The Views of Orthodox Theology on Bioethical Issues

1. Introduction

I have been involved for many years with bioethical problems arising from contemporary genetic issues concerning the beginning of biological life, its prolongation and its end. The outcome of this involvement was my book Orthodox Bioethics - The Theology Perspective, which was published in Greek.

This book attempts to give a brief presentation of the genetic problems, from the point of view of molecular biology and genetic engineering, and after each chapter the theological view of the Orthodox Church on each issue is briefly set out.

This is an English translation of the theological views of the Orthodox Church on bioethical issues, which have been taken from the above-mentioned book. The English translation is by Sister Pelagia.

2. The Beginning of Life

a) Mapping the Human Genome

1) In general, the Orthodox Church does not reject scientific discoveries. It accepts their results, which can have a positive effect and benefit people. Of course, as the Fathers of the Church teach, there is no conflict between theology and science, because they have different aims and roles. Science attempts to improve the conditions of human life, because after the fall human beings put on the ‘garments of skin’ of corruptibility and mortality. Theology, however, leads people to communion with God and to deification.

What is more, there are scientists who are aware of the presence of God in nature. For example, Aris Patrinos, a co-ordinator of the Human Genome Project in the USA, said in one of his talks:

“All of us who took part in the Human Genome Project [considered that] this success was like touching God. Even some of us who had said that they were atheists were in awe when we came so very close to having this first glance of the book of life, written in a language that until now was known only to God. Although we have this book, and we may perhaps know some of the words and perhaps some of the letters, we still do not have a good knowledge of what it says, and it will take decades. Perhaps through this success we will find ourselves nearer to God.”

Also, some scientists sense that the more research progresses, the more questions arise. Aris Patrinos, whom we mentioned above, said characteristically in an interview in the periodical Popular Science that the more our knowledge of biology increases, the more “our ignorance increases. The function of life is so complicated that we may perhaps never manage to make it deterministic. There is a huge element that, however much progress we make, we will never surmount.” Scientific theories continuously develop and change. For this reason the Church, on the one hand, lays down basic theological principles for humankind, but, on the other hand, it follows scientific research calmly, discreetly and unhurriedly, because today’s discoveries may possibly be overturned.

2) God’s existence-bestowing and life-giving energies, which patristic theology calls logoi ‘inner principles’, exist within creation, and therefore within DNA. These are the inner principles of beings. According to St Gregory Palamas, the whole of creation participates in God’s existence-bestowing energy; animals and plants participate in His life-giving energy as well as His existence-bestowing energy; human beings participate not only in the previously mentioned energies, but also in His wisdom-imparting energy; and the saints and angels participate additionally in God’s deifying energy. God directs history and creation towards a purpose, and human beings co-operate in various ways in this process. This is what is meant by the term ‘synergy’ in theological language. Consequently, if human beings are able to do something in creation and develop scientific knowledge, this is due to God’s existence-bestowing, life-giving and wisdom-imparting energy. In any case, human beings cannot create something out of nothing.

3) It is significant that, from the information available so far, there appears to be only a small difference in the number of genes between man and irrational beings. For centuries, long before the study of genes, our Tradition has considered that what defines a human being is the fact of being in God’s image and progressing towards God’s likeness. This is called the hypostatic principle. What bestows worth on man is the soul that animates the attached body. It is not genes but the nous and free will that give rise to all the differences between human beings and the rest of creation, and between one human being and another

4) Science hopes in the future to cure various diseases by means of gene therapy, but it cannot defeat death permanently with human means. The time will come when the human being will die. This means that from the moment human beings are conceived they have death and the genes of ageing within them. Thus death is a disease of nature.

5) There is mutual interaction between genes and the environment. Genes are influenced by the environment, and the environment is influenced and shaped by human beings. At the same time, culture, our role models and ideals, but above all God’s grace influence and shape us. Human beings are not victims of determinism, necessity and oppression. They have freedom and can act positively or negatively.

6) Before the fall, the first-formed human beings lived like angels. After their fall, corruptibility and mortality entered into humankind. This is how the Fathers interpret the fact that Adam and Eve put on garments of skin. With His incarnation Christ assumed the mortality and passibility of human nature in order to conquer sin and death. After His Resurrection He deified human nature, and His risen Body was incorruptible. Subsequently, through the Mysteries (Sacraments) of the Church, human beings receive the deified Body of Christ and overcome the laws of corruption and immortality, and the fear of death, and their bodies become the dwelling-place of the Holy Spirit. Within Christians, through the holy Mysteries, there is spiritual DNA, which to a great extent cancels out the coercive effects of biological DNA.

7) According to Orthodox Tradition, life is the gift of God to man. The important thing, however, is how man makes use of this gift, and particularly what meaning he ascribes to his biological life. Human beings do not live simply to indulge in pleasure and to enjoy their biological life in various ways, but to be united with Christ, to participate in God’s purifying, illuminating and deifying energy, to conquer death and to live for ever with the Triune God.

8) The deciphering of DNA may pose another bioethical problem in the future. If there are major advances in biomedical research, it will be possible to foresee some illnesses which are likely to affect babies before and after birth. This will give rise to bioethical dilemmas, as it will pose the problem of whether to kill the newborn or unborn baby, if, of course, these illnesses are incurable. If this happens, humankind will enter an era of eugenics and euthanasia, with a society composed solely of healthy people. This is unacceptable to the Orthodox Church.

9) On the day when this great discovery, the mapping of the human genome, was announced, a newspaper wrote something profoundly significant: “The identity [of life] has been found; the meaning is being sought.” Today people are in need of the meaning of life, the answer to the question of why they are alive and what the purpose of life is. Unless this question is answered, however many years are added to their biological life, it will be a tragic existence.

Medical science by its very nature fights against death, but without overcoming it. So any success in medical science, although it may bring people rest and relief from suffering and various kinds of misery, nevertheless also reveals its failure to overcome humankind’s greatest enemy, which is death. As we are very well aware, death is overcome by the grace of God, which is offered in abundance within the Church. The relics of the saints show this transcendence of death.

10) Consequently we welcome the new discovery, the mapping of the human genome, in the hope that it may benefit humankind by enabling many new cures to be found. Ultimately, however, we believe that the “medicine of immortality” is Christ, Who can give meaning to biological life, to illnesses, suffering, and even biological death.

b) Cloning

The Orthodox Church deals with the problem of cloning from its own theological, ecclesiastical and anthropological perspective. In any case, Orthodox theology is both simple and great. It has high aims and uses simple means, with God’s energy and man’s synergy, to achieve them. These simple theological views are as follows:

1) There is a difference between what is created and what is uncreated. God is uncreated and human beings, like all creation, are created. Everything uncreated and created has energy, as a being without energy is inconceivable. The difference, however, is that the energy of uncreated things is uncreated, and the energy of created things is created.

The uncreated energy of God exists within creation, even within DNA. This means that the existence-bestowing and life-giving uncreated energy of God is inside cells. However much science develops, it will never be able to remove the difference between created and uncreated. And however much progress scientists make in human knowledge, they will never be able to be the same as uncreated God, because scientists process existing genetic material and cannot create new genetic material. God created the world from nothing, whereas human beings create things from existing material.

