When Jesus stood before Pilate to be judged, Pilate asked him, “Are you the king of the Jews?” Jesus replied, “My kingdom is not of this world. If it were, my servants would fight to prevent my arrest by the Jewish leaders.” By referring to his kingdom as a spiritual reign and not one of this world, Jesus gives us good reason to maintain a healthy perspective on and participation in current events, including sports and politics.

Recent research confirms the wisdom of this perspective. A paper published in the Proceedings of the National Academy of Sciences shows that in addition to the spiritual and psychological benefits of following this advice, our physical health actually depends upon it. A team of twelve medical researchers led by Matthew Mefford discovered a surprising connection.

Mefford’s team first cited previous studies showing that within minutes to hours after major traumatic events, the number of acute cardiovascular disease events (angina, heart attacks, and strokes) rises substantially.¹ For example, on the day of the 6.7-magnitude Northridge, California, earthquake in 1994, the number of deaths due to cardiovascular disease events (CDEs) of Los Angeles County residents rose by 92% above the average daily rate for the 16 days previous and the 14 days following the quake.² More people died as a result of increased CDEs than from the earthquake itself.

On September 11, 2001, medical diagnoses associated with cardiac ischemia (restriction of blood supply to heart tissues), even thousands of miles away from New York City, rose by 70%.³ Even something far less disastrous, such as a nationally significant sports defeat, can trigger an uptick in CDEs. On June 22, 1996, when the Dutch soccer team was eliminated from the European championship, mortality from heart attacks and strokes among Netherlands’ male adult population increased by 51%.⁴

The research team compared these numbers with the rate of acute CDEs among Kaiser Permanente Southern California patients around the time of the 2016 US presidential election. They found that during the two days after the election, the rate of heart attacks and strokes increased by 62% compared with the same two days of the previous week. The increase was similar across race, age, and sex.

Healthy Responses to Political Upheaval
Mefford and his colleagues made no recommendations on how to better respond to the health challenges posed by disasters and other stress-inducing events other than to conclude that more research studies are needed. However, reading their paper stirred my thinking about spiritual connections.

Given a surge in CDEs after a sporting event, no wonder we see a substantial increase in them after a national election, which has bearing on our laws, economy, national security, international relations, and so much more, including the moral-ethical-spiritual climate of the country.

From a Christian perspective, we should not be surprised by the degree to which many political contests become rancorous, disturbing, and stressful. Paul reminds us in Ephesian 6:12 that rulers, authorities, powers of darkness, and spiritual forces are engaged in a battle for human souls. In Daniel 10 we learn that God may deploy angels to oppose or support the rulers of nations.

While I do not mean to imply that all political events involve supernatural interventions by demons and angels, I believe that some do. So, we can expect that many of our political leaders, especially those with the greatest influence over a municipality, state, nation, or cluster of nations will be affected by “spiritual forces of evil.”

Given that our political leaders are targets of spiritual forces, Scripture commands us to pray for these individuals (see 1 Timothy 2:1–2). However, we can pray without grave anxiety, fear, or stress because “the army that fights for us is more powerful than the one against us” (2 Kings 6:16).

Meanwhile, our cardiovascular system can be protected from undue stress as we focus on the certainty that God is in control. Whatever happens in the political arena or anywhere else, “God works for the good of those who love him, who have been called according to his purpose” (Romans 8:28).

Endnotes

1. Matthew T. Mefford et al., “Sociopolitical Stress and Acute Cardiovascular Disease Hospitalizations around the 2016 Presidential Election,” Proceedings of the National Academy of Sciences USA 117, no. 43 (October 27, 2020): 27054–58, doi:10.1073/pnas.2012096117.
2. Robert A. Kloner et al., “Population-Based Analysis of the Effect of the Northridge Earthquake on Cardiac Death in Los Angeles County, California,” Journal of the American College of Cardiology 30, no. 5 (December 1997): 1174–80, PII S0735-1097(97)00281-7.
3. S. Claiborne Johnston, Michael E. Sorel, and Stephen Sidney, “Effects of the September 11th Attacks on Urgent and Emergent Medical Evaluations in a Northern California Managed Care Plan,” American Journal of Medicine 113, no. 7 (November 2002): 556–62, doi:10.1016/s0002-9343(02)01321-9.
4. Daniel R. Witte et al., “Cardiovascular Mortality in Dutch Men during 1996 European Football Championship: Longitudinal Population Study,” British Medical Journal 321 (December 23, 2000): 1552–54, doi:10.1136/bmj.321.1552.

As the coronavirus (SARS-CoV-2) continues to wreak havoc throughout the world, scientists have been working diligently to come up with a solution to this daunting pandemic. Hopes remain high for a vaccine, but a safe and effective one may not come soon enough to prevent more people from being infected.

In the meantime, researchers are looking furiously for alternative forms of treatment that can help those who have already been infected. We know so far that steroids and a new antiviral medication called Remdesivir can provide some relief by acting directly on the virus and preventing replication, but better medications are needed, and soon.

