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Audrey is unconscious following a stroke. Her doctors have said there is little chance of her recovering and she is unable to communicate with her family. She has lost many of her critical faculties, so to what extent does her life still have value?
Over the past fifty years there has been an explosion of ethical challenges facing doctors and other healthcare professionals. Ranging from abortion to euthanasia, via human enhancement technologies, many of the arguments Christians put forward in debate revolve around the principle of the sanctity of life – the intrinsic value bestowed on each of us simply because we are human. According to the Bible, the image of God stamped on us (1) lies at the heart of what it means for us to be human. It not only marks us out from all other living creatures, but also imparts human life with an extraordinary value.
It is important that Christians not only have a grasp of the practicalities of ethical issues, but also what the Bible tells us about personhood – or what it means to be human – as this is so central to many debates. This file will not look in depth at specific issues, many of which are covered by other CMF publications. Instead, by briefly stepping back from the nuances of individual debates, we can gain a deeper understanding of how and why the value of human life underpins so much of Christian ethics. First, we will look at what the Bible tells us about what it means to be human, before going on to explore the concept of the image of God and its relevance to bioethics.
In Psalm 8, a hymn of praise to the Creator God, David reflects on 'the work of [God's] fingers':
When I consider your heavens, the work of your fingers, the moon and the stars, which you have set in place, what is mankind that you are mindful of them, human beings that you care for them? You have made them a little lower than the angels and crowned them with glory and honour. You made them rulers over the works of your hands; you put everything under their feet: all flocks and herds, and the animals of the wild, the birds in the sky, and the fish in the sea, all that swim the paths of the seas. (2)
God created the whole universe, yet still values mankind highly, not because of any action on man's part, but simply as a gift. Human beings are 'crowned... with glory and honour' and established as the 'ruler over the works of [God's] hands.'
This concept of mankind as the crowning work of creation first arises in the creation narratives at the very beginning of the Bible, in Genesis 1:26-27:
Then God said, 'Let us make man in our image, in our likeness, and let them rule over the fish of the sea and the birds of the air, over the livestock, over all the earth, and over all the creatures that move along the ground. So God created man in his own image, in the image of God he created him; male and female he created them.
The text in Genesis 1:26 refers to both 'image' (Hebrew: tselem) and 'likeness' (Hebrew: demuth). There have been discussions about whether or not the words represent different things, but it seems likely that they can be considered synonymous. The theologian Anthony Hoekema notes that in the original Hebrew text of the Bible there is no conjugation between the two words. The 'and' was inserted the Latin translations produced in the fourth century AD, giving the impression that 'image' and 'likeness' refer to two different things. The words appear to be used interchangeably in the other references to the image in Genesis. (3) However, both Genesis 1 and Psalm 8 clearly imply that human beings are more than just highly developed animals and the only God-like creature in all of creation.
Although other Old Testament (OT) references to the image of God are scarce, it seems clear from the restriction of Genesis 9:6 that the importance of the topic is out of proportion with its brief treatment. Intentional killing of another human being is explicitly ruled out because human beings are made in the image of God, affirming the worth of mankind hinted at in Psalm 8.
Genesis 1 goes on to explain that our position in creation involves dominion over the earth – our role as God's representatives, ruling over the fish in the sea, the birds in the sky and every living creature that moves on the ground. (4) The image of God is central to this. In Old Testament times it was common for kings and rulers to erect statues, or images, of themselves in a conquered land to signify their presence and rule there.
Aside from the references to the image of God, tselem – the Hebrew word meaning 'image' – is used over twenty times in reference to physical replicas of gods, men or things established to represent and resemble the ruler they pictured. (5) 'Likeness' (demuth) also occurs several times, each referring to physical resemblance or appearance. (6)
Following the entrance of sin into the world in Genesis 3, we know that our intellect has been corrupted, our purity lost, and our relationships with both God and each other spoilt. Some have thus questioned whether humans still retain God's image. However, it seems that we still possess it in some sense as 1 Corinthians 11:7 and James 3:9 still both refer to mankind as 'made in God's likeness.' The image may well have been distorted by our own disobedience, but writers have struggled to put a label on exactly which aspect of the image has been lost.
