Popping Pills

Redesigning Humans through Drugs

This article first appeared in the January/February 2005 issue of BreakPoint WorldView magazine. Subscribe today or get someone you know a gift subscription! Call 1-877-322-5527.

Relax, moms and dads. When you ship your sons and daughters off to college, you don’t have to worry about them becoming cocaine addicts. The most common recreational drug on college campuses today is Ritalin. Even though it was designed for people with ADHD, students buy Ritalin and Adderall to sharpen their attention span and improve their memory before a test. These drugs can shorten response time and enhance higher-level cognitive functioning such as novel problem-solving and planning.

The ethics of legal drugs has moved from Major League Baseball scandals to our medicine cabinets. It’s not just about getting an athletic or academic performance edge. As adults, we may be tempted to take antidepressants, even if we’re not clinically depressed. A pill may help you experience life as “hassle-free” and make you socially more relaxed.

Can’t get enough done during the day? Provigil, a drug developed to treat narcolepsy, can assist you to stay awake and alert, brightening your mood at the same time. It is being tested experimentally for treatment of jet lag or simple catnapping. The Defense Department is keenly interested in this drug, which can keep pilots and soldiers alert, focused, and able to perform complex operations for up to eighty-eight hours without noticeable side effects.

It’s not just the military that wants to improve human performance. Gene therapy, which has slowed to a crawl since three highly publicized deaths, may be available on the Russian black market to athletes who want to boost skeletal muscle or red blood cell production, giving them extraordinary strength and endurance. These therapies, many of which were developed to slow or reverse muscle deterioration caused by disease or aging, are now eagerly pursued by football coaches, marathon runners, and swimmers. The World Anti-Doping Agency admits that detection of genetic alteration may be difficult and intrusive. But Olympic hopefuls, when asked if they would be willing to risk shortening their life by twenty years in order to win a gold medal, all said, “yes.”

In the December 2004 issue’s “Viewpoint” column, I ventured to comment on assisted reproduction and some moral questions it raises for Christians. That is just one of many technological changes with which we must wrestle. Cloning and embryo stem-cell research are now familiar, and most of us have instinctive aversions to these biotechnologies. But what about genetic engineering, nanotechnology, cybernetics, neuropharmaceuticals? Are any of these as obviously wrong as, say, abortion? Are there good reasons to employ biomedical advances? How do we know?

I submit that the Church has an undeveloped bioethical conscience. We take a few issues seriously and are vaguely aware of others. But we are poorly informed about most of them and ill-equipped to make moral decisions about using them. Who is going to lead the Church? Pastors may be uneasy about the promiscuous use of all biotechnology, but most don’t know how to frame the issues for their congregants.

I conducted a “Bioethics 101” seminar at a recent pastors’ conference. The number of pastors who came? Zero. Attendees? One nurse and a pastor’s wife. Granted, pastors are racing to keep all those plates spinning. Spending time on esoteric issues ranks farther down the list than pastoral care for overextended single moms. But, bioethical issues are not esoteric. As Nigel Cameron notes in this issue’s “Viewpoint” column, they go to the heart of what we believe about being made in God’s likeness.

Even if pastors are reluctant to address the moral questions raised by certain drugs, physicians, parents, and patients confront these choices daily. If my doctor will prescribe Ritalin for my son based on my description of his fidgetiness, why shouldn’t she give it to him to help him juggle eighteen credit hours, a part-time job, and tennis competitions? Should she make it available to her patients who can’t afford this uninsured use? Is there anything wrong with this? Can I be a better steward of my time and accomplish more for the kingdom if I can work alertly sixteen hours a day?

Mental- and behavior-altering drugs are a biotechnology we can grasp, and many of us use them. Taking drugs involves decisions about whether they are therapies or enhancements. Three biblical themes frame the enhancement/therapy discussion.

First, God gives us freedom to make choices about how we live. Freedom gives us the capacity to shape our world. Some would say we are co-creators and have the privilege and responsibility to wrest as much as we can from nature, to do all we can to overcome the human condition in a fallen world. But the use of biotechnology is more properly understood as an exercise of stewardship, to care for and manage natural and human resources to bring good to others and glory to God. Ephesians 2:10 reminds us that in Christ Jesus, we are created to do good works.

Our freedom exists in tension with the reality of God’s sovereignty. He creates each of us as unique, with our particular strengths, intelligence, physical endowments, artistic sensibilities, emotional vulnerabilities, genetic diseases, and chemical imbalances. Do we passively accept all our limitations? Or should we expect God’s transformation, whether sudden or gradual, unassisted or medically enabled, of our deficiencies? Our answer will affect our choices about using biotechnologies.

Some of our choices may harm us and others. We are also free to choose self-giving over self-assertion, God’s glory over our satisfaction, enjoyment of His creation over abusing it. In every case, we must accept moral responsibility for the choices we make.

Second, God has given us the instruction and desire to heal the sick, to care for the wounded, to ameliorate suffering. With humility and power, Jesus healed not only bodies, but also minds, souls, and spirits. This commitment to the highest good of others, rather than profit-seeking or self-serving materialism, is the heart of modern medicine. But to seek a world without pain is not the highest good; in truth, a pain-free world is not good at all. Pain alerts us that something is amiss and needs attention. Pain triggers avoidance of a greater harm. Dr. Paul Brand tells of the sorry dilemma of lepers who mutilate themselves because they cannot feel physical pain.

