Thursday, January 18, 2018

Fostering Civil Discourse - and Humor - in a Partisan Era

By Tarris Rosell, PhD, DMin
Fifteen years ago in the aftermath of 9/11, I was invited to respond as an Ethics panelist to a new, self-published book, The Fundamentals of Extremism (Blaker, et al., New Boston Books, Inc., 2003). The authors aimed to expose “the Christian Right” as a danger to democracy. While I sympathized with chief editor Kimberly Blaker’s agenda, the book itself struck me as taking much the same rhetorical tack as the religious fundamentalists that she and her co-authors vociferously critiqued.

My invitation to a book-signing event came with the expectation that I, a progressive clergyman ethicist, would be an enthusiastic proponent who might also help sell a few books. While preparing remarks, I was challenged with the dilemma of not wanting to disappoint a young author with worthy aims, while also engaging in truth-telling as I saw it. Most importantly, I wished not to support or practice the very thing we both condemned: divisive, speculative, paranoid, demonizing fundamentalist—or even anti-fundamentalist—rhetoric. Unfortunately, to my Ethics eyes, The Fundamentals of Extremism was pretty much what it denounced.

So, for my panel presentation, I resorted to writing poetry, or possibly doggerel - an Ethics response in rhyme.

It seemed to me then, and now, that our ideological divisions are ameliorated best by civil discourse laced with mutual respect and a dose of good humor. This is difficult, and especially so when the stakes appear high, as they did back then, and now. Yet, if we who disagree with political or religious extremism engage in the same sort of rhetoric and behaviors as those we oppose, if our own claims are factually challenged anecdotes and innuendo, we only foster more schism and less democracy.

This is the poem I wrote (with minor edits). I think it still works in the partisan era of Trump.

An Anti-Fundamentalist Confession

Tarris Rosell
© 2003, 2018

I’m fundamentally opposed to fundamentalism,
And separate myself from those who foster any schism.
I feel an obligation to expose the boorish Right
And other such extremists whom the rest of us must fight.

I fear their chief ambition is to slay democracy;
Their paranoia leads them to engage conspiracy.
They’d have us all subservient to Fundie* ways of being,
Dichotomize and simplify our thinking and our seeing.

Black and white, or good and bad, on absolutist values
Strikes me as absolutely wrong, as I’m compelled to tell you.
Yet, in my strident anti-fundamentalist critique,
Another thought has struck me, and has left me feeling meek.

One problem with Conservatives in all their stridency
Is one that tempts both Right and Left as human tendency.
While exorcism of their demonizing fits the facts,
Sometimes I look into the mirror and see “Them” looking back.

The rhetoric we choose to use, the labels we assign,
The latitude we grant to those across the picket line,
Our attitude of hubris, or of apt humility—
All these demark the difference between Us and Them
Or We.

* A pejorative slang abbreviation that refers to religious fundamentalists of any religion or denomination.

Dr. Rosell is the Rosemary Flanigan Chair at the Center for Practical Bioethics. He is also Professor of Pastoral Theology at Central Baptist Theological Seminary, Clinical Professor, History and Philosophy of Medicine at the University of Kansas Medical Center, School of Medicine, and Chair of the Department of Bioethics at Kansas City University of Medicine and Biosciences.

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Monday, December 11, 2017

Ethics, Morality and Genomic Science: Can We Play God the Way God Plays God?

Richard Payne, MD
The wisdom of humans tinkering with nature has been challenged throughout the ages based on a common storyline: humans unwisely tamper with nature with disastrous consequences for the creator when we cross a line previously reserved for the deity. Three decades ago, in the early days of gene engineering, scientists raised ethical and moral concerns about “playing God.” They weren’t opposed to interrupting the natural order to cross breed animals and plants or to cure or treat disease. Rather, they warned against exercising the power of science and technology without sufficient regard for its consequences, admonishing not to cross boundaries that manipulated nature in ways traditionally thought only an omniscient and benevolent God could or should do. 

Recently, a new study reported that defective genes in an embryo were edited and repaired through a revolutionary technique known as CRISPR-Cas9. The procedure was used to eliminate hypertrophic cardiomyopathy – a devastating heart disease and the most common cause of death in otherwise healthy young athletes. Use of this technology is under intense scrutiny by scientists and ethicists to understand its risks and benefits. Moral, ethical and practical concerns are particularly strong as applied to genetic engineering of sperm and egg cells, because such “germline” editing not only affects the individual embryo, but also future generations.

