Genetics and Suffering - Introduction

In 1953, James Watson and Francis Crick cracked the genetic code, and out tumbled As, Ts, Gs, and Cs in three-dimensional array. Over forty-five years later, we are dealing with the questions raised by this new genetic science and the unforeseen manipulative power it has placed in human hands. Not only do we now understand the makeup of our biology, we are on the horizon of being able to alter our biology as we see fit - whether for medical, agricultural, or economic reasons.

We are not simply facing technological aspects of genetic science, however. Our genetic code is indicted as the source of suffering for millions of individuals inflicted by genetic diseases such as Tay-Sachs, Cystic Fibrosis, or even learning disabilities. Suffering from disease, indeed, suffering of any sort, has always challenged the Judeo-Christian faiths, which profess believe in a God who as all-good and all-powerful. If such a God truly exists, many ask, then how can this suffering continue?

Genetic science, however, has added a twist to the age-old question of suffering. Now the possibility exists that suffering, at least that suffering inflicted by genes gone awry, can be remedied with human hands - by changing the genetic makeup of an individual. Christians now have a two-fold question raised by genetic technology:  If God is truly all-good and all-powerful, how can we explain the presence of suffering from genetic disease? And, the new question, what course of action should we take in light of the possibilities of genetic technology? Does this technology promise to eradicate suffering? Could gene therapies be a type of redemption?  Science, suffering, genetics, evil - how do these intertwine with one another and in our lives as human beings? On October 17, 1998, one hundred people gathered in a small auditorium to discuss these things in a conference entitled Science & Suffering: Genetics and the Problem of Evil

21st Century Research Genetics - John Medina

Watson and Crick asked science to tell them the structure of DNA; contemporary geneticists ask science to discern how life begins, from the fusion of parental genetic material to selective activation of genes in a developing embryo. This “idea of turning genes on and off and seeing in some cases profound effects of activation on cellular careers,” says Dr. John Medina in his presentation ‘Womb with a View: The Research Genetics of the 21st Century,’ “is providing great insight into our understanding of this marvelous embryonic construction project. And the more we understand what is occurring, we will be knocking on the door of deeper and more profound questions about the substance of life. Even issues like identity begin to change.”

“[U]nbelieveable vistas are coming,” Medina says. “It is an amazing thing, and it is not terrifying - it is awe-inspiring.” There are, however, “many things that bring concern to me a scientist,” he says. “It can start innocently enough - there’s nothing wrong with A’s and G’s and T’s and C’s, nor is there anything wrong with trying to keep a little girl who has cystic fibrosis alive from choking in her own fluid. The problem is simply that our curiosity comes with some unintended consequences having to do with both the nature of the inquiry as well as the nature of the inquirer. In the end, we have asked science to answer a question for us” - what are the beginnings of life, how does this cell work, and how do you make certain things occur? And the answer we have received, Medina says, “has not only changed the nature of the interrogation, it has had a powerful transforming effect on the people asking the question.”

 “From genetic testing to stretching our definitions, it is the whole purpose of this conference to bring dialogue to these issues,” Medina says. “And for us who both perceive and profess moral absolutes, to see where the conflict lies, it is the twenty-first century’s most interesting contribution to the age-old quandary of pain and suffering.”

Can we Play God? - David Perry

Dr. David L. Perry, a Lecturer in Philosophy at Seattle University, contributed to this dialogue by examining three criticisms theology often raises against the use of genetic technology. One criticism, Perry says, is that “Genetic engineering is often judged as ‘unnatural’ or said to ‘violate natural law.” But such an argument is flawed, Perry argues, because “strictly in descriptive or empirical terms, the claim that genetic engineering is ‘unnatural’ is very strange, since if it truly violated natural law it would not be possible for us to do. In this sense, it would truly be ‘unnatural’ for human beings to defy the law of gravity - unnatural because impossible - but it is quite ‘natural’ for human beings to manipulate genes,” Perry says. “I don’t mean to imply that any and all genetic manipulations are ethical,” Perry cautions, but rather “that whatever is in our power to do is in an important sense natural to us.”

A second criticism raised by theologians is that “Genetic engineering is condemned as ‘violating the dignity of human life.” Disabling genes for Tay-Sachs or Huntington’s disease in parents who desire healthy children is not a violation of human dignity, argues Perry; rather, it is “morally acceptable, even praiseworthy.” Similarly, using genetic knockout research to create brainless human organisms for organ- and tissue-donor purposes does not necessarily violate human dignity, Perry argues. “[A] capacity for consciousness is a necessary condition for being a person and having interest, rights and dignity,” Perry says, and “since the human beings created not to have brains will never be conscious persons, harvesting their organs need not represent a violation of human dignity.” This does not mean, however, that such a practice is “morally justifiable,” Perry stresses. This line of reasoning simply points to a weakness in the theological criticism.

Thirdly, Perry says, genetic engineering “is often criticized as ‘playing God.’”  The first weakness found in this criticism was first put forth 200 years ago by the philosopher David Hume. “Hume pointed out that if we violate God’s sovereignty whenever we intentionally take human life, then logically we must also violate God’s sovereignty whenever we prolong human life beyond its ‘natural’ length,” Perry says; such violations include inoculations and medical interventions.

An even more fundamental weakness of the criticism of “playing God,” Perry argues, is the mistaken belief “that God intervenes in nature or human events in any way.” If it “is claimed that God has intervened in the past to promote good, limit suffering, prevent evil or establish justice, then the question arises as to why that God manifestly does not intervene in all such cases,” Perry says. “[I]f we are to believe that God is wholly and consistently compassionate, we must therefore abandon our belief in divine intervention and omnipotence.”    