2) A couple may have many children, but they each have their own personality and character. Scientists may perhaps be able, using the same genetic material, to create people who are outwardly similar, but they will each have their own personality. In fact, if they grow up in different environments with different traditions, they will be completely different characters and personalities, because they will be influenced by the culture in which they live and will accept the traditions and role models that they encounter. Even when people grow up in the same surroundings, they each develop their own personality, as happens with identical twins.

3) Cloning human beings raises important theological issues. It should be emphasise here that, although scientists may be able, by intervening in cells, to cure some illnesses using gene therapy and cell therapy, even if so far this has not achieved the desired degree of success, ultimately it is impossible to do away with human mortality and corruptibility. The time will come when the human being will die. It may be possible to extend life and postpone death, but one day death will come. From the moment we are conceived by means of our father’s sperm and our mother’s ovum, we inherit death and corruption. Consequently, the problem is not how to live longer and postpone the hour of death, but how to overcome death. This is the most basic problem of humankind. And this is achieved through the sacramental life of the Church, by which we are united with Christ, Who is the medicine of immortality.

4) The Holy Synod of the Church of Greece says in a press release on this subject (17 August 2000):

“Our knowledge with regard to the consequences of cloning is very limited, and the possibilities of being able to evaluate our actions in advance are even more limited. For this reason, every decision about applications of, and experiments with, cloning must be made with extreme caution, common agreement, and great respect for human values. There is an obvious danger of making human beings into objects and using them as material.

Also, cloning could lead to an economic, or unrestrainedly mercenary and manipulative, attitude to human beings. And the fate, dignity and future of human beings could be handed over to governments or corporations with unethical and selfish aims, or for imprudent and trivial use.

Who can assure us that a society that legalises today – and it is now the law – what it prohibited yesterday will not legalise tomorrow what it prohibits today? So who can safeguard us from the danger that ‘therapeutic’ cloning may become the intermediate step to ‘reproductive’ cloning of human beings?”

5) The profound purpose of the Church today is to help people to solve their existential questions about what life and death are. This is something that neither science nor philosophy nor technological progress can offer. The most tragic thing is that, the more technology and research increase, the more pressing these existential questions become. The Church should make this its priority, rather than concentrating all its attention on the social and biological level.

6) If God permits the cloning of a human being, we do not know exactly what the result will be. There is no doubt, however, that in such a case it will be a created being that will be subject to corruption.

Within the Church, however, we speak of another kind of ‘cloning’ that science cannot provide. Through the incarnation of Christ the created was united with the uncreated. Therefore every human being was given the possibility of experiencing the union according to grace of his created nature with the uncreated energy of God in Christ Jesus. The saints had the experience of becoming gods according to grace, because uncreatedness and immortality entered them, and they experienced eternal life starting from this biological life. The problem, therefore, is not “the transfer of the nucleus of a somatic cell”, but God’s entry into us. Such an experience gives meaning to human life.

c) Stem Cell Research

1) As has been repeatedly stressed, Orthodox theology has never wished to place obstacles in the way of scientific research that aims to benefit humankind. All the scientific successes that have contributed to the health of human beings began with many years of research. Science itself, however, ought to set limits and a framework within which research should be conducted. The science of bioethics performs this task.

2) There is no problem with research on the stem cells of adults for the purpose of benefiting the sick. The physiological renewal of many bodily tissues, such as the skin, the blood cells, and so on, relies on stem cells.

3) Research on embryonic stem cells poses serious pastoral questions and wider ethical dilemmas. The theological problems arise from the fact that, in order to obtain embryonic stem cells, scientists destroy the blastocyst, and consequently kill the fertilised ovum (embryo) in the first days of its development, before the stem cells have been differentiated. This causes a serious theological problem, because, according to Orthodox theology, the soul exists from the beginning of conception – the doctrine of “the existence of an autotelic human entity from the first moment of conception” – as the embryo “receives a soul immediately upon conception”, according to Christological teaching. The Orthodox Church does not accept the theory about “the process of receiving a soul”. This is the reason why there are feasts relating to conceptions, such as the feast of the Conception of St John the Forerunner (23 September), the feast of the Conception of the Theotokos (9 December), and the feast of the Annunciation of the Theotokos, which celebrates the conception of Christ (25 March). The Orthodox Church cannot accept the view that during the first fourteen days after conception research on fertilised ova and interventions can be carried out freely, with the result that the blastocyst, which has a soul, is destroyed.

Because some people refer to “genetic material” after fertilisation, it should be pointed out that even scientific terminology refers to an embryo or foetus, the only distinction being that an embryo is at a very early stage, whereas a foetus is more developed. One of the pioneers of research on embryonic stem cells, Gerhart, responded to the view held by some people that the result of research cloning is not an embryo but an ovum (genetic material), stated: “I assert that it is an embryo; I do not think that anyone believes that it is simply an ovum.”

The Holy Synod of the Church of Greece, in its press release of 17 August 2000, says on this subject:

“Our Church expresses its categorical opposition to performing experiments on human embryonic cells. Such experimentation entails the destruction, not of embryonic cells, but of human embryos.

The view that the human person begins to be formed from the fourteenth day after conception may provide British scientists with an alibi, but, being scholastic in origin and not scientifically based, it constitutes a subjective belief and an arbitrary opinion. The Church and the Christian conscience accept the human being as a person with an eternal and immortal aspect from the moment of his conception.

The distinctions between people are constantly increasing. Everything points to the fact that our societies are now openly ‘eugenic’ and racist. However, the attempt to improve life cannot involve the destruction of millions of human beings at the embryonic stage.”

4) In addition, the attempt by doctors to differentiate an embryonic stem cell in accordance with their own preferences poses a theological problem, because the blastocyst is destroyed. This must be seen from the point of view that human beings cannot be regarded as laboratory animals from their conception, nor as workshops for ‘living spare parts’ for the benefit of a few, usually wealthy, people who want to live longer.

It is a different case when progenitor cells are taken from the umbilical cord or from adults, provided that this is not done deliberately (abortions) or exploited commercially.
Today scientists try to avoid the ethical dilemmas that arise from destroying the blastocyst by devising other methods of producing embryonic stem cells. Because these efforts are still at an early stage, the Church can wait until research is completed. It seems that the new methods do not provoke the same serious ethical dilemmas, but it cannot be excluded that new bioethical problems may arise.

5) From everything set out above, it is clear that the phenomenon of expediency dominates and is being increasingly cultivated, as reproductive technology, in vitro fertilisations, are being promoted, not so much to enable childless couples to have children, as to enable scientists to take the ‘surplus’ fertilised ova, which will be in the freezer for their research.

6) The basic danger that concerns us is the possibility of scientists allowing a human being to develop in their laboratories. It is possible that the being who will be produced may be a chimera or hybrid (for example, human-animal) with terrible consequences.

