Right-to-Life Issues in Contemporary Bioethics Fiction

Abstract:  This study reviews literary works from the twentieth and twenty-first centuries which concern bioethical aspects involving the foundations of the right-to-life issues of abortion, infanticide, and euthanasia.  After considering definitions of “bioethics” from various sources, the paper derives three general principles from the literary works and examines how each of these principles is depicted.  Finally, the research highlights fictional works which include ethical standards developed by religious sources, filling the ethical void created by most bioethics fiction.

          Granted that, according to Merriam-Webster’s etymology, the term “bioethics” was first used in 1970, it is spectacular how a concept of a mere half a century has had such a major effect on humanity after six millennia of culture, law, philosophy, and religion.  United with its companion term “technology”, bioethics has not only affected, but also changed (in the sense of altered the generation and physical composition of) human life as profoundly as any economic, industrial, political, or other revolution of the past.  While other conference speakers will address the legal, moral, and philosophical aspects of bioethics, this study offers a humanities perspective, focusing on bioethics fiction, specifically full-length novels.

I.  Resolving Two Questions

          Before delving further, it may be helpful to resolve two questions: first, what can a humanities approach bring to a subject which is essentially more technical than artistic, and, second, since there are many genres of “fiction” (for example, “cowboy fiction”, “romance fiction”, “science fiction”, or even, here in Minnesota, “Lake Wobegon fiction”) what is the definition of “bioethics fiction” and how does that differ from the other categories?

Although it has its limitations, scholarly commentary on bioethics in literature provides some interesting ideas to help answer these two questions.  For example, in what reads as a philosophical justification of a humanities approach to bioethical works, if not an effort to allay humanities professors’ anxieties about being excluded from the discussion about such fiction, Meera Lee Sethi and Adam Briggle write:

Science and storytelling appear antithetical.  Science deals in a non-narrative form of rationality, offering facts where stories offer interpretations.  But Rejeski pushes back on that easy dichotomy.  “Storytelling and narrative are absolutely critical to science,” he will tell you.  “The public uses stories to understand science, and so do scientists, whether they’re doing it on purpose or not.”  One place where the two realms intermingle is the space Rejeski happens to inhabit every day: evaluating the human significance of new scientific discoveries.  What is life? What would it mean to live in a world where humans synthesize life?  (33; italics in original)

Bruce Jennings considers the deeper structure of the category of literature under discussion here.

Indeed, the narrative that bioethics has fashioned for itself has been mainly a liberationist romance: a quest narrative in which the individual, seeking autonomy, struggles against limitations, constraints, and inhibitions imposed by forces (rules, roles, institutions, interference by others, customs, traditions) from the outside.

Today this liberationist romance is being challenged, revised, and deepened from at least two angles.  One, which might be referred to as “deontological humanism,” refines our comprehension of individual freedom and dignity beyond minimalist notions of self-reliance and freedom from others’ interference.  A second perspective, which offers a critical deconstruction of what it calls “biopolitics” and “biopower,” provides a more overtly political and systemic narrative of ethics in the face of power.  (16)

Despite efforts to show that a humanities approach to bioethics is warranted, some humanities scholars may be hesitant about addressing contemporary controversial issues which bioethics fiction raises, which is understandable if they are anti-life since opposition to right-to-life positions is never morally justifiable.[1]  However, one can concede from these few citations that a humanities approach is appropriate.

Resolving the second question (what constitutes “bioethics fiction”) is more challenging.  The definitions of “bioethics” range from simple-structured sentences to elaborate formulations.  Merriam-Webster defines it simply as “a discipline dealing with the ethical implications of biological research and applications especially in medicine.”  In contrast, one essay in the magisterial Bioethics combines both etymology and definition:

Bioethics originated in the late 1960s in the United States.  Its roots are in the traditional medical ethics of Anglo-American medicine; in the cultural setting of American health care; and in certain social, religious, and moral perceptions that had emerged in the American ethos.  As the 1970s opened a number of scholars were attempting to analyze issues in medical ethics using the perspectives and methodologies of the two disciplines traditionally concerned with ethics, philosophy and theology.  As these scholars began to publish and discuss their work, a distinct field of study called bioethics came into being.  The word bioethics was coined by Van Rensselaer Potter (1971) and first applied to the ethics of population and environment.  It soon became the rubric for a diverse collection of considerations about the ethical issues inherent in health care and the biological sciences.  (Jameton and Jonsen, 184; citation omitted)

This same source provides a more detailed account of the definition of “bioethics” thus:

Bioethicists show considerable interest in the theoretical definition of the field and its methodologies.  In 1974 Albert R. Jonsen and André E. Hellegers published an essay delineating bioethics as a mélange of traditional professional ethics, philosophical ethics, and theological ethics.  Robert M. Veatch, however, was the first to attempt a full exposition of the theoretical underpinnings of bioethics.  His 1981 book, A Theory of Medical Ethics, set the field firmly on the ethical considerations relative to autonomy of the patient.  H. Tristram Engelhardt Jr. […] followed in 1986 with The Foundations of Bioethics, an even more strongly stated thesis about autonomy as the basis of the discipline.  Nevertheless, some have asserted that bioethics, though it had its origins in the strong affirmation of autonomy for patients, may have moved too far in this direction and thereby neglected other aspects of health care, such as benevolence, community, and social justice (Jameton and Jonsen 196; citations omitted)

The definition of “bioethics” in the most common online source which virtually all students and the general reading (that is, internet “reading” or surfing) public (and many faculty) use, Wikipedia, is as follows:

Bioethics is the study of the typically controversial ethical issues emerging from new situations and possibilities brought about by advances in biology and medicine.  It is also moral discernment as it relates to medical policy and practice.  Bioethicists are concerned with the ethical questions that arise in the relationships among life sciences, biotechnology, medicine, politics, law, and philosophy.  It also includes the study of the more commonplace questions of values (“the ethics of the ordinary”) which arise in primary care and other branches of medicine. 

          As can be expected, legal scholarship is substantial in bioethics.  Although legal contributions often add to the ambiguity of what “bioethics” means, some scholars add contemporary political controversies to the field, thus clarifying the domain of this body of legal literature.  For example, the first edition (2001) of Timothy Stoltzfus Jost’s Readings in Comparative Health Law and Bioethics defines “bioethics” in a stipulative definition which applies to an entire chapter of essays:

The third chapter addresses bioethics—here understood as the right of patients to autonomous decision making, and the limits that bound this right.  This chapter examines abortion, assisted reproduction, and the right to die, including the right to assistance with suicide and euthanasia.  (xii)

This definition is repeated verbatim in the 2007 second edition (xi).

Furthermore, addressing the need for a review of bioethical practices internationally, some essays in Bioethics Around the Globe (2011) provide conflicting definitions.  In an essay on bioethics in central Europe, Bruce Jennings writes an extended definition which reads more prescriptively than descriptively:

Bioethics is a form of discourse that is shaped by particular social and cultural conditions, and that has a particular normative function in relation to these conditions.  It operates on a theoretical level and on a political-cultural level.  It must engage with moral philosophy and cognate disciplines (political philosophy, jurisprudence, theological ethics) to provide a basic normative conceptual framework.  And bioethics must engage with the actually existing values, norms, and cultural belief systems that form the context for human behavior.  Bioethics must meet actors and institutions where they are, but it cannot leave them there, because change in assumptions, commitments, understanding, and action is the entire point of the enterprise.  If it is not critical, bioethics can become apologetic and ideological.  [93]

A later essay on bioethics in South Africa asserts that the

term bioethics will not only refer to the outcome of systematic reflection (mainly occurring in an academic context) on moral problems raised by health care and the life sciences and informed by a range of multidisciplinary perspectives (e.g., philosophical, political, medical, anthropological, etc.), but also to institutional practices that provoke or are influenced by such reflection.  In short, while bioethics will refer to what is done on the level of academic training and research in the discipline, it will also refer to practices and institutions that occur and operate on the basis of social endeavors that are fundamentally informed by moral ideas and concerns.  [van Niekerk and Benatar 134]

In contrast, a final essay in this volume declares that bioethics in China “is a rational endeavor based on evidence and reasoning, and is not subject to religious influence” (Qiu 182).