“Many people who have reflected seriously on the problem of evil have concluded from it that God does not exist. I disagree with that conclusion,” Perry says, but I think that at the very least the problem of evil forces us to give up many cherished beliefs about God’s providence. Even if God exists and is wholly good,” Perry says, “we are in an important sense on our own. Thus,” Perry concludes, “the ethical questions concerning genetic engineering become all the more acute.

Theological Perspectives on Genetics - Ron Cole-Turner

While Perry demonstrated the weaknesses of several popular theological arguments against genetic engineering, Dr. Ronald Cole-Turner, the H. Parker Sharp Associate Professor of Theology and Ethics at Pittsburgh Theological Seminary, discussed theology’s historical attempts to “defend God” from the indictment of suffering’s presence in the world. In “The Human Condition: Theological Perspectives on Genetics,” Cole-Turner asks “Why do innocent people suffer?” “The question is as old as humanity and yet as new as today’s genetics lab, where scientists search for the relationship between genes and disease.”

“Some suffering, we might agree, is due to our behavior,” Cole-Turner says. “but not all of it, and so people who believe in God have tried to ‘defend’ God against the accusation that God is, at bottom, either weak or evil.” This defense of God “is the task of theodicy,” Cole-Turner says, and he presents three types of theodicies, each “with implications for how we see genetics and what we expect of it.”

The first theodicy Cole-Turner presents, the most popular in the Christian tradition, emphasizes “The Fall” of humans from the complete goodness and rightness of God’s creation. Attributed primarily to Augustine, this theodicy claims that the “fallenness” of Adam and Eve is carried to and through all of their offspring, even to contemporary humankind. “We are born in the image of God,” Cole-Turner says, “but the image is impaired or ‘defective,’ not the way God intends. Nature doesn’t obey us the way it should. Even our own body, our own will itself, is disordered and does not obey us.” Thus, Cole-Turner says, God is not responsible for suffering because all suffering results from humankind’s fall from the original perfection created by God, and redemption becomes restoration of creation’s original state.

“An alternative theodicy stresses that creation is incomplete,” Cole-Turner says, and the original creation was partial, or “embryonic.” In this theodicy, proposed to the early church by the theologian Iraneus, “Adam and Eve are like children who rebel.” Because they disobey God, Adam and Eve’s “adolescence is arrested at an early stage in development.” Redemption, then, puts humankind “back on the right track and restores the process, and true human identity is found not in the beginning, not by imagining what Adam and Eve were like,” but by moving toward Christ, the “full expression of the image of God.” And, Cole-Turner says, in the end “nature will be whole, and like a giant tapestry, will mix the different colors of suffering and joy into a magnificent picture that would be less if anything, even suffering, were omitted.”

The third major theodicy “does not try to get God off the hook, nor does it try to explain suffering,” Cole-Turner says. “Suffering is horrible and incomprehensible. And where is God? On the cross, in the rack, bearing the full brunt of the suffering.”

According to Cole-Turner, two ways to think of God suffering have been proposed. In the first, that of process theology, “God experiences the joy and the happiness of life, and the creativity of life, but God also experiences all that is awful, all that is tragic, all that is painful.” God is intrinsically limited “to being vulnerable to the full range of cosmic experience.” And the second way to conceptualize a suffering God suggests that God is a “perfectly rich, perfectly powerful triune community who is nevertheless, in love, self-limiting.”

“Each option has implications for technology, including genetics,” Cole-Turner says. The Augustinian theodicy “led to the whole notion that we could use technology to fix nature.” Francis Bacon, a 17th century English philosopher and statesman, “urged massive use of science and technology to repair the effects of the fall.” For Bacon, Cole-Turner says, humans could “cooperate with God in restoring Eden. God does this through redemption; we help through technology.” Even today, echoes of Augustinian theodicy are seen in the concepts of “normal” and “defective” genes. “And so, many think,” Cole-Turner says, that “genetic technology tries to fix defective genes” to restore the original, good form of nature and humanity. 

The Iranean theodicy, “combined with Darwinian evolution, led to the idea that technology could advance evolution, almost without end,” Cole-Turner says. “Forget restoring Eden; go for the stars.” If the Augustinian theodicy “leads us to think of technology as repair or therapy, [the Iranean] opens up the idea of enhancement, of improving on what nature gives us.” In this theodicy there is no “normative state” or standard of “normal humanity,” opening the question of whether genetic enhancement is simply another part of the evolutionary process.

The question of whether genetics should be used only for therapy or enhancement, as well, Cole-Turner says, is simply “another echo of the debate between Augustinian theodicy and Iranean,” whether technology’s goal is to restore or exceed Eden. The danger, however, for Cole-Turner, is not the possibility of using gene technology for human enhancement. Instead, he says, the problem is “that we have jettisoned the theological framework” of our ethics. We have with evolutionary biology a view not like Iraneus at all, but a view in which there is not normative state, no Christ at the end of the process to which we ought to aim.” Quoting Hans Jonas, Cole-Turner says that “‘in a world of technological ethics, built within an evolutionary framework, nothing is sanctioned by nature, and therefore everything is permitted to us.’” There is no Adam and Eve to define normative humanity. There is even no Christ at the end of the process that defines the target to which we ought to use our technological interventions.”