Most helpful is Jim Packer who argues that after the Fall we still bear the image of God formally – we still have within us the abilities that, if rightly harnessed, enable us to live a God-like life – so the unique value of each human being must still be respected. But we have lost the image substantially, and it takes God's grace-gift of union with Christ to restore it fully. (7)
References to God's image abound in the New Testament (NT), where mankind is described as the 'image and glory of God'. (8) Two particular themes emerge, of Christ as the true image of God, and of the Christian being conformed more and more to that image by God's grace. We see the awesome reality of the image of the invisible God in Christ, (9) the manifestation of God's glory. (10) (11) (12) (13) As 'the second Adam', Christ is also the head of a new humanity. As Adam shared the distorted image with his descendants, so Christ shares the perfect image with his descendants, those believers who are 'in Christ'. Paul writes in Romans 8:29 that 'those God foreknew he also predestined to be conformed to the likeness of his son, that he might be the firstborn among many brothers'. The likeness of Jesus is thus the pattern for all those who are his. (14)
However, this restoration is a work of God, by his grace, not the result of our own endeavour. The process of sanctification – making us more like Christ and restoring the image – is an ongoing work in Christians, accomplished by his death on the cross. (15) (16) However, although we are being changed 'with ever increasing glory', (17) complete conformity will not be achieved until Christ's return 'when we shall be like him, for we shall see him as he is'. (18)
For many, the human body is dispensable and open to our manipulation. We see this, for example, in debates about human enhancement technologies. However, according to the Bible, our bodies are a crucial aspect of our humanity. This is resoundingly confirmed by both the incarnation and resurrection of Christ. John 1:14 tells us that 'the Word became flesh, and dwelt among us'. When God breaks into human history to bring redemption to his fallen people, he does so not by bringing about a new creation, but by revealing himself as a 'Mark 1, original human model'.
John Wyatt writes, 'when Christ is raised as a physical human being, God proclaims his vote of confidence in the created order'. (19) Jesus' physical body after the resurrection not only affirms the general goodness of God's original creation, but specifically mankind created in his own image as the climax of that creation, with a physical body that is described in Genesis 1:31 as 'very good'. (20)
The essential meaning of the image of God is that human beings have intrinsic value because we are in some way like God. Even if the similarities couldn't be further defined, this would be of enormous significance. However, countless writers down the ages have explored this idea in more detail. Although this has largely been guided by the anthropology and theology of their own times, there are two main schools of thought.
The 'functionalist' perspective seeks to define the image in terms of God-given human qualities that make us like our creator but distinct from animals. Irenaeus (c.130-c.200) was perhaps the first to draw a distinction between the Hebrew words tselem and demuth. He argued that God created human beings in his image and after his likeness. The 'image' represented mankind's rationality and his freedom; this was retained after the Fall. In contrast, our 'likeness' to his Creator – his holiness and relationship with God – was lost and needs to be restored via the process of redemption. (21)
Thomas Aquinas (1225-1274) disagreed that human beings lost the likeness at the Fall but retained the image. Instead he regarded the two terms as virtually synonymous. He wrote that the image of God is found in all people as 'man's natural aptitude for understanding and loving God', (22) or in his intellectual capacities. Rather than the Bible, Aquinas's logic most probably has its roots in the Greek thought of the philosophers Plato and Aristotle, who both called mankind's intellect divine: the Bible says that God is love; nowhere does it say that God is intellect. (23) However, Augustine (354-430) also considered intellect to be important: he taught that God's image relates to memory, intellect and will – capacities that he implied mirrored God's Trinitarian nature. (24)
The Protestant Reformation brought about a recommitment to the biblical perspective of what it means to be human. Martin Luther (1483-1546), like Irenaeus, believed that mankind had lost the image of God at the Fall, and that its restoration was the goal of salvation. However, he felt that the essence of the image was our original righteousness, the relationship Adam enjoyed with God. (25) In contrast, his fellow Reformer, John Calvin (1509-1564) felt that the proper seat of God's image is in the soul (26) and, although the Fall had a devastating effect on it, the image was not totally annihilated, but frightfully deformed. (27) He insisted that all of mankind's gifts had been distorted by sin, making us not just deprived, but depraved. (28)p>
Karl Barth (1886-1968) rejected the previous attempts of theologians to locate the image of God in human structures and qualities. He returned instead to Genesis 1:27 which describes mankind's creation: 'So God created man in his own image, in the image of God he created him; male and female he created them.' He argues that our creation as male and female, and the relational aspect of this partnership, must be central to the way we reflect God. (29) Barth's position has been paraphrased as: 'The human person is a being whom God addresses as Thou and makes answerable as I. Thus the image describes the I-Thou relationship between person and person and between a person and God.' (30) At the heart of the image in Barth's view, therefore, is love for God and love for others.