I do not know whether God will allow the production by human cloning in a laboratory of a being with a human body, but without a soul. This does not happen now because man’s life is linked in a mysterious way with his soul. However, the soul and body owe their existence to God’s creative energy with the synergy of the parents (Fr. John Romanides); and according to St Maximus the Confessor, the body and the soul come into being in different ways – although this happens simultaneously at the moment of conception – since the soul is formed ineffably from the divine and life-giving inbreathing, and the body consists of existing bodily matter. For these reasons, the possible case in which God, for our chastening, allows a separation between the soul and life, and the creation of a chimera or hybrid seems tragic.

These are all serious theological problems and they should cause scientists, and people in general, intense concern.

d) Reproductive Technologies

1) According to the teaching of the holy Fathers of the Church, the conception of a human being is not exclusively an act of nature, but the work of God’s Providence through human beings. The theological principle of synergy applies here: God acts and human beings collaborate.

2) The reason why a couple wishes to have children by any means or method whatsoever should be investigated from the pastoral point of view. In most cases, apart from some exceptions, this is connected with their insecurity in life, a lack of meaning, and the failure to achieve their theological purpose, as defined by the Church.

3) Up to a point one can use scientific achievements in order to have children. The words “up to a point” mean that human dignity must be preserved, and one’s life must be consistent with God’s will. For example, surrogate motherhood, the use of sperm or an ovum from a donor (heterologous fertilisation), the use of sperm after the death of the woman’s husband or partner, and so on, cannot be accepted by the Orthodox Church, because the principle that “the end justifies the means” must not prevail, and because many theological, pastoral, legal and social problems arise. The Orthodox Church, therefore, can only accept ‘by economy’ for its members homologous insemination and homologous fertilisation that does not leave surplus embryos and is not associated with selective reduction of the embryos inside the womb.

4) It is clear that there is a serious problem, from the Orthodox point of view, with regard to in vitro fertilisation. With the method of medically assisted human reproduction, many eggs are fertilised and many embryos are produced. Some of these are implanted in the mother’s womb; the remainder are kept frozen in special banks, to be supplied to other mothers wishing to have children, or they are used for research purposes, or they are killed. The embryos that have been implanted in the womb are also selectively reduced. Furthermore, there is the inherent danger of eugenics, in other words, selecting the best fertilised ova and choosing their sex. None of these things are acceptable to Orthodox theology.

5) The Orthodox Church is against artificial intervention in fertility (abortions). We shall look at this point below. In addition, although the antenatal check solves some problems, it also creates theological and ethical dilemmas, as some diseases that are detected cannot be treated, at least until now (although some interventions can be carried out within the womb). In most such cases, therefore, the antenatal check leads the couple to seek an abortion, which is unacceptable to the Orthodox Church. This excludes those cases in which the antenatal check enables medical experts to prepare to deal with the problems once the child is born.

6) When facing such circumstances, we cannot distance ourselves from our basic aim, as defined by the Church, which is to progress from being in God’s image to being in His likeness, in other words, deification. No human achievement or success can replace or be a substitute for this deepest purpose of man.

e) Development of the Embryo and Abortions

1) The human being receives a soul immediately upon fertilisation; the soul exists “from the first moment of conception.” The soul does not exist without the body, nor the body without the soul. At the moment of fertilisation the soul is created by God. The Orthodox Church does not set a limit of fourteen days or a few weeks and months, in order to justify interventions in blastocysts or other interference with embryos prior to that.

Conception takes place through God’s energy and human synergy. St John Chrysostom writes that conception is not the outcome and result of nature and intercourse, but of God’s Providence. He writes: “Bearing children has its origin from above, in God’s Providence, and neither woman’s nature, nor coming together, nor anything else at all is sufficient to bring it about.”

The conception of a human being and the union between soul and body are a mystery. St Gregory the Theologian, rebuking those who think that they can understand God with their reason, states that is unthinkable that we should comprehend rationally the essence of God or the manner of existence of His hypostases, especially as it is impossible for us even to understand how man’s soul is united with his body. He says that it is impressive how we are first moulded and originally composed in nature’s workshop, how we are finally formed and completed, and how we desire food and are nourished. He asks who it was who led us instinctively to the first springs, which are our mother’s breasts, and the sources of life. St Gregory the Theologian marvels as he considers his own construction and that of the whole human race, as regards the elements of which we are composed; how we move; how the immortal was mixed with the mortal; how we drift downwards and at the same time are borne upwards; how the soul is confined in the body; how the soul gives life to the body and at the same time shares in its sufferings; how the mind is both circumscribed and boundless, and how, although it stays within us, it nevertheless observes everything with rapidity and ease. And he marvels as he studies the organs and members of the body, and the harmony that exists between them.

2) The Christian woman who is pregnant regards the embryo inside her with great respect. She feels that it is a gift from God to her. She waits with longing for it to be born. She prays for it from the moment of conception, and she lives life in the Church. In this way the Christian upbringing of the child begins from the embryonic stage.

3) Abortion, according to the teaching of the Church, is murder, and murder of a defenceless human being. The embryo has a soul, which expresses its energy as the embryo’s body and organs mature. The Fathers of the Church have laid down Canons that forbid abortion. St Basil the Great writes in his second Canon: “The woman who has deliberately procured an abortion is subject to the penalty for murder.” And he goes on to say that among us there is no distinction between a formed or unformed embryo, because we respect the human being from the first moment of conception. He also writes that, when an abortion takes place, this not only has consequences for the embryo that was going to be born, but also for the woman who thought of it and did harm to herself, because many women die during such procedures.

4) The couple should face whatever difficult circumstances arise during pregnancy with faith in God’s Providence, prayerfully, and with discussion with an experienced and discerning spiritual father. There are some parents who avoid having antenatal checks, because they create many ethical and spiritual dilemmas that they cannot face, unless a Christian medical specialist indicates a particular reason for such a check. In any case, there is the possibility of treatment by surgical interventions inside the womb, as mentioned earlier, or it may be possible to diagnose an illness and to make the necessary preparations in advance for appropriate action after the birth. The antenatal check is helpful in such cases.
Ultimately, whatever may happen in this respect, the Christian woman who is pregnant faces the situation with prayer and faith in God. We know, of course, that whenever an unfortunate choice is made and a sin is committed, the mercy and love of God can put everything right through sincere repentance and confession. The Church is a spiritual hospital and the Clergy are spiritual physicians who treat people by the power and energy of God.

3. Prolongation of Biological Life

a) Blood Transfusions

1) Man’s soul is the spiritual element of his existence which, together with the body, constitutes the whole human being. The blood is part of the bodily organism and is not, of course, identified with the soul. According to St Gregory Palamas, “The soul is everywhere in the body.” As essence it is in the heart as in an organ, and as energy it is in the whole body. In Holy Scripture the word ‘soul’ is used with many meanings. Sometimes it denotes the spiritual element of human existence, sometimes it describes the human being, and sometimes it means life. Thus in some cases it is written that animals also have a soul, in other words, life. In human beings the soul has essence (nous and free will) and energy, whereas in animals it only has energy, which is why they act by feeling and instinct. There are passages in the Old Testament in which the soul is equated with blood, for instance, “The soul of all flesh is in its blood” (Lev. 17:11) and “Be sure not to eat the blood, for the blood is the soul” (Deut. 12:23). Here the word ‘soul’ means life (and is translated as ‘life’ in English versions of the Old Testament), because blood is the basic element that constitutes and sustains life.