It is in the theodicy of a God who suffers with creation, that Cole-Turner finds his hope for the ethical future of gene therapy and genetic technology. This theodicy “suggests something completely different,” Cole-Turner says. “Suffering, finally, will not be eradicated. Diseases may be treated, problems might be solved, pain might be eliminated, but suffering arises not just primarily from disease but from love and its vulnerability, from life and its irreplaceability, from joy and its transience. Suffering can be addressed technological but never removed finally, and it is a dangerous illusion to try. We may pursue technology,” Cole-Turner says, “but we need to devote at least some of our attention to learning to live with limits, with loss, with death.”

In this theodicy “God is present in the creation in the form of the second and third person of the trinity.” We thus experience “suffering and God at one and the same time, and what that creates as a possibility for human beings is . . . an emerging community, in which there is compassion and technology side by side.” If there is any hope “that we will use the [genetic] technology wisely,” Cole-Turner says, “it will come from a re-theologizing of the entire framework so that we understand anew the relationship between God and the natural world,” not from “attempts to remake Eden or exceed Eden.” Rather, Cole-Turner hopes we become “become a community of people who use technology wisely, even while we remain fragile creatures.” 

The Need for Education - Cynthia Fitch

Dr. Cynthia Fitch, professor of genetics and molecular biology at Seattle Pacific University, spoke from her experiences of teaching General Biology to non-Biology majors.”[W]e learn that if the gene is mutated, and someone inherits two copies of the mutated gene, disease is the result. I know that the severity of the disease is often variable and the environment can serve to modify the genetic expression of a particular mutation. But these nuances are difficult to explain to a class of over 150 college students not interested in majoring in anything remotely resembling biology. They are simply trying to understand ‘big A,’ ‘little a’ and what on earth an allele has to do with them.”

“Why do we insist that all students take a course in biology?” Fitch asks. Quoting Dr. Cole-Turner on Rothman, Fitch says, “every possible issue of our time - race and racism, addictions, cancer, sexuality has all been placed in the genetics frame.” Therefore, Fitch says, “educating our students and our colleagues about this powerful tool called genetics is essential to our understanding of our world today.”

Referencing the opening story in Cole-Turner’s book Pastoral Genetics, Fitch tells of a pastor faced with counseling a couple whose fetus exhibited the gene for Cystic Fibrosis. The couple terminated the pregnancy and, after much counseling and prayer, chose to bear another child - who was born healthy. The pastor struggled “to help, to listen, to cope, and to advise on principles that might run contrary to her own,” Fitch says. The pastor “‘wished she could remember what she had learned’ in high school genetics and ‘she hoped she would never again face a similar situation.’” “My goal,” Fitch says, “is for my students to remember their genetics instruction as being significant and important and how to find resources when they have questions.”

“My fellow geneticists, biochemists, and biologists should also be helping to educate our communities about genetics, technology and the power of the information it provides,” Fitch says. Scientists, she says, “must be accountable for the information we are uncovering. We cannot simply deliver it without compassion and feeling. Yet, as scientists, we are called to objectivity and [are] obliged to present all the genetic knowledge that is before us. We cannot try to simply make a genetic disease go away because it feels bad.”

“Where scientists have failed, however,” Fitch says, is in “learning to rely on the community ... the Pastors and counselors to help disseminate the information in a way that is healing or sensitive.”

“We have long had a relationship between clergy and physician,” Fitch says, “one to heal the soul, the other the body. Now we add scientists and their genetic predictions to this complex relationship.”

“Pastors, your understanding of this genetic information is crucial,” Fitch says. “You, too, may be called upon to counsel” in a situation similar to that of the pastor in Cole-Turner’s book, for “[m]embers of your congregation face some form of genetic testing or recombinant DNA-based medicines every time they go to a large hospital.”

“Scientists and Pastors probably seem odd collaborators,” says Fitch, but our mutual mission of providing vital information related to the value of a life can bring us together.” Pastors and scientists must collaborate, dialoguing “both formally and informally about the genetic future and the information it holds.” And Fitch concludes, “Let us help young parents possess this genetic information so that when faced with a life and death decision, it will be with all the facts of the day.” Thus, the decisions made by individuals facing genetic disease will reflect integration of solid genetic information and sound moral reasoning after “consultation with pastors who understand genetics and geneticists who understand the value of life.”

Feminist & Process Theodicies - Nancy Howell

Humans, created by God, imago Dei - in the image of God.

For the Judeo-Christian, we are made in the image of a Creator God; thus, we create. In centuries past, human creativity mirrored that of God’s in music and art. Now, however, we can create ourselves - with genetic technology we possibly can, and most likely will, influence the biological direction and development of both humankind and nature. But what does this imply for a the theological understanding of the relationship between God and humankind? And if genetic science influences theology, does theology have any reply to genetic science?

According to Nancy R. Howell, Academic Dean and Associate Professor of Theology and Philosophy of Religion at Saint Paul School of Theology, “Scholarship bringing science and religion together for the purposes of dialogue and integration uses the concept of created co-creator to think about the impact of evolutionary biology and genetics on Christian theology.” This concept of created co-creator “fruitfully tells us that humans will be involved in genetic research and technology,” Howell says, “but as a theological construct it does not yet tell us how humans should conduct and apply genetic experimentation.” Thus, Howell suggests “a theology of redemption, informing both theological anthropology and theodicy, is key to discerning how genetics should address human suffering.”

Theology of the Created Co-Creator.