We can also find solutions by learning how the immune system protects us against viral infections. Novel biomedical solutions involve B cells: Convalescent plasma therapy and monoclonal antibodies. By mimicking the immune system’s operation, biomedical researchers are making significant progress toward this end, highlighting the elegant and sophisticated design of the immune system.

B Cells

When a virus or another microorganism enters the body, it is initially captured by sentinel cells in our immune system. These cells break the microorganism into many fragments and “present” these fragments to special cells called B cells. The B cells that “recognize” the fragments will be recruited in the fight against the microorganism. The cells will replicate themselves in high numbers and become factories that produce proteins called antibodies whose goal is to neutralize the microorganism and protect the body from further harm. The population of B cells is a clone of the original one that recognized the fragments presented by the sentinel cells and the antibodies are highly specific in targeting the particular infecting microorganism.

Convalescent Plasma Therapy

When a person is in the recovery stage from a viral infection, these B cells produce a significant amount of specific antibodies against the virus circulating in their blood. This principle is the basis for convalescent plasma therapy, in which the blood from a person who has recovered from a viral infection is harvested and the plasma or liquid portion of the blood that contains these antibodies is separated. This plasma is then transfused to a sick person with the hope that it contains enough antibodies to fight the virus and let the person recover more rapidly.

Even though the principles for convalescent plasma therapy are straightforward, the plasma may not have enough neutralizing antibodies to help the sick person who is receiving it. If this is the case, the benefit may be minimal. One of the solutions for this problem is to “pool” many donors and prepare a mixture of plasma from different donors in the hope that one may have enough neutralizing antibodies to fight the infection. Another solution is to screen the plasma for those neutralizing antibodies and use the plasma units that have a high number of antibodies against a pathogen.

Monoclonal Antibodies

In a second research effort, scientists have sought to take the guesswork out of the process of harvesting convalescent plasma by employing a new technique in the medical field called monoclonal antibodies. Monoclonal antibodies try to mimic the way in which the B cells protect us against viral infections. These antibodies are proteins designed to attach to specific three-dimensional molecules. That interaction can result in the modification of a cell function or, in the case of infectious diseases, block a pathogen from entering a cell.

The use of monoclonal antibodies is relatively new. The first monoclonal antibody was licensed in 1986.¹ Today there are over 75 FDA-licensed monoclonal antibodies that researchers use to treat cancer, chronic inflammatory diseases, cardiovascular diseases, and to aid in transplantation. However, only a handful of them are available for the treatment of infectious diseases. One of the most recent successful such applications involved treatment of Ebola virus.²

There are several ways to manufacture monoclonal antibodies, but all are complex and expensive. Some of them use human tissue and some use transgenic mice.³ Once biomedical researchers obtain the desired antibody (or mixture of antibodies), it proceeds through clinical trials to evaluate its efficacy as a treatment for a disease. The process to produce an effective monoclonal antibody is long and can take months to years. Nevertheless, this solution has materialized by studying the human immune system in exquisite detail.

The COVID-19 Challenge

Coronaviruses have a very distinct protein on their surface that resembles a crown. It is this protein (SPIKE protein) that gives the virus its name (corona = crown). The interaction of this protein with the ACE2 protein on the surface of a human cell allows the virus to invade the cell and start its replication cycle. During the first months of the pandemic, researchers studied the SPIKE protein in great depth and they have now developed monoclonal antibodies against this protein.⁴ As of today, a few companies have moved to the testing phase for some of these antibodies in clinical trials. However, results may not be available until late 2020. Nevertheless, some people believe that researchers will produce monoclonal antibodies before we have a vaccine against SARS-CoV-2.⁵

 

The Case for Design

The coronavirus pandemic has sparked a massive hunt for solutions that can help decrease the virus’s global impact. The amount of resources and the number of people involved in the development of novel therapies is astounding.

It is remarkable to think that with all the accumulated knowledge in the world and with a massive amount of resources behind this research, it will take us many months to accomplish what the immune system can do in just a few days. The complexity and efficiency with which our bodies run this process speak loudly about the exquisite design of our immune system. As the psalmist writes, we truly are “fearfully and wonderfully made.”

One of the many ways that modern civilization reflects a Christian worldview of the nature of humanity—creation, fall, redemption—is in the kinds of food we eat. With food accessibility being a nonissue for most people, we might expect most of us to be making wise food choices, correct? Well, not exactly, and this is how a biblical view of humanity helps.

Knowing what constitutes a healthy diet is necessary for making wise food choices, but with all the conflicting nutrition information online and in the media, it is sometimes difficult to find the truth. Yet, even the consumer with the least knowledge of nutrition knows that an apple is a better choice than a candy bar. So although some poor food choices can be chalked up to inconsistent and poor nutrition information, the better food choice is often obvious. And there are foods we can consume with confidence, knowing that the Bible and all the diet doctors agree they are good for us (see previous blog post “Do Nutrition Scientists and the Bible Agree on What Constitutes a Healthy Diet?”).

The Human Condition

Even when we know what foods are good for us, it is difficult to eat as we should. We eat sweet, salty, and highly refined foods that are low in nutrients despite knowing such foods are not good for our bodies. We know a small shake has fewer calories than a large, but we still choose the large even when we want to eat fewer calories. This is the human condition: we know what we should do, but don’t have the self control to do it.

