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RAE0010.1177/00346373221133843Review & ExpositorLeMasters

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Review and Expositor

A theological and ethical analysis

2022, Vol. 119(1-2) 110­–121
© The Author(s) 2022
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DOI: 10.1177/00346373221133843
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pandemic

Philip LeMasters
McMurry University, USA

Abstract
The response of the Eastern Orthodox Church to the COVID-19 pandemic reflects its
distinctive theological and liturgical traditions as well as its decentralized system of governance.
Foundational beliefs and practices inform Orthodoxy’s understanding of the imperative
to care for the physical well-being of the sick. Points of disagreement arose in Orthodox
communities concerning public health restrictions on attendance at the Divine Liturgy, the use
of a common communion spoon, whether diseases may be transmitted through the Eucharist,
and the appropriateness of receiving vaccinations tested or produced with cell lines derived
from the tissue of aborted fetuses. Such contested matters reflect points of tension between
characteristic beliefs and practices of Orthodoxy and its commitment to care for the health of
neighbors during a global pandemic.

Keywords
abortion, communion spoon, COVID-19, Eastern Orthodoxy, Orthodox bioethics, pandemic

Introduction
The response of the Eastern Orthodox Church to the COVID-19 pandemic reflects its distinctive
theological and liturgical traditions as well as its decentralized system of governance. This article
describes the rich foundational beliefs and practices that inform Orthodoxy’s understanding of the
imperative to care for the physical well-being of the sick. It also analyzes points of disagreement in
Orthodox communities concerning public health restrictions, communion practices, and the appro-
priateness of receiving vaccinations tested or produced with cell lines derived from the tissue of
aborted fetuses. Such contested matters arise from points of tension between characteristic beliefs
and practices of Orthodoxy and its commitment to care for the health of neighbors during a global
pandemic.

Corresponding author:
Philip LeMasters, McMurry University, 1400 Sayles Blvd., Abilene, TX 79697, USA.
Email: lemastep@mcm.edu
LeMasters 111

Background and context

The Eastern Orthodox Church is a communion of churches with shared theological affirmations,
liturgical practices, and spiritual disciplines. The Church understands itself to embody the fullness
of the Church founded by Jesus Christ and to maintain the beliefs and practices of apostolic
Christianity. The schism of Orthodoxy and Catholicism dates from 1054 CE and occurred due to
different understandings of papal authority and other theological disagreements. In distinction
from the dynamics of Catholic-Protestant relations in the West, the Eastern Roman or Byzantine
experience shaped Orthodoxy decisively. The vast majority of Orthodox Christians live in histori-
cally Orthodox nations, such as Russia, Romania, and Greece, while adherents have been present
in the West in noticeable numbers only since the end of the nineteenth century. Most of their com-
munities outside of traditionally Orthodox regions stem from immigration, but Orthodoxy has
received an increasing number of converts in recent decades.1
The word “Orthodox” has the literal meaning of both “right worship” and “right belief.” The
service of eucharistic worship in the Orthodox Church is called the Divine Liturgy, the two most
common forms of which are associated with saints Basil the Great and John Chrysostom. Orthodoxy
was not shaped decisively by Medieval Scholasticism or the Enlightenment and appeals to natural
law or other standards of morality universally known by reason are not as prominent as they are in
many forms of Western Christianity. Consequently, discussions of both doctrinal and moral matters
often draw heavily on the language and practices of sacramental worship, which manifest the cor-
porate faith of the Church.2
The Divine Liturgy provides a shaping context for how Orthodoxy envisions God’s purposes for
social interaction, including how people and societies should respond to persons in sickness or
other types of need. After initial petitions “For the peace from above and for the salvation of our
souls . . . [and] For the peace of the whole world,” prayers follow

For favorable weather, for an abundance of the fruits of the earth, and for peaceful times . . . For those who
travel by land, sea, and air, for the sick, the suffering, the captives and for their salvation . . . [and] For our
deliverance from all affliction, wrath, danger, and necessity.

