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Meta-Theoretical Frameworks and Theological Ethics: Bioethical Decision-Making from a Reformed Perspective

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Meta-Theoretical Frameworks and Theological Ethics: Bioethical Decision-Making from a Reformed Perspective Meta-theoretical frameworks and theological ethics: Bioethical decision-making from a reformed perspective M. C. de Lange Thesis submitted for the degree Doctor of Philosophy in Ethics at the Potchefstroom Campus of the North-West University Promoter: Prof. Dr. J.M. Vorster Co-promoter: Prof. Dr. H.J.M. van Deventer POTCHEFSTROOM December 2010 '11iis tfiesisis aer£icater£to'Dr. 'Dank{.:A..'Vorobiof, M.'D. (Mer£ica{Oncofogist) at Sanr£tonOncofogy Centre, Jofiannes6urg, Soutfi:Africa for fiis professiona{anr£ compassionate care over tfieyast fourteen years, anr£ for being an instrument in <god's fianr£s. ACKNOWLEDGEMENTS I would like to extend my heartfelt gratitude and appreciation to the following people and institutions whose assistance enabled me to complete this study: • Professors Koos Vorster and Hans van Deventer, my promoters, for their scholarly insight, critical guidance and their genuine interest in my scholarly development; • Professors Dries du Plooy and Fika J. van Ransburg, Deans of the Faculty of Theology, Potchefstroom Campus, NWU for their belief in me and this interdisciplinary project, and for their sincere interest in me, both as a colleague and as a postgraduate student; • Professors Herrie van Rooy and Francois Viljoen, Research Directors of the Research Unit for Reformed Theology and the Development of South African Society, for financial support and encouragement; • The Research Support Directorate, Institutional Office, NWU for financial support; • The management and staff of the following libraries for permission to use the libraries and for assistance in locating material: The Theological Library, especially Mesdames Gerda van Rooyen and Malie Smit for assistance with locating material, as well as the staff of the Interlibrary Section of the Ferdinand Postma Library, Potchefstroom Campus, NWU and Stellenbosch University Library; • The staff of Statistical Consultation Services, Mrs. Wilna Breytenbach and Professor Faans Steyn, for assistance with the empirical component of the study; • The reviewers of the various articles for useful and stimulating suggestions; • The ministers of the Reformed Churches of SA who completed the questionnaire; • Ms Jacolette Hatting, a student assistant, for photocopying and filing material; • The nursing and administrative staff of Sandton Oncology Centre for their care and support; • My colleagues and friends for their interest in my work and constant encouragement; • My extended family; and lastly, • Very special thanks to my husband, Attie, and sons Rudi and Dieter for all the loving support and consistent encouragement during the often physically difficult times while working on this project. God has blessed me through you. SOLi DEO GLORIA ACKNOWLEDGEMENTS SUMMARY META-THEORETICAL FRAMEWORKS AND THEOLOGICAL ETHICS: BIOETHICAL DECISION-MAKING FROM A REFORMED PERSPECTIVE. The overarching aim of this thesis was to investigate and clarify the role played by meta­ theoretical frameworks and Christian theological ethics in the decision-making practices of Reformed ministers when advising congregation members on bioethical matters. The theory of ethics was dealt with by focusing on those aspects of Reformed epistemology and methodology necessary for ministers to be able to play their pastoral role concerning bioethical decision-making. The focus then moved to the current praxis - based on the feedback garnered through empirical research on how Reformed ministers in the RCSA reflect on and deal with bioethical issues. The application possibilities of this research in practice were then dealt with by proposing a possible model for decision-making practices. Article One argues that postmodern interdisciplinarity provides a more flexible and productive methodological framework for the age-old dialogue between Theology and the Natural Sciences than the more rigid and oppositional modernist disciplinary framework did. The second article explores aspects of interdisciplinarity, arguing that Bioethics as ttie systematic study of specific moral dilemmas implies conjoining a variety of ethical methodologies in an interdisciplinary framework. The theoretical considerations regarding the interface between Theology, Philosophy and Life Sciences are examined, concluding that it is vital to re­ examine the theoretical basis of Bioethics as a philosophical grounding or methodology in order to place moral knowledge within a meta-theoretical and epistemological framework. Article Three deals with the theory of ethics and aspects of Reformed epistemology which could enable ministers to play a more informed pastoral role when dealing with bioethical