The Bible accurately describes this universal human condition through the words of the apostle Paul: “For what I am doing, I do not understand; for I am not practicing what I would like to do, but I am doing the very thing I hate” (Romans 7:15, NASB). In our fallen state we often give in to desires of the flesh that aren’t the best for our health. The main problem, then, of consuming a healthy diet seems to be our inability to do it, not the lack of knowledge about proper eating. But even in our fallen state, there are practical steps we can take to make the healthy choice the easier choice.

Step 1: Decrease Portion Sizes

The first step is to reduce portions—not by restricting certain foods, but by changing the dining environment to be more like it was in the past. Historically, portion sizes—as well as eating utensils (e.g., plates, bowls, and silverware)—were much, much smaller. The following graphic shows the number of larger sizes introduced during the last quarter of the twentieth century.¹

Figure 1: . Credit: Lisa R. Young and Marion Nestle, 2002

One obvious way to reduce calorie intake is to choose smaller portions, but this is easier said than done. The following study demonstrates that simply by decreasing the size of eating utensils, portions are naturally reduced.

Figure 2: Ice Cream Consumption Varies by Bowl and Serving Spoon Size. Credit: Wansink, van Ittersum, and Painter, 2006

This study was conducted a second time on CBS’ The Early Show and it yielded the same results: simply changing the size of eating utensils can help us eat less at every meal.

Step 2: Limit Visibility and Accessibility of Food

The second step is to make food less visible and accessible. We are on a “seefood diet”—meaning if we see it, we’ll eat it. Simply keeping food out of sight and slightly less accessible will decrease consumption. Researchers conducted a study with office employees working at their desks for eight hours. Candy kisses were placed in three different locations on alternate days: on the desk, in the desk drawer, and in the cabinet two meters away. Moving the candy from the desktop (visible and convenient) to the desk drawer (invisible but convenient) decreased consumption by 30%, and candy moved to the cabinet (invisible and inconvenient) decreased consumption by 60%.³

Figure 3: Candy Consumption by Visibility and Proximity. Credit: Painter, Wansink, and Hieggelke, 2002

Considering the human condition, adopting these first two steps allows us to consume less without having to make conscious decisions to do so at the point of consumption. They help prepare the way long before eating takes place.

Step 3: Fasting

For most of human existence, food wasn’t readily available in unlimited portions. For centuries, fasting was an integral component in many religious traditions, including Judaism. Jesus himself never told his disciples to fast. He assumed they would when he said, “Whenever you fast” (Matthew 6:16, NASB). Recent research on fasting has discovered many health benefits for reducing the risks of dementia, heart disease, and diabetes.⁴ It isn’t necessary to go on an extended fast to get the benefits. Simply reducing the number of hours we eat in a day to 6­–10 consecutive hours can produce results.

Figure 4: The Positive Effects of Intermittent Fasting. Credit: Adapted from Ferah Armutcu, 2019

The Biblical Solution

The natural solutions given above don’t actually solve the human temptation to eat more than is necessary, but provide only palliative ways to help. Paul gives the answer: “Thanks be to God through Jesus Christ our Lord!” (Romans 7:25, NASB) The answer lies in the person of the Lord Jesus Christ. When we accept his atoning sacrifice for our shortcomings, he comes to live within us through the Holy Spirit and gives us the power to do what is right, including how to take care of our God-created bodies. Scripture not only describes the human condition in great detail, but it also gives impetus to correct wrong ideas: “We are destroying speculations and every lofty thing raised up against the knowledge of God, and we are taking every thought captive to the obedience of Christ” (2 Corinthians 10:5, NASB). It’s tempting to spend the day dreaming about and lusting after junk food. We need to cast down those thoughts and set our minds on the things above (Colossians 3:2). Wrong choices follow wrong thoughts. Considering that Paul still struggled with not being able to do what he knew he should, it is expected that we would have the same struggles.

Although nutrition knowledge is important in making good food choices, the bigger part of the issue is more likely our inability to choose the foods we know we should eat. The Bible explains this dilemma and provides the answer—the God of the universe has come to live with us and in us to give us the ability to do the things we know we should do. Bon appétit!

Greater love has no one than this: to lay down one’s life for one’s friends. — John 15:13

More than 6,000 people die every year in the US because they didn’t receive a transplant in time.¹ Help may arrive soon, according to a recent press release from the National Institutes of Health, which highlights research that might help save some of these lives. Researchers have turned data from successful studies of organ preservation in rats to applications in human health and treatments.