The term “created co-creator,” Howell says, as defined by Philip Hefner, indicates the “primacy of God’s creativity.” Creation of the cosmos ex nihilo, out of nothing, demonstrates the universe’s dependence on God for existence. Humans, in turn, are “simply creatures and not God, who emerged in evolutionary processes under divine rule ... created by God to have a place in the processes that are part of the design of nature.” Secondly, “created co-creator” reflects the imago Dei:  the “co-creator creates with God” - not as God’s equal, but in relationship with God. “The co-creator is the evolutionary process-become-aware, who can be God’s instrument and agent in evolutionary processes,” Howell says. “Thus, humans and human technology are parts of nature itself . . . Human co-creators have the energy and freedom to shape the future toward the telos of God.”

Ted Peters, in Playing God?: Genetic Determinism and Human Freedom, elaborates on the term “created co-creator.” For Peters, Howell says, created co-creator is to be the imago Dei and “to participate in the world’s future. God creates and redeems . . . through future-giving, and humans are part of future-giving through their creativity.” This view, Howell says, quoting Peters, “calls humans to ‘work creatively in the present in light of a projected vision of a redeemed future.’” Genetic technology, therefore, “could be a visionary and benevolent act of human creativity.”

Ronald Cole-Turner, too, uses the concept of co-creation, although in a modified form. For Cole-Turner, Howell says, “creation cannot stand alone but must be joined with redemption. Human creators must be understood to participate in both creation and redemption.” And secondly, Cole-Turner proposes that “God calls human creators to participate vocationally in creative, redemptive transformation of nature and, further, that genetic engineering is a natural extension of God’s creativity.”

However, while genetic technology has the potential to do incredible good for humankind, Hefner, Peters, and Cole-Turner each note that “unrestrained optimism about human creativity and genetics is unwise.” Genetic technology is a human endeavor, and as such it is tainted by original sin, death, exploitation, and greed. Consequently, “for these and other reasons,” Howell says, “I urge further reflection on theodicy, redemption, and genetics even as I am happy to concur that genetic research and technology are instances of human creativity with the intrinsic and instrumental potential for good.”

Theodicy and the Tragic Structure of Creation.

In order to reflect on genetics and suffering, Howell introduces Wendy Farley’s theodicy of the tragic structure of creation. Farley’s theodicy “emphasizes the centrality of suffering,” Howell says; “Suffering rather than sin is the focal point,” and “tragedy rather than the Fall is the conceptual locus for reflection on suffering.” Farley’s radical suffering, such as that experienced by a victim of child abuse, “can never be explained as deserved punishment or retribution for sin,” Howell says. Radical suffering “compromises all that is human in persons” and “is the loss of all power to resist suffering.”

Radical suffering is the result of the world’s diversity, which generates “conflict of values and opposition of ends sought by the multiplicity of creatures. Suffering is born from the conflict of values and ends,” Howell says. Similarly, a theodicy by David Griffin suggests that “any capacity for good carries with it the capacity for evil.” Creation has a tragic structure - and this concept is not uniquely theological. “Diversity in the gene pool is the treasure that enables adaptation and survival for populations and species,” Howell says. “The genetic flexibility that assures a dynamic and changing population is a value, a good. However, the mechanisms that promise species survival, such as natural selection, function simultaneously to generate tragedy.” As Farley writes, “Tragedy is the price paid for existence.”

Radical Suffering and Genetic Defects.

“In tragic cases,” Howell says, “genetic expression is defective and fosters radical suffering. The question is, what do we mean by ‘genetic defect’?” Cole-Turner, Howell  suggests, “genetic defects are conditions comparable to those conditions touched by Jesus healing,” such as skin diseases, mental and neurological disorders, and loss of hearing, sight, or limb. But while “Cole-Turner extricates understanding of genetics from simple associations with the doctrine of creation and begins to relate genetics with the redemptive and healing work of Christ,” Howell says, “my concern regards the fallibility of theology and science in naming what constitutes a defect.”

While science often labels as defect anything causing an organism inability to reproduce, Howell cautions that “defect” is often a socio-cultural distinction. Take, for example, the Deaf community, which “has resisted cochlear implants” and has “already used prenatal genetic testing to assure that their children will also be deaf. What the medical community calls disability or defect, the Deaf community sees as a gift” Howell says. Similarly, both theology and science have been used to label femaleness, race, and ethnicity as defects, exemplifying how much “of what is labeled disease, defect, or disability is socially constructed.” Consequently, Howell suggests that we should look more closely at Scriptural accounts of Jesus-healing. 

Howell points us to Rita Nakashima Brock’s theological interpretation of the healing of the hemorrhaging woman in Mark 5:21-34. For this woman, the bleeding “has social consequences: she suffers from her femaleness. The woman cannot be healed because social structures interfere, even with Jesus’ healing since he is a Jewish male. With courage to violate a social taboo, the woman touches Jesus in public, and her courage makes her whole. The touch literally saves her and she is not simply cured medically. Jesus affirms that the woman’s faith has made her whole rather than that he has healed her. Brock points out a vital healing in this story that is rarely mentioned,” Howell says. “The brokenness maintained by patriarchy and social hierarchy is healed.”

“The paradigm in Mark’s Gospel is significant for interpreting genetics and healing,” Howell says. “It does not deny suffering and the importance of physical healing or sin and the healing that comes by faith.” But as important as the physical cure in this paradigm “is the model of the transformation - the redemption - of culture as it is healed from its social defects.”

Divine Compassion and Redemptive Power.

“Particularly when suffering and oppression are the standpoint of theodicy,” Howell says, “resistance and redemption take on theological importance.” For Womanist and Black theologies, remembrance and retelling of the stories of ancestors’ suffering empowers Black women to resist and survive. “Redeeming gives meaning to suffering as Black women and God become partners in redemption of black people and their suffering,” Howell says. Similarly, for Martin Luther King, Jr. the “redemptive role of Black suffering  was as a model for bringing new meaning to community and civilization. Humans cooperate with God to overcome evil and restore community.”