These definitions are helpful to distinguish the field of bioethics from, for example, art criticism, especially when specific principles are identified to show how bioethicists resolve problems under their consideration.  These principles have remained relatively stable since the beginning of this century.  For example, in 2000 Mark Levin and Ira Birnbaum acknowledged that “the most widely accepted formulation of principles in modern bioethics [include] the four principles of respect for persons/autonomy, beneficence, nonmaleficence, and justice/fairness” (477).  A year later, Ben A. Rich identified professional competence, beneficence and nonmaleficence, autonomy, and justice as “the four ethical principles generally considered to be basic to medical practice”, “traditional medical ethics [having] evolved into bioethics during the last half of the Twentieth Century” (13, 10).

However, the definitions and enumeration of principles are largely secular formulations.  To balance the secular understanding of bioethics itself, one should consider Jewish and Christian formulations since these religions inform Western culture and should carry significant weight in any study of bioethics concerns in fiction.

Although Jewish bioethical principles are difficult to confine in a simple definition, the entire conclusion of a case study by Levin and Birnbaum summarizes the tension between Jewish bioethical principles and contemporary bioethics within that tradition:

Although the very existence of “Jewish bioethics” has been questioned, we have demonstrated that the parochial features of the Halachic system relate to the subject of inquiry rather than absence of critical reasoning or inductive process.  The approach of the Jewish Law to the issues of concern to secular bioethics can be characterized as being rule- and principle-based, where rules are distilled from the Talmudic and cognate literature, and principles are continuously established as guides to action in specific cases.  This case-based approach provides for flexibility as well as integrity and reproducibility within the Halachic framework.  It also allows translation of Halachic reasoning into philosophical language and the Western method of discourse, and has much to contribute to the methodology of applied bioethics.  It not only expands our vision of who we are and what kind of world we live in but challenges and energizes.  We believe that the perspectives of this ancient system will be a valuable addition to the ongoing debate about the topical issues of modern bioethics.  (482)

Christian bioethicists bifurcate the field; that is, Protestant Christians may focus on autonomy as the central attribute of a “Protestant bioethics”, the presumption being that other categories of Christians may include autonomy and other items constitutive of the field.  Thus, Merril Pauls and Roger C. Hutchinson enumerate several tenets of Protestant bioethics (emphasizing the preeminence of autonomy, a reliance on the grace of God, and formation of ethical principles based only on scripture) yet conclude within the space of a few paragraphs that it “is difficult” and “is so difficult” to determine beyond generalities the Protestant determination of the concept (340).

However, a Christian determination of “bioethics” is possible, and three sources can contribute to a working definition for purposes of this study.  For example, basing her work on several writers advocating narrative ethics,[2] Hannah Wakefield develops a summary statement of “Christian bioethics” which is general enough to encompass all denominations of Christianity as well as contrast against the more secular definitions given thus far.  She argues for

a Christian bioethics that is formulated narratively.  A narrative bioethics leads us to empathize with the other, to confront his or her otherness in suffering, to recognize the intersubjective, relational context of the patient’s story, and to honor the patient in his or her concreteness and particularity.  When grounded first in response to God, the author of life, a Christian bioethics allows us to engage the story of the other as rooted in our engagement with God’s much larger story.  It is only in this ordered interaction that we can demonstrate our love for both God and other by making decisions that honor both.  (124)[3]

          A definition supplied on the website of the National Catholic Bioethics Center corresponds with the simpler one provided by Merriam-Webster, where, after a listing of specific issues with which the field should be concerned, the term is defined thus: “Bioethics is the study of the ethical concerns arising from advances in biology and medicine.  Its task involves distinguishing between morally appropriate and inappropriate uses of biotechnology and medicine” (“Making”).[4]

While not formally defining “bioethics”, the third source (new guidelines issued by the Vatican this year) suggests a functional definition of “bioethics” which is unambiguous:

To offer clearly and accurately the Catholic Church’s positions on abortion, contraception, genetic engineering, fertility treatments, vaccines, frozen embryos and other life issues, the Vatican released an expanded and updated guide of the church’s bioethical teachings.

          The “New Charter for Health Care Workers” is meant to provide a thorough summary of the church’s position on affirming the primary, absolute value of life in the health field and address questions arising from the many medical and scientific advancements made since the first charter was published in 1994 [….]

 The charter “reaffirms the sanctity of life” as a gift from God and calls on those working in health care to be “servants” and “ministers of life” who will love and accompany all human beings from conception to their natural death.  (Glatz)

II.  Selecting Bioethics Fiction for Discussion

Although library research on the subject of bioethics could have been overwhelming since it has generated a substantial quantity of scholarly articles and books in its brief history and divides into numerous subcategories, surprisingly few fictional works address the right-to-life issues of abortion, infanticide, and euthanasia as major themes.  Consequently, most scholarly studies address general ethical, and not specific literary, concerns of bioethical issues, such as medical standards for determining death or the conditions under which organs can be obtained from patients.[5]  However, while scholarly study of bioethical concerns in literature may constitute a relatively recent subject area, the life issues are discussed, although obliquely.  That is, while bioethics fiction does not often mention abortion, infanticide, and euthanasia directly, fictional works do address the philosophical foundations on which the life issues rest, such as the definition of being human, the establishment of rights applied to those who are determined as human, and, perhaps most importantly, the denial of rights to those deemed not human and the consequences thereof.

Moreover, it is noteworthy that, while some scholarly commentary is simply ad hoministic attacks against the pro-life movement,[6] if some scholarly commentary on bioethics fiction does address the life issues, it does so not according to ethical standards derived from religious sources, but politically-correct matters long considered “safe” (either non-controversial or issues considered appropriate for “liberal” academics to promote).  For example, many scholars would rather write about the application of feminist or Marxist tenets more than how well bioethical principles illustrated in contemporary fiction comport with standards derived from millennia of religious teachings.  This is the case in Sheila Jasanoff’s 2005 study of biotechnological developments in Germany, the United Kingdom, and the United States, where references to the religious basis of ethical decision-making are negative.  Instead of recognizing that the first civil right to life is based on millennia of Jewish and Christian teaching, Jasanoff contorts the efforts of the US pro-life movement from one which seeks to restore the first civil right to life to one which fits a Marxist literary view of competing ideologies: “As deployed by the US religious right, the concept of ‘life’ is less an instrument for classifying or regulating populations than a device for keeping at bay unruly social movements or novel constellations of social life” (147).  Furthermore, Jasanoff sees President George W. Bush’s support of pro-life principles as merely simplistic evidence of “a Republican administration out to consolidate its conservative religious support” (148).[7]

          Pending changes warranted by future research, the balance of this study isolates three general principles from various literary works (one from the early twentieth, the rest from the last quarter of the twentieth and the years of this twenty-first century), examines how each of these principles is depicted, and evaluates whether the literary examples comport with the Judeo-Christian understanding of bioethics.  Excluding older titles for the moment (those written before the twentieth century),[8] many fictional works addressing the philosophical foundations identified above have been catalogued since the 1970s,[9] so an extensive body of literature exists and needs to be evaluated from a pro-life perspective.  Finally, the paper will highlight a fictional work which closes the ethical void of most bioethics fiction by including ethical standards formulated by religious sources.