Keeping organs viable is key. To meet that challenge “scientists have greatly extended the amount of time human livers can be stored for transplantation by modifying a protocol that extends the viability of rat livers. Previously, human livers were only viable for an average of nine hours, but the new method of preservation maintains liver tissue for up to 27 hours, giving transplant doctors and patients a much longer timeframe to work with.”²

Due to tissue damage caused by the formation of ice crystals in liver tissue, human livers for transplant are routinely stored and transported at temperatures above freezing (4°C). This process has allowed about nine hours for viable liver transplants from donor to recipient. Previous research conducted in rats allowed development of a method for supercooling livers by perfusing them with a cooled protective solution that included additives of a modified glucose compound and polyethylene glycol (a component of antifreeze). By this method, rat livers could be stored at temperatures just below freezing (-6°C) yet avoiding the formation of ice crystals, thus extending the time for successful transplants. However, human livers are much (200 times) larger than rat livers, and when this method is directly applied to human livers it does not sufficiently protect them from the formation of damaging ice crystals.

Prolonging Organ Storage

Working in collaboration, researchers at Massachusetts General Hospital and Harvard Medical School have modified the protocol with three additional steps that now allow perfusion of human livers and prolonged storage at subzero temperatures.

• They removed air from the supercooling storage bag, eliminating the air-solution interface where ice crystal formation progresses more rapidly.
• They included two more additives to the protective solution: trehalose and glycerol. Both of these components are used in cryogenic preservation of cells at temperatures far below zero, but had never been used in organs destined for transplant.
• They developed a perfusion delivery system—using machine perfusion rather than manual perfusion—that solves the problem of delivering a more viscous modified supercooling solution. Machine perfusion allows profusion at 4°C with the traditional protective solution followed by gradual decreases in temperature while increasing the concentration of the additives.

Researchers have yet to implement this new protocol in human transplants, but traditional standards of assessing liver viability indicate that this process will not negatively affect these organs.³ This is certainly good news. The increase in time of viability gives transplant teams more time to get an organ from the deceased donor to the neediest recipient, not just the closest. So this factor may save some lives each year as patients in critical condition may be able to receive organs from more distant sites.

Every Life Saved Matters

Over 120,000 people remained on the wait list at the end of 2015—a year in which nearly 31,000 transplants took place. Despite the amazing ability to save over 30,000 lives in a single year, the gap between the number of patients on the wait list and the limited number of available organs continues to widen.⁴

Although the news from NIH is promising and may save thousands of lives, another challenge remains. The time from harvest to transplant is not the primary reason why so many people are left on the donor recipient lists or find that their time runs out before receiving a donor organ. No, the biggest problem is the insufficient number of donors/organs available.

One possible solution to the organ shortage problem might be to change policies surrounding organ transplants from appropriate deceased donors. Many people believe that there would be no shortage of organ donations if we would adopt a national opt-out policy (also known as intended consent or intended approval) as compared to the current opt-in policy (also known as explicit consent).⁵

There are hard and soft versions of intended consent policies.⁶ A soft version of intended consent is likely to do well in the US where there is widespread religious support for organ donations already.⁷ Under a soft policy of intended consent, the intent for organ donation is assumed, but the option to opt out remains open to the family.⁸ If increasing human organ donations doesn’t meet the organ shortfall, perhaps additional animal research will close the gap.

How Shared Physiology and Genetic Similarity Help

The extended time for liver transplants came from insights garnered in rat studies and highlights one of many ways that research in animals has helped provide practical applications affecting human health and treatment. Perhaps research in and with animals will provide a solution to the organ shortage problem as well. Researchers are investigating this possibility. Another recent report highlights how human organs for transplant may one day be grown as animal chimeras (or animal hybrids growing human-like organs) thanks to gene-editing techniques provided by CRISPR technology that allow for gene manipulation of blastocysts.⁹

Both of these studies show how scientific advances and research in animals might help save human lives and improve quality of life for those suffering from organ disease and deficiencies. Many people think that the only explanation for all of life sharing the same DNA code and similar physiologies is that naturalistic evolution has occurred. But it’s obvious our shared biologies provide a way for us to discover means to better care for creation and for others who suffer from various ailments and disease. As we consider these insights into how God has provided for us through shared biology with animals and capacities to discover ways to steward creation and care for one another better, we can see ways to help others.

Loving Our Neighbor

A hallmark of following Christ is that we love God with all our heart, soul, mind, and strength and that we love our neighbors as ourselves. All the law and prophets are fulfilled in these two great commandments. Our neighbor may be the one we find in need no matter who they are or what circumstances surround their needs (Matthew 5:42–47, 22:37–40; Luke 6:27–28, 10:25–37).

Organ donation really is a way to give the gift of life. And who knows whether such a gift might extend someone else’s life and provide greater opportunity for them to discover grace, generosity, and new life in Christ before their time runs out. These studies and our actions show how God allows us to discover ways to care for one another and creation, and by acts of mercy, to contribute to human flourishing.

America remains in the grip of an opiate* epidemic. Over 70,000 Americans died from legal and illegal drug overdose in 2017 alone, more than four times higher than in 1999.

The tragic history of this crisis was carefully documented by investigative journalist Sam Quinones in his 2015 work, Dreamland: The True Tale of America’s Opiate Epidemic.¹ Cast members in this drama represent a cross section of human society, from Mexican laborers to executives of multinational corporations. A sobering element of this story is that the American medical community bears much responsibility for the crisis. This example serves as both a lesson and a reminder that sometimes the scientific community can err en masse.