So, does germline gene editing “cross the line?” There are strong arguments in support of the wise use of CRISPR-Cas9 technologies in medicine. Obvious examples relate to eliminating types of cancer, cardiovascular and neurological diseases by selective editing  genes of embryos with identifiable mutations that cause these disorders. The study reporting correction of the cardiomyopathy mutation specifically targeted the abnormal gene, indicating that the technology is becoming more precise and safer in a remarkably short period of time. This is why the National Academy of Sciences, Engineering and Medicine and the FDA have ethics guidelines permitting research on germline editing and engineering. The ethical principles behind these safeguards include the notion that genomic editing technologies will be used by appropriately trained scientists in transparent processes to promote well-being for all humans.

However, there are concerns we should not ignore. Germline editing requires monitoring of future generations of the embryo’s offspring, which raises a host of practical, legal and regulatory issues currently unaddressed. Furthermore, use of gene editing to enhance human characteristics such as physical appearance and cognitive performance is less ethically justifiable and subject to potential abuse. Despite these concerns, many prominent scientists warn that halting research and potential medical applications for fear of unknown risks and unaddressed ethical questions is also risky, and poses problems by not addressing current moral concerns—such as application of these technologies to reduce the number of abortions and loss of embryos.

The late theologian-ethicists Paul Ramsey and Alan Verhey raised the possibility that “playing God” may not always be negative, with one qualification. They wrote that humans should only “play God, the way God plays God.” By that they meant that it is morally appropriate for humans to research and explore the natural world and to wisely use wonders such as CRISPR-Cas9 because God made humans in his image and made us stewards of creation. We humans “can play God the way God plays God,” they argue, if we intend and promote human flourishing through our scientific and medical discoveries and technologies, and if we make these advances available to all humankind by seriously attending to social justice and fairness. This is truly wise counsel and worthy of application as we inevitably push forward on our revolutionary genomic journey. It also may be much more challenging than the science.

Richard Payne, MD, is the John B. Francis Chair at the Center for Practical Bioethics, Kansas City, MO, and the Esther Colliflower Professor of Medicine and Divinity (Emeritus) at Duke University.

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Thursday, October 12, 2017

Gun Violence: Prevention by Paying Attention

Tarris Rosell, DMin, PhD
In a time of heightened anxiety about gun ownership and gun violence, the theme of this blog may already have some “Second Amendment People” reaching for their Glocks in self-defense. Or those impassioned for increased regulation of gun sales and ownership may be anticipating a welcome shot in the arm of support for that cause, especially in the wake of “Las Vegas”— the newest city whose name now depicts a national tragedy.

While I am unafraid to take on proponents of unfettered gun ownership and, as a life-long gun owner myself, I still remain an ardent proponent of tougher laws restricting access and distribution of firearms, this is not the tack I am taking here. The moral of this message is that we ought to pay attention as an ethically astute means of community care and also gun violence prevention.

To what or whom should attention be paid?

Lessons from Sandy Hook

I attended a community forum on October 9, 2017, organized by the Heartland Coalition Against Gun Violence, a program of Grandparents Against Gun Violence, and with co-sponsors that included the Center for Practical Bioethics. Plenary speaker Nicole Hockley urged us to pay attention to signs of a potential shooter. She claims that most incidents of gun violence are preventable, not so much by reducing the number of weapons (although she is not opposed to such efforts), but by identifying those whose trajectory of emotional-relational distress seems headed towards an act of violence, most often involving self-harm.

As the Public Service Announcement recently released by Hockley’s organization compellingly demonstrates, interventions can happen only if we are paying attention to those lurking in a lonely background. The 2½ minute YouTube video, “Evan,” is a must see and show for teachers, clergy, parents and other community leaders (

Ms. Hockley is the mother of Dylan, one of 20 young children killed by 20-year old Adam Lanza at Sandy Hook Elementary School on December 14, 2012. She and some other bereaved parents have put their mourning to work in a nonprofit called Sandy Hook Promise ( Hockley speaks to groups like the one in Kansas City about prevention by paying attention. She trains listeners to “recognize the signs of chronic social isolation or marginalization or rejection and how to practice inclusivity, which is step one onto a different pathway or not going down one towards self-harm.”

The parents of Sandy Hook victims teach that “Gun violence is preventable when you know the signs. Learn them now.”

