Autonomy and the Value of Human Life in Christian Bioethics: A Critique of Functional Moral Reasoning

Abstract

Contemporary bioethics treats autonomy as the governing principle in decisions involving euthanasia, abortion, and end-of-life care. Yet the operative moral reasoning in these debates frequently depends not on autonomy but on implicit judgments about the value of human life based on functional capacity, suffering, or perceived quality of life. This paper identifies and analyzes this conceptual inconsistency. It argues that functional valuations of life, not autonomy, are doing the decisive moral work in contemporary clinical ethics, and that this hidden reliance on conditional assessments of human worth creates an unstable foundation for protecting vulnerable persons. Drawing on the Christian theological tradition, particularly the doctrine of the imago Dei, Augustinian and Thomistic moral anthropology, and the work of Edmund D. Pellegrino, the paper proposes an alternative framework in which human dignity is intrinsic and inviolable, and autonomy is understood not as sovereign self-determination, but as responsible moral stewardship exercised within the created order. Three case studies in euthanasia, abortion, and advance care planning illustrate the practical consequences of this reorientation. The paper concludes with implications for clinical ethics consultation, institutional policy, and the role of Christian bioethics in pluralistic healthcare discourse.