In previous posts we examined pitfalls in belief formation and the perils of overconfidence from a theoretical perspective. This story underscores the dire consequences of ignoring these principles—in this case by highly educated professionals. We will focus on two salient biases: information cascade and confirmation/disconfirmation; and two nonrational contributors to belief formation: moral grandstanding and economic self-interest.

 

Information Cascade

Experts once widely accepted the notion that opiate narcotics were highly addictive. However, some people questioned the idea in the early 1990s as a movement gained traction to treat pain with aggressive medication. A powerful new belief ignited and sustained the boom in narcotics; namely, that addiction from prescribed opiates was actually quite rare. Yet, there was never any evidence for this belief, and considerable evidence to the contrary.

The wildfire was unwittingly sparked by an innocuous five-sentence letter to the editor in the 1980 New England Journal of Medicine.² The authors commented that new addictions seemed to be rare in hospitalized patients receiving low doses under direct supervision with no prior history of addiction. In ensuing years, this source was repeatedly cited, then those sources were cited, snowballing into a widespread false consensus regarding the low risk of addiction.

By early 2017, over 400 scientific papers had cited the letter as evidence that addiction from prescribed opiates was rare.³ It was a classic information cascade. Physicians were not basing their opinion on the evidence but on what other experts said, who were themselves biased by earlier opinions. Almost no one, it seemed, knew or gave much thought to what the original citation actually said. (And it was a letter, not a clinical investigation!)

As a consequence, almost 218,000 Americans died from prescription opioids between 1999 and 2017, while the annual fatality rate rose 400% over the same period.

 

Confirmation/Disconfirmation Bias

Throughout my medical training and early years in practice, physicians generally agreed that narcotics were potentially addictive and should be used with restraint. This belief wasn’t necessarily based on hard data, but the stream of addicts passing through the healthcare system left little room for doubt. That was anecdotal evidence, but it was evidence, nonetheless.

But physicians were not emotionally invested in withholding narcotics; in fact, quite the opposite. Restraint was the path of greater resistance. Liberal prescribing took less time, gratified patients, and left one with a sense of accomplishment. The new paradigm—we could dispense without concern—was liberating. But how could we justify it scientifically?

Confirmation bias is the tendency to favor evidence in support of one’s own position. If a doctor wanted to prescribe opiates freely, scientific papers in support of that position were proliferating due to the previously mentioned information cascade. As we noted, it was faulty yet adequate evidence if someone really wanted to believe it.

Disconfirmation bias is the tendency to dismiss evidence against one’s belief. What about all the addicts? In the case of opiate addiction, physicians began to argue that opiates didn’t cause the addiction; rather, those who were already addicts sought out the opiates. That was a false dilemma between two partial truths, which is why the deception was so persuasive.

 

Moral Grandstanding

A powerful driving force behind the rise in prescription narcotics emerged from the belief that too many patients suffered unnecessary, easily treatable pain. Convinced that the risk of addiction was low, there was no downside to liberal use of narcotics. If narcotics were safe, it was virtuous to prescribe them and heartless to withhold them.

Interns and residents were taught that these drugs were now not addictive, that doctors thus had a mission, a duty, to use them.⁴

Once framed in moral terms, the stage was set for moral grandstanding and ramping up. Consequently, physicians and health care organizations competed in expressing their zeal for pain remediation. By 1998, over 1000 multidisciplinary pain clinics had been established. They vanished almost as rapidly, as the increasing use of narcotics effectively eliminated the need for multiple disciplines.⁵ Other social influences kicked in. As the epidemic unfolded, physicians faced increasing pressure from patients while accreditation agencies demanded proof that they were relieving pain—and that meant more narcotics.⁶

 

Economic Self-Interest

One particular drug occupied the epicenter of the prescription drug crisis: OxyContin, a slow-release preparation of oxycodone. This was a proprietary product of Purdue Pharma, privately held by the Sackler family. Upon the release of OxyContin in 1996, Purdue unleashed a sales and marketing juggernaut to aggressively promote it. According to Quinones:

Purdue set about promoting OxyContin as virtually risk-free and a solution to the problems patients presented doctors with every day.⁷

Eleven years later, Purdue Pharma pled guilty for, among other things, misrepresenting OxyContin’s abuse potential, for which it was fined over $600 million.⁸

Complicit physicians, driven by greed, began and continue to run prescription mills in some of our most vulnerable communities. Many have been caught, convicted, and sent to prison. But it’s a lucrative business and demand is virtually unlimited. In April of 2019, the biggest crackdown to date charged 60 healthcare providers in rural Appalachia with the illegal distribution of narcotics.⁹ As many as 32 million pain pills were distributed, and at least five patients died.

At this point, some may object, “What does belief have to do with it? They knew they were doing wrong and did it just for the money.” This may indeed be true for genuine psychopaths but is otherwise a one-dimensional view of human nature that overlooks our compelling need and skill for self-rationalization. Inside each of us is an excuse factory efficiently manufacturing plausible beliefs to justify our own behavior. According to the science of human nature—and the Bible (“Every way of a man is right in his own eyes” Proverbs 21:2, KJV)—most perpetrators probably believed they were not doing wrong.