The petitions after the consecration of the eucharistic gifts in the liturgy of Basil the Great call for
God to

Free those who are held captive by unclean spirits; sail with those who sail; travel with those who travel;
defend the widows; protect the orphans; liberate the captives; heal the sick. Remember, Lord, those who
are in mines, in exile, in harsh labor, and those in every kind of affliction, necessity, or distress; those who
entreat your loving kindness; those who love us and those who hate us; those who have asked us to pray
for them, unworthy though we may be. Remember, Lord our God, all Your people, and pour out Your rich
mercy upon them, granting them their petitions for salvation.3

These appeals for peace and salvation do not exclusively concern hope for eternal life in the
eschatological consummation of the heavenly reign. They address tangible, mundane circum-
stances faced by persons and social groups in the present. These petitions occur at the very

  1. See Timothy Ware, The Orthodox Church (London: Penguin Books, 1993); and Hilarion Alfeyev, The
Mystery of Faith (London: Darton, Longman and Todd, 2002) for lucid introductions to Orthodox
Christianity.
  2. See John Breck, The Sacred Gift of Life: Orthodox Christianity and Bioethics (Crestwood: St. Vladimir’s
Seminary Press, 2000).
  3. N. Michael Vaporis, ed., “The Divine Liturgy of St. Basil the Great,” The Greek Orthodox Archdiocese
of America, https://www.goarch.org/-/the-divine-liturgy-of-saint-basil-the-great.
112 Review and Expositor 119(1-2)

beginning of the service and immediately after the most solemn moment of the Divine Liturgy
when the priest recalls the words of institution and prays for the Holy Spirit to descend upon the
bread and wine such that they become the body and blood of Christ. That these concerns are placed
in such positions of prominence indicates their great importance, as well as the obligation of com-
municants to care for the suffering physical bodies of their neighbors.4
Taking its sensibilities from the repudiation of Gnostic denigrations of the body in the early
centuries of Christianity, Orthodoxy rejects escapist forms of spirituality that view physical reali-
ties as being spiritually irrelevant. An exalted view of materiality reflects beliefs in the goodness of
creation, the full humanity of Jesus Christ, his bodily resurrection and ascension, and bread and
wine becoming truly his body and blood in the Eucharist. The healing of the sick was a paradig-
matic characteristic of Christ’s ministry as a sign of the blessedness of God’s reign, which also
manifests the great importance of caring for suffering persons. Orthodoxy teaches that human
persons are icons of God, as they bear the divine image and likeness. How people treat an image of
something reveals their relationship to it. Consequently, those who disregard people in obvious
need enact their rejection of God. As stated in 1 John 4:20-21 (NRSV),

Those who say, “I love God,” and hate their brothers or sisters are liars; for those who do not love a brother
or sister whom they have seen, cannot God whom they have seen. The commandment we have from him
is this: those who love God must love their brothers and sisters also.5

From its origins as described in Acts, the Church continued healing the sick through the philan-
thropic ministries of the apostles. Even the pagans of Rome noted that the early Christians literally
risked their lives to care for victims of plague, which demonstrates that a deep commitment to
therapeutic practice remained characteristic of the believing community. The category of Orthodox
saints known as “the holy unmercenary healers” includes physicians who cared for the ill without
charging fees. Their veneration in the Orthodox Church stands as a reminder that the ministry of
healing is a sign of Christ’s merciful deliverance of humankind from debilitation and death, conse-
quences of the fall of humanity due to Adam and Eve’s primal disobedience.6
Given its affirmations of the goodness of the body and the imperative to care for the sick as a
means of participating in Christ’s love for humankind, Orthodoxy honors the healing vocation and
does not view the use of medicines or therapies with suspicion. To the contrary, it welcomes them
as divine blessings that convey the love of God for humanity. As stated in the Wisdom of Sirach 38,

Honor physicians for their services, for the Lord created them; for their gift of healing comes from the
Most High, and they are rewarded by the king. . . . The Lord created medicines out of the earth, and the
sensible will not despise them. . . . And he gave skill to human beings that he might be glorified in his
marvelous works. By them the physician heals and takes away pain; the pharmacist makes a mixture from
them. God’s works will never be finished; and from him health spreads over all the earth. (vv. 1-2, 4, 6-8
NRSV)