2) The Church does not regard blood transfusions as a problem, provided that they take place with the free consent of the donor, but also with benevolent intentions towards the recipient.

3) Blood transfusions should not take place with selfish aims or on a commercial basis.

b) Organ Transplants

There has been, and continues to be, much discussion about transplants, particularly within the Church, because they give rise to various ethical and theological dilemmas. The basic views on this discussion are as follows.

1) The Orthodox Church does not reject science and does not come into conflict with it, provided that the results of research prove beneficial for humankind, and that science itself erects barriers to prevent unreasonable and harmful research. In any case, the Church and science have different aims. Science can never replace or be a substitute for the Church and its theology. Organ transplants help to prolong human life and improve the so-called ‘quality’ of biological life.

The Church, of course, has the right not to accept some achievements of scientific research that go against its theology, just as Christians are free not to make use of all scientific achievements. If they are at liberty to refuse to obey God’s will, they are even more at liberty to refuse, on a personal level, to accept scientific developments.

2) Orthodox anthropology, according to the patristic tradition, states that the rational and noetic soul acts as essence in the heart, which is not regarded as a vessel containing the soul, but as its organ. The energy of the soul is located in the brain and throughout the body. It acts or is manifested as the body grows, according to the words of the commentator on The Ladder of St John Climacus: “The soul at that time is just as active as the flesh. As the body grows, so the soul increasingly manifests its energies.”

The soul is not simply contained in the body, but contains and holds the body, gives it life and unites it. When an organ of the body becomes sick for various reasons or stops functioning, this does not means that the soul is lost or fragmented.

In the patristic tradition it is clear that, apart from the soul’s rational faculty (reason, logos), the soul also has a noetic faculty (nous). When the rational faculty does not function because there is no suitable organ, as in the case of embryos, newborn infants, anencephalic newborn infants, and people who are brain-dead, the soul’s noetic faculty nevertheless exists and functions, as do other energies. Consciousness and man’s relationship with God are not determined solely by the soul’s rational faculty, but primarily by its noetic energy.

St John of Damascus defines the soul as follows:

“Now the soul is a living essence, simple, incorporeal, invisible to bodily eyes according to its nature, rational and noetic, formless, using the body as an organ and giving it life, growth, sense and generation. It does not have the nous as something distinct from itself, but as its purest part, (for, as the eye is to the body, so is the nous to the soul). It is free, endowed with will and the power to act, and liable to change, that is, changeable because it is created. It has received all these things according to nature from the grace of its Creator, and from this grace it has also received both its existence and its being naturally as it is.”

According to St Maximus the Confessor, the human soul has three powers: the power of nourishment and growth, the power of imagination and instinct, and the power of reason and nous.

Consequently, the question of when the soul leaves the body must be investigated from the point of view of what the soul is. This is not scholasticism. Also, the soul’s departure from the body comes about by God’s will, because “the most natural bond of kinship is cut off by the divine will, and every human being is dissolved.”

Certainly, in most cases medical science does not accept this Orthodox Christian anthropological viewpoint today. We Orthodox, however, should not easily renounce and deny it. If we do, this will open the way for us to accept that the embryo does not have a soul in the first fourteen days after its conception, because medical science asserts that the stem cells have not yet been differentiated, the foundations of neural tissue have not yet started to be formed, and embryos do not have souls. It will also open the way for us to accept that those who are in a deep coma and unconscious do not have souls.

3) The Orthodox Church faces all issues, including that of organ transplants, from a pastoral point of view. From this perspective it takes a pastoral approach to the donor, the recipient, and the transplant team who harvest and transplant the organs. It investigates why and how the transplant is offered, why and how the recipient accepts it, and why and how the transplant team acts.

4) From a theological point of view, it must be investigated whether the organs for transplantation are taken from living donors or from ‘cadaveric’ donors. We use the term ‘cadaveric’ donors with reservations, because there is a serious problem on this point, as we have mentioned. Essentially, someone who has undergone what is called ‘brain death’ is not dead according to Orthodox theology. When someone donates an organ of which he has two, without this bringing about his death, this is regarded as altruism, sacrifice and love. When, however, taking organs presupposes the death of the donor, this raises many questions.

5) The whole issue of ‘cadaveric’ transplants rests on what brain death is: whether brain death is identical with biological death, and when the soul leaves the body. Many views have been expressed on these matters. To assert that brain death is absolutely identical with biological death poses a major problem from the point of view of Orthodox theology. The fact that the heart functions, albeit with mechanically assisted respiration, and that other functions continue means that there is still life in the human being, and so the soul is still there. The same applies to the embryo in the first stages of its development, when there is life and soul, even though the brain has not yet been formed and does not function. Brain death is an iatrogenic phenomenon, in other words, something that results from mechanically assisted respiration. According to Orthodox theology, death is a mystery, so defining death as brain death is philosophically and theologically doubtful.

6) The Church accepts the transplantation of organs that can be taken without leading to the death of the donor. In other cases, there is a need for great caution and thorough investigation on the basis of theological and patristic anthropological criteria. The issue of offering organs could probably be solved from the point of view of conscious and free self-sacrifice and voluntary offering, acting within a Christian framework, which is distinct from suicide and euthanasia. Even this, however, is problematic for some people, because the character of the gift “changes” after death, as after death “the gift becomes autonomous of the donor” (G. Mantzarides).

Consequently, in order for organs to be harvested, it is necessary, on the one hand, to ensure the free written consent of the donor, while he was still conscious, because we do not accept what is called ‘presumed consent’. On the other hand, there must be safeguards to prevent organs that are freely offered becoming the subject of commercial transactions on the part of the donor, the relatives, the recipients, medical staff, corporations, and so on. Unfortunately, this cannot be taken for granted. It is reported that even the correctness of free written consent is doubted in various theological and medical circles.

7) We would probably not object to the use of xenotransplants (from animals), provided these were judged to be safe by medical science, because there are fears about transferring viruses from animals to humans, and upsetting the existing equilibrium in nature. The Church, however, cannot agree with the possible creation of tissues for transplantation following the appropriate cultivation of human embryonic cells, because in the process of obtaining these cells the blastocyst, and consequently the embryo, is destroyed. This is because, according to Orthodox theology, the soul is in the embryo from the moment of conception. It is a different case when progenitor cells from adults and progenitor embryonic cells (stem cells) taken from the umbilical cord are used for research and transplantation, provided that this is not the result of abortion and is not commercialised.

8) The ultimate aim of transplants ought not to be simply the prolongation of biological life, but the repentance and cure of human beings, so that, by means of purification, illumination and deification, they may be eternally united with Christ. Without this basic presupposition, any sort of transplant is expedient, utilitarian and anthropocentric in character, and does not assist in salvation. Merely prolonging biological life is not enough, nor is it theologically correct; death must be overcome by participation in the mystery of the Cross and Resurrection of Christ.

c) Cell and Gene Therapies and Prevention of Illnesses

1) The Church is not against scientific research that aims to relieve human suffering and cure illness, even by means such new developments as gene therapy, organ transplants and so on, provided that the scientists themselves set barriers to prevent unreasonable research.