Other commentators hold that the image of God is located in different human capacities. Some understand the word 'image' in a very physical sense, contrasting for example our upright posture with that of other animals. For others, mankind's moral, rational and spiritual qualities are important, whilst another group consider our dominion to be key. Yet others in this 'functionalist' school think it is our capacity for selfawareness that marks us out from every other creature. (31)
The concern about the functionalist perspective is that it runs the risk of alienating and diminishing whole groups of human beings who lack a particular capacity, such as those lacking rationality or self-consciousness after a brain injury. As the Christian writers Rae and Cox note, 'the entire project of defining personhood in functional terms fails because…a thing is what it is, not what it does.' (32)
The second school of thought – the species perspective of mankind – suggests that the image of God lies simply in our membership of homo sapiens. Certain distinctive human characteristics are demonstrated in the creation narratives and undeniably mark human beings out as different from animals, associating us with God. In the species view, however, the image of God is considered to be descriptive of human nature in its entirety. It is not linked exclusively to any one particular aspect or characteristic. We might in fact also call it a 'wholistic' (sic) view. This perhaps first emerges in the writings of John Calvin who was willing to grant that 'although the primary seat of the divine image was in the mind or the heart, or in the soul and in its powers, yet there was no part of man, not even the body itself, in which some sparks did not glow'. (33)
The functionalist perspective seeks to make a clear distinction between human beings and the animal kingdom in a similar way to the Old Testament authors. However, it seeks to define God's image, and hence the essence of our humanity, based on what we can do. In contrast, the whole person species perspective pays much more attention to what we are by creation. Ethicists Rae and Cox again explain the importance of this distinction:
The image of God is not a capacity we possess or lose, but rather a part of our essence. We are, or reflect, God's image, as opposed to possessing God's image in terms of certain capacities. Of course, the image of God will manifest itself in certain capacities... [but] the capacities express God's image which is a part of the human essence. (34)
Some argue that personhood is grounded in biological considerations, that the human genotype implies moral status. (35) However, the image of God is no more located just in our DNA than solely in our rationality. As we have seen, humans are more than the sum of their parts; we are unique combinations of body, soul and mind, each known and loved by God, and called into existence by him. It is this that implies personhood – membership of the moral community, with rights and duties of a moral nature. (36) Put more simply, we qualify as persons because we are human. Some theologians rule out any reflection of the image in our physical form, largely on the basis of John 4:24 where Jesus says, 'God is spirit.' They argue that this suggests God himself has no physical form, so therefore our bodies cannot image him in this way. However, if we image God in our entirety, our bodies must be involved in this reflection in some way and, again, we cannot concur with the view that the body is dispensable.
In contrast to the functionalist view, the species perspective supports the Christian view of all mankind being made equal, regardless of ability: 'rich and poor have this in common: The Lord is the Maker of them all.' (37) As Nigel Cameron writes, 'man the biological entity and man the creature must be one. The image, with all that implies, must be present wherever this species is to be found.' (38) It is only this view, rather than a checklist of capacities, that allows us to authentically defend the sanctity of all human life.
In the past, the concept of the sanctity of human life was perhaps most clearly associated with Christian concerns about abortion. (39) In recent years, discussions have shifted towards topics such as voluntary euthanasia and assisted dying, (40) as well as the use of novel technologies such as stem cells to create human life. (41) However, at the heart of each of these very different issues lies a fundamental challenge to the biblical view of what it means to be human and particularly what is acceptable at the limits of life.
Reflecting on what the Bible teaches us about being human not only illuminates our path as we seek to offer solutions to healthcare dilemmas such as these, but also demonstrates great truths about the relationship we have with our Creator God. The Bible makes it clear that mankind is made in the image of God. This in turn makes him something more than the rest of the animal kingdom because, as far as we know, he is the only creature who bears that image. We also see that the image lies at the heart of the 'specialness' placed on human beings by God. This value is not a consequence of our actions, but simply a gift. It is also not a capacity we possess or lose, but rather a part of our very essence. Because of the image and our likeness to God, taking the life of another human being is explicitly ruled out. (42)
For secular writers, and indeed for many Christians with a functionalist perspective of the image, my value and claim to personhood depends on what I can do: if my function is diminished, it follows that my moral worth must also decrease. On the basis of this argument, human embryos and the lives of the frail and elderly, for example, are expendable. Returning to our case study, however, the 'wholistic' species perspective holds that the value of those such as Audrey, unconscious after a stroke, lies not in what they can do, but in what they are. Mankind is not only 'crowned with glory and honour' but made in the very likeness of God to represent him on earth. Our lives therefore not only have intrinsic value because of his image in us, but are also not simply our own to do with as we please. As Elihu in the book of Job explains: 'if it were his intention and he withdrew his spirit and breath, all mankind would perish together and man would return to the dust.' (43)
In conclusion, the image of God stamped on us is not a capacity we gain or lose, but part of our make up as human beings. We are the very reflection of our Creator: far more than just the next link in a great evolutionary chain, mankind is the pinnacle of creation. It is this we are called to defend.