While the Orthodox Church prays for the sick and provides the sacrament of holy unction for
the healing of soul and body to its ailing communicants, the use of conventional medical therapies
is neither prohibited nor discouraged.7 The origins of the modern hospital are in the philanthropic

  4. Philip LeMasters, “Philanthropia in Liturgy and Life: The Anaphora of Basil the Great and Eastern
Orthodox Social Ethics,” St Vladimir’s Theological Quarterly 59.2 (2015): 187–211.
  5. See Daniel B. Hinshaw, Suffering and the Nature of Healing (Yonkers: St. Vladimir’s Seminary Press,
2013).
  6. Jean-Claude Larchet, The Theology of Illness (Crestwood: St. Vladimir’s Seminary Press, 2002), 26–33.
  7. See Jean-Claude Larchet, Mental Disorders and Spiritual Healing: Teachings from the Early Christian
East (Hillsdale: Sophia Perennis, 2005), 40; and Stanley Samuel Harakas, “The Eastern Orthodox
Church,” in Caring and Curing: Health and Medicine in Western Religious Traditions, ed. R. L. Numbers
and D. W. Amundsen (New York: McMillan Publishing, 1986), 153.
LeMasters 113

endeavors of the early centuries of the Eastern Roman Empire, such as the Basiliad of St. Basil the
Great, which employed the treatments and methods of health care used at that time.8 Likewise, the
holy unmercenary healers availed themselves of medicines and therapeutic procedures, as well as
prayer.9 In the twentieth century, Saint Luke of Simferopol, an Orthodox archbishop, surgeon, and
political prisoner, combined steadfast piety with groundbreaking scholarly publications and life-
saving surgeries for Soviet soldiers in World War II.10
In order to ease pain, restore bodily function, and otherwise provide the best care possible for
the living icons of Christ who present themselves to healthcare professionals, Orthodoxy endorses
using medical science’s current therapeutic methods. While death is inevitable and the preservation
of physical life is not the highest good, love for suffering neighbors requires caring for the embod-
ied person as a living icon of God.11

Limiting attendance at liturgy

As of this writing, over 6 million people have died from the pandemic.12 The disease has no cure,
even as highly contagious variants develop and marginalized populations suffer disproportionally
from its effects.13 As the Church has not been immune from the political and social tension associ-
ated with the pandemic, factors other than the philanthropic vision of Orthodoxy have played
important roles in shaping the responses of clergy and laity. In this light, the Assembly of Canonical
Orthodox Bishops in the United States of America urged the faithful to embrace “an authentic life
of patient obedience, sincere humility, genuine compassion, and sacrificial love even towards those
with whom we differ.”14
Different ecclesiastical jurisdictions have responded in different ways to the many challenges of
the pandemic. Orthodox churches around the world limited or forbade lay attendance at the Divine
Liturgy, as well as other services, during the initial outbreak of the pandemic, which began during
the season of Lent, the most spiritually intense and liturgically rich time of the church year. “A
limited attendance” of Orthodox laity at services for Pascha (Orthodox Easter) in 2020 was appar-
ently permitted only in Georgia and Bulgaria.15 In forums ranging from diocesan assemblies to
parish councils and Internet discussion boards, debates ensued on whether restricting attendance by
the laity at the Divine Liturgy was a necessity to be embraced out of loving concern for the safety
of one’s neighbors or a sign of fear that is contrary to hope for eternal life.
In order to respond with moral integrity to the pandemic, Eastern Orthodoxy’s commitments to
love the neighbor, provide care for sick, and treat even the lowliest people as those who bear God’s
image should shape decisively how the Church responds to COVID-19. Some of the most basic

