second addition, it is still 20 years old and has lost a lot simply by its age. The majority of major biological issues are addressed here, but pretty superficially. I think the main goal for this book must have been to simply help you start thinking of these sorts of issues like genetic and parental screening, abortion, physician assisted suicide, and so forth. For real depth, you will need to look elsewhere.

[Nancy Teal · Rating 3 out of 5]

This book introduces important topics; Meilaender states his points then moves to the next topic. If Primer is meant to stick your toe into the deep water, then this book succeeds. However, many of these topics require a full immersion to become familiar enough to conclude for self and not just be led by the nose.

[Sean · Rating 4 out of 5]

A very good introduction to the subject. All arguments for and against are given a consideration and the author does well to put a Christian perspective across. He is in no doubt, Christian perspectives will be challenged, for this reason a clear and positive argument is very helpful.

[Landon · Rating 4 out of 5]

Not the easiest writing to follow, and I didn't agree with all conclusions but it was a very interesting look at the complexities of the ethical dilemmas rampant in science. Some hit home personally with the chapters on human embryos and human experimentation.

[Zach Hollifield · Rating 4 out of 5]

Excellent. While I do not agree with every conclusion Meilaender comes to on certain issues, I do respect that he does land somewhere and can defend such a position from a Christian standpoint. Best brief book I’ve read on bioethics.

[Shaun · Rating 3 out of 5]

I read the fourth edition (published in 2020), which is 20 pages longer than the first edition and has a more updated discussion of genetic advance, euthanasia, and use of cloned embryos for research.

[Reyna · Rating 1 out of 5]

I had to read this for class. To me it was judgmental and the author's views are too extreme

[Mario Tafferner · Rating 4 out of 5]

A very sophisticated introduction to Christian bioethics. Meilaender explores bioethical issues within the context of human freedom and finitude and provides deep theological thinking.

[Kyle · Rating 5 out of 5]

Every thoughtful Christian should read this. It's short, and even when you don't agree, it will help you think through your positions.

[Monica · Rating 1 out of 5]

I think I expected something different out of this book. As I read this in an academic environment, I really missed the scientific approach to ethical problems - albeit from a Christian standpoint.