          Proceeding chronologically, ten representative novels concerned with bioethics issues will be considered: Sinclair Lewis’ Arrowsmith (1925), Robin Cook’s Coma (1977), Eva Hoffman’s The Secret (2002), Jodi Picoult’s My Sister’s Keeper (2004), Kazuo Ishiguro’s Never Let Me Go (2005), Mary E. Pearson’s The Adoration of Jenna Fox (2008), Jodi Picoult’s Handle with Care (2009), Laurence Gonzales’ Lucy (2010), Kira Peikoff’s No Time to Die (2014), and Don DeLillo’s Zero K (2016).

III.  Three General Principles Culled from Bioethics Fiction on the Life Issues

          Three general features can be culled from these fictional works.  First, bioethics fiction seems devoid of Judeo-Christian ethical principles.  That is, obvious ethical principles obtained from five thousand years of Jewish thinking and two thousand years of Catholic and Protestant formulation (such as the recognition that human life is a gift from God and that all human beings must be respected, no matter their condition of dependency) are not explicitly referenced.[10]  Religious terminology, however, is usurped in bioethics fiction and often appears in surprising paradoxical formations.  Second, fictional works which concern bioethical matters adopt utilitarian principles above any other ethical system.  A corollary of this second general feature, perhaps following a standard set by Sinclair Lewis in Arrowsmith (1925), illustrates the quest for profit over ethical concerns.  Finally, the presumed loss of religious force in society may account for the third general feature of bioethics fiction, the dehumanization not only of genetically-based humans, but also of cybernetic beings which approach humanness, including, for example, clones or robots.  This last general principle offers significant dramatic tension in many works of bioethics fiction; after all, if respect for mankind is not based on a divine power, then some can alter the definition of the humanity of their peers as social needs demand, and the ensuing conflict makes for great drama.

          Absent either an author’s or a character’s explicit renunciation of Jewish and Christian ethical principles,[11] although they can be discussed independently, one can argue that the three general features evident in the works to be reviewed proceed causally.  That is, abandoning Judeo-Christian ethical principles may lead to a utilitarian view, which in turn can lead one to view economic factors as the paramount social good; it is a short step from this position to the dehumanization of those who are vulnerable to biopower or who pose a threat to what is perceived as the paramount social good.

A.  Absence of Judeo-Christian Principles and Usurpation of Religious Terminology

          Although tracing the abandonment of Judeo-Christian values in society is beyond the scope of this study, it is common knowledge that, as Stephen Prothero has suggested in his Religious Literacy (2007), contemporary Americans are increasingly more secular than previous generations, and authors may therefore not need to refer to these values.  Indeed, if referring to these values may confuse readers, sales suffer, so there is an economic motivation to “go light” on these ethical issues.  And yet, even though Western society has become supposedly more secular from the twentieth century on, religious terminology is inescapable.  These conflicting aspects may account for the first general principle of bioethics fiction; while the works discussed below may be bereft of Judeo-Christian values, some openly hostile to such values, they retain religious imagery and vocabulary, even usurping those images and terms to advance a life-denying perspective on the bioethical issue being dramatized.

Characters in Sinclair Lewis’ Arrowsmith (1925) have clearly renounced the Judeo-Christian perspective.  The main character, Martin Arrowsmith, thinks that belief in a soul is “that junk” (596); “he saw no one clear path to Truth but a thousand paths to a thousand truths far-off and doubtful” (600), uses “God” as an interjection (639), and indicates his attitude toward monotheism by referring to “one’s gods” (673).

However, the novel is replete with instances of religious terminology to express how scientific progress, especially laboratory research (the beginnings of late twentieth-century bioethical controversies), has usurped religious meaning.  According to Martin, “just being in a lab is prayer” (607); when a doctor draws blood, he is “like a priest of diabolic mysteries” (612).  This priesthood for doctors includes “Father Nietzsche and Father Schopenhauer […] and Father Koch and Father Pasteur and Brother Jacques Loeb and Brother Arrhenius” (614).  One of Martin’s professors gives him “episcopal blessings!” (624).  In a form of transference of deities, since the “god” of the dean of the medical faculty “was Sir William Osler”, Dean Silva, therefore, becomes Martin’s “new god” (646, 664).  Martin achieves paradox when he discusses “the superiority of divine mankind” (676).  The private office of Hunziker, a pharmaceutical researcher, “was remarkably like a minor cathedral”; similar sacerdotal functions are ascribed to doctors when another character asserts, “the country doctor often has to be not only physician but dentist, yes, and even priest” (685, 698).

A half century later, Robin Cook’s Coma (1977), which involves a hospital deliberately putting patients into a coma during surgery for the purpose of harvesting their organs, displays similar renunciation of the Judeo-Christian heritage.  The main character, Susan Wheeler, wonders about “the [meaninglessness] of life” (46).[12]  Characters typically use “Goddamn” in swearing, curiously maintaining the rule about capitalizing the term throughout; “Christ” is similarly used only as an interjection (72, 76).[13]  To show that sexual values were changing in the seventies, shifting from the traditional view that sex was appropriate for a married couple’s mutual pleasure and for the procreation of children, when “holy fuck” is used, the reader should not think that the character is referring to the sanctity of sexual relations between husband and wife in marriage (91).[14]  Instead of the Deity in Heaven, “occupying the entire top floor”, the hospital’s “computer being above everything else in the hospital” is compared to God and jokingly known as “help from above” (120).  Continuing the sacerdotal transference that Lewis used for his doctors, Susan’s lover “almost had the attitude of a contrite sinner who has confessed”, the implication being that Susan herself has the priestly capacity to “forgive” him for a sexist comment (176).  Similarly, Susan’s “mild sense of euphoria” can be attributed to her mentor: “It was as if Dr. Chapman had powers of absolution” (209).

Eva Hoffman’s The Secret (2002) contains often subtle indications that Judeo-Christian values do not apply in this novel of a woman who is a clone of her mother.  In the opening pages, the lack of Judeo-Christian values becomes evident when Iris, the narrator, inexplicably calls her “soul” “a travesty” (7) and that she “was wrong, a mistake, a result of bad judgement”, contrary to the religious tenet that every human being is right, wanted (and therefore not a mistake), and deemed valuable because he or she—no matter the conditions of one’s fertilization—is valued by God (12).  Steven, the mother’s boyfriend, suggests the futility of life when he ambiguously claims, “We don’t matter so much, maybe” (44).  When Iris learns she is a clone of her mother, her perception of her existence is changed, but she has no knowledge that she is one of God’s creatures.  Iris’ “Adviser” says, “we’d all prefer more divine origins”, the implication being that a divine origin is not what humans experience (68).  In a debate on cloning, a speaker calls humans “the creators” while an opposing speaker talks about objective reality without mentioning God: “though he knew very well about veils of illusion, the reality behind these veils was not going to be manmade.  Then he became inarticulate” (106, 108).

Some explicit religious references occur, but it is obvious that the characters are confused about their religious beliefs.  Iris’ grandparents are supposedly Jewish (most probably cultural, instead of practicing, Jews), yet her grandmother, though not religious, indecisively claims, “Well, I suppose we believe life is sacred, God-given” (148).  Iris’ aunt shrugs as she identifies herself as Christian, but not Catholic, which is disparagingly categorized as “that kind of Christian” (219).  Iris’ assertion “I wanted someone to know” about her being a clone could be construed as a secular form of confession, the psychological value of the sacrament well-known among religious persons (233).  There are “abstruse hypotheses” about the origins of life, but no certainty provided by religious tenets in a God who could be Creator (250).