  8. Timothy S. Miller, The Birth of the Hospital in the Byzantine Empire (Baltimore: The Johns Hopkins
University Press, 1997), 87.
 9. Miller, Birth of the Hospital, 63–66.
10. Vasiliy Marushchak, The Blessed Surgeon: Life of Saint Luke Archbishop of Simferopol (Point Reyes
Station: Divine Ascent Press, 2001), 122.
11. See Hinshaw, Suffering and the Nature of Healing, 33–36, for a discussion of traditions of Orthodox
ambivalence toward medicine.
12. “WHO Coronavirus (COVID-19) Dashboard,” World Health Organization, https://covid19.who.int.
13. Katherine LeMasters, Lauren Brinkley-Rubinstein, Morgan Maner, Meghan Peterson, Kathryn
Nowotny, and Zinzi Bailey, “Carceral Epidemiology: Mass Incarceration and Structural Racism During
the COVID-19 Pandemic,” The Lancet Public Health 7.3 (2022): e287–90.
14. “A Message of Hope from the Assembly of Bishops,” Assembly of Canonical Orthodox
Bishops in the United States of America, October 7, 2020, https://ocl.org/assembly-of-canonical-
orthodox-bishops-of-the-usa-october-2020-meeting.
15. Emil M. Marginean, “The Institutional Reaction of the Orthodox Churches Faced with the Initial Covid-
19 Crisis,” International Journal of Orthodox Theology 11.4 (2020): 169.
114 Review and Expositor 119(1-2)

characteristics of the sacramental life of the Church have presented challenges to doing so. The
Orthodox Church is highly liturgical, teaching that the celebration of the Divine Liturgy is a mysti-
cal entrance to the heavenly kingdom. The service manifests the identity of the Church as the body
of Christ with many members, a communion of persons united in love as an image of the Holy
Trinity. Regular attendance at Liturgy is an expected spiritual discipline for all parishioners, though
in practice often enacted by only the most pious. Such practices do not, however, eliminate the
spiritual and moral import of how people’s behavior impacts the well-being of their neighbors who
bear the image of God.
In the midst of a global pandemic, compassionate concern for others has required new and
unprecedented sacrifices, including following the guidance of public health officials in order to
slow the spread of the pandemic. Especially in the early months of the pandemic, bans on large
gatherings and requirements for social distancing challenged the practices of liturgical worship and
were often met with resistance. As Ioannis Kaminis notes,

The many controversies over such restrictions raise the question of whether receiving Holy Communion
and participating in the Eucharist has not been transformed into an ordinary ritual, a religious duty that
forgets the word of Jesus: “The Sabbath was made for humankind, and not humankind for the Sabbath.”
(Mk 2:27)16

Since the Eucharist manifests believers’ communion with Christ, insistence on celebrating reli-
gious services without regard for the health and well-being of the sick surely contradicts the
demands of discipleship.
Important models within Orthodoxy are a guide for strengthening the spiritual life apart from
corporate, sacramental worship. Metropolitan Joseph, the primate of the Antiochian Orthodox
Christian Archdiocese of North America, appealed to the ancient example of Palestinian monks
who spent each Lent alone in the Sinai desert and abstained from the Eucharist during this time in
order to inspire parishioners who could no longer attend the Divine Liturgy due to bans on social
gatherings. This example is especially fitting as restrictions on attendance began during the season
of Lent. As well, one of the saints commemorated during this penitential season is Mary of Egypt,
whom the monk Father Zosimas encountered in the Sinai desert when he was following his mon-
astery’s practice in this regard. The Metropolitan wrote, “Although our time of social distancing is
not quite the same type of asceticism, let us treat it as a sacrificial offering of love to God and our
neighbor.”17
In refutation of criticisms concerning such restrictions, Metropolitan Joseph stated that

We did not ask our faithful to worship from home out of a fear of death or a belief that our churches or
sacraments are carriers of disease. Our world was confronted by a novel virus to which no one had yet been
exposed and no doctor had yet learned to treat. In addition to those factors, the virus could be spread before
the onset of symptoms by people unaware they were sick. We were asked to join our local communities in
slowing the spread of the virus by not gathering in crowds. This was to prevent an overwhelming of the
healthcare system, allowing the doctors and nurses to give adequate care to the sick and thus avoid
unnecessary deaths.18

