[Editor’s Note: Gilbert Meilaender is Senior Research Professor at Valparaiso University and the Paul Ramsey Fellow at the Notre Dame Center for Ethics and Culture. He taught at the University of Virginia (1975-78), at Oberlin College (1978-96), and at Valparaiso University (1996-2014), where he held the Duesenberg Chair in Christian Ethics. He spoke to Charles Camosy about his Bioethics: A Primer for Christians, which is soon coming out in its fourth edition.]

Camosy: Your Christian primer on bioethics is now coming out in a fourth edition. What do you think gives it such staying power as a text?

Meilaender: The most honest answer to that question is probably, “I don’t know.” When the first edition of the Primer was published, I knew the kind of book I wanted to write but had no real idea what sort of audience, if any, it would find. I wanted a book that dealt with some central issues in bioethics, did so from within the perspective of Christian faith, and was aimed at general readers. I think it has turned out to be that sort of book, and that, of course, pleases me.

I myself believe that part of the reason for the book’s longevity is that it keeps its focus pretty much on questions that have been of central importance in bioethics and that almost everyone sooner or later has to think about. As a field of study and writing, bioethics had its start in the U.S. in the 1960s. Since then the field has grown, professionalized, and become something a little more like an academic discipline. As that has happened, its focus has often become oriented more toward public policy and a little less on questions we all face in our everyday lives. Not so the Primer. Although I range a little more widely in it, I have paid attention mostly to problems that arise at the beginning and end of life, problems that have to do with the relation between the generations – how we ought to live and how we ought to die. There are lots of serious people who want to think about those problems.

You say that while non-Christians are welcome to “listen in” on arguments you are making, you write this primarily for Christians. Why did you take this kind of approach?

Thomas Nagel, a very fine philosopher who is not a Christian, once published a book titled The View From Nowhere. Part of his point in the book was to suggest that if I try to view my life solely from an impartial standpoint, from nowhere in particular, I might lose the ability to think about how I, this particular person, ought to live. What we think about some of the important bioethical questions depends a good bit on many other beliefs that we, so to speak, carry along with us and which form the background for our reflection. It is a view not from nowhere but from somewhere in particular.

My aim, then, was threefold: First, I wanted a book for Christians, a book that sought to suggest what Christians should think about some important bioethical problems (even though, of course, I realize that our world is such that not all Christians will agree with the positions I lay out on some matters). Second, I hoped that some who are not themselves Christians could profit from looking at issues in bioethics through the lens of Christian faith — in order, at least, to understand a little why these strange people called Christians think as they do. And third, it seems to me that, simply as members of a community, Christians ought to explain as best they can to their fellow-citizens the reasons that underlie their views about life, death, and what comes between them.

Our moral stance has its root in particular beliefs about what God has done, but it opens up into a vision that is by no means narrow — a vision of what it means to be human.

You were on George W. Bush’s President’s Council on Bioethics, joining a very impressive group of people (including Ben Carson, Charles Krauthamer, Leon Kass, Michael Sandel, Mary Ann Glendon, Francis Fukuyama, and more), many of whom were not Christian, but were nevertheless trying to work together to advise a secular government on intense complex moral and policy questions. Were you able to speak authentically as a Christian and be heard in this group? And what do you make of what happened under the presidencies of Obama (almost no explicitly Christian thinkers at all) and Trump (refused to even create a bioethics council in the first place)?

I think so. That rather hesitant answer simply reflects the fact that one never knows for sure what other people make of what we say. But thanks in large part to the way Leon Kass structured our discussions from the outset, almost everyone on the Council worked hard to understand and take seriously others’ viewpoints. Of course, that doesn’t mean we always agreed. Far from it, as anyone who followed the Council’s work will know.

As to the Obama and Trump presidencies, my views are necessarily formed from a distance.

I don’t think the Obama administration ever fully understood the kind of approach we had taken on the President’s Council. I suspect they were still captive to the idea that the Council had been a gathering of people chosen to support a particular viewpoint (in particular with respect to stem cell research). The slightest serious examination of the Council’s work would actually show that it was far more diverse in the viewpoints represented than had been true of any previous national bioethics commission. But I don’t think that truth ever really sank in for the people making these decisions during the Obama presidency.

In the case of the Trump administration my guess (and it’s only a guess, informed by no special information) is that the president himself really has little interest in these questions. Other issues always rise to the top of his concern, and, of course, from the outset his presidency has been the object of so much criticism that a focus on bioethics has probably never occurred to him. All of this, I might add, should make us realize just how astonishing it was that the first national address of George W. Bush after his inauguration should have dealt with the issue of stem cell research. Clearly, he took the problem seriously.

One lesson I’ve learned the hard way is that writing books on bioethics is difficult because the issues and facts keep changing so rapidly. What have you done to update the fourth edition?

I agree about the difficulty. The fact that I focus largely on issues at the beginning and end of life has helped a little, and, of course, some parts of the book — such as the opening chapter, “Christian Vision” – have not really required updating.

But there will always be more recent data and information about certain matters: Success rates in organ donation and assisted reproduction, or advances in gene editing, for example. Apart from data scattered here and there in the book, what is new is mostly a little increased attention to gene editing (where a great deal has been happening) and to conscience protection in health care. I would still say what I wrote in the Preface to the second edition: “This is not a book primarily about data or statistics; nevertheless, there were places where it seemed important to use more recent information, and I have done so.”

I want, however, to emphasize something that Christians may too easily overlook. Just because a procedure — a technique used in assisted reproduction, for instance – is improved and made more efficient, we should not assume that it is therefore morally more acceptable. Many of the deepest and most troubling issues in bioethics do not depend on statistics or success rates; they have to do with action that truly respects the nature of our humanity as it has been created and redeemed by God.

Let me conclude by asking more about conscience protection in health care. The idea is under sustained attack in many influential circles of secular bioethics. Do the recent rulings by the Supreme Court give you hope we might protect it here in the US, at least? Also, your book focuses on protection of the consciences of physicians. What about nurses and other health care providers? Their cases seem to be gaining substantial public attention.

As to nurses and other health care providers, I plead guilty. I have to admit that the book does not really focus on special problems they face, apart from those that affect the practice of medicine more generally. But, of course, one can only do so much in a small book.

In the new fourth edition I note the pressure physicians have faced in several other countries, and then I write: “It may be that the US commitment to religious freedom will make something similar less likely here, but similar pressures are emerging, especially with respect to issues at the beginning of life.” The recent Supreme Court rulings to which you refer should, I suppose, be somewhat reassuring.

But the Court is a weak reed on which to place one’s hopes, as some of its other recent decisions have amply demonstrated. Christians will need to be prepared to make the argument in public not just for protection of conscience (important as that is), but also for the particular moral vision that we think should be protected. We need to help others understand both what we think and why we think it. I continue to hope that this book will be of some help in that effort.