Third, there is virtue in setting our minds on things above. In aspiring to God’s highest good for us, we are called to trust Him with our weaknesses. That might include enduring physical, emotional, and mental impairments in order that He is glorified. Much as we chafe against it, God’s ways aren’t our ways, and His thoughts are quantum leaps higher than our thoughts. As obedient managers, we must accept that there are boundaries. We ought not change that which is fundamental to our human nature or unique, God-designed personality. We may be called to live with conditions that are debilitating and permanent, with no apparent reason.

Therefore, how do we make moral decisions to alleviate suffering, in the context of pursuing God’s highest good for us? Are there any limits to the development and use of biomedical technologies? The inquiry must examine both our motives and the goal of using the particular technology.

A biotechnological option may be employed as a therapy or as an enhancement. Does it cure a disease, or is it intended to improve on a natural trait? The question usually cannot be answered with a simple, black-and-white formula. Enhancement occurs along a continuum, ranging from treatment to re-engineering. Therapy, or healing, has the goal of “putting right what has gone wrong with the human body,” as Dr. William Cheshire puts it. Healing is designed to correct, restore, or prevent human malfunctioning. Therapy is about returning to “normal,” or what is typical for a human being of similar age, gender, and condition.

Enhancement, on the other hand, seeks to improve the individual’s condition beyond what is normal. “Normal” is not a point on a line, but a range that depends, in part, on individual characteristics. For example, a fourteen-year-old boy who is 4 feet, 6 inches and whose parents are 5 feet, 10 inches may have dwarfism, which may be treated therapeutically. On the other hand, if his mother is 4 feet, 10 inches and his father just over 5 feet, the use of human growth hormone is an effort to compensate for the natural trait of shortness. Similarly, getting breast implants after a mastectomy is different than cosmetic implants to increase breast size.

Let’s face it. We want some enhancements because we feel that “I’ve been shortchanged in the genetic lottery of life.” But others are pursued to give the individual an edge. Some biotechnology is expressly designed to modify an individual to perform beyond the capability of the fittest, most well-trained member of the species, that is, better than Arnold Schwarzenegger on his best day.

We may resort to all sorts of methods to overcome the normal effects of aging, such as gray hair, sore joints, myopic eyes, deaf ears, and crumbling teeth. Are these treatments unethical? Not necessarily. Some are simply cosmetic; others restore lost function.

We may have to look at the consequences of therapeutic options. Some may alleviate physical suffering, or help us continue to function. What about impotence? The consequences of sildenafil citrate (Viagra) are not uniformly benign. It doesn’t always reignite marital passion. One woman filed for a “Viagra divorce” when her newly rejuvenated husband abandoned her for younger, more energetic talent.

It is good to desire the fulfillment of others as human beings. We are created in God’s image and reflect, in some mysterious way, creativity, passion, reason, pleasure, love, self-sacrifice, and other divine qualities. These are good things. But we are called to an even higher good, the highest good: our spiritual good. As Dr. Edmund Pellegrino puts it, we must have humility in addressing the question: “What is the destiny of the human being, and how does what we do affect that destiny?”

If we believe that our destiny is eternal bliss in fellowship with God, we should live that way now. It is tempting to help each other avoid the costly, painful, struggling steps of discipleship. Maybe we are not designed to “fix” everything that burdens our bodies and minds. We must ask: Is this a matter of chemistry, or character? That “defect,” whether depression or inability to focus, might be the means to a higher good. It might call us to greater cooperation with the Holy Spirit.

As we grow in childlike confidence in God, we are promised His dynamite power to reveal strength in our weakness. Our candid acceptance of our flaws might be the very thing that makes us approachable to seekers hungry for an authentic Gospel. C. S. Lewis wrote, “God uses bent sticks to draw straight lines.” Dr. Jarrett Richardson reminds us that “our greatest moments have not come out of pleasure-filled, pain-free living, but out of our brokenness.”

Are we Christians willing to say that any (not all) legal behavior-modifying drugs are wrong? Francis Fukuyama warns that we are “unwilling to take a clear stand on drugs solely on the basis that they are bad for the soul.” If Big Pharma develops a pill that makes us happy and socially comfortable without side effects, we have abandoned the moral grounds to protest it. Maybe we wouldn’t want to.

“Have you ever thought about taking an antidepressant to get you through this stress?”

Of course. It sure would be better than the hives, sleepless nights, and emotional outbursts I’m having now. My husband’s job transfer, six-month commute, and our move last fall have definitely pinned the needle on my “stress-o-meter.” Yes, I’ve been tempted to take some happy pills to survive the move, remodeling, homeschooling, college teaching, and my lifelong battle with depression. This is why I’m grateful to have spent time contemplating God’s truth about His plan for all people, His particular design for me, and how to live in ever-increasing dependence on Him. He is my ideal “anti-drug.”

Paige Comstock Cunningham, a Wilberforce Forum and Council for Biotechnology Policy Fellow, is former president of Americans United for Life and a contributor to the new book edited by Charles Colson and Nigel Cameron Human Dignity in the Biotech Century.

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