God Weeps For Anencephalics
Dr. Calhoun practices Ob/Gyn in Biloxi, Mississippi
Loma Linda University suspended its use of anencephalic infants for their transplantation program in 1988 but the use of fetal tissue remains a very active area for concern. The year 1992 saw the approval of a national tissue bank for aborted infants for research and possible medical use. What ought to be the response for the Christian physician to the use of anencephalics for tissue research?
The issue must be addressed in an organized, Biblical manner. The best way to discuss organ donation by anencephalics is to use a Biblical model for elucidation.1,2 The framework we will use consists of a five part framework defined by the mnemonic of THEOS.
We must deal first with the presupposition that the Lord is sovereign and speaks authoritatively on His earth. This article affirms the Reformed position of the absolute sovereignty of God with His transcendence over His creation. The Lord establishes His transcendence in Exodus 20:1-17. God clearly states in Exodus 20:3 that He is the sovereign on the earth and that there is no other God before Him. This is the key to the argument against organ donation of anencephalics. If we do not accept the sovereignty of the Lord, and, hence, His infallible Scripture, we cannot be expected to make the appropriate Biblical decisions. The reason we accept the Lord's authority concerning His sovereignty is simply because He is God. He has shown Himself faithful in truth throughout the Scriptures. Therefore, He is able to speak authoritatively to us today through His Word.
The hierarchy mentioned shows us that we are to be subordinate to God. God expects obedience through subordination to His revealed written will. God's hierarchy starts in the family through Exodus 20:12 and Deuteronomy 6:7. The development of the Lord's hierarchy extends to the nation of Israel as the priests are designated not only as spiritual leaders but physical healers as well (Lev. 13-15). The priests are God's designated representatives to initiate and substantiate "cure" through the power of God.
The New Testament carries the hierarchical concept even further to include all believers as "a chosen people, a royal priesthood, a Holy nation, a people belonging to God" (1 Peter 2:9). We Christian physicians inherit the hierarchical position of not only the royal priesthood of believers, but also meld with that of the New Testament gift of "healing." We are the New Testament "healer-priests." As such, we physicians have a tremendous responsibility to teach our patients not only proper physical but spiritual health as well. We must teach the correct, Biblical thoughts on the issue of anencephalics.
Because we hold such a position of trust, Christian physicians are expected to remain defenders of the helpless and weak. Nowhere do the Scriptures tell us that a specific set of physical or mental attributes make us human. It is in Genesis where we are made in God's image" that we take on our humanness.
My frame was not hidden from you when I was made in the secret place. When I was woven together in the depths of the earth, your eyes saw my unformed body. Psalm 139:19
Therefore, just because a child has less brain than another it does not justify murdering him to obtain organs. God holds each child dear and Christ said, "suffer the children to come unto me" in Mark 10:14. Utility is never the coin of man s worth as deserving God's healing mercy.
How we ought to act lies in the ethics of the issue as revealed in Exodus 20:1 - 21:26. The Lord in Exodus 20:13 says, "You shall not commit murder." The Hebrew word here is rasho.ch and signifies lying in wait and taking life. It is a premeditated murder. The idea is most like a vengeful murder. There is no intent here to include persons executed from crimes or killing in war. The distinction is quite precise. Perhaps the easiest way to explain the concept of killing-murder is to use C.S. Lewis' analogy that "all sex is not adultery any more than all killing is murder." Intention makes all the difference. Exodus 20:22-24 applies to a pregnant woman involved in a fight with a resulting premature birth. If there is a premature delivery with no serious injury there is a monetary fine for the assault. However, if there is serious injury or death, life for life, eye for eye, tooth for tooth, hand for hand, foot for foot, burn for burn, wound for wound, bruise for bruise, is required.
If the unborn infant is a person worthy of protection as the above implies, why should a live born anencephalic be different? The Jews never talked about children's rights because a live born Hebrew was assumed to be part of the covenant people with infanticide as unthinkable. That was something a Canaanite did. We need only look to the detestable practices of the followers of Molech, who heated up brass/metal statues with fires underneath outstretched arms and placed live infants on the white hot arms, to understand why the Hebrew children's regard of life and children was so high.