Warning Signs and Things You Can Do Today

The warning signs they point to include the following:

  • a strong fascination or obsession with firearms, shooting techniques and mass shootings
  • overreacting or acting out aggressively for seemingly minor reasons
  • real or perceived feelings of being bullied
  • unsupervised, illegal or easy access to firearms and bragging about such access
  • gestures of violence and low commitment or aspirations towards work or school, or a sudden change in academic or work performance

It is natural to feel demoralized after yet another mass shooting such as we saw in Las Vegas, with 59 dead and nearly 500 injured. Yet there is hope. Nicole Hockley encourages all of us to “know that gun violence is preventable, and . . . if you’re frustrated by the lack of progress on this from a legislative perspective, just don’t give up, because there are things you can do today that can protect your own children and your own community if you promise to learn how.” (See

Dr. Rosell is the Rosemary Flanigan Chair at the Center for Practical Bioethics. He is also Professor of Pastoral Theology at Central Baptist Theological Seminary, Clinical Professor, History and Philosophy of Medicine at the University of Kansas Medical Center, School of Medicine, and Chair of the Department of Bioethics at Kansas City University of Medicine and Biosciences.

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Wednesday, September 6, 2017

Lifetime Achievement in Bioethics

Center for Practical Bioethics Founding Executive Myra Christopher Honored by American Society for Bioethics and Humanities 

Forty years ago, a young Johnson County, Kansas, homemaker stood by her mother’s grave and promised to spend the rest of her life working to ensure that those living with serious illness could have their wishes honored and values respected. That same year, her college philosophy professor introduced her to a new “movement” called bioethics that advocated for patients to actively engage in their own care. Following graduation, from 1984 through 2011, she served as founding executive director of the Center for Practical Bioethics in Kansas City.

On October 20, 2017, Myra Christopher’s four-decade journey will culminate in her acceptance of the 2017 Lifetime Achievement Award from the 1,800-member American Society for Bioethics and Humanities (ASBH) at the national association’s conference hosted in Kansas City.

Early in Christopher’s career at the Center for Practical Bioethics, she and her founding board faced challenges like court reporters, judges and lawyers appearing in hospital rooms to intervene on end-of-life decisions. Hospice care was, for the most part, still rare.

Unlike the half dozen academia-based bioethics centers that existed at the time, the vision for the Center was to create an independent, free-standing nonprofit that converts bioethics theory into services and resources to serve real patients, families, providers and policymakers facing real-life healthcare issues and crises in real time.

In recognition of Christopher’s role in achieving this vision, ASBH professionals from clinical and academic settings along with those from medical humanities throughout the country will present her with its most prestigious honor in afternoon ceremonies at the Sheraton Crown Center Hotel in Kansas City, Missouri.

Christopher, who credits her success to early believers and supporters, will be honored along with Steven Miles, MD, who is recognized for his contribution to bioethics scholarship and devotion to the alleviation of suffering.

In announcing the award, ASBH stated: “Christopher’s work has changed how shared decision making among families helps to match the care a loved one receives with his or her wishes, how hospital ethics committees respect and advocate for the rights of patients, and how communities care for those with terminal illness.”

In response to the ASBH announcements, congratulations from national and local leaders in healthcare have poured in, as exemplified below:

Myra Christopher has long been a hero of mine. Her values and unwavering commitment to service represent a personal True North.

Ira Byock, MD, Founder & Chief Medical Officer
Providence Institute for Human Caring, Torrance, CA

Myra Christopher is part of a group of pioneering women – in which I include Dame Cicely Saunders, Florence Wald and Elisabeth Kubler-Ross – each of whom stood up, powerfully and strategically, on behalf of people who are suffering. Because of Myra, the beginnings of a transformation towards person-centered care has begun.

Diane Meier, MD, FACP, Director of the Center to Advance Palliative Care
Mount Sinai Health System, New York, NY

Myra Christopher’s contributions to improving care for patients at the end of life are emblematic of some of the best features of bioethics. Rather than simply engaging in research (which she also does), she has shown how commitment and intelligent action can lead to changes in policy and practice that actually improve the lives of patients.

David Magnus, PhD, Director of the Stanford Center for Biomedical Ethics
Stanford University, Palo Alto, CA

As we continue to wrestle with ongoing issues in bioethics (end-of-life care, protection of human subjects, pain management, etc.), as well as enter into new challenges in bioethics (new technologies, genomics, healthcare financing, etc.), we will all benefit from the legacy of your work and be better prepared to bring bioethics down to that “practical” level that you have so successfully advocated.

Betty Drees, MD, FACP, FACE, Professor of Medicine and Dean Emerita
University of Missouri-Kansas City School of Medicine, Kansas City, MO

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