1The spread of languages amongst the questionnaire respondents at the Reformed Churches in South Africa synod, June 2009. http://hts.org.za/index.php/HTS/article/downloadSuppFile/882/726
2The frequency with which ministers were confronted with ethical issues regarding reproductive technologies and pregnancy. http://hts.org.za/index.php/HTS/article/downloadSuppFile/882/727
3The frequency with which ministers were confronted with general medical issues. http://hts.org.za/index.php/HTS/article/downloadSuppFile/882/728
4The frequency with which ministers were confronted with ethical issues regarding agricultural and environmental technologies. http://hts.org.za/index.php/HTS/article/downloadSuppFile/882/729
5Ministers’ responses to certain value judgements. http://hts.org.za/index.php/HTS/article/downloadSuppFile/882/730
6The level of agreement of ministers on issues regarding pastoral moral leadership. http://hts.org.za/index.php/HTS/article/downloadSuppFile/882/731
7Ministers’ preferred theoretical basis when dealing with ethical issues. http://hts.org.za/index.php/HTS/article/downloadSuppFile/882/732
8The degree to which various disciplines played a role in establishing ministers’ ethical theory. http://hts.org.za/index.php/HTS/article/downloadSuppFile/882/733
9The degree to which various concepts were necessary for practicing pastoral care. http://hts.org.za/index.php/HTS/article/downloadSuppFile/882/734
Discussion and conclusion The present study set out to examine three questions by means of a survey amongst ministers serving within the Reformed Churches in South Africa. The first question concerned assessing the bioethical dilemmas ministers encounter in their work environment and to determine how often they are confronted with these dilemmas. The data demonstrated that the respondents are confronted by a vast number of bioethical issues in the congregations they serve (cf. Tables 2, 3 and 4). When considering the distribution and frequency of the various issues indicated in the questionnaire, it confirms the need to assume a more holistic approach towards bioethics than is presently the case. It also indicates the need for ministers to be well equipped to deal with these dilemmas in a proper way. When considering which value judgements they make when reflecting on bioethical dilemmas and pastoral moral leadership (cf. Tables 5 and 6), a very interesting phenomenon occurs. Although indicating a significant reliance on Scripture in the open-ended question (Section F), the need for other forms of knowledge, viz. technology, scientific research, medical facts and an engagement with other professionals in the field of Bioethics is strongly emphasised. A high percentage of respondents indicated that it is not viable for individuals to take responsibility for making decisions and this coincides with the need for ministers to become more involved in pastoral guidance, as indicated in the open-ended question. The RCSA must take note of the fact that almost 80% of the respondents indicate that the Church does not contribute significantly to guidance about bioethical issues. The third question deals with the theoretical and/or theological sources or resources ministers call upon and their reflection on these difficult situations when counselling members of their congregation on bioethical dilemmas (cf. Tables 7, 8 and 9). Interestingly, almost all of the respondents indicate a deontological theoretical basis for ethical reflection. Another interesting aspect of the data presented in Table 8 is that only 52% responded to Theology as a discipline involved in bioethical reflection. A possible explanation for this phenomenon could be that they do not regard Theology as a socially relevant discipline, but rather one that only has relevance for the domain of spirituality. Note, however, that this does not correspond with the results of Question 15 in Table 6, in which Christian Theology is considered to be the fundamental framework for ethical discussion. Further research is therefore necessary to assess this discrepancy. The author is of the opinion that a lack of moral consensus often stems from not understanding ethical paradigms and not having the knowledge of ethical theories which form the basis of ethical decision-making. This view is also underpinned by Van der Merwe (2002:17–19) when he argues that ‘knowledge of ethical theories is a great help in identifying one’s own ethical identity and in understanding people with apposing ethical views’. Taking into consideration the fact that the data reflect the eagerness of a large number of ministers to learn more about bioethical issues, it is clear that they are of opinion that additional and different educational experiences would have prepared them more adequately for providing moral leadership with regard to bioethical issues; they understand the need for the interdisciplinary nature of Bioethics in order to provide pastoral care. This research project has underlined the need for the integration of empirical research in bioethical reflection and decision-making. This will provide better and more workable solutions for the practical reality of the interdisciplinary nature of rational bioethical problem-solving. The emphasis is thus on a form of integrated empirical ethics (cf. Molewijk et al. 2004), where ethical theories and empirical data are integrated in order to arrive at a normative conclusion with respect to specific bioethical practices. It can be concluded that recent advancements in biotechnology cannot be ignored or dealt with in a piecemeal and impressionistic fashion, either by the RCSA