Helen Barratt is a Wellcome Trust Research Training Fellow at University College London and a Specialist Registrar in Public Health. She also has an MA in bioethics.
1. Genesis 1:26, 27
2. Psalm 8:3-8
3. Hoekema A. Created in God's image. Grand Rapids: Eerdmans, 1994:13
4. Genesis 1:28-30
5. See for example the statue of King Nebuchadnezzar in Daniel 3.
6. Motyer A. Look to the Rock. Leicester: IVP, 1996:201
7. Packer JI. Reflected Glory. Christianity Today, 2003 December. Accessed 16 August 2011.
8. 1 Corinthians 11:7
9. Colossians 1:15
10. John 1:14
11. 2 Corinthians 4:4-6
12. Hebrews 1:3
13. John 12:45
14. Ephesians 4:24
15. Hebrews 10:10-14
16. Motyer A. Look to the Rock. Leicester: IVP, 1996:79
17. 2 Corinthians 3:18
18 1 John 3:2
19. Wyatt J. Matters of Life and Death. Leicester: IVP, 1998:69-70
20. Grudem W. Bible Doctrine. Leicester: IVP, 1999:263
21. Cairns D. Image of God in Man. London: Fontana, 1973:80
22. Aquinas T. Summa Theologica, I.93.2. Accessed 16 August 2011
23. Hoekema A. Created in God's image. Grand Rapids: Eerdmans,1994:39
24. Augustine. (396) On the Trinity (Book IX). Accessed 16 August 2011
25. Sullivan DM. The Conception View of Personhood: A Review. Ethicsand Medicine. 2003;19(1):11-33
26. Calvin, J. Institutes of the Christian Religion. Vol 1. ed McNeill JT.Trans. Ford, Lewis, Battles. Philadelphia: Westminster Press,1973: 186
27. Calvin J. Institutes of the Christian Religion. Vol 1. ed McNeill JT.Trans. Ford, Lewis, Battles. Philadelphia: Westminster Press,1973:189-190
28. Hoekema A. Created in God's image. Grand Rapids: Eerdmans,1994:46
29. Barth K. Church Dogmatics Vol III/1. Edinburgh: T. & T. Clark,1958:195
30. Clines D. The Image of God in Man. Tyndale Bulletin 1968; 19:53-103.
31. Atkinson D. The Message of Genesis 1-11. Leicester: IVP, 1990:36-37
32. Rae S, Cox P. Bioethics: A Christian Approach in a pluralistic age.Grand Rapids: Eerdmans, 1999:167
33. Calvin J. Institutes of the Christian Religion. Vol 1. ed McNeill JT. Trans.Ford, Lewis, Battles. Philadelphia: Westminster Press, 1973: 188
34. Rae S, Cox P. Bioethics: A Christian Approach in a pluralistic age.Grand Rapids: Eerdmans, 1999:132
35. Nelson S. The Least of These. Ethics and Medicine 2004; 20:1.
36. Sullivan DM. The Conception View of Personhood: A Review. Ethicsand Medicine. 2003;19(1):11-33
37. Proverbs 22:2
38. Quoted in Rae S, Cox P. Bioethics: A Christian Approach in apluralistic age. Grand Rapids: Eerdmans, 1999:138
39. Sims P. Abortion. CMF File 23 (2003)
40. Saunders P. Assisted suicide: the law is both clear and right.Triple Helix 2008; Winter:3
41. Pickering R. Stem cells. Triple Helix 2007; Winter:4
42. Genesis 9:6
43. Job 34:14-15
Scripture quotations taken from The Holy Bible, New International Version Anglicised Copyright 1979, 1984 by Biblica, Inc. TM Used by permission of Hodder & Stoughton Publishers, a division of Hachette UK Ltd. All rights reserved. “NIV” is a registered trademark of Biblica, Inc.TM UK trademark number 1448790.