16. Ioannis Kaminis, “Eastern Orthodox Church and Covid-19 A Threat or an Opportunity?” Theologische
Rundschau 86 (2021): 418–19.
17. Metropolitan Joseph, “Updated COVID-19 Policy From His Eminence Metropolitan Joseph,” Antiochian
Orthodox Christian Archdiocese of North America, March 17, 2020, https://www.antiochian.org/regu-
lararticle/623. As Alexander Agadjanian noted, Patriarch Kyril of Moscow made a similar appeal to
Mary of Egypt; see “Pandemic, homo somatis, and Transformations of the Russian Orthodox Ethos,”
Entangled Religions 12/13 (2021): 12 n. 40.
18. Metropolitan Joseph, “Letter to ‘Beloved Faithful in Christ,’” June 8, 2020, in author’s possession.
LeMasters 115

Similarly, Metropolitan Tikhon of the Orthodox Church in America appealed to both the norm of
love for neighbor and the ascetical practices of Lent in writing that precautionary measures and
restrictions

have been taken as our Christian response to protect our brothers and sisters. Our Lord tells us, “Greater
love has no man than this, that a man lay down his life for his friends (John 15:13).” The life we “laying
down” [sic] now is our normal life, because these are extraordinary times. We are making a sacrificial
effort, which is in keeping with the present season of repentance and ascetical striving. Like the ascetics of
old who would depart from their monasteries for the forty days of Lent in preparation for Holy Week, we
should take this opportunity to prayerfully reflect on our life in Christ and increase our desire to be with
Him.19

Not all ecclesial jurisdictions were led at the outbreak of the pandemic with such philanthropic
concern. Kaminis speculates that most Orthodox churches around the world that followed the guid-
ance of public health officials “decided to act due to government pressure and thus reluctantly
accepted the government measures.”20 He notes that “some spiritual elders from Mt. Athos . . .
supported and spread the conspiracy theory that a microchip could be slipped into the vaccines
against Covid-19.”21 The Moldovan Orthodox Church also made statements supporting such
fears.22 Lax adherence to public health guidelines or their repudiation led to the death of Patriarch
Irinej of the Serbian Orthodox Church and of other bishops there. While the Russian Orthodox
Church quickly endorsed the restrictions required by the government, many clergy and laity have
opposed them.23 How widely clergy and laity are disregarding them is not clear, but “almost all
large Russian monasteries have become hotbeds for spreading Covid-19, and in many of them the
mortality rate of priests and monks is quite high.” Prominent bishops, priests, and monks from
Russia, Ukraine, and Belarus have spoken publicly against public health restraints.24

Communion during COVID

In addition to tensions over restricting attendance and requiring social distancing and other public
health practices, the manner of serving communion in the Orthodox Church has become a point of
controversy. With degrees of frequency varying widely, during the Divine Liturgy, Orthodoxy laity
receive the body and blood of Christ from a spoon that the priest or deacon uses to place commun-
ion in their mouths. Concern arose about the potential of spreading the virus through the use of the
communion spoon. Early in the pandemic, some jurisdictions replaced the common spoon with
disposable individual spoons or required disinfecting the spoon after its use by each communicant.
Others instructed the laity to open their mouths as widely as possible so that the clergy could
administer communion without the spoon touching the tongue or other parts of the mouth.25