2) Unfortunately we see that the production of human embryos is being pursued in order to take the progenitor embryonic cells and exploit them for so-called therapeutic cloning. Many people claim that even in vitro fertilisations have taken place, and continue to take place, in order to facilitate research by using the ‘surplus’ fertilised ova, rather than for the purpose of bearing children. Orthodox theology cannot accept this.

It is to be hoped, however, that the necessary drugs and suitable methods will be found to treat the various illnesses that afflict humanity.

There are many people who stress the need to pay particular attention, on the one hand, to research on progenitor cells from adults, which are a very viable alternative solution to treatment with cell transplants, and, on the other hand, to harvesting progenitor cells from the umbilical cord so that they can be used later for possible therapeutic purposes, and perhaps also to new ways of producing stem cells, should this eventually become feasible. This second case, however, again raises a question and concern about lack of confidence in God’s Providence and the rationalisation of life.

3) Gene therapies using different techniques run the risk of provoking scientists to create a human being with exaggerated abilities and skills in various members of his body, essentially, to create a superman. Such experiments are also attempted in sport by means of genetic doping. Consequently, there is always the potential danger of genetic racism and a eugenic society as a result of such interventions. In addition to therapies for the good of humankind, the issue can deviate into actions hostile to human beings. In philosophy and theology this is called hubris, and it could lead to the creation of chimeric (partly human) beings.

4) It should not be ignored that none of these scientific efforts can conquer death, because among the genes there are also genes that contribute to ageing. Death, therefore, is an illness that we inherit from the moment of our conception. Human life can be extended through medical research and discoveries, but death cannot be overcome by created human means. Victory over death is a gift given to humankind by Christ, as He conquered death through His Resurrection.

This is clear from the lives of the saints, especially from their incorrupt relics. We know that human skin is a mass of cells and, of course, the genes of ageing are present in these cells. When the soul leaves the body, in the normal way the skin ought to disintegrate, being subject to the corruption and mortality that rule humankind. In the relics of the saints, however, it is clearly shown that the law of corruption has been conquered by the uncreated deifying energy of God. The incorruptibility of the saints’ relics is an actual fact, and, apart from its theology, it would be interesting for it to be studied from the scientific point of view.

4. The End of Biological Life

a) Euthanasia

The Church faces the issue of euthanasia from the Orthodox perspective that we saw earlier, when we identified the way in which the Church handles other bioethical problems. Four important points will be mainly emphasised here.

1) Life was given to human beings by God, so it is God’s gift to humankind. This means that God alone, not man, has exclusive rights over life. God has power over life, and He takes life when the right time comes. A human being is not entitled to take his life, as he is not the cause of life.

2) Biological life is not an absolute. Human life does not end with the death of the body. Liturgical texts contain the phrase “perfected in peace”, referring to the death of saints. Lifetime ends with death, but life is perfected. The end of a lifetime is one thing, and the perfection of life is another. In any case, the departure of the soul from the body is not called death but falling asleep. The soul lives after its departure from the body; the human being is not abolished. At Christ’s Second Coming the body will rise, the soul will enter it, and the human being will live for ever with both soul and body, a spiritual body, according to the degree of purification, illumination and deification. It is significant that the way of life after death depends on the way of life before death.

3) Pain is beneficial for human beings as it opens a new perspective on life, gives life meaning, and enables them to see everything in their lives, and the whole world, in a different light. The attempt to free oneself from pain is a sign of a false way of life, a life in accordance with the senses that increases another, existential, pain. What is the point of someone getting rid of bodily pain and drowning in existential pain, which is worse torture?

4) The whole dying process is regarded by most people as lost time, but this is not correct. For the patient, it is a time of repentance and preparation for meeting Christ. For family members it is a time to restore relations with their sick relative and among themselves. At the same time, all those who are near the patient’s bed express feelings of affection, love and sympathy towards the patient in various ways. It is not, therefore, wasted time, but important time for those who are ill and those close to them.

5) The dilemma of euthanasia was created by the development and use of life-support techniques and technologies that prolong life. For doctors, nursing staff and patients’ relatives, however, life-support machines create the dilemma of “prolonging life or hindering death”. What is more, the prolongation of life is only worthwhile when it has meaning, just as hindering death is only worthwhile when it has meaning.

6) When Christians, in spite of their efforts to stay alive in order to repent, understand that nothing else is going to help, it is not a sin for them to wish for a ‘natural’ death, without life-support machines and with only the necessary conservative treatment, with consciousness and prayer. And when doctors realise, on the basis of their experience, knowledge and faith in God, that they cannot do anything more, and therefore they do not use life-support machines to prolong life, but only conservative treatment, they are not ethically discredited.

In such cases we cannot refer to euthanasia.

In general, science is beneficial when it helps people to give their lives meaning, to repent, and to live with God, and when it helps them to die in a Christian way.

b) Intensive Care Units

Treating patients in intensive care units creates many ethical problems. We shall mention some of these.

1) Most patients who are admitted to Intensive Care Units are under sedation and intubated, so they cannot make decisions about future developments. Consequently the loss of ‘personal consciousness’ is replaced by ‘social consent’, in this case, the consent of the relatives. Certainly, in the case of brain death the so-called ‘presumed consent’ of patients ought not to apply.

2) Another problem is the state of the relatives of patients being treated in Intensive Care Units. The area of the intensive care ward does not lend itself to frequent or prolonged visits, so relatives crowd into waiting rooms for long periods in a state of anxiety, psychological insecurity, shock, fear, and so on. This obviously gives relatives the chance to express their love for the sick, to pray and also to restore strained relationships between themselves. On no account should they argue or take decisions about their sick family members based on economic interests.

3) Another ethical and spiritual problem to be faced concerns the nursing staff. Their work is certainly difficult and calls for attention, seriousness, courtesy, sensitivity and composure. As well as these professional qualities, those of them who believe in God ought to have a prayerful attitude towards patients. Sensitive movements and prayer for the patients help effectively. Because patients in Intensive Care Units are unable to pray, and their relatives are not able to help, as they are not allowed to be present, nursing staff ought to be like angels of prayer and kindness. It is they who stand beside dying patients and face the mystery of death with all its consequences. They are the only ones who are with these people in the last hours of their life.

In conclusion we ought to say that science with its achievements should help people to have quality of life. It must not, however, make them die unconscious and without prayer. It ought to help them, particularly if they are Christians, up to a point, and subsequently, using conservative treatment, it should leave them to prepare themselves for their meeting with Christ, provided, of course, that this is what they wish, because their freedom must never be violated. On the other hand, those who are sick ought not to choose this way of ‘natural’ death because they reject medical science, but because they know that there are limits to human efforts, and that in the end they must leave themselves in God’s hands with absolute faith in Him.

Christians know that death is the end of biological life, but it is not the end of life, which continues after death, as the Orthodox Christian Tradition teaches. Both biological life and biological death ought to have meaning, and above all a Christian meaning. When this meaning is lost, human beings lose their aim and their destiny.

5. Biotechnology and the Environment

1) The universe was created by God and He is the Lord of the world. The one who creates something also has power over it. The Father, through the Son and in the Holy Spirit, created the angels first, then the material creation, and finally man, who is made up of spiritual and material elements (soul and body), and is the microcosm of the entire universe. The kingdom was created, and then the king was created to enter it.