Liberation theology, as seen in Gustavo Gutierrez, suggests a theological model of a “relation between God and humans to enact redemption out of the context of suffering,” suffering rooted in social and political oppression. “Humans are involved in ongoing creation and salvation through political liberation, which is the self-creation of humans and the transformation of the world.”

Black, Womanist, and Liberation theologies hold that redemption can be born from suffering inflicted by socio-cultural oppression. These theologies demonstrate one character of Wendy Farley’s theodicy, Howell says - “divine compassion and redemptive power address radical suffering, as in race and class oppression. Compassion and redemptive power resist the dehumanizing, tragic conditions of suffering,” Howell says. And this divine compassion “is redemptive because it makes transcendence of suffering and resistance to evil possible.”

“Thinking about radical suffering as a consequence of social sin and oppression,” Howell says, “and about redemption in relation to resisting evil” as it is found in Black, Womanist, and Liberation theologies “causes me to pause and reconsider genetics and suffering.” Using as an example the controversy of the “gay gene” and the deaths of homosexual individuals from “gay bashing,” Howell asks whether suffering in such cases results from a genetic “defect” or from the cultural constructs of a “human community that cries out for healing in acts of violence toward gays.” 

“What are compassion and redemption in the tragic structure of heterosexism?” Howell asks. Where are compassion and redemption in the tragedy of socially constructed defects?

Suffering and Buddhism - Paul Ingram

While Howell touches on possible integrations of genetic science, suffering, and aspects of Christian Womanist, process, and liberationist theologies, Dr. Paul O. Ingram of Pacific Lutheran University presents the Buddhist tradition’s treatment of the problem of suffering. “Reflection about how Buddhist tradition has conceived the ‘problem of evil’” as it relates to science, suffering, and genetics is problematic, Ingram says. “Buddhists have been exploring the relationship between the Buddhist doctrines of interdependence and impermanence with contemporary physics and biological evolutionary paradigms for at least fifty years. Yet Buddhists have not, to my knowledge, explicitly connected analysis of the experience of suffering with the science of genetics.” And, secondly, Ingram says, “the ‘problem of evil’ is not a Buddhist problem.” Rather, Ingram says, the question of “how one can account for the existence of evil and suffering” rises from Jewish, Christian, and Islamic characterization of God as good, just, loving, and all-powerful.

“Buddhism indeed focuses on the suffering undergone by all sentient beings - not just human beings,” Ingram says, but “evil in a world created by a just, good and loving, all-powerful deity, as well as the problem of undeserved suffering of the righteous and the ‘undeserved prosperity’ of the unrighteous have never been structural elements in Buddhist explanations for the nature and cause of universal suffering.”

To understand Buddhist treatment of suffering, one must be acquainted with four “interdependent aspects of the Buddhist world view - apart from which there is no Buddhism” - the doctrines of impermanence, non-self, and interdependent co-origination, and the Law of Karma. “The first three doctrines characterize the structural character of all things and events at every moment of space time,” Ingram notes, “while the Law of Karma points to how human beings cause suffering both to themselves and other sentient beings. These elements of the Buddhist world view are so interdependent that each involves the other - like spokes of a wheel - so that each one needs to be understood in light of the other three.”

The doctrine of impermanence and the Law of Karma.

“[T]he Buddha taught that all existence is duhkah, usually translated as ‘suffering’ in Western languages,” Ingram says. “But more than simple suffering is involved in this teaching . . . all existence involves suffering, or better, ‘unsatisfactoriness,’ because all existence is characterized by change and impermanence. Literally, everything and event at every moment of space-time - past, present, and future - has existed, now exists, or will exist as processes of change and becoming, because all things and events are processes of change and becoming. Consequently, life as such is duhkha, ‘unsatisfactory’ ‘suffering,’ physically, mentally, morally.” When “we become aware that our own lives mirror the universality of impermanence, that change and becoming are ingredient in all things, that there is no permanence anywhere; when we experience our own mortality and feel the resulting anxiety about our lack of permanence, we have an understanding of what the Buddha was driving at in the first noble truth.”

“Seeing permanence of any kind forces us to live out of accord with reality, ‘the way things really are,’” Ingram says. And as “Buddhists understand the Law of Karma, living out of accord with reality causes suffering in the numerous forms suffering can take individually and collectively.”

The doctrines of non-self and interdependent co-origination.

“If there exist only process and becoming, but no permanent ‘things’ that process and ‘become,’ who or what experiences ‘suffering?’” Ingram asks. “Or put another way, if there is no ‘soul,’ who suffers?”

“Hinduism, some forms of classical Greek philosophy, and traditional Christian teaching,” Ingram says, suggest “the existence of a permanent soul-entity remaining self-identical through time to explain continuity, “the paradoxical experience that we are the same person through the changing moments of our lives even as we experience that we are not the same person through the moments of our lives.” Buddhism, however, “rejects any and all notions of permanence, including the notion of unchanging self or soul entities,” Ingram says. “We are not permanent souls or selves; we are impermanent non-selves.”

“Non-self,” however, does not mean “non-existence.” Rather, Ingram says, “we either exist or non-exist as a continuing series of interdependently causal relationships.” According to the doctrine of interdependent co-origination, “things, events, and us become in interdependent relation with everything in this universe at every moment of space time . . . we are as impermanent as the systems of relationships that constitute us.” Stated differently, Ingram says, “we are not permanent soul entities that have interdependent relationships and experiences. We are those relationships and experiences as we undergo them. We are not soul-entities that suffer, we are our suffering” as we experience suffering.