          Religious items are not absent in Jodi Picoult’s My Sister’s Keeper (2004), but the various references illustrate that the main characters are minimally-practicing Catholics who are ignorant not only of how their faith responds to bioethical issues, but also of the basics of their faith.  Sara, the mother of the child conceived for the express purpose of being of medical use to a sibling who has leukemia, speaks casually of the child conceived for the benefit of the sibling: “The doctor was able to screen several embryos to see which one, if any, would be the ideal donor for Kate.  We were lucky enough to have one out of four—and it was implanted through IVF” (102).  She seems blissfully unaware that her statement has violated several life-affirming and religious principles: that three unborn lives were sacrificed; that the fertilization was desired for a utilitarian purpose, not out of love for another child; and that the fertilization occurred beyond the sex act.  To add to the insult, the child, their daughter Anna, was identified by the neuter pronoun.  In a contorted variation of the Golden Rule, Sara’s operating principle is “You do whatever you have to, when it comes to people you love, right?”, and the questioning at the end of what should be a declarative statement indicates that she herself does not believe in the assertion (169).[15]

Several instances show the characters’ disrespect and hostility to religion.  The attorney who advances the medical emancipation claim distorts the Virgin Birth as an episode where Mary would justify herself for “a nice little roll in the hay with Joseph”; as he further queries, “Who’s going to contradict you if you say God’s the one who knocked you up?” (205; italics in original).  Anna asserts that the story of Adam and Eve “I know is a load of crap” (249).  Brian, the father, does not know “where to look for” the “right answer” regarding whether his daughter should “donate” a kidney to her sister (346).

          A second novel of Jodi Picoult’s, Handle with Care (2009), shows yet another presumably Catholic family ignorant of their faith as they negotiate bioethical issues involving Willow, a child born with osteogenesis imperfecta.  Just as casually as Sara in the above Picoult novel, Charlotte was “about to try in vitro” before she was pregnant with Willow (49).  A family friend asserts that Charlotte “rarely missed a weekend Mass”, affirmed again by this same family friend later in the novel, but these are odd affirmations, given the preceding casual acceptance of in vitro fertilization ([56], 140).  Even though the O’Keefes are called “die-hard Catholics”, Charlotte obviously does not follow the most fundamental Church teaching when it comes to voting, and her justification is redolent with sentiment instead of logic combined with feeling:

I had grown up Catholic.  I had been taught by nuns.  There were girls who’d gotten pregnant, but they either disappeared from the class rosters or left for a semester abroad, returning quieter and skittish.  But in spite of this, I’d voted Democratic ever since I turned eighteen.  It might not be my personal choice, but I thought women ought to have one.  (162, 189-90)

Charlotte’s weak and utterly contemporary American Catholic profession of faith justifies what her husband Brian would later say about her: “You’re conveniently Catholic, when it suits you” (297).  Writing to her daughter, Charlotte’s claim that she “was the one who had summoned your soul to this world” may be allowed from a sentimental mother, but is prima facie unorthodox as an abrogation of an attribute belonging to the Creator (339).

          Laurence Gonzales’ Lucy (2010) concerns a young woman conceived by a human father and born from a bonobo ape mother.  While the plot follows Lucy’s struggle to affirm her human status (an unsuccessful effort, since she will eventually find satisfaction—and maternity—in the African jungles away from humans), the presence of many negative comments about religion is striking.  Lucy was raised by her father to think “religion was part of the problem” [103].  A TSA official, who questions the propriety of “animals” flying on board a plane instead of in the baggage compartment, calls Lucy “an abomination before Christ.  You should be put to sleep” (159).  Protesters have scriptural passages on their signs to justify their animosity against Lucy, and an obviously fundamentalist Christian blares Leviticus’ admonition against human sexual contact with animals through a bullhorn ([168]-69).  The author’s political bias becomes evident when he identifies “Steven Rhodes, the Republican from Utah”, as the sponsor of a bill to outlaw interspecies life forms like Lucy [170].  Senator Rhodes is further depicted as a religious zealot with an anti-Lucy pastor (217).  A scientist who befriends Lucy displays hasty generalization when he tries to comfort Lucy with, “There’s no reasoning with the Christian right.  They hate science” [232].  A nurse identifies herself as a Christian, yet she still collaborates with Lucy’s captors [243].

Despite these instances of religious bigotry, the natural law within Lucy cannot be silenced.  Even though her father was anti-religious and she herself expressed one anti-Catholic sentiment,[16] her nascent theology is respectful and life-affirming.  Lucy’s religious experience in her girlhood consisted of a simple prayer “to the forest to arrange things in a beneficial way” (253) because she “wanted to live” [265].  A standard denouement of a happy-ending plot is repeated in this work: returning to Africa to live among the bonobos, Lucy seems to be in paradise, rejoicing especially in being pregnant.  Moreover, she reaches deep spiritual insights.  She admires her mother-in-law for “embracing her suffering and turning it into a thing of beauty that could endure beyond her brief lifetime”, and has learned that she was named “Lucy”, according to her father’s written testimony, “not, as some might think, because of the australopithicine [sic] of the same name, but because the name means ‘light’” (305).  This last entry, of course, recalls for the educated reader the beginning of Genesis.

          Kira Peikoff’s No Time to Die (2014) illustrates the life of Zoe, a teenager who does not age beyond her fourteen years.  Zoe is a standard agnostic or atheist character, who expresses her opinions about tenets of religious beliefs on several occasions.  Instead of eternal life, she thinks that death is “the idea of vanishing—poof—for all of eternity” (20; italics in original).  As with other fiction discussed above, “Jesus” is used not as an affirmation of faith, but as a mere exclamation in several instances (137, 305, [363], 403).  Since “this [life is] all we’ve got”, Zoe, who “had never given much thought to religion”, thinks that, “long after anyone had ever heard of her, after the Earth stopped turning and the sun exploded and life went on somewhere else in the universe, she would still be dead.  Just another piece of galactic debris” (316, 321, 341; italics in original).

Despite these negative ideas about religious belief, religious terminology and concepts are evident, and the several instances support Zoe’s existence as a human being and not a mere genetic freak.  A first indication that “God language” is inescapable occurs when a professor comments about her dean’s being “skittish around any scientist ‘trying to play God’” (73).  Normally, this phrase is used by a character attacking one who supports anti-life practices, such as embryonic stem cell research.  However, that a relatively secular professor would use the phrase (recorded in double quotation marks) does not necessarily suggest that the character denies the existence of God.  A religious basis for this character’s action is thus possible.  Similarly, when she reflects that her “crippled old” grandfather and she “were trapped in bodies that belied their souls”, Zoe similarly evidences a belief in a most difficult, because incorporeal, religious concept, the existence of her soul, quite an intellectual feat for an agnostic or atheist (124-5).  Perhaps the most interesting affirmation of life comes from Galileo, the novel’s hero, which reads like a pro-life manifesto:

“But one thing I do know is that life is precious.  Life is good.  And you can never have too much of a good thing.  Which boils down to the bottom line—we’re lucky to be alive.  And the world is lucky to have you in it, not just because of your DNA.  You’re much more than your genes.”  (343-4)

Don DeLillo’s Zero K (2016), the most recent bioethics fiction work to be examined, involves one family’s venture into cryonic suspension offered by the Convergence, whose goal is to have people “emerge in cyberhuman form” after their cryonic suspension ends (67).  While the plot of this novel follows the primary purpose of bioethics fiction (to illustrate humanity’s quest for physical immortality), religious imagery permeates the entire work.  While ethical concerns are not discussed in a didactic fashion as in some novels reviewed here to educate the reader (for example, Peikoff’s No Time to Die, where several passages debate the effects of human longevity on the economy), virtually every page of DeLillo’s work contains a religious allusion or a distortion of the original intent of the religious symbol or term.