2) Human beings reign over creation; they are rulers of creation by God’s command. They cultivate creation and manage it with God’s special permission and authorisation, so they are not able to appropriate it for themselves. Although they manage it they must not usurp it. This means that their jurisdiction is limited and they cannot behave as God, but as God’s stewards and managers who have been authorised by Him. Arrogance has consequences both for human beings themselves and for nature.

3) God’s energies exist in creation. God created the world from nothing and directs it by His uncreated energies, not by created means. The creation does not bear fruit automatically, and reproduction is not a characteristic of the creation, but it is God’s energy that brings it about. Precisely for this reason, those who are in contact with God, the saints, love and respect creation. This also means that it is not vitamins and calories that nourish human beings, but God Who keeps them alive by means of food, vitamins and calories.

4) With the fall of man corruption entered irrational creation as well, so nature groans and suffers together. The creation does not have a moral will and it cannot do evil, but it was changed by the fall of man. Because man is the microcosm of the entire universe and the connecting link that holds creation together, his fall had devastating consequences for the whole creation, as he dragged it down with him into corruption. At the same time, however, the regeneration of creation will come about by the regeneration of human beings through God’s grace.

5) Human passions have consequences for creation as well. Overconsumption of food, due to the passion of self-indulgence, creates the need for overproduction, and this leads to the violation of nature. Thus nature suffers violence from rebellious, arrogant and presumptuous human beings. It is significant, however, that violated nature takes revenge on humankind, from the point of view that the modification of natural foodstuffs that people eat has terrible effects on their health and physical constitution.

6) Many of the efforts made by geneticists can be regarded as a violation of nature. By means of recombinant DNA from different organisms and plants, using a process different from natural reproduction – introducing animal and human genes into plants – they seek to intervene in nature. This has serious consequences.

7) We do not, of course, reject every attempt to improve the resources and products of the earth and created things. However, we must not reach the point where these created things are changed, resulting in genetic contamination of the environment and a crisis in eco-systems, which may give rise to unforeseen consequences for human health and life.

8) The argument that the phenomenon of hunger on our planet will be dealt with by means of such methods of recombining the DNA of organisms and plants is invalid from the biotheological point of view. Hunger is dealt with by ensuring that just social and economic systems prevail, so that wealth is not concentrated in the hands of a small number of people. It is also countered by reducing armaments and space research. Nor is the argument that foodstuffs should be improved valid from the point of view of Orthodox bioethics, because it is the passions of love of money, acquisitiveness, ambition and self-indulgence that pollute nature through overproduction and overconsumption. People’s health does not depend only on eating, but most of all on their lives having meaning. In the same way, illness is not only the result of external factors, but originates, on the one hand, from the corruptibility and mortality inherited by human beings, and, on the other hand, from existential problems that preoccupy them and remain unsolved. A doctor used to say that we do not fall sick from the things we eat but from the things that ‘eat’ us.

Finally, many such efforts reveal that man wants to become immortal, or feel immortal by his own abilities, as though he were a little God, and he wants to live in an eternal and healthy world, ignoring the fact of mortality and corruptibility, overlooking the “new heavens and new earth” that will come after the Second Coming of Christ, and not waiting for the arrival of the eschatological Kingdom of God, which can be sampled from now by living in the Orthodox Tradition.

6. Biomedical and Medical Research

1) From the views of various scientists, researchers and specialists in biomedical and medical research connected with patents, biobanks and clinical trials, it is clear that all research is implicated in different forms of interdependence with corporations and research centres. These things are not as natural as some people claim. Apart from some well-disposed researchers motivated by an interest in dealing with problems afflicting humankind, there are others who place all research in the context of vested interests and commercial gain. There is a difference between scientists in the past and those of recent times, because corporations and universities complicate the issues.

One way or another research continues and it requires sources of funding and capital. Some people claim that without funding by corporations there would be no progress in medical science or in the discovery of drugs. It should be emphasised, however, that we must not go so far as to accept the principle that “the end justifies the means”; nor should timeless ethical, cultural, social and theological principles be infringed. It is in this sense that we ought to investigate these issues, and not in the sense that we are against scientific research and the contribution that corporations make to it by.

2) Orthodox theology regards the science of biotechnology and biomedical research as human sciences that ought to be concerned with the human body and the illnesses that afflict it. They are unable, however, to give life meaning or to overcome death. It is wrong for human research to replace God and man’s relationship with Him, and to evolve into an autonomous religion of its own.

3) The attempt by some researchers to replace God or to be a substitute for Him is arrogance – ‘hubris’ in its ancient sense of insolently overstepping human limits. It is like building a Tower of Babel. Human beings can cultivate the earth. They can even carry out research on the human body in order to improve their health and treat various illnesses. But they cannot feel as though they were God on earth. In any case, they are unable to create something out of nothing; only God can do that. The uncreated existence-bestowing and life-giving energy of God is present in the whole of creation.

4) It is possible that an attempt could be made through modern biotechnology to arrive at the philosophical concept of the superman, as formulated by Nietzsche. Human beings want to feel that they have many capabilities, so as to impose themselves on other people and on the environment. This desire, however, expresses the passions of self-indulgence, love of glory, and love of money. In Orthodox theology, by contrast, the concept of the superman is fulfilled in the best possible way by the empirical experience of deification. We do not speak about supermen in Orthodox theology, but about the deified. By the energy of God human beings even overcome death and become gods according to grace.

5) Orthodox theology cannot accept a eugenic mentality, according to which new human beings can be constructed to high specifications, and, by extension, others who do not have the same specifications can be destroyed. This would result in the development in modern societies of a sort of racism, or a strange and erratic Caeadas ravine, like the one into which Spartans flung ‘unfit’ individuals.

6) Modern biomedical research may help people to be delivered or find relief from various illnesses and the pain they cause. When, however, this research proceeds unchecked, it violates nature and the human organism with unforeseen consequences, as we have stated repeatedly. Human beings cannot be regarded either as supermen or as laboratory animals.

With regard to biomedical research, not only should the framework set by modern bioethical science be taken seriously into account, but also the principles of Orthodox theology. Bioethics itself must be imbued with biotheology.

7. General Biotheological Principles

According to Aristotle, man “by nature has a desire to know”. If this applies to every field of human knowledge, it applies even more to the mystery of life. Human beings have always been preoccupied with the question of what life is, how life begins, who gave them life, what existed before their conception, where they were before, and what the meaning of life is. It is striking that from the beginning of their lives children are interested in these questions. However, such questions frequently arise at any age and at critical times, in adolescence, middle age and old age, as well as in extreme life-or-death situations.

Today, with the combination of technology and medicine, it is possible for human beings to investigate these serious questions, particularly about what happens as soon as they are conceived and how they lived in their mother’s womb from the moment of conception. The problem is basically theological.

A few brief but crucial theological responses on bioethical and related issues are set out below.

a) Theology and Science

Elsewhere I have upheld the view that Orthodox theology does not come into conflict with science and is not opposed to it. If this was the case at some point in history, it was in the West, where theology was identified with metaphysics and for that reason, during the Renaissance and the Enlightenment, leading thinkers attacked and refuted metaphysics. Orthodox theology, however, as it was expressed by the Fathers of the Church, was never linked with metaphysics.