Nirvana, enlightenment, and awakened compassion. 

Through meditation the Buddhist experiences “nirvana,” “awakening,” “enlightenment,” or “wisdom” - an “apprehension of the universal interdependence and interrelatedness of all sentient beings as these processes coalesce in our own lives. This wisdom “Generates ‘compassion’ or karuna - experiencing the suffering of all sentient beings - not just human beings - as our own suffering, which is exactly what it is in an interdependent universe.” For the Buddhist, Ingram says, “no one is free from suffering unless all sentient beings are free from suffering.” Thus, “energized by awakened compassion, the awakened ones . . . are moved to work in the world to relieve all beings from suffering.”

The Buddhist way of addressing suffering - “social engagement,” or “social activism,” as it is more familiarly called by American Christians - is grounded in the practice of non-violence and the practice of meditation. Because “individual greed, hatred, and delusion are central problems from which all need deliverance,” Ingram says, quoting Thich Nhat Hahn, “‘social work entails inner work.’” And it is meditation, that practice in which Buddhist social engagement is grounded, that opens us “to the experience of interdependence [of] all things and events” and “engenders compassionate action.”

“However,” Ingram writes, “while Buddhist have always been socially engaged with the forces that engender suffering, focus on ‘systemic’ suffering has not generally been a central point of Buddhist thought and practice until its contemporary dialogue” with Christian liberation theology’s emphasis on “issues of structural suffering” - institutionalized causes of economic, gender, social, political, and environmental oppressions, as well as racism and war. Systemic suffering, Ingram says, the “suffering all persons experience but which bears little, if any, relation to personal choice or an individual’s clinging to permanence in an impermanent universe,” is “the primary form ‘the problem of suffering’ seems to be assuming in contemporary Buddhist theory and practice.”

Two particular issues - and “problems” for the Buddhist treatment of suffering - are human rights and violent social activism. “[T]hrough Buddhist eyes, the Western struggle for human rights seems to be a disguised form of clinging to permanent existence as in an impermanent universe,” Ingram says. “From this perspective the struggle for human rights can only engender more suffering for all sentient beings. “Nevertheless, according to Ingram, “Buddhists realize the importance of human rights issues as issues of suffering," and thus "Buddhist debate on the nature of human rights still continues.”

“Related to the issues of human rights is non-violent resistance against economic and political oppression,” Ingram adds. “Since the heart of Buddhist social engagement is the practice of non-violence that grows out of the sense that all things and events are interdependent, Buddhists are in principle opposed to any form of violent social activism in the struggle for justice and release from communal suffering. The general Buddhist principle at work here,” Ingram says, “is that violence only creates more violence in an interdependent universe. For this reason, until recent times, Buddhists have not been led to be socially active in struggle against unjust political systems, institutionalized forms of economic exploitation, and other forms of international violence. That is, classical Buddhist teaching and practice has tended to focus on individual suffering, but has not focused attention on how suffering becomes institutionalized in social systems.”

However, in “confronting systemic suffering,” Ingram says, “Buddhists are now facing this question: in a universe in which life must eat life to survive, is non-violence always the most ethical response to systemic suffering?” Or are there times in which the practice of non-violence “might itself engender more systemic suffering?”

Monotheistic theology faces “the problem of evil” and the related “problem of suffering” - the task of defending the Christian, Judaic, or Islamic good, just, all-powerful and loving god against accusations of unjust suffering and evil in the world. Buddhist teaching, however, grounded in the classical Buddhist doctrines of impermanence, non-self, interdependent co-origination and the Law of Karma, faces a different challenge. Buddhist teaching explains the presence of suffering as a result of individuals attempting to cling to permanence in a fleeting universe. The difficulty for Buddhism, however, lies in how to address, from a worldview grounded in non-violence, the suffering that results from oppression institutionalized in social systems.

According to Ingram, “the issue of suffering is not approached anywhere in Buddhist thought as a ‘problem of evil,’ since, given the non-theistic character [of] the Buddhist world view, the problem of theodicy cannot even occur. Furthermore, Buddhist reflection on unmerited systemic suffering has occurred only within the last thirty years, mostly inspired by Buddhist dialogue with Christianity.” Ingram concludes, “All that can be said for certain in this regard is that Buddhist thought and practice on this issue [are] still in process.”

Unremitting Compassion - Richard Steele

It is often easier to conceptualize the suffering from genetic diseases from the removed and theoretical perspective of theology, ethics, and philosophy. However, Dr. Richard Steele, Associate Professor of Theology at Seattle Pacific University, shared “some of the internal changes” he has experienced through the process of raising a daughter with both Fibrodysplasia Ossificans Progressiva, a rare genetic disease, and craniopharynginoma.

FOP turns “most of her muscles, first into masses of cartilage, and then into bones . . . jutting out at odd angles from normal bones, crossing joints, even penetrating the skin from the inside out,” Steele says, while craniopharynginoma created a benign brain tumor that had to be removed with her pituitary gland. Consequently, Steele’s daughter Sarah “has endocrine deficiencies and diabetes insipidus.” And, due to the rigidity of her body from calcification, Sarah cannot “walk, dress herself, use the toilet, put on her own glasses or hearing aids, bathe, turn her head, or roll over in bed.”