Jeffrey, the narrator, is immediately confronted with religious imagery and concepts within the first few pages when Ross, his father, explains the Convergence as “Faith-based technology.  That’s what it is.  Another god.  Not so different, it turns out, from some of the earlier ones.  Except that it’s real, it’s true, it delivers”, after which explanation Jeffrey affirms that “We’re back to the old-time religion” (9-10).  The narrator says that he is not Catholic, yet the phrases “dust thou art” and “dust thou shalt return” become meaningful for him as the mere act of repetition suggests (15; italics in original).  A conversation between a man in a monk’s cloak and Jeffrey reinforces the motif of death and suggests an opposing view to the purpose of the Convergence:

“I want to die and be finished forever.  Don’t you want to die?” he said.

“I don’t know.”

“What’s the point of living if we don’t die at the end of it?”  (40)

Since the novel is devoted to the time that Jeffrey will spend with Artis, his stepmother, before her cryonic suspension, their conversation contains many significant religious elements.  Artis has a different perspective on the Convergence from that of the monk-like character above.  For her, being in a cryonic state will eventually lead to being “reborn into a deeper and truer reality” (47).  When she speaks “in serial fragments”, he “found [himself] lowering [his] head in a sort of prayerful concentration” (53).

The opposing view about the Convergence and its underlying bioethical choice probably accounts for Jeffrey’s need for definition, and his quest for definitions results in an existential fear:

There was something satisfying and hard-won about this [effort to define things] even if I made it a point not to check the dictionary definition.  [….]  But I was afraid of the conclusion I might draw, that the expression was not pretentious jargon, that the expression made sense, opening out into a cogent argument concerning important issues.  (55)

Jeffrey’s definitional tendencies mirror those of the biblical character Adam; he “would give” the speakers guiding a group of people into cryonic suspension “names, both of them, just for the hell of it” (66).  Jeffrey’s definitional tendency is in contrast to the two Convergence speakers’ litany of rhetorical questions, spanning three pages (69-71).

          Jeffrey is as confused about his religious nature as the environment of the Convergence confusedly uses religious terms and gestures to guide those entering cryonic suspension.  Jeffrey views a false limp as “my faith”; curiously, this false condition becomes a “circular way to recognize myself” and reinforces his need to define things: “Define person, I tell myself.  Define human, define animal” (103; italics in original).

Perhaps the most telling item in the novel is Jeffrey’s reaction to Ross’ and Artis’ cryonic suspension.  “It’s not their resonant lives that haunt me,” he says, “but the manner of dying” (266).  This is an odd reaction when the Convergence seems to have done everything to have prepared the deaths of his parents as a serene event.  The pods which contain the bodies are likened to, in Jeffrey’s words, a “shrine” (117).  Although the location for the Convergence (desert regions in Asia) is deemed necessary because of geopolitical problems, it is appropriate for the teleological purposes of this novel since the desert is the place “to repeat the ancient pieties and superstitions” (128).  The preserved bodies are placed in what Jeffrey calls a “catacomb” (133).  Each of the four people to enter cryonic suspension receives a blessing when the speaker places a hand on his or her head, an event which gives Jeffrey another opportunity to add religious words and a string of appositions to the act: “She placed her hand on my father’s head—my father or his representation, the naked icon he would soon become, a dormant in a capsule, waiting for his cyber-resurrection” (245).  Why this entire event would “haunt” Jeffrey eludes the reader, but some speculation is possible.  Even though the outward appearance of the Convergence’s efforts to guide one into cryonic suspension seems to convey familiarity and comfort for persons who may be used to a sacramental approach to the act of dying, it is still a death, engineered by human beings, acquiesced by the person to be killed him- or herself.  Jeffrey, focused on determining clear definitions for items and concepts, is keenly aware of the cognitive dissonance between death engineered biotechnologically and death which should be the natural end of human life.

B.  Utilitarian Principles, Focusing on Economics

Several novels employ utilitarian ideas as the philosophical foundation for their plots, the second general ethical principle of bioethics fiction discussed here.  Lewis’ Arrowsmith highlights the utilitarian philosophy of the medical profession succinctly when the character Pickerbaugh argues that the ends justify the means:

“What if my statistics aren’t always exact?  What if my advertising, my jollying of the public, does strike some folks as vulgar?  It all does good; it’s all on the right side.  No matter what methods we use, if we can get people to have more fresh air and cleaner yards and less alcohol, we’re justified.” (750)

Lewis’ novel repeatedly emphasizes the need for profits.  Martin Arrowsmith is urged by his boyhood mentor to “make five thousand dollars [a] year” (589).  When they often associate with each other, doctors “argue about whether they can make more money if they locate in a big city or a town” (604).  A character who ostensibly begins his speech with the dichotomy of ethics vs. money makes it clear that the “gospel” of new furniture for doctors’ offices settles the debate (648-9).

Cook’s Coma not only has the benefit of the characters’ utilitarian perspective but the author’s commentary.  Susan Wheeler takes the contraceptive Ortho-Novum not to correct any hormonal imbalance, but because she “was a practical woman; strong-willed and practical” (19) regarding her sexual immorality.  Her lover, Dr. Bellows, has a similar utilitarian view of sexuality, calling himself “Machiavellianly practical” (24).  The purpose of the Jefferson Institute, the place where long-term care patients who have fallen into comas, reside, is to “curtail costs” (156), and the economic basis of the Jefferson Institute is elaborated towards novel’s end (263-4).  In a chilling passage, surgeons discuss how much the organs they are harvesting would earn (275-6).  The reader learns only in the denouement that the main character’s protector, Dr. Stark, is part of the Jefferson Institute’s black market organ plan (290-1).  In the “Author’s Note” following the novel, Cook declares how the “market economy” (304) drives the need for organs, which are called “valuable human resources” (305).

Evidence of utilitarianism in three novels following the publication of Coma can be summarized.  In Hoffman’s The Secret, Dr. Park, the scientist who cloned Iris, “didn’t want to bring anyone damaged into the world.  Or mentally unstable”, in contrast to the Judeo-Christian ethic, where “damaged”, “defective”, or handicapped human beings are valued (98).  Dr. Park refuses to speak further with Iris about her status, and he can justify his refusal because, under the economic hierarchy of a utilitarian worldview, Iris’ mother “was my customer, not you” (100).

In Picoult’s My Sister’s Keeper, Anna recounts the utilitarian reason why she was conceived (to save her sister Kate) (7-8).  The utilitarian mindset is evident in the rest of the family as well.  Jesse, Anna’s brother, thinks he is worth more dead than alive (94), and Sara openly thinks of her still unborn daughter as a tool for Kate: “I have thought of this daughter only in terms of what she will be able to do for the daughter I already have” (94, 100).  The entire plot of Kazuo Ishiguro’s Never Let Me Go (2005) exemplifies utilitarianism.  The sole purpose of the children at Hailsham is to be organ donors; after they have “donated” their organs, their death is euphemistically called “completing” (207).

Although Willow’s father in Picoult’s Handle with Care (2009) is outraged that a lawyer would suggest wrongful birth, Charlotte, the mother, asks a simple utilitarian question: “What happens if we win?” (65).  Sean, the husband, is aware of utilitarian ethics “a means to an end”, but for Charlotte lying about wrongful birth is a way to “play a game” because “The ends justify the means” (104, [171], [186]).  Eventually, Charlotte wins $8 million in the lawsuit.

Three novels after Picoult’s Handle with Care contain brief evidence of the utilitarian approach.  Lucy’s father in Gonzales’ Lucy (2010) clearly identifies his scientific experiment of mating with a bonobo in utilitarian terms: “And I offer Lucy as proof to the world that, even though the ethics of what I’ve done may be questioned, the results are unequivocal” [50].  It is significant that another character comments on this ethics/results terminology much as pro-lifers would consider in vitro fertilization unethical yet value the child born as a result of that procedure:

“So the issues here revolve around her father’s decision to bring her into the world, which most of us would agree was a very bad decision from an ethical point of view.  But we must keep that ethical issue separate from the very good outcome of that bad decision.  Lucy is a remarkable person.  Her father did something reprehensible, but that in no way detracts from her value as a human being.”  ([186])

Zoe’s father in Peikoff’s No Time to Die angrily claims, “They don’t care about you, the human being—only you, the DNA!” (63).  The political impact of funding for medical research is often discussed in this novel.  For example, extending life “wasn’t too appealing to a bloated government” because it would have to pay more if people lived longer; funding human longevity research would “crash” the economy (70, 80-1).