In fact, the subject-matter and aim of Orthodox theology are different from the subject-matter and aim of science. Orthodox theology holds that the whole world is the creation of the love of the Triune God and that it is directed towards an end, which is its transfiguration. Human beings were created by God in His image and likeness, which means that they have a nous and free will, and make their way towards deification. Science investigates the world, specifically the world as it became after the fall of man, when corruption and mortality entered human beings and the creation. Whereas science is engaged in treating the ‘garments of skin’ of corruption and mortality, Orthodox theology’s involvement and concern lies in overcoming death and uniting human beings with God.

Another interesting point in this connection is that, although science does not have God and is involved in researching the created world, it is possible for a scientist to believe in God or not. As Fr. John Romanides has written in characteristic fashion, a theologian can get involved in science, but he does this on account of the scientific knowledge he may have acquired, not on account of his theology. And a scientist can engage in theology, but he does so on account of his theology, if he has empirical knowledge of God, and not on account of his science. As in earlier times astronomers who studied the phenomena of the starry sky could declare “How great are Your works, O Lord!”, so now scientists working in molecular biology can declare “How small are Your works, O Lord!”, or rather, “How great are Your works in their minuteness, O Lord!”

There cannot be hostility between science and theology or between theology and science. This does not mean that scientific research should proceed unchecked, because this could have terrible and distorting results. Medical research should be limited by the rules put it place by science itself, which will probably be influenced both by theological views on human beings, and by other principles accepted by philosophy and society.

It was precisely this that prompted the development from the 1960s onwards of the science of bioethics, which attempts to set boundaries within which medical research will be conducted.

I shall now set out the basic theological principles with regard to human beings from their initial conception until the end of their biological life, principles that Orthodox scientists may bear in mind.

b) Basic Theological Principles for Biomedical Science

According to Orthodox teaching, human beings are God’s most perfect creation. First God created the noetic world, the angels, and then the visible world, the whole universe. Last of all He created man, who consists of noetic and perceptible elements and is therefore the microcosm of the whole universe and the summary of the entire creation. After the fall, corruptibility and death entered human beings, and are expressed through illnesses and death. For that reason, Christ, by becoming man and voluntarily assuming a mortal and passible body, summed up the world and deified the human nature that He had assumed, making it possible for everyone to experience deification starting from this biological life.

I shall set out ten basic theological principles. These are not philosophical principles, but expressions of Orthodox theology. They concern human beings and, of course, they concern all research on human life.

First Principle. The uncreated energy of God exists in the whole of creation and in human beings. According to the teaching of the Fathers of the Church, there are no natural laws in creation, but there is God’s uncreated energy. God did not create the world, place within it certain natural laws, and then abandon it, as Deists believe. Instead, He directs the world Himself through His uncreated energies. The whole world participates in different ways in the existence-bestowing, life-giving, wisdom-imparting, and deifying energy of God. The entire creation shares in God’s existence-bestowing energy. Animals and plants share in His life-giving energy as well. Human beings share not only in His existence-bestowing and life-giving energy but also in His wisdom-bestowing energy. And the angels and the deified share in God’s deifying energy as well.

Some fixed principles certainly exist within creation and humankind. These, however, cannot be regarded as created natural laws. Rather, they indicate that God’s uncreated energy acts in a stable way and they reveal God’s faithfulness. Miracles, therefore, are not a denial of the natural laws that were allegedly put in place by God. If this were the case, God would remove Himself by miracles. Instead, the explanation for miracles is that at this moment God wishes to act differently from how He acted previously.

It is well-known that the natural world as we know it today is not as God created it. After the fall of man corruption and death entered creation. However, we expect that even this creation will be set free from corruption and renewed at the Second Coming of Christ. We have a foretaste and preview of this renewal of creation in the life of the saints.

Second Principle. God created the world personally of His own volition and in a positive way. He did not act of necessity when He created the world and human beings. We say thus to underline the fact that we cannot accept the views of metaphysics about a naturally mortal body and a naturally immortal soul. According to metaphysics, the soul was allegedly in the uncreated and immortal world of ideas, and that it moved away from there, with the result that it was punished by being imprisoned in a mortal body; thus man’s salvation consists in the soul’s liberation from the body and its return to the uncreated world of ideas.

Orthodox theology teaches that man, who is made up of a soul and a body, was created in a positive way by God, and at no time was the soul alive before the body, nor the body before the soul. Both soul and body were created simultaneously.

As God’s creation, man “has existence on loan”. It is a gift from God, and man ought by nature to relate to God. His fall was the loss of this relationship. Consequently, humans are not self-sufficient and autonomous beings.

Third Principle. The creation of Adam and Eve is repeated at every new human birth. According to St Athanasius the Great, “The same hand that fashioned Adam then also fashions and constructs, now and always, those after him.” And according to St John Chrysostom, “Bearing children has its origin from above, in God’s Providence, and neither woman’s nature, nor coming together, nor anything else at all is sufficient to bring it about.” Everything comes about by God’s creative energy. The body is created by God through the genetic material of the parents, and the soul is created at the same time as the body by God’s direct intervention.

St Maximus the Confessor, writing about the biological birth of a human being, says that it is one single birth on account of the co-existence of soul and body, but it is divided into two “because each is generated in a different way”. He says this because the cause of the soul’s existence and the manner of its creation are different from the cause and manner of the body’s creation. The body is generated at conception from the existing matter of the other body, whereas the soul is generated at conception by the will of God, through His life-giving inbreathing, in an ineffable and unknowable manner. Both soul and body, however, constitute one unity, “one species”: man.

According to the teaching of St Basil the Great, “With us there is no nice enquiry as to its being formed or unformed”. In other words, we cannot make a distinction between an embryo that has not taken shape and an embryo that has taken shape. According to Balsamon, an interpreter of the sacred Canons, “This was said on account of those who say that, because, when the seed is sown in the womb, it does not at that point assume the form of a human being, but first it is turned into blood, then it solidifies into human flesh, and then it is shaped and moulded into members and parts of the body, it is not murder when an embryo that has not yet taken form is aborted.”

It should also be mentioned that the Fathers say in connection with Christ’s conception that “[the embryo] receives a soul immediately upon conception.” Thus the human being receives a soul at the very moment of conception. There is no intervening time between conception and receiving a soul, nor is the soul received by a gradual process. In the Orthodox Church we believe in the existence of the soul “from the first moment of conception” of the human being. That is also why the Church celebrates the Annunciation of the Theotokos, which is the feast of Christ’s conception in the womb of the All-Holy Virgin, and the feasts of the conception of the Theotokos and the conception of the Honourable Forerunner. The human being is a unity of soul and body from the first instant of conception, as soon as the ovum is fertilised.