19. Metropolitan Tikhon, “Archpastoral Letter on the Coronavirus,” Orthodox Church of America, March
17, 2020, https://www.oca.org/holy-synod/statements/his-beatitude-metropolitan-tikhon/archpastoral-
letter-on-the-coronavirus.
20. Kaminis, “Eastern Orthodox Church and Covid-19,” 422–23.
21. Ibid., 424.
22. Alexander Agadjanian and Scott Kenworthy, “Resistance or Submission? Reactions to the COVID-19
Pandemic in the Russian Orthodox Church,” Berkley Forum, Berkley Center for Religion, Peace &
World Affairs, August 19, 2021, https://berkleycenter.georgetown.edu/responses/resistance-or-submission-
reactions-to-the-covid-19-pandemic-in-the-russian-orthodox-church.
23. Kaminis, “Eastern Orthodox Church and Covid-19,” 424.
24. Kaminis, “Eastern Orthodox Church and Covid-19,” 424–25.
25. For a critique of Orthodox response to scientifically-based concerns about the pandemic, see Gayle E.
Woloschak, “Life and Death in the Time of Covid-19,” The Wheel 23 (Fall 2020): 20–26. For a description
of communion practices endorsed by the Russian Orthodox Church, see Agadjanian, “Pandemic,” 3 n. 6.
116 Review and Expositor 119(1-2)

With reference to icons, crosses, and other physical items that clergy and laity commonly kiss
as a sign of honor, Archbishop Elpidophoros of the Greek Orthodox Archdiocese of America
acknowledged that “material elements that can convey the blessings of God are also subject to the
broken nature of our fallen world.” He prohibited kissing them at the outbreak of the pandemic, but
he continued to require distribution of communion with a common spoon, for as “the sacrament of
sacraments, the Holy Eucharist, is not simply a material element but the very body and blood of our
Lord Jesus Christ.”26 Metropolitan Joseph of the Antiochian Orthodox Archdiocese of North
America taught similarly:

We have stated throughout these difficult days that Holy Communion is the “medicine of immortality,” not
a vector of disease. We have also consistently stated that our method of distributing the Holy Gifts is not
open to question.27

As Eugenia Constantinou wrote in support of maintaining this practice, “Whether it is received on

a common spoon or not, the most sacred Mystery of the Church can never be the vehicle of
illness.”28
Others perceived the method of administering the Eucharist as not being of decisive theological
importance, especially since use of the spoon developed only in the eleventh century, and they
affirmed the legitimacy of serving communion in a manner less likely to spread the virus. Sister
Vassa Larin notes evidence that “communion in some areas was still given to the faithful in the
hand, and in two separate species” until the twelfth century. The development of this practice seems
to have reflected “possible abuses and irreverence on the part of the laity.”29 In the earlier history
of the Church, the laity received the elements from the hand and the chalice, respectively, as
Orthodox clergy continue to do. Rejecting the view that the use of a single spoon is a dogmatic
matter, Larin argues that its development was for “practical and pastoral reasons” and has come to
symbolize “the tongs, with which Isaiah received the heavenly coal” in Isaiah 6.30 In countries like
Germany and Austria in which authorities have forbidden communion by a common spoon, bish-
ops approved other means of serving the Eucharist to the laity early in the pandemic.31 The Russian
and Romanian Orthodox churches have required or allowed practices such as disinfecting the com-
mon spoon or using individual disposable spoons.32
The Church does not attempt to define with rational precision how the eucharistic elements
miraculously become Christ’s body and blood, and unsurprisingly the relationship between receiv-
ing the communion and contracting a potentially deadly disease is controversial within Orthodoxy.
On the one hand, the Church embraces Ignatius of Antioch’s understanding of communion as “the
medicine of immortality” and repeats Paul’s warning that judgment, disease, and death may result

26. Archbishop Elpidophoros, “Encyclical of His Eminence Archbishop Elpidophoros of America and the
Eparchial Synod on the Covid-19 Pandemic (Coronavirus),” Orthodox Observer, March 6, 2020, https://
www.goarch.org/-/encyclical-covid-19-pandemic.
27. Metropolitan Joseph, “Letter.”
28. Eugenia Constantinou, “More Dangerous than Covid-19,” Orthodoxia Info, May 30, 2020, https://ortho-
doxia.info/news/more-dangerous-than-covid-19.
29. Vassa Larin, “The Communion Spoon as Icon,” The Wheel 23 (Fall 2020): 30.
30. Larin, “Communion Spoon as Icon,” 32.
31. Larin, “Communion Spoon as Icon,” 34. Marginean notes that the Metropolis of Austria chose to serve
communion according to “a typicon of the Divine Liturgy of St. James in order to avoid using the com-
munion spoon” (“Institutional Reaction,” 168).
32. See “Russian Orthodox Church Adopts Sweeping Anti-Coronavirus Rules” The Moscow Times, March
17, 2020, https://www.themoscowtimes.com/2020/03/17/russian-orthodox-church-anti-coronavirus-
rules-a69649; and Ron Synovitz, “Coronavirus Vs. The Church: Orthodox Traditionalists Stand Behind
the Holy Spoon,” Radio Free Europe/Radio Liberty, March 17, 2020, https://www.rferl.org/a/coronavi-
rus-vs-the-church-orthodox-traditionalists-stand-behind-the-holy-spoon/30492749.html.
LeMasters 117