Finally, in a rhetorical twist of utilitarian ethics, a character in DeLillo’s Zero K states a clearly anti-egalitarian view which contorts the utilitarian goal of the greatest good for the greatest number: “Life everlasting belongs to those of breathtaking wealth” (76).

C.  Dehumanization of Humans and Human-Like Characters

          The loss of religious force and the standard of utilitarian ethics may account for the third general feature of bioethics fiction discussed here, the dehumanization expressed by various characters not only of cybernetic beings who approach humanness (clones, “bots”, etc.), but also of genetically-based humans.  This dehumanization may account for three instances where Martin Arrowsmith, the hero of Lewis’ Arrowsmith, views his fellow humans with less than the respect demanded by Judaism and Christianity.  Martin regarded people “as he had regarded animals in biology”, and this perspective moves quickly to his comment that “most people [are] above the grade of hog”, ultimately leading to the most dehumanizing statement in the novel, wherein a Negro doctor, mistaken for a servant, is described (in an apposition, no less, a rhetorical feature meant to draw attention to the preceding term which it further defines) as “a beautiful young animal” (595, 809, 856).

          Cook’s Coma contains dehumanization elements peppered throughout the novel.  Dr. Bellows’ attitude about donating kidneys from comatose ICU patients is obvious when he refers to their brains twice as “squash”, a variation of the metaphor of a human being reduced to a “vegetable”, a metaphor which is repeated when his lover, Susan, describes another patient “like a vegetable” (47, 48, 90).  A unique dehumanizing metaphor occurs when a patient is likened to a football:

[Susan] was faced with the fact that Bellows and probably the entire crew were not thinking of Nancy Greenly as a person.  The patient seemed more like the part of a complicated game, like the relationship between the football and the teams at play.  The football was important only as an object to advance the position and advantage of one of the teams.  Nancy Greenly had become a technical challenge, a game to be played.  (81)

Elsewhere, patients are “brain stem preparations”, a synecdoche which reduces the entire human being to one small, albeit significant part of his or her existence (267).  The dehumanizing element culminates in the novel’s denouement when the antagonist, Dr. Stark, criticizes “the common folk” and claims that respect for life is “a public policy handicap” (297, 298).

          Gonzales’ Lucy (2010) illustrates the obvious conflict between humans and interspecies generation.  Senator Rhodes’ bill to outlaw interspecies generation becomes law, and Lucy—although an obviously literate and communicative being capable of deep philosophical thought—is automatically not a legal human (249).

Dehumanization occurs in Peikoff’s No Time to Die when a character queries whether “cockroaches” are “a microcosm for human life on Earth”; later, this same character views humans as “bacteria” (158, 209).

IV.  An Example of a Life-Affirming Bioethics Novel

          Certainly, the above works which are largely anti-life (in the sense that they illustrate the dehumanization of their characters) could be cited as examples of rhetorical negation in literature.  That is, readers can appreciate and learn how biotechnology can assault human life by reading the adventures of humans or bots resembling human beings.  Moreover, it would be illogical to presume, absent clear evidence, that the author him- or herself promotes an anti-life perspective through his or her fiction.  Besides that, when they would finish most of the above fiction, readers would feel dispirited and hopeless, two results of a steady stream of life-denying fiction.

          This is not to say that, in contrast, fictional works which negotiate the ethical void of most bioethics fiction by including ethical standards developed by religious sources throughout the millennia have plots which necessarily end satisfactorily or happy.  A recent trilogy by Mary E. Pearson, for example, depicts a forlorn twenty-fourth century: the United States and many other nations have split into smaller political entities, human cloning has become a reality, biogeneticists are experimenting with material which needlessly prolongs human life (even to the point of salvaging human life onto computers), and Christianity seems to have gone underground.  However, The Adoration of Jenna Fox (2008) by Mary E. Pearson is in stark contrast to the above works regarding the three general principles identified in this study.

Written for a young adult audience, the novel follows the lives of Jenna, Kara, and Locke.  Jenna is responsible for a car accident that should have killed all three; all of them were saved by Jenna’s father, who loaded the essential data of their brains onto computers for later full-body reconstitution.  The novels thus concern not merely adolescent romance, but also the appropriateness of maintaining life at all costs, the issue of natural means to end human life, and the wisdom of human longevity spanning centuries.

Adoration has life-affirming features in contrast to the above three general principles evident in most bioethics fiction.  The novel uses religious imagery and terminology in an appropriate way, absent any authorial intention to show irony or to disparage the religious term.  While the utilitarian ethos is never challenged by name and key terms in that philosophical approach (for example, “ends”, “means”, or any variant of the name of the approach) are not analyzed or replaced explicitly by Judeo-Christian values, the value of human life is affirmed on several occasions and in the two sequels.[17]  Consequently, dehumanization is refuted by clear affirmations of the value of human life, whether wholly human or, as in the instances of the three main characters, a human who may be composed of biogenetically-modified material.

A life-affirming statement is made within the first few pages when eighteen-year-old Jenna discusses “the fetus that was me”, and the affirmation of her unborn humanity is related two-thirds through the novel:

She pulls me close again, my head on her chest.  I can hear her heartbeat.  Familiar.  The sound I heard in her womb.  The whoosh, the beat, the flow that punctuated my beginnings in another dark place.  [….]  I close my eyes, pressing my ear to her chest again.  Hearing the sounds, the pulse of Claire, the world of my beginnings, the time when there was no doubt I had a soul.  When I existed in a warm, velvet liquid that was as dark as night, and that dark place was the only place I wanted to be.  (10, 182-3)

Even though she had had “no feeling” on entering a church earlier in the novel (35), Jenna’s religious sentiments become obvious when she discloses the accident “in a desperate breathless finish, feeling like I have confessed a sin and I need forgiveness” (79).  When her father explains how her brain was saved and stored on a computer, Jenna asks an odd question for a work of bioethics fiction in an outpouring of frustration that could be aimed not merely at her father, but also, beyond this novel, at the entire enterprise of biotechnological advance:

“What about a soul, Father?  When you were so busy implanting all your neural chips, did you think about that?  Did you snip my soul from my old body, too?  Where did you put it?  Show me!  Where?  Where in all this groundbreaking technology did you insert my soul?”  (129)

In contrast to her father’s biogenetic activity, Jenna states the obvious fact that most plots of bioethics fiction work against, that death is the end of life: “Everyone has to die eventually” (204).  This novel ends 260 years later with the consummate life-giving plot ending modified by a bit of biotechnology whose ethical problem not even Jenna, who had been “baptized” by her grandmother, apparently did not question: Jenna “arranged for Kayla”, her daughter, by her husband Ethan “long after he was gone” (264).[18]

However, not all is right with Pearson’s future world, despite Jenna’s and other characters’ respect for religious values and developing faith.  At least two instances of symbolic euthanasia or suicide occur, and the disjunctive is necessary since the action against the entities “killed” depends on how they are defined.  Jenna’s friends, whose lives are stored on computers, are bemoaned as existing in a “purgatory [that] will go on and on” (239).  Note that the entities stored are not the friends themselves, but computer files; in Pearson’s world, if 10% of a person’s brain can be saved, then that person can be reconstituted, and his or her “software” (intelligence stored on the computer) can be placed in the reconstituted body.  In a symbolic act of euthanasia, Jenna disconnects the three computer cubes containing her friends’ and her own backups from their power docks and throws them into a pond (254-5).[19]  One can argue that the act of destroying the computer copies is neither suicide nor euthanasia since the person committing the act is the real, as in incarnated, entity doing the action to not another incarnated human being, but a mere computer copy.  Perhaps this episode in the novel is a fictional opportunity to safely explore the rights of cloned or reconstituted human beings and to determine their legality before anyone in the real world ventures to force the issue.