dilemmas. This was done by critically reviewing Reformed epistemology within the context of Christian theological ethics in particular. Placing bioethics within the Reformed tradition, reasoning is informed in a way that acknowledges that concrete answers are not found in the tradition alone, but also in the intelligent use of our unique ability for rational judgment, arguing that grounding bioethical arguments in a specific theological tradition provides more specific, clear, and reliable norms that can be applied consistently and comprehensively to complex situations. Article Four reports on the results obtained from a questionnaire completed by RCSA ministers, and indicate that they are confronted with a vast number of bioethical issues. The distribution and frequency of the various issues indicated in the questionnaire confirm the need to assume a more holistic approach towards bioethics than is presently the case. It also indicates the need for ministers to be well equipped to deal with these dilemmas. SUMMARY ii It is concluded that recent advancements in biotechnology cannot be ignored or dealt with in a piecemeal fashion much longer by the RCSA or its ministers. The need for clarity and analysis of the principles underlying theories that should guide their decision-making and pastoral care in dealing with bioethical dilemmas is emphasized. There is a need for appropriate courses in Bioethics during initial theological training, and in continuing training through workshops, seminars and short courses to enhance interdisciplinary awareness and allay uncertainties in this dynamic and morally challenging field of human and scientific endeavour. Keywords: Meta-theory Theological Ethics Bioethics Reformed Theology Epistemology SUMMARY iii OPSOMMING METATEORETIESE RAAMWERKE EN TEOLOGIESE ETIEK: BIOETIESE BESLUITNEMING VANUIT 'N GEREFORMEERDE PERSPEKTIEF. Die oorkoepelende doel van hierdie proefskrif was om ondersoek in te stel na en duidelikheid te kry oor die rol van metateoretiese raamwerke en Christelik-teologiese etiek in die besluitnemingspraktyke van Gereformeerde predikante wanneer hulle gemeentelede moet adviseer oor bioetiese sake. Die teorie van etiek is hanteer deur te fokus op die aspekte van Gereformeerde epistemologie en metodologie wat nodig is vir predikante om hulle pastorale rol te kan vervul met betrekking tot bioetiese besluitneming. Die fokus het daarna verskuif na die huidige praksis - gebaseer op die terugvoer wat verkry is uit empiriese navorsing oor hoe Gereformeerde predikante in die GKSA dink oor bioetiese kwessies en hoe hulle dit hanteer. Die toepassingsmoontlikheide van hierdie navorsing in die praktyk is hanteer deur 'n moontlike model voor te stel vir besluitnemingspraktyke. Artikel een voer aan dat postmoderne interdissiplinere praktyke 'n meer buigsame en produktiewe metodologiese raamwerk bied vir die eeue-oue dialoog tussen teologie en die natuurwetenskappe as wat die meer rigiede en opposisionele modernistiese dissiplinere raamwerk gebied het. Die tweede artikel ondersoek aspekte van interdissiplinere praktyk, en voer aan dat bioetiek as die sistematiese studie van spesifieke morele dilemmas die samevoeging van 'n verskeidenheid etiese metodologiee in 'n interdissiplinere raamwerk impliseer. Die teoretiese oorweginge rakende die koppelvlak tussen teologie, filosofie en lewenswetenskappe word ondersoek en die gevolgtrekking word gemaak dat dit noodsaaklik is om weer te kyk na die teoretiese basis van bioetiek as 'n filosofiese begronding of metodologie, om sodoende morele kennis binne 'n metateoretiese en epistemologiese raamwerk te plaas. Artikel drie handel oor die teorie van etiek en aspekte van Gereformeerde epistemologie wat predikante in staat kan stel om 'n beter ingeligte pastorale rol te vervul wanneer hulle bioetiese probleme moet hanteer. Dit word gedoen deur 'n kritiese beskouing van Gereformeerde epistemologie, veral binne die konteks van Christelike teologie. Deur bioetiek binne die Gereformeerde tradisie te plaas, word die argument toegelig op 'n manier wat erkenning gee daaraan dat konkrete antwoorde nie slegs in daardie tradisie gevind word nie, maar ook in die intelligente gebruik van ons unieke vermoe om rasionele oordele te maak. Terselfdertyd word daar aangevoer dat die begronding van bioetiese argumente in 'n spesifieke teologiese tradisie meer spesifieke, duidelike en betroubare norme verskaf wat konsekwent en omvattend toegepas kan word op komplekse situasies. OPSOMMING iv Artikel vier doen verslag oar die resultate wat verkry is uit 'n vraelys wat die GKSA­ predikante ingevul het en toon aan dat hulle met 'n groat aantal bioetiese kwessies gekonfronteer word. Die verspreiding en frekwensie van die verskeie kwessies wat in die vraelys aangedui word, bevestig die behoefte vir 'n meer holistiese benadering tot bioetiek as wat tans die geval is. Dit het oak die behoefte ge"identifiseer
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