from communing in a spiritually unworthy way (1 Cor. 11:29-30).33 Receiving the Eucharist as true
personal communion with Christ is at the very heart of the liturgical and spiritual life of the
Church.34 Suggesting that communing sacramentally could be a means of contracting a deadly
virus due to the natural process of infection remains anathema to most Orthodox commentators. On
the other hand, the bodily experience of tasting and digesting the eucharistic elements is shared by
all communicants. The eucharistic elements by all appearances retain the physical properties of
bread and wine, including susceptibility to changes in temperature and to mold. The Church does
not teach that the reality of the bread and wine disappear at their consecration, as though they were
completely removed from the natural processes of the created world. As Father Alexander
Schmemann puts it, their transformation is one “not of discontinuity, but of fulfillment and actual-
ization.”35 In this light, forthcoming theological reflection is needed in order to respond to the
charge that affirmation of the impossibility of spreading disease through the Eucharist amounts to
“magical fundamentalism” or a denial of the full humanity of Christ, whose body and blood people
receive in the Eucharist.36

Vaccination and abortion

The moral appropriateness of receiving vaccinations for COVID-19 has become controversial for
some Orthodox Christians in light of the connection of the testing and production of vaccines to
cells taken from aborted fetuses. As H. Tristram Engelhardt, Jr, comments, Orthodoxy forbids
abortion, viewing the intentional destruction of fetal life “as a radical failure of love, as one of the
worst of actions, whether or not the embryo is yet a person.”37 A statement from the Assembly of
Canonical Orthodox Bishops in the United States does not address the relationship of the vaccines
to abortion but places the question of whether its members should receive vaccinations and thera-
pies for COVID in the context of biblical injunctions “to respect and protect the body as the temple
of God (1 Cor. 6:19)” and to refrain “from either tempting or testing the Lord (Matt. 4:7).” In this
light, the bishops teach that “it is neither wrong nor sinful to seek medical attention and advice. In
fact, we welcome interventions that provide us more time for spiritual renewal and repentance.”
The statement encourages people to consult their physicians on what medical treatments are most
appropriate for them, noting that even as the clergy provide spiritual guidance, “your personal doc-
tor will guide your individual medical decisions.”38
A statement from The Orthodox Theological Society of America notes that the Pfizer and
Moderna vaccines were tested using cells “derived from the 1960s and 1970s from therapeutic
abortions.” While the abortions did not occur for the sake of producing vaccines, “many of the
other Covid-19 vaccines (e.g., AstraZeneca and Johnson and Johnson) are grown using the same
fetal cell line.” These vaccines do not contain the cells of aborted fetuses, but cells descended from

33. Ignatius of Antioch, “The Epistle to the Ephesians,” in Early Christian Writings: The Apostolic Fathers,
ed. Andrew Louth (London: Penguin Books, 1987), 66.
34. See Alexander Schmemann, For the Life of the World (Crestwood: St. Vladimir’s Seminary Press, 1998),
23–46, for an interpretation of the centrality of the Eucharist to Orthodoxy.
35. Schmemann, For the Life of the World, 143.
36. See Kaminis, “Eastern Orthodox Church and Covid-19,” 426; and Cyril Hoverun, “‘Covid Theology,’ or
the ‘Significant Storm’ of the Coronavirus Epidemic,” State, Religion, and Church 8.2 (2021): 23–25.
37. H. Tristram Engelhardt, Jr., The Foundations of Christian Bioethics (Lisse: Swets & Zeitlinger, 2000),
275.
38. “Statement Regarding Developments in Medicine: COVID-19 Vaccines & Immunizations,” Assembly of
Canonical Orthodox Bishops of the United States of America, January 22, 2021, https://www.assemblyof-
bishops.org/news/news-archive/2021/statement-regarding-developments-in-medicine-covid-19-vaccines-
and-immunizations.
118 Review and Expositor 119(1-2)