 

A Lesson for Us All

While science is our best source for understanding the physical world, physicians and scientists are subject to the same cognitive pitfalls as everyone else. In certain circumstances, they err communally with potentially disastrous consequences. Familiarity with the science of belief can help us to discern when a prevailing consensus should be questioned. Is there emotional investment? Moral grandstanding and ramping up? Peer pressure? Information cascade? Economic self-interest? We all must endeavor to avoid these traps.

In this case, silence was complicity. Had more people been willing to speak up and challenge the paradigm, the false consensus surrounding opiates might have been thwarted, sparing thousands of lives. It takes courage to stand against the crowd—after clearing the logs from our own eyes—but sometimes it is morally necessary.

Beliefs have consequences. False beliefs have worse consequences. A constant attitude of humility can help us avoid such pitfalls. After all, just because we think doesn’t necessarily mean it’s true.

*Note: for purposes of this article, “opiate,” “opioid,” and “narcotics” are basically synonymous. For precise definitions, click here.

 

In the wake of a recent outbreak of measles originating at Disneyland and spreading to more than 20 states, California state legislators have passed a bill implementing mandatory vaccination for students attending public schools. The grassroots uprising against this legislation surprises and disappoints me. This is a charged topic, but it seems that this reaction is primarily rooted in misinformation and a false sense of security that may also involve a failure to consider civic responsibilities. I share here my scientific perspective on vaccine safety and my Christian perspective—that vaccinations can be an apologetic demonstration of Christlike love for our neighbors.

Let me say now that I have no ties to pharmaceutical or vaccine companies. As a virologist, I have spent nearly 25 years teaching, studying, and researching viral pathogenesis (how viruses cause disease) and correlates of immunity (what aspects of the immune response are necessary for protection from viral infections). Much of my research involved vaccine proof-of-concept studies. Motivated by the love of God, and informed by years of study, I saw my research as a form of creation stewardship and as a way to love and serve others. I felt like my work was making a direct contribution to redeeming aspects of human disease and suffering.

I offer my perspectives from a passion for the well-being of others. Vaccination is a rich opportunity for our Christian witness based in the precept of loving others as ourselves, caring for the least of those among us, and considering others as more important than ourselves (Matthew 25:40; Philippians 2:3). On these grounds, my appeal echoes that offered by family physician Matthew Loftus in Christianity Today (May 2015).

Viruses Kill—Vaccines Save Lives

Successful US immunization campaigns have erased some diseases from day-to-day concerns—measles, polio, and rubella are no longer endemic, and incidences of mumps, chicken pox, hepatitis B, and whooping cough are greatly reduced. Decades of successful childhood immunizations have led many in society to no longer see their need for vaccines or their responsibility to act for the benefit of shared public health.

However, as recent measles outbreaks have demonstrated, we are not as protected and insulated as we think. Many viral-associated diseases are just a plane ride away. Measles is endemic in many other countries and is highly contagious. Globally, measles kills about 16 people every hour. Outbreaks occur in the US when individuals are infected abroad, return to the States, and come in contact with unvaccinated people. Continued widespread immunization is necessary to prevent such outbreaks and to protect those most vulnerable.

Evaluating Vaccine Safety

Vaccines administered in the US undergo rigorous evaluation. Long before licensure, research laboratories conduct proof-of-concept (preclinical) studies for potential vaccines. Relevant animal models are employed to demonstrate safety, immunogenicity, and efficacy. This multi-year process examines the extent and ability of potential vaccines to elicit an immune response and it examines the level of protection offered from subsequent challenges with the actual virus.

Once the best potential candidate is identified, production of the vaccine occurs under highly regulated manufacturing processes. Only then can prelicensure clinical trials begin, which are a multi-stage, highly regulated process that evaluates safety at every step in increasing populations. (See table.) If and when the vaccine successfully passes through clinical trials, panels of Food and Drug Administration (FDA) and non-FDA experts review all preclinical and clinical data prior to licensure. Even after licensure, safety evaluations continue through the nationwide Vaccine-Adverse Event Reporting System (VAERS) and, if warranted, in Phase 4 clinical trials. Many times the scientific community foresees potential side effects and may call for further scrutiny prior to licensure as is the case for current Dengue vaccine trials.¹ (Dengue virus threatens millions worldwide each year.)

The FDA has a specific division dedicated to oversight of vaccine manufacturing and development and pre-licensure clinical trials. If at any time before, during, or after licensure a vaccine demonstrates dangerous adverse side effects, the FDA can demand more studies, halt manufacturing and administration, or revoke licensure.

FDA/CBER Road to Vaccine Approval

Initial human studies evaluated for safety and immunogenicity in a small number of closely monitored volunteers.