          Consider the cumulative evidence from the denouements of the novels considered here.  Martin in Lewis’ Arrowsmith continues his quest for quinine research, but the reader knows that the cost is the sacrifice of love.  Susan Wheeler in Cook’s Coma will not suffer the fate of others who were put into coma before their organs were harvested, for her lover arrives—deus ex machina—to save her from the anesthesia which would kill her, police ready to arrest the antagonist Dr. Stark.  Iris comes to appreciate her unique self in Hoffman’s The Secret despite her having been made purposefully a clone of her distant mother.  A sense of divine justice occurs in Picoult’s My Sister’s Keeper when Anna, who had been conceived for the purpose of being an organ donor for her sister, dies and becomes an organ donor despite her successful lawsuit asserting bodily integrity.  The clones in Ishiguro’s Never Let Me Go fulfill their purposes (being organ “donors”) and die, yet the final reflection by Kathy suggests that even clones in this novel devoid of religious imagery hope for resurrection.  In Pearson’s The Adoration of Jenna Fox, Jenna becomes a mother, a sign that she values life enough to have another person experience it.  Divine justice occurs again in Picoult’s Handle with Care when Charlotte, fresh from winning her wrongful birth lawsuit, loses the daughter at the crux of the case.  In Gonzales’ Lucy the hybrid human Lucy finds a welcoming society among the bonobo apes of Africa.  Those characters seeking Zoe’s life are rebuffed in Peikoff’s No Time to Die.  Jeffrey is perhaps the only character studied here who finds neither solace nor safety in DeLillo’s Zero K, but that is entirely proper; the lack of closure which natural death would have given his parents indeed “haunts” him, a fitting verb to describe what happens when bioethical advances attempt to deprive mortal life of a natural death, which millennia of human culture has acknowledged as the entree to immortality.

This study began with a substantial quantity of definitions of the term “bioethics”, and it may be appropriate to end it with another, a stipulative definition summarizing a pro-life perspective on the various novels discussed.  Bioethics is a field designed not only to resolve challenging or difficult applications of biotechnology, but also to forewarn society when limits have been, are being, or will be superseded.  This admonitory function has been evident from the beginning of the genre, and the claim can be made that the fictional need to end bioethical challenges posed by the various plots with human life being affirmed may be the novelist’s way of overcoming the ethical challenge presented.  Unless one despairs and resigns oneself to live in a biotechnical dystopia like Brave New World or 1984, this life-affirming tendency of contemporary bioethics fiction is certainly comforting for the modern reader.

Works Cited

“Bioethics.” Merriam-Webster, 2017,

“Bioethics.” Wikipedia, 14 May 2017,

Carpi, Daniela. Introduction. Bioethics and Biolaw Through Literature, edited by Carpi, De Gruyter, 2011, pp. [1]-19. Law & Literature 2.

Clayton, Jay. “The Ridicule of Time: Science Fiction, Bioethics, and the Posthuman.” American Literary History, vol. 25, no. 2, 2013, pp. 317-43. Academic Search Complete.

Cook, Robin. Coma. Little, Brown, 1977.

Cox, D. Michael. “Prophets of the Posthuman: American Fiction, Biotechnology and the Ethics of Personhood.” Modern Theology, vol. 32, no. 1, Jan. 2016, pp. 139-41. EBSCOhost, doi:10.1111/moth.12233.

DeLillo, Don. Zero K. Scribner, 2016.

Glatz, Carol. “Vatican Releases Updated Guidelines for Bioethical Questions.” Catholic News Service, 6 Feb. 2017,

Gonzales, Laurence. Lucy. Alfred A. Knopf, 2010.

Hoffman, Eva. The Secret. PublicAffairs, 2002.

Hughes, James. Citizen Cyborg: Why Democratic Societies Must Respond to the Redesigned Human of the Future. Westview Press, 2004.

Ishiguro, Kazuo. Never Let Me Go. Random House, 2005.

Jameton, Andrew, and Albert R. Jonsen. “America, Bioethics in.” Bioethics, edited by Bruce Jennings, 4th ed., Macmillan Reference, Gale, Cengage Learning, 2014, pp. 184-202.

Jennings, Bruce. “Biopower and the Liberationist Romance.” Hastings Center Report, vol. 40, no. 4, 2010, pp. 16-20. Academic Search Complete.

Johnson, Sandra H., et al., editors. Health Law and Bioethics: Cases in Context. Wolters Kluwer Law & Business, 2009.

Jost, Timothy Stoltzfus. Readings in Comparative Health Law and Bioethics. Carolina Academic Press, 2001.

—. Readings in Comparative Health Law and Bioethics. 2nd ed., Carolina Academic Press, 2007.

Laethem, Erica. “Why Bother with Bioethics?” Bioethics Across the Life Span, edited by Marilyn E. Coors, National Catholic Bioethics Center, pp. 1-22.

Levin, Mark, and Ira Birnbaum. “Jewish Bioethics?” Journal of Medicine and Philosophy, vol. 25, no. 4, 2000, pp. 469–84.

Lewis, Sinclair. Arrowsmith. Lewis at Zenith: A Three-Novel Omnibus; Main Street, Babbitt, Arrowsmith, Harcourt, Brace & World, 1961, pp. [585]-914.

Magalhães, Susana, and Ana Sofia Carvalho. “Searching for Otherness: The View of a Novel.” Human Reproduction & Genetic Ethics, vol. 16, no. 2, July 2010, pp. 139-164. EBSCOhost, doi:10.1558/hrge.v16i2.139.

“Making Sense of Bioethics.” National Catholic Bioethics Center, 2017,

Marks, John. “Clone Stories: ‘Shallow Are the Souls That Have Forgotten How to Shudder’.” Paragraph, vol. 33, no. 3, Nov. 2010, pp. 331-353. EBSCOhost, doi:10.3366/para.2010.0203.

Montello, Martha. “Middlebrow Medical Ethics.” Hastings Center Report, vol. 40, no. 4, July 2010, pp. 20-22. EBSCOhost.

Myser, Catherine. Bioethics Around the Globe. Oxford UP, 2011.

Pauls, Merril, and Roger C. Hutchinson. “Bioethics for Clinicians: 28. Protestant Bioethics.” CMAJ, vol. 166, no. 2, 5 Feb. 2002, pp. 339-43.

Pearson, Mary E. The Adoration of Jenna Fox. Henry Holt, 2008.

—. Fox Forever. Henry Holt, 2013.

—. The Fox Inheritance. Henry Holt, 2011.

Peikoff, Kira. No Time to Die. Pinnacle Books, 2014.

Picoult, Jodi. Handle with Care. Atria Books, 2009.

—. My Sister’s Keeper. Washington Square Press, 2004.

Prothero, Stephen. Religious Literacy: What Every American Needs to Know—and Doesn’t. HarperSanFrancisco, 2007.

Qiu, Renzong. “Reflections on Bioethics in China: The Interaction Between Bioethics and Society.” Myser, pp. [164]-87.

Rich, Ben A. Strange Bedfellows: How Medical Jurisprudence Has Influenced Medical Ethics and Medical Practice. Kluwer Academic/Plenum Publishers, 2001.