or its ministers, for much longer. In order to deal with this problem, they must look for clarity and analyse the principles and underlying theories that guide, or should guide, their decision-making and pastoral care in these situations. The findings highlight the need not only for appropriate courses in Bioethics during ministers’ initial theological training, but also the need to keep the debate alive by offering workshops, seminars and short courses for practicing ministers in order to enhance awareness and allay fears and uncertainties in this very dynamic and morally challenging field of human and scientific endeavour. Acknowledgements The author would like to thank her promoter, Prof. J.M. (Koos) Vorster and co-promoter, Prof. H.J.M (Hans) van Deventer for useful comments during different stages of this research project. Competing interests The author declares the she has no financial or personal relationship(s) which may have inappropriately influenced her in writing this article. 1.http://dx.doi.org/10.2105/AJPH.92.7.105632222772.AsaiANakayamaTNaitoM2003Ethics in questionnaire-based research131471513.BabbieE.AMoutonJ2001The practice of social research4.http://dx.doi.org/10.1023/B:MHEP.0000021844.57115.9d5.http://dx.doi.org/10.1111/j.1467-8519.2005.00424.x158129726.BoskC.L1999Professional ethicist available: Logical, secular, friendly12847687.BreakwellG.M2003InterviewingG.M. Breakwell, S. Hammond & C. Fife-Schaw8.BurnsNGroveS.K1997he practice of nursing research: Conduct, critique and utilisation9.http://dx.doi.org/10.1093/oxfordhb/9780199279272.003.005510.CoughlinM.DWattsJ1993A descriptive study of healthcare ethics consultants in Canada: Results of a national survey5314416411.CreswellJ.W2003Research design: Qualitative, quantitative, and mixed method approaches12.CreswellJ.WPlano ClarkV.L2007Designing and conducting mixed method research13.CrossW.O1977Toward a context for the ethics of abortion59221222014.De RoubaixJ.A.M2002‘‘n Postmoderne uitdaging aan die “paradigmale biomediese etiek model” met verwysing na kompleksiteits-teorie’15.De LangeM.C2009Exploring interdisciplinarity: A theoretical consideration of Bioethics at the interface between Theology, Philosophy and Life Sciences5219121616.De VosA.SStrydomHFoucheC.BDelportC.S.L2005Research at grass roots: For the social sciences and human service professions, 3rd edn.17.FieldA2005Discovering statistics using SPSS, 2nd edn.18.FletcherJ.C1981Clergy involvement: Relating practice to principleC. Baumiller19.http://dx.doi.org/10.1080/152651607011935751736618220.FryH.L2005The application of virtue ethics to the practice of counselling21.2009Die Almanak van die Gereformeerde Kerke in Suid Afrika vir die jaar 200922.GoldenbergM.J2005Evidence-based ethics? On evidence-based practice and the “empirical turn” from normative bioethics23.GrosserM.M1999Die rol van koöperatiewe leer in die ondersteuning van ‘n denkontwikkelingsbenadering24.http://dx.doi.org/10.1007/BF00489796189695425.GubaE.GLincolnY.S1989Fourth generation evaluation26.GusheeD.P2003Ethical method in Christian bioethics: Mapping the terrain27.GustafsonJ.M1983Ethics from a Theocentric perspective: Theology and Ethics28.http://dx.doi.org/10.1007/s11089-006-0044-z29.HollowayI1997Basic concepts for qualitative research30.HumanHMüllerJ.C2009Doing the job well: Looking at the role of ethics and ethical dilemmas in the work of pastoral counsellors24216117931.JacobyLSiminoffL.A2008Empirical methods for Bioethics: A primer32.KeenanJ.F2005Notes on moral Theology: Ethics and the crisis in the church6611713633.KumarR2005Research methodology: A step-by-step guide for beginners, 2nd edn.34.LateganL.O.K2007Etiek in navorsing: ‘n Voorgestelde raamwerk vir waardegedrewe navorsing433/423525135.LateganL.O.K2008Identifying critical indicators to deal with research integrity441/210312036.McMillanR.C1986Bioethical decision-making: Where the buck stops13212513637.McMinnM.RRunnerS.J2004Why should Christian counsellors care about ethics research?124565938.MertensT.RHendrixJ.RGordonL.M1986ndiana clergy: A survey of their human genetics/bioethics educational needs40143551164558439.http://dx.doi.org/10.1023/B:MHEP.0000021848.75590.b040.NeumanW.L1994Social research methods: Qualitative and quantitative approaches, 5th edn.41.NeumanW.L1997ocial research methods: Qualitative and quantitative approaches42.OrrB.J1992A comparative study in normative ethics: Perceptual differences of educators, physicians, and ethicists concerning life and death issues43.RosnowR.LRosenthalR1996Beginning behavioural research: A conceptual primer44.2003The SAS System for Windows, computer software45.SchotsmansP.T2009Christian Bioethics in Europe: In defence against reductionist influences from the United States011446.SeitzM.JPerkinsIMarcinR.BHoganC2004The role of the priest in bioethical decision-making1565802547.http://dx.doi.org/10.1016/S0840-4704(10)61072-148.SteynA.G.WSmitC.FDu ToitS.H.CStrasheimC2000Statistiek, ‘n middel tot ‘n doel49.SudmanSBradburnN.M1983Asking questions50.SugarmanJSulmasyD.P2001Methods in medical ethics51.SuttonA2008Christian Bioethics: A guide for the perplexed52.TaylorG1996Student’s writing guide for the arts and social sciences53.ThietartR.A2001Doing management research: A comprehensive guide54.ThomasmaD.C1985Empirical methodology in medical ethics5 31331455.http://dx.doi.org/10.1162/1526516013171394051195463856.TulskyJ.AFoxE1996Evaluation ethics consultation: Framing the questions7109115888988557.Van Der MerweJ.C2002Making ethics workL. Lategan & P. Le Roux58.http://dx.doi.org/10.2466/pr0.100.1.191-1941745102459.http://dx.doi.org/10.2307/352798810742940