In his presentation, “Unremitting Compassion: The Moral Psychology of Parenting Children with Genetic Disorders,” Steele discusses the characteristics of compassion. “Compassion,” Steele says, “is a double-sided disposition. It is an emotion that we experience and must let ourselves experience, but it is also a virtue we must practice, a habit we must cultivate. And these two elements thoroughly interpenetrate, so that truly compassionate people always display both.” Those with compassion have the capacity for both “self-transcendence, which allows them to suffer with others, and a capacity for self-sacrifice which allows them to suffer for others. Moreover, although compassion always involves a willingness to suffer with and for someone who is suffering, one who displays compassion usually retains a certain distance or detachment from the sufferer.”

“But parents of children with serious genetic or congenital disorders cannot distance or detach themselves from the sufferers. This fact makes the kind of compassion which such parents display toward their children peculiar in several respects. It involves horror that the child should suffer, guilt that the parent gave the child the gene which causes the suffering, and eeriness over the child’s abnormalities. It also involves grief and guilt - grief rooted in death of the expectations for your child to have a happy, fruitful life, and guilt for the feelings of grief and resentment toward the diseased child.”

“How is it possible, in the midst of such overwhelming emotions,” Steele asks, “to suffer-with and suffer-for your child in appropriate and helpful ways?” For “compassion presupposes a certain detachment from the victim of suffering, even as it entails identification with her.” But parents cannot detach themselves from the child’s suffering and limitations; instead, “they impose constant burdens and responsibilities that become, in time, a form of suffering in their own right. Suffering-with and suffering-for the child seem to shade into suffering-from the child,” Steele says. 

According to Steele, the second peculiarity affecting parental compassion of children with genetic disorders is chronic fatigue. The limitations genetic diseases impose upon children create a need for parental help in even the smallest of matters. “Put sharply,” Steele says, “parental compassion bids us to do what we can to make her life as pleasant and normal as possible. But doing so turns our lives into an endless string of errands, favors, and interruptions.”

And the third peculiarity is the “apparent futility” of it all. “For me,” Steele says, the hardest thing about being the parent of a child with a genetic disease is not the horror or the fatigue, but the aggravation of investing so much to accomplish so little, or even to go backwards. I want to see improvement,” he says, “but often I see only decline.”

These peculiarities of parental compassion toward a child with a genetic disease, the “sheer uninterruptedness and interminability of the attention that the parent must give to the child, coupled with the extreme anguish he feels,” Steele says, “turns parental compassion into a form of suffering in its own right.”

Through the experience of this parental compassion-suffering, however, Steele found that “instead of rescuing us from our troubles, God redeems us through them, and that instead of reducing our sufferings, God uses them to increase our wisdom.” It was through Sarah’s genetic disease that Steele was made aware of his illusions that happiness depends on physical beauty and economic productivity. Faith, hope, and love are all that is needed to make life worthwhile, Steele says; “Sarah can have these . . . and so can I.” It was through the sheer exhaustion of caring for Sarah that Steele discovered his limits, his need for others, and the folly of his self-reliance. And it was through struggling with the seeming futility of his labors that Steele learned “to ask myself why I suppose that my ‘labor’ must yield ‘results.’” Steele learned to care for Sarah, simply because it is the right and good thing to do. And through Sarah, Steele has experienced the sacrament of grace; “I am not only the minister of this sacrament,” Steele says, “but perhaps even more than Sarah, its beneficiary.”

“I certainly do not rejoice that Sarah must suffer as she does, or that Marilyn and I must undergo the collateral sufferings associated with caring for her,” Steele says. “But I am learning how to rejoice in our sufferings, because it is there, more than anywhere else, that I have felt the inexpressible peace that comes when God begins to strip us of our selfishness and our illusions.”


The “problem of evil” is evident all around us, from the suffering of Steele’s daughter to the political oppression of indigent cultures, to the child born with Cystic Fibrosis. But while “problem of evil” and genetic intricacies make for interesting conversation among theologians and scientists, can “the ordinary person” gain much from these discussions? Adrian Wyard, co-director of the Science and Suffering conference, presented his own personal attempt to tie the academic treatment of Christian theology’s “problem of evil” with his own ‘lay-persons’ perspective on the dilemma.

 “The God described by traditional Christian theology is all-powerful, and completely good,” Wyard says. But while “these are fine qualities for a God, they set up on of the greatest challenges for Judeo-Christian theology, the problem of suffering.”

“Historically,” Wyard says, “there have been several ways of interpreting the cause or meaning of suffering within religious contexts. Here are some common ones:

1] Evil Spirits or Forces. This view attributes suffering, whether it be disease or poor crops, to the hopefully temporary triumph of dark spiritual forces which are constantly battling good forces in the unseen super-natural realm.

2] Just Desserts. If we suffer, we must have sinned somehow and therefore deserve the suffering as punishment. God is just by definition, so we have no one to blame but ourselves for what comes our way. There is the possibility of intergenerational suffering too; children are cursed because of the sins of their forebears.

3] Trials and Rewards. God is testing us to see if we will remain faithful through hardship. If we successfully endure our trials then we will reap rewards, either in this life, or in the afterlife.

4] Nature is ‘Fallen.’ This approach points to Genesis 1 as a description of an ancient utopian existence that was corrupted with suffering, death and disease because of man’s sin.

“We could begin to identify the merits and flaws of each of these ideas,” Wyard says, “but they all share one significant problem - they don’t address the underlying paradox; how can a totally good and totally powerful God allow suffering at all?” Either God is not all-powerful or God chooses not to exercise God’s power to alleviate suffering. “It seems as though we can’t have it both ways,” Wyard says; “either God is not completely good, or He is not completely powerful.”