Sethi, Meera Lee, and Adam Briggle. “Making Stories Visible: The Task for Bioethics Commissions.” Issues in Science & Technology , vol. 27, no. 2, 2011, pp. 29-44. Academic Search Complete.

van Niekerk, Anton A., and Solomon R.  Benatar. “The Social Functions of Bioethics in South Africa.” Myser, [134]-51.

Wakefield, Hannah. “Narrative and a Christian Bioethics.” Ethics & Medicine: An International Journal of Bioethics, vol. 29, no. 2, summer 2013, pp. 111-26. EBSCOhost.

[1] For example, while they may obliquely mention larger political and social issues, specific common controversies (such as designer babies, “selective reduction” of one or more unborn children when multiple pregnancies occur, or organ “harvesting” from comatose persons) are omitted, as in Jay Clayton’s discussion of biotechnology impacting science fiction:

Both of these developments—acceptance of artificial reproduction and respect for diversity—are signs of how the subculture of SF genre fiction had joined other new social movements such as feminism, queer and transsexual politics, disability rights, and multiculturalism to stake out a distinctive, countercultural position in opposition to prevailing trends in the Nixon–Regan [sic] years.  Although many women active in feminist causes reacted against invasive biomedical technology in matters of reproduction, science fiction emphasized the thematics of reproductive choice to align its [belief] for genetic engineering with women’s rights.  (329)

This list of contemporary social and political issues is almost a casual litany of politically-correct ideas, one which certainly omits the more controversial right-to-life terms “abortion”, “infanticide”, or “euthanasia” which are raised in bioethical literature.  The source has the word “brief” in place of the term bracketed in the above quote, but “belief” was most likely intended.

[2] As described by Ben A. Rich, “narrative ethics” differs not only from the common understanding of “narrative” within the humanities, especially English academics, but also from Wakefield’s formulation: “Narrative ethics challenges the position of many prominent analytic philosophers that personal identity and a full understanding of the unity of the life of a person can be understood as nothing more than the persistence of certain psychological connections over time” (20).  This statement omits the literary understanding of the term as well as Wakefield’s emphasis on God in her definition of Christian bioethics.

[3] The idea that bioethics is inherently narratological is reinforced by the editors of Health Law and Bioethics, where they begin and end the preface, affirming that “leading health law scholars tell the stories behind thirteen landmark [law] cases in the field” (Johnson et al. xvii).

[4] This definition parallels one provided in a print publication: “Bioethics is a systematic way of addressing ethical questions that arise in medicine and science.  Its focus is the study of morally relevant human action.  Its methodology, depending on the approach, involves rational thought (philosophy) or faith seeking understanding (theology), or both” (Laethem 4).

[5] A notable exception is Christina Bieber Lake’s Prophets of the Posthuman: American Fiction, Biotechnology and the Ethics of Personhood (Notre Dame, IN: University of Notre Dame Press, 2013), which was praised in a review by D. Michael Cox thus:

Lake’s text is brimming with insightful readings of fiction in dialogue with thoughtful ethical reflections.  Well-suited to ethics courses and general readers interested in issues surrounding biotechnology, it offers a compelling and accessible defense of the abiding importance of the humanities, particularly literary fiction, for the cultivation of the moral imagination.  (141)

[6] See, for example, James Hughes’ colorful albeit unsubstantiated vituperative claim that “For the human-racists in the right-to-life movement, killing an abortion doctor is the same as assassinating death camp doctors at Auschwitz—a moral obligation” (117).

[7] Of course, there are exceptions to the scholarly bias against the pro-life movement.  Some scholars have analyzed bioethics fiction in an objective manner, unlike the obvious bias that Jasanoff displays.  For example, Jodi Picoult’s My Sister’s Keeper (2004), a novel concerned with a couple who decides to become pregnant for the express purpose of addressing the medical needs of another child, is examined in two articles, one by Susana Magalhães and Ana Sofia Carvalho and another by Martha Montello.  John Marks examines two novels addressing cloning, Eva Hoffman’s The Secret, and Kazuo Ishiguro’s Never Let Me Go.

[8] Daniela Carpi identifies several fictional works addressing bioethical issues:

Literature is helpful in creating mental experiments that alert us to problems in the real world.

            In fact, literature has often anticipated such existential problems and questioned the ethical and legal limits we should set for science.  Let us consider, for instance, Mary Shelley’s Frankenstein, where there is an experiment on the creation of life through the collection of organs and body parts; in H. G. Wells’s science-fiction novel The Island of Doctor Moreau, the mad physician Doctor Moreau, wants to transform animals into human beings through long and painful explants and transplants […]  (6)

[9] Jay Clayton explains why certain years did not have as many bioethics fictional works as others.  He writes:

After Blish’s The Seedling Stars (1957), there was little SF about genetics for more than 20 years.  A recent review of “Science Fiction and the Life Sciences” by Joan L. Slonczewski and Michael Levy suggests that a growing interest in environmentalism, which intensified after publication of Rachel Carson’s Silent Spring (1962), stimulated SF writers to turn their attention toward ecological issues, producing imaginative explorations of alien ecosystems such as Dune (1965) and The Left Hand of Darkness (1969).  Another likely factor was the rise of the counterculture and new social movements concerned with minority and gender issues, which led to increased emphasis on fiction about altered states of consciousness and changed racial and sexual norms, especially in New Wave SF.  In any event, almost no science fiction confronted questions of evolution and genetics in any depth until the excitement about recombinant DNA reignited interest in the mid-1970s.  (328)

[10] An exception occurs in Jodi Picoult’s My Sister’s Keeper where six principles of bioethics are enumerated by a character called to testify in a medical emancipation case brought by the protagonists:

“In Western Bioethics, there are six principles we try to follow [….]  Autonomy, or the idea that any patient over age eighteen has the right to refuse treatment; veracity, which is basically informed consent; fidelity—that is, a health-care provider fulfilling his duties; beneficence, or doing what’s in the best interests of the patient; nonmaleficence—when you can no longer do good, you shouldn’t do harm…like performing major surgery on a terminal patient who’s 102 years old; and finally justice—that no patient should be discriminated against in receiving treatment.”  (301; ellipsis in original)

[11] Often, authors’ statements about their adherence to or disagreement with religious tenets are ambiguous.  Such is the case with Jodi Picoult, whose seemingly clear statement “I personally am pro stem cell research” is rhetorically challenging since “stem cell research”, as the right-to-life community knows, divides into the life-affirming research using adult stem cells and the life-destroying research which requires the killing of the unborn child (unpaginated interview within My Sister’s Keeper).

[12] The source has the word “meaningless”, but the term “meaninglessness” was most likely intended.

[13] A curiously appropriate use of the term occurs when Susan is saved from a harrowing death and exclaims, “Thank God” (281).

[14] The casual attitude towards sex continues when characters view sex as recreation and call “mindless sex” an “escape” (158-9).

[15] It might be too much of a close reading, but, grant that the second comma changes this simple declarative to an interrogative, the first pause before the dependent clause may suggest that Sara thinks that the obligation to “do whatever you have to” does not apply to those whom one does not love.  Whom she does not love would refer, of course, to her family, especially her husband with whom she is having the conversation.

[16] The severity of this one instance of anti-Catholicism, however, may be lessened by the circumstances under which it was uttered.  As she flees her pursuers, Lucy tries to convince someone to help her pass a checkpoint by saying that she was in “a Catholic orphanage.  There was a priest there.  He was molesting all the boys.  I had to get away” [268].

[17] The plot continues in The Fox Inheritance (2011) and Fox Forever (2013).

[18] The circumstances and moral integrity of this child’s conception are ambiguous.  Although Jenna can “never have a child”, her mother says, “We saved an ovary, darling.  It’s preserved at an organ bank.  And a surrogate mother won’t be a problem” (137).

[19] A similar act of destruction occurs in Fox Forever when Locke destroys 200 copies that were made of Kara and himself (278).

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