The intention of the present medical climate is to make it possible to use dead aborted fetuses and live anencephalics as organ donors and research tools. Dead fetal organs don't make good transplant tissue. There is a bit of squeamishness now but, as with abortion, once the initial horror is gone, it will be business as usual. The easiest route to the acceptance of this horrible practice is to make it "legal" as we did abortion. We merely legally define the anencephalic infant to be out of person-hood and presto! Anencephalics no longer qualify for protection under the law because they are not legally "people" with the right of equal protection under the law.
The real crux is that, even if this horrendous law were to pass, what would be the medical utility of the organs harvested? A very articulate analysis is provided in the March, 1989, issue of JAMA.4 It is noted that there are nationally 3.75 million births per year in the United States. The anencephalic rate is about 0.3 per 1000 total births. This would yield about 1125 anencephalics each year.
About 20% of pregnancies get alphafetoprotein screening for neural tube defects. Ninety-five percent of these anencephalics are aborted. This makes the number of births about 911. Two thirds are stillborn. This reduces the number to 304 live-born infants. About 50% of anencephalics are premature (less than 37 weeks) and some 50 - 80% have weights less than 2500 grams. If we assume 60% as being too small to use as donors, then we end up with 122 useful anencephalics. If about two thirds of families would donate, that would make the useable number 81.
Kidneys are generally not transplanted because of the higher success rate with older grafts and infants generally wait until 2 years for a graft. About 15% of the anencephalic hearts are unusable due to hypoplasia and 25% of the livers are unacceptable for similar reasons. This effectively brings the estimated number of useable organs to 0, 69, 61, respectively.
The actual number of transplantable organs is usually about 25% of the total number for various reasons due to compatibility, transport of organs, or availability of recipients. So, the actual number of organs useful would be 0, 17, 9. The benefit at present is not really delineated. The long term survival of heart transplants is about 50% and liver transplants about 20%. This pushes the benefits to 0, 9,2 for kidneys, hearts and livers. The most optimistic benefits projected in the next 10 years at present rates of surgery and technology show 25 kidneys, 12 hearts, and 7 livers per year.
If we weigh what the Lord said in Exodus with even the most optimistic numbers, it doesn't justify disenfranchising a whole group of people. Even the utilitarian can see no benefit to using anencephalics for transplant. However, what if we become able to make our own anencephalics? If we can define away their "personhood" what is to stop a totally depraved individual from making an "organ farm?" If surrogacy is acceptable, we have the technology to create our own neural tube defects. We can pay mothers to have anencephalics and legally have no grounds to interfere. The organs could be sold to the highest bidder and the infants used in research. Methotrexate, valproic acid, or retinoic acid, all folate antagonists, could easily be used to "create" anencephalics at the critical time in neural tube closure. Vaginal ultrasound at 10-12 weeks could be used to confirm the skull defect and, if not present, just legally abort the infant and try again.
Lest we think this is too macabre, remember drug companies in Europe already use aborted infants' collagen in cosmetics. Aborted fetal pituitaries have already been implanted in Parkinson's patients for attempted cure. It is later than we think!
The final difficulty in dealing with anencephalics is to define what is consciousness and what is not. Anencephalics can range in type from total craniorrachischis to hydranencephaly. Human infants with intact brain stems can exhibit complex behaviors, distinguishing their mothers from others, consolability, conditioning and associative learning. Therefore, these infants do not differ in consciousness as much as in ability to accomplish further cognitive learning. If we use this standard, then we may destroy the retarded and senile humans as well.
The use of raw judicial fiat in the face of ethical considerations places no one safe from "legal murder." All we need do is make someone or some class of people "unhuman" under the law and all legal protections fall. It is only a short step, then, to euthanasia, i.e., Holland, infanticide (already done on Down's infants), and the gas chambers.
To understand our position as physicians before the Lord, we need to understand that as people of God we took an oath before Him to serve and obey. Exodus 24:7-8 has the people, after receiving the law, confirming the covenant by swearing "We will do everything the Lord has said; we will obey (emphasis added). Moses then took the blood from the young bulls and said, "This is the blood of the covenant the Lord has made with you in accordance with all these words." The blood sealed the covenant for the Jews just as Christ's blood sealed our new covenant once and for all. We don't have the blood of animals any longer. The blood of Christ is the one and sufficient sacrifice.