How do we reconcile this problem with our understanding of who God is? According to Wyard, process theologians have “resolved” the problem by proposing that “God is not all-powerful in the traditional sense,” and “is therefore not capable of miraculously fixing suffering, and so the paradox does not occur. Traditional Christian theology, however,” Wyard says, “makes very definite claims about the reality of overt divine intervention.” Thus, if we’re “going to try and find a way to make this all work together we obviously need to be prepared for a bumpy ride.”

Why would a good God create a world so full of suffering? Saint Augustine answered this question by pointing to the “Fall” of humankind, in which “the initially idyllic setting of Eden as God’s preferred order for nature” was “corrupted with death and suffering when man misused his freedom and acquired more knowledge of good and evil than was good for him. The current order of nature, including death and suffering, is therefore traced back ultimately to man’s misguided actions,” and not to God’s will, Wyard says. Unfortunately, this Augustinian idea does not reconcile well with the history of the Earth revealed by science.

Iranaeus, on the other hand, “paints Adam as an innocent, immature, creature living in a garden that’s pleasant, but not necessarily heaven-like.” Adam ignores God’s warnings about the danger of acquiring knowledge of good and evil, and when he attains it, his life changes drastically. “But unlike Augustine,” Wyard says, “the ‘Fall’ is not from an idyllic state, and the acquisition of moral wisdom - and the suffering that comes with this capacity - is not entirely bad since it is a step along the path of maturity. So then, inasmuch as our environment is one which leads to our maturity, this greater good will justify the suffering along the way and is therefore consistent with God’s goodness.”

We also need to draw a distinction “between natural evil (i.e. genetic disorders, avalanches, hurricanes etc.) and moral evil (the free actions of murders, rapists, etc.)” While we can grasp that in order to be more than robots, we need to have freedom to commit evil, how do we explain suffering which results from natural evil, such as genetic disease?

Wyard suggests the possibility that since “we choose to make our own way, and God will not violate our free will, He has warped the whole landscape of nature in the hope that our free choices might head us in the right direction.” Like a ski-slope, both dangers and pleasures are potential human experiences of the landscape. Although the choice of which route to take is ours, all routes from the top lead the skier to the bottom. Misfortunes, such as avalanches, arise simply because they are characteristic of the landscape. “The unfortunate side-effect of a steep world designed for soul making is that avalanches can, and do happen,” Wyard says.

But while the Iranean answer may be partially satisfactory, Wyard says, “it seems there is a distinction between everyday pain, and what we might call unjustified suffering” - suffering rooted not in human decisions of free will or seeming “lessons” taught by God. Do we really have an answer “for the suffering that seems truly unjustified?” Wyard asks. Can we explain the genocide of World War II? Why does God not act in these circumstances?

Wyard suggests that “only one barely satisfying line of reasoning” stands here - the concept of “transcendent causes,” causes so worthwhile that “they supercede (transcend) the value of individual happiness.” War, in which nations understand that hardship is necessary for the needs of the many, is one example of a transcendent cause. And perhaps a more contemporary application of this concept of transcendent causes is the idea of “the maturing - we could even say ‘the evolution ’ - of humanity,” Wyard says. “Wherever there is suffering, there is an opportunity for a decision to love, an opportunity for heroism. It seems love, heroism and happy-suffering are the kinds of qualities we must learn if we are to progress from a self-centered, war-mongering species into caring, other-centered kind of people.” What we must understand, however, is that while a the steepness of life may be “to our collective benefit, it many not be to my individual benefit, Wyard says. “Tragic circumstances may only make fractional sense when viewed from a transcendent perspective.”

The transcendent cause, the life we should strive toward, Wyard says is the life of Jesus, one which “appeared in the immediate human context to be full of unjustifiable suffering and failure,” but which “was in the transcendent context the ultimate triumph. His was a life of pure love, culminating in the ultimate demonstration of transcendent love in his death on the cross.” 

As much as we soothe our conscience with scientific and theological justifications of the problem of evil, however, the problem still remains. “At the end of the day,” Wyard says, “We may be able to tease out the conceptual problem of suffering into its constituent parts and convince ourselves that the components of our proposed solution are internally consistent and successfully match up with the rest of our theology. We may be happy to report that the underlying motives for a world with suffering are probably good,” he says. However, “the question ‘but why me?’ still seems to stick.” The problem does not altogether disappear even when treated by the authorities of science and theology.

In light of this, Wyard asks, “I wonder if the most satisfying way to reconcile genetic disease and suffering with Christianity is not to develop a complex logical justification, but to simply point to the life and death of Jesus as a backdrop.” And in Jesus we see “that even a perfect life entailed suffering, and that he didn’t shrink from it, even the horrific pain of crucifixion. At least God is not asking us to go through anything that He hasn’t been through first himself,” Wyard says. The problem of evil remains, theology and science remain, but in the midst of them is the Christ suffering with us.

“While the experience of suffering is only made barely justifiable by focusing on that aspect of God that prioritizes transcendent good over individual happiness, the Biblical account assures us - paradoxically - that He’d do anything to help us on this treacherous journey. Even die for us. And of course,” Wyard says, “Christian theology tells us He already has.”

Can science and religion talk to each other? Do genetics and suffering and ethics have any bearing upon one another? “Science & Suffering: Genetics and the Problem of Evil” demonstrated not only the possibility of dialogue; it revealed the existence of an already rich and vibrant discourse between these disciplines. Science, we see, needs theology to guide it toward wise applications of technology, while theology needs science to enlarge its understanding of what it means to be human in the cosmos. While science and technology may seem to be a strange marriage, it is a vital one for humankind’s continued understanding of and existence in the beautiful, joyous, and suffering Creation of our Creator God.