Preclinical Studies and Manufacturing	Candidate vaccines undergo extensive evaluation for animal safety and immunogenicity and for Good Manufacturing Protocols (purity, sterility, stability, potency, reproducible lots, assay validation, quality control, assurance, etc.).
Phase 1 Clinical Trials	Initial human studies evaluated for safety and immunogenicity in a small number of closely monitored volunteers.
Phase 2 Clinical Trials	Dose-ranging studies evaluate safety and immunogenicity at various doses in dozens to several hundred volunteers.
Phase 3 Clinical Trials	Evaluates disease prevention and safety in large and diverse populations (usually 1,000s–10,000s).
Application for Licensure	Internal FDA review and external FDA review: Data from all preclinical and clinical studies and manufacturing protocols reviewed by experts, including scientists, doctors, regulators, and consumer advocates.
Licensure
Continued Monitoring (Optional Phase 4)	Even after licensure some vaccines may undergo Phase 4 clinical trials to collect more information under certain conditions or in certain populations. All vaccines undergo continued safety and manufacturing evaluations and reviews. Adverse events are reported via VAERS.

The FDA rigorously and continuously evaluates all components of licensed vaccines for purity, potency, and safety. Continued monitoring has helped suspend or halt production and use of poliovirus, rotavirus, and respiratory syncytial virus vaccines when adverse side effects were detected.

Refuting a Falsified Study

In 1998, British surgeon A. J. Wakefield published research on an extremely small number of individuals suffering from bowel disease and implied a link between vaccination and onset of autism. It was later discovered that Dr. Wakefield had falsified data and had a direct conflict of interest in discrediting the MMR vaccine. The journal Lancet retracted the article and Dr. Wakefield was banned from practicing medicine in the UK.²

More importantly, other researchers have never been able to corroborate his research findings. Numerous additional studies (from multiple countries and multiple research groups) have since documented vaccine safety in extremely large populations and have found no association of vaccination or thimerosal (a vaccine preservative) with autism or any other developmental disease. The data overwhelmingly supports the safety of vaccines. Even the national autism advocacy organization Autism Speaksindicates the safety and need for vaccination.

Real side effects (not autism) occur in a low percentage of those vaccinated. The side effects are very rare and, in many cases, pale in comparison to the risks associated with contracting the disease if unvaccinated. The risks for each vaccine should be discussed with your doctor or pediatrician.

Loving Our Neighbors

One of the amazing things about national vaccination campaigns is that you don’t have to reach every single individual. Based on epidemiological studies measles vaccine coverage of approximately 95 percent is sufficient to protect almost 100 percent of the population.³ As the Disneyland outbreak demonstrated, this “herd immunity” is critical in protecting those who are immunocompromised (due to age, illness, or treatments) and unable to receive or elicit a protective response to vaccination. I believe protecting the vulnerable is a critical part of our Christian witness.

For the sake of others, please consider immunizations. Consider vaccinations for your children’s well-being and safety. If you think your child is receiving too many immunizations at once, discuss it with your pediatrician. Please avoid spreading misinformation and unsubstantiated, falsified reports. Instead consider what impact you might have with your unbelieving neighbors if you shared with them the conviction that you vaccinate, despite uncertainties, for the sake of their children and the most vulnerable in society.

Superbugs are frightening and the latest news on this medical front isn’t good. Investigators from the Washington University School of Medicine in St. Louis discovered that two genes (dubbed NDM-1 and KPC) that confer resistance to carbapenems—one of the most powerful classes of antibiotics—readily transfer among Escherichia coli, Klebsiella pneumonia, and other members of the family Enterobacteriaceae.¹ These bacteria cause many hospital infections. Once they acquire resistance to carbapenems, there is no way to treat the infection.

According to Gautam Dantas, one of the researchers who made this discovery, “Carbapenems are one of our last resorts for treating bacterial infections, what we use when nothing else works…Given what we know now, I don’t think it’s overstating the case to say that for certain types of infections, we may be looking at the start of the post-antibiotic era, a time when most of the antibiotics we rely on to treat bacterial infections are no longer effective.”²

Bacteria and other infectious agents cause us quite a bit of misery. Why would an all-powerful, all-knowing, all-loving God create a world filled with bugs that can so readily evade our efforts to keep them in check?

This is such an important question that Reasons to Believe (RTB) has developed a creation model for the origin of infectious disease. The keystone features of this model are (1) God created bacteria to serve a beneficial role and (2) bacteria evolved into pathogens after their creation through a variety of mechanisms, including horizontal gene transfer.

One feature missing from this model is the role human sin played (and continues to play) in pathogen-induced suffering. Recent work by investigators from the Australian National University (ANU) Medical School demonstrates that human moral failings contribute significantly to the rise and spread of antibiotic resistance among bacteria.³

Most scientists who study causes of antibiotic resistance focus on drug usage. The more frequently antibiotics are prescribed, the greater the likelihood that bacteria acquire drug resistance. The ANU Medical School researchers, however, wanted to understand if other factors might contribute to this major threat to modern medicine. They statistically compared the role antibiotic usage plays in the emergence of antibiotic resistance to governmental, social, and economic factors. The researchers conducted their study in Europe because it is the only region of the world where there is good data from multiple countries.