"Sacrificing" our anencephalic children to the god of this age, the devil, only serves his purposes. We must obey the Godly covenants. They are operative today unless specifically addressed by Christ. Psalm 82: says,
Defend the cause of the weak and fatherless, maintain the rights of the poor oppressed.
The succession of the saints is addressed in Exodus 20:4 where God says that He will "punish unto the third and fourth generation" of those who hate Him and "showing love to a thousand generations of those who love me and keep my commandments." The ultimate hate of God is destroying those He made in His image. There can be no sin worse than the taking of innocent life. Murder is specifically prohibited and the Scripture says in Leviticus 24:17, "If anyone takes the life of a human being, he must be put to death." Christ does not invalidate this assertion in Matthew 5:38-42 when He says not to resist evil: He merely does away with personal vengeance. He says we are not to take "eye for an eye" in personal vengeance. The declaration of guilt for a murder applies to those who take innocent life in murder. Capital punishment for murder is not the issue, but breaking God's prohibition against murder is.
The punishment for the Jews for destroying infants by offering them to Molech (i.e., science) called for the penalty of death.
Any Israelite or any alien living in Israel who gives any of his children to Molech must be put to death ... If the people of the community close their eyes when that man gives one of his children to Molech and they fail to put him to death, I will set my face against that man and his family and will cut off from their people both him and all who follow him in prostituting themselves to Molech. Leviticus 20:1-5
The same lie by the god of this world is trotted out to us in the medical world. Sacrifice your children and for you it will be well. Just destroy these children so others benefit. After all, it is the "loving" thing to do since these children would just suffer anyway. God save us from such well-intentioned tripe, and the misguided minions of satan! If Sodom and Gomorrah were destroyed for their sins, we must soberly understand that any nation that sanctions infanticide is definitely under judgment. God will "set His face against us. Succession for the Jew came as a result of bloodline. However, in Exodus 20:6 God makes clear that it is those who "love Him" and demonstrate their love by "obeying His commandments" who are the true successors in God's kingdom. We, as "grafted in/adopted children" in the family of God, become heirs with Christ. If we become disobedient, misuse our priestly role, and call to mercy, we become like Esau who traded his birthright for a "mess of portage." We may not serve the flesh and God. The demonstration of our love toward God, and hence our legitimacy as heirs to Godly succession, is our obedience to God's commandments. Included is God's injunction to "not commit murder."
WHAT TO DO?
The most important action we take as Christian physicians is to know what the Word says about murdering. The Scriptures clearly forbids it. Infanticide is not directly addressed because it presented such a horrible crime the Jews could not imagine participating in it. We should not bow to popular pressure to allow anencephalics to be legally made into "nonpeople" as we allowed with unborn babies in the abortion mills.
Next, we need to be part of the solution and not the problem. We ought to be on the hospital ethics committees to insure the Biblical perspective is presented in a thoughtful, loving, and articulate manner. We must vote against candidates who support abortion, infanticide, and fetal research. We need to support those women pregnant with anencephalics not to abort them for organs. We need to deal sensitively with the impending death of the anencephalic child and work to support family involvement in the infant's life.
Finally , we ought to be involved directly and personally in taking these infants home with us to die peacefully in a loving, Godly atmosphere if the parents lack the strength to cope with the inevitable death of the severe anencephalic.
1. Kline, Meredith G., The Structure of Biblical Authority, Ferdmans: Grand Rapids, Michigan, 1972, pp. 131-153. Also, "Deuteronomy" Wycliffe Bible Commentary, Southwestern Co.: Nashville, Tennessee, 1962, pp. 155-204.
2. Sutton, Ray R., That You May Prosper, pp. 16 - 17.
3. All Scripture quotes are from the New International Version, Zondervan Publishers: Grand Rapids, Michigan, 1982.
4. Shewman, D.A., Capron, A.M., Peacock, W.J., Shulman, B.L.,
The Use of Anencephalic Infants
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