Fourth Principle. The soul and body are united to one another. According to the Fathers, just as the lover is attracted towards his beloved, so the body and soul are mutually attracted. The soul is not located in one specific place in the body, as metaphysics teaches, but “is everywhere in the body”. As essence it is in the heart – not as in a container but as in an organ – and as energy it is in the thoughts and in the body. The separation of soul and body at the moment of death comes about by God’s will, but “the most natural bond” is loosed “forcefully from its harmony and kinship.” This is the mystery of death.

The soul has two parallel energies: the noetic faculty and the rational faculty. The noetic faculty exists and functions from the first moment of conception, but the rational faculty develops with the passage of time. Verbal thinking is cultivated in childhood, and later, during adolescence, critical thinking develops. As time passes the composition of soul and body is perfected. Although the human being exists immediately upon conception, the soul expresses itself as the body develops and becomes complete.

Human beings were created by God in His image and likeness. Being in His image is a given fact; being in His likeness is the goal that we ought to reach. Human beings have a nous and free will. They are not living machines, but have a distinctive quality that separates them from other beings. For that reason they cannot be regarded as laboratory animals or as biological machines.

Fifth Principle. The mortality and corruptibility of the body are the result of Adam’s sin. Essentially they result from the ancestral sin that human beings inherit. Death exists in man; we are born and we die. Sicknesses, the growth of the body, decay and ageing are consequences of the entrance of death into the human body.

In the Orthodox Church we believe that Christ voluntarily assumed a mortal and passible human body without sin, in order to conquer death within it. However, corruptibility and mortality did not act on Christ compulsorily: Christ, as God, had authority over them. And those who are united with Christ are set free from the tyranny of death.

Medical science wages war on death and struggles to prolong biological life, but it cannot conquer death or help people to overcome it. Human beings want victory over death, not prolongation of life. We are grateful to science, which acts as God’s gift when it mitigates human suffering, but death is only conquered by the grace of God starting from this life.

Sixth Principle. Corruptibility and mortality, which are expressed initially by illnesses and then by death, can function to the benefit of human beings. They remind them that biological life is temporary. This makes them see things in a completely different way and also to develop their creativity.

Pain perfects human beings. It makes them love one another and see life and one another from a different perspective. Suffering refines their attitude to life. Death-centred cultures are more social and humane.

Pain and suffering are inseparably linked with pleasure, according to St Maximus the Confessor’s analysis. Pleasure brought pain, and overcoming suffering and pain cures pleasure. Thus pain, according to Orthodox teaching, is beneficial for humankind. According to St Gregory Palamas, all suffering and trials “collaborate for salvation”, and are sometimes “better than health itself”. A society that banishes pain and strives for continuous happiness (eudaimonia) in incapable of helping people to be saved through faith, patience, tolerance and prayer. Pain is a new revelation in history that came about through Christ. Through His self-emptying, through assuming a perishable and mortal body, and through His Passion and His Cross, Christ showed us a new dimension to our life, which is an expression of love for our neighbour. Man is made perfect through suffering and sacrifice.

Seventh Principle. Human beings have the privilege of freedom. If one bears in mind that, according to Orthodox teaching, they are human beings from their conception, this means that they have freedom, which ought to be respected, from the beginning of their life. Their ‘right’ to life and freedom must be respected absolutely, especially in those cases when, as embryos or newborn infants, they cannot defend themselves.

When we refer to freedom, we do not mean it only in the philosophical or ethical sense, simply as the possibility of choosing between good and evil, although even that has its value, but as the possibility of self-determination of one’s existence. This cannot be the case at conception or birth, because no one is asked whether he wishes to born. As this is impossible, human beings are given the possibility of experiencing freedom through their own conscious rebirth. Apart from their birth, for which they are not responsible – they were not asked and often their conception resulted from love acting as an instinctive necessity on the part of their parents – there is the possibility of rebirth, which comes about by God’s action and their own collaboration, within the Church and through the Mysteries.

Eighth Principle. The worth and significance of human beings does not lie simply in their birth and biological development, but above all in their development towards God. Just as there is biological development, because they start as embryos, they are born, become infants and grow, so there is also a spiritual development that starts from biological life and reaches as far as deification. Human beings, while preserving the elements of their biological nature, can be deified. They can reach participation in the deifying energy of God, the deification of soul and body, and communion with God.

St Maximus the Confessor speaks of three births: the biological birth by which we receive “being”; birth “from Baptism”, by which we receive “well-being”; and birth “from resurrection”, when we are transformed through grace into “eternal being”. The last two births make the first, biological birth worthwhile.
Consequently, man’s birth and his rebirth in grace prompt him to go on to exalted spiritual states and to become god by grace, in other words, to become according to grace what God is according to nature.

Ninth Principle. Although human beings from their conception bear within them mortality and particular inherited traits, they can nevertheless, through life in the Church, Baptism, Chrismation and Holy Communion, overcome death starting from this life. This is expressed and experienced by not being afraid of death, by the desire for death – because they want to meet those dear to them, especially Christ, the All-Holy Virgin and the saints – and by the incorruption of their bodies (holy relics). All these characteristics are observable in holy people, who have been united with Christ and whose lives have acquired another meaning.

At this point we should look particularly at the great significance of the incorrupt relics of the saints, which show clearly that skin, which is a mass of cells, does not disintegrate and decay. The cells that contain the genes of ageing ought, in the normal way, to be destroyed. The fact that they are not destroyed is due to another power, God’s grace, by which corruption and mortality are conquered. Science should research this important case, which is part of biological life.

Tenth Principle. The Orthodox Church believes in life after death, that the soul, even when it is separated from the body, exists, lives and feels. Also, despite the separation of the soul from the body, the human being is not abolished. The saints are referred to as deified, because they have received the grace of God in their souls and bodies, and their bodies have become holy relics. They experience the suspension of bodily energies. The bodies of the saints do not have the elements of corruption. At the Second Coming of Christ, their souls will enter their bodies, which will be resurrected as spiritual bodies. They will not be subject to corruption, death, illness, or the limitations of space and time.

Orthodox bioethics, biotheology, without overlooking medical science and ethical and deontological rules, transcends them, and gives human life another dimension.

In general, it should be noted that the Orthodox Church with its theology does not hinder research in scientific subjects. Such research can and does produce some positive results for human life, as well as negative ones. The Church respects science and scientists.

With regard to biomedical research, the Orthodox Church accepts three things. First, that bioethics and the international organisations, for the good of humankind, should set limits to contemporary research, which could get out of control. Secondly, it wants the science of bioethics and doctors to take seriously into account the theological principles that are the life of the Church, and at least to respect the Christian faith. Thirdly, it wishes to stress that the value of human beings does not lie solely in their birth, but in their rebirth, when they find a meaning to life, because then they rejoice in their own biological birth and in the whole creation. It should be emphasised that even the very best conditions – springtime, physical well-being, material happiness, economic sufficiency, various kinds of prosperity, and social and scientific success – without a meaning to life, without the God-man Christ, Who is experienced in the Church by participation in the purifying, illuminating and deifying energy of God, are hell.

On the one hand, another tragedy like the Tower of Babel must be avoided; on the other hand, human beings must find meaning in life and communion with God.



Since 1982 the nuns of the Birth of the Theotokos Monastery have been publishing the books of Metropolitan Hierotheos, the founder and spiritual father of the community, and distributing them throughout the world.


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