To their surprise, the researchers discovered that antibiotic usage only contributed to about 33 percent of the average antibiotic resistance in each country and that income level made no contribution at all. The two most significant contributors to the average antibiotic resistance were governmental corruption and private health care expenditures. In other words, the greater the corruption and the more spent on private health care, the greater the average antibiotic resistance in a given country. The researchers speculate that when governments are corrupt and health care is administered in the private sector there are less controls and oversight, which can lead to ill-advised treatment protocols and a misuse of antibiotics. Human moral failing, not antibiotic use, is primarily responsible for the rise in antibiotic resistance and the concomitant pain and suffering that goes along with it.

Pain and suffering characterize the world in which we live. Too often, skeptics will reject belief in God (and with it the truth claims of the Christian faith) because they can’t reconcile these features with the existence of the all-powerful, all-knowing, all-loving biblical Creator. Philosophers refer to this conundrum as the problem of natural evil.

Philosophers and theologians recognize two kinds of evil: moral and natural. Moral evil stems from human action (or inaction). Natural evil occurs as a consequence of nature—earthquakes, tornadoes, floods, diseases, and the like. For many people, natural evil presents a greater theological challenge than moral evil. A skeptic might admit that God can be excused from responsibility for the free-will actions of human beings who violate His standard of goodness. But natural disasters and disease don’t result from human activity—therefore, this type of “evil” must be attributed solely to God.

Yet, as the recent research on antibiotic resistance illustrates, moral evil can greatly exacerbate the pain and suffering caused by natural phenomena. That is, what we call natural evil is really moral evil in disguise. For more examples of human moral failings masquerading as natural evil check out these other articles from RTB:

• “Natural Evil or Moral Evil?”
• “Why Do People Die in Earthquakes? Blame Corrupt Governments, Not God
• “Are Tsunamis Natural or Moral Evil?”
• “What’s in a Name? Hurricane Monikers and the Problem of Evil”

“If you listen carefully to the LORD your God and do what is right in his eyes, if you pay attention to His commands and keep all His decrees, I will not bring on you any of the diseases I brought on the Egyptians, for I am the LORD, who heals you.” Exodus 15:26

Which has benefited humanity more, science or religion? Most atheists would say science. The hard-fought advances in knowledge, won by the unrelenting application of the scientific method, have consistently improved humanity’s lot—enabling us to live longer, healthier lives.

Skeptics often ask, “Can Christianity, or any religion for that matter, boast of the same accomplishment?”

In this context a skeptic recently asked me, “If there was a deity who made and loves humanity, and communicated with humans through the Bible, why wouldn’t he provide information that would help human beings live healthy lives?”

According to the questioner, if people had to rely on religious systems exclusively, we would still be living in the medical “dark ages.” And thanks to science we don’t.

But, as it turns out, the Bible does impart medical wisdom that allows humans to live long, healthy lives, as cutting-edge advances in the war on AIDS attest.¹

Male Circumcision and the Spread of AIDS

Researchers have discovered that African boys, who are circumcised as part of the rite of passage to adulthood, contract AIDS at a much lower rate than those who aren’t circumcised. In fact, the odds of contracting AIDS are reduced by about 57 percent.

Based on these promising statistics, thirteen countries have implemented programs to try to get 80 percent of men in Africa circumcised by 2015. If successful, this mission will not only dramatically reduce the number of AIDS cases, but also will save almost $17 billion compared to the current treatments that involve the lifelong administration of antiviral agents.

Male Circumcision and Cancer of the Penis

Male circumcision confers other benefits as well. The medical community has observed that the incidence of penile cancer is practically nonexistent among men who have been circumcised. While medical experts are still uncertain why removal of the foreskin protects against cancer, a significant amount of statistical data supports the prophylactic benefit of the procedure.²

Male Circumcision and Cervical Cancer

New research has determined that male circumcision also promotes female health as well. For example, a recent study discovered that the incidence of cervical cancer in women is reduced when their partners have been circumcised.³

None of These Diseases

In the classic work, None of These Diseases, physician S. I. McMillen demonstrates that the commandments given to Israel thousands of years ago serve as an extraordinary manual of preventive medicine.⁴ Clearly, the commands given to Israel had purposes other than the medical benefits they would provide. Still, the fact remains that by adhering to these laws, God’s chosen people derived very real health benefits.

Such is the case when it comes to circumcision.

God commanded Abraham to perform circumcisions on the eighth day after birth (Gen. 17:12). As McMillen points out, this is the ideal time to carry out the procedure because it ensures that the infant’s blood readily clots after circumcision. For the first four days after birth, an infant has a limited amount of vitamin K and clotting factors in its blood. On day five, the level of these materials increases, reaching the maximum level on day eight.

Additionally, God commanded that a flint knife be used to perform the circumcision (Josh. 5:2). According to McMillen, this practice is significant because when a flint knife is sharpened the surface layer is removed, leaving behind uncontaminated stone that would have minimized infection.

To be certain, the Bible does not focus on healthy living or on dispensing medical advice. It is a book about God’s plan of redemption. Still, the commands that God gave to the Israelites—instructions designed to reveal His plan for humanity—if carefully followed, provide (as a secondary consequence) protection against the diseases that plagued Egypt. And as medical science advances, the wisdom found in the pages of Scripture is substantiated again and again, giving believers confidence of its divine inspiration.