Creating Life

This chapter considers ecclesiastical teaching and personal experience regarding new reproductive technologies, such as in vitro fertilization, repro-genetic options, such as preimplantation genetic diagnosis, and stem cell research ethics. The principal argument is that the ethics of medical technologies used to treat and provide remedies for infertility turns primarily on questions of moral agency, familial integrity, and medical professionalism, including safety and efficacy. The Church of Jesus Christ of Latter-day Saints (LDS) procreative imperative can make the experience of infertility a wrenching personal ordeal that necessitates re-storying personal and gender identities relative to spiritual entrustment. Repro-genetic technologies find a moral point through disease prevention but are ethically controversial when their intent is for nonmedical purposes, such as sex selection or enhanced capacities. Despite firm convictions about the sanctity of human life, LDS teaching shows surprising acceptance regarding use of embryos for stem cell research.

Epilogue

The Church of Jesus Christ of Latter-day Saints (LDS) has not addressed the structure of health care delivery in the United States that is simultaneously expensive far beyond the levels of any other nation and yet fails to provide access to basic health services for nearly 10% of the population. The concept of adequate health care in LDS teaching on welfare principles provides a basis for constructing an LDS argument for universal access to basic health care. This epilogue draws on the examples of Church advocacy of health care reform in Utah—and Church priorities in international humanitarian assistance programs—to construct a framework of ethical principles to assess proposals and criteria for a social commitment to provide adequate health care to all citizens.

The Wisdom of Prevention

The teaching and communal practice of The Church of Jesus Christ of Latter-day Saints (LDS) has embodied an ethic of prevention to retain good health and minimize the ravages of disease. This chapter provides two primary illustrations of this preventive ethic, the 19th-century revelation known as the “Word of Wisdom” and 20th- and 21st-century advocacy of vaccinations. The Word of Wisdom’s structure of invitation, restriction, permission, and promises is illustrative of a covenantal principle of responsibility for health. The prevention ethic of vaccinations was initially greeted with skepticism by members of the LDS community as a further infiltration of state hostility to religious liberty, but ecclesiastical teaching beginning in the 1970s and continuing through international humanitarian programs of vaccination exhibit a generalized acceptance of the value of vaccines. The new vaccine to prevent the most prevalent sexually transmitted infection, HPV, has raised practical ethical questions for LDS students, parents, and professionals committed to ecclesiastical teachings on sexual morality.

Faith, Medicine, and Healing

This chapter develops from the revealed realities and moral culture formed by the Church of Jesus Christ of Latter-day Saints a theological and ethical rationale for the healing professions as callings within which the moral reality of healing is conceptualized and enacted. Healing, which is characterized by restoring wholeness, relationships, witnessing the patient’s narrative, the potency of touch, and empathetic solidarity, provides moral convergence and continuity between communal rituals and practices oriented by faith convictions and communal reliance on medical interventions. An evolving moral reality of healing is represented through a typology of three broad patterns of relationship between faith convictions and medical practice that emerged historically in LDS culture: faith against medicine, faith and medicine, and faith in medicine.

Gifts of Life

This chapter examines views and practices of The Church of Jesus Christ of Latter-day Saints (LDS) regarding organ and tissue donation, which historically have evolved from a posture of ecclesiastical discouragement to a contemporary commendation. The ethics of organ and tissue donation can be situated within an LDS communal ethos of love of neighbor, altruism, and offering “gifts of life” as a morally and spiritually valuable action and a matter for individual agency rather than a state or ecclesiastical mandate. Communal practices surrounding organized blood donation, sacramental rituals of the offering of Christ’s body and blood for human salvation, and scriptural analogies of self-giving to others provide religious motivations for an organized culture of donation regarding organs and tissues.

Public Bioethics

The Church of Jesus Christ of Latter-day Saints (LDS) ecclesiastical policy on health, medical, and moral issues has seldom addressed itself to the healing professions or to questions of public policy, an ethical insularity coherent with the principles of respect for moral agency and trust in the healing vocation of the professions. However, some issues reveal limits to peaceful compromise between ecclesiastical policy with both professional morality and public policy of the secular state and have prompted the LDS Church to forgo ecclesiastical silence and present a public witness of its values and positions on a policy question to a broader civic audience. This chapter focuses on two such examples, elective abortion and medical marijuana. The public square of moral reasoning within LDS teaching is constructed by principles of engaged citizenship, separation, and the moral core.

Dying Well

The most meaningfully charged ethical choices confronted by members of The Church of Jesus Christ of Latter-day Saints (LDS) and by LDS medical professionals concern decision-making at the end of life. This chapter examines ethical considerations confronting the LDS community in decisions regarding both forgoing medical life support and in medically assisted dying. LDS teaching has supported a negative right to die from treatment cessation while consistently opposing legalization of a positive right to die through a physician-prescribed medication or administration of a lethal drug. The ecclesiastical emphasis on responsible exercise of moral agency leaves open the prospect for adherents to claim that a version of death with dignity is compatible with LDS ethical principles. Nonetheless, ecclesiastical opposition has extended to opposing specific legislative and citizen referenda advancing patient rights to request a life-ending medication from their physician.

Back to the Future

The Church of Jesus Christ of Latter-day Saints (LDS) practice of research on genealogy and family history has contributed to momentous advances in identifying, testing, and treating genetic-based diseases. This chapter examines the ethical dimensions of genetic testing and interventions in the human genome. The ethical questions raised by various forms of genetic testing for diseases carry over into innovative developments in human gene editing technologies to prevent diseases. Gene editing also holds out the prospect of enhancing human physiological and cognitive capabilities. Enhancements are a feature of contemporary technology appropriated by LDS theologies of transhumanist perfectionism. The chapter presents a framework of normative ethical principles for personal, professional, and policy decisions on these controversial questions.

Born Dying

This chapter examines the existential and ethical questions raised by care for infants born with life-threatening physiological impairments. The parental narratives of infants born dying present unique illustrations of how The Church of Jesus Christ of Latter-day Saints (LDS) convictions of the revealed reality—including the salvific value of embodied life, parental commitment and autonomy, the eternal family relationship, and medical futility—influence medical decisions regarding life endings at the beginnings of life. These convictions support a narrative that can run contrary to the progressive and vitalistic impulse of biomedicine: children who die prior to accountability have already displayed their faithfulness in the pre-mortal life and do not need the trials for mortal life for their eternal progress. These convictions enable parents to re-story their experience of tragedy into a quest for blessing.

Introduction

This chapter constructs a moral reality of the ethics and moral culture of The Church of Jesus Christ of Latter-day Saints (LDS) by (1) identifying critical and distinctive pre-moral convictions that manifest the revealed realities of the LDS religious worldview and (2) providing a substantive exposition of formative principles, values, and virtues of LDS ethics that constitute a restored morality. The pre-moral values highlighted include a progressive salvation narrative, the harmony of religion and biomedicine, embodiment, and family. These values are supplemented by five core ethical principles, including love, hospitality to strangers, covenant, justice, and respect for agency and self-determination. These principles display moral continuities with the moral values and ethical teachings of other philosophical, religious, and cultural traditions.