the tissue of aborted fetuses are used for producing and manufacturing these vaccines. The state-
ment concludes that use of any of the vaccines is “the best ethical option to promote health and
life.” It rejects the claim that the vaccines’ connections to cells taken from fetuses aborted for thera-
peutic reasons should forbid their use by Orthodox Christians:

Most Church leaders have agreed that the many lives saved by vaccination are an important factor in
permitting the use of these vaccines. While it is a sad reality that the origin of these cell lines is from these
very few therapeutic abortions, the cell lines are already in existence, no new fetuses will be used, and as
such it is far preferable to cure diseases as a result of the use of these cell lines than to totally forbid the use
of these cell lines. The vaccines in no way legitimize or promote abortion; rather they combat disease and
death, support health, and enable life—not death—to prevail, all of which are of the highest ethical value.39

Father Alexander Webster reaches the opposite conclusion, arguing that Orthodox ethics forbids
the use of vaccines with “any connection to aborted preborn baby cells.” In support of his argu-
ment, he cites statements from the Holy Synod of the Patriarchate of Moscow against “so-called
fetal therapy,” in which a fetus is aborted and “used in attempts to treat various diseases and to
‘rejuvenate’ an organism,” as well a statement from the Holy Synod of Greece against human clon-
ing and experimentation on human embryonic cells. Webster also notes a statement on the official
site of the Patriarchate of Romania that forbids extracting or transplanting tissues without the con-
sent of the donor, which is obviously impossible for embryos or fetuses, as well as doing so in a
fashion that causes the death of the donor. These statements provide a basis for condemning the
actions of those who intentionally destroy embryos or fetuses for therapeutic benefit to others.
They do not speak directly, however, to whether it is morally acceptable for people to receive
potentially lifesaving vaccinations that were tested or produced through cell lines, the origins of
which come from abortions performed decades ago.40
Webster seeks more direct support for his argument from a letter signed jointly by Archbishop
Makarios of the Greek Orthodox Archdiocese of Australia together with local Catholic and
Anglican archbishops, which states that vaccines “cultured on a fetal cell-line will raise serious
issues of conscience for a proportion of our population.” The bishops “accept that the proposed
vaccine may be sufficiently remote from the abortion that occasioned the derivation of the cell-
line” but they call on the Australian government to respect the conscience of those who do not want
“to benefit in any way from the death of the little girl whose cells were taken and cultivated, nor to
be trivializing that death, and not to be encouraging the fetal tissue industry.”41 While the bishops
hope for “an ethically uncontroversial alternative vaccine,” they do not, as Webster claims, reject
“on moral grounds, any vaccines derived from ‘fetal cell lines.’”42

39. “Covid-19 Vaccines: How They Are Made and How They Work to Prime the Immune System to Fight
SARS-CoV2,” Orthodox Theological Society of America, March 8, 2021, https://www.otsamerica.net/
wp-content/uploads/2021/03/Covid19-VaccineTech.pdf.
40. Alexander Webster, “The Moral Peril of Taking Most COVID-19 Vaccines,” Monomakhos, April 15, 2020,
https://www.monomakhos.com/on-covid-vaccines-and-the-church. From the Patriarchate of Moscow, he
cites Bases of the Social Concept of the Russian Orthodox Church, ch. 12, §7, http://orthodoxeurope.org/
page/3/14.aspx. From the Holy Synod of the Church of Greece, he Cites “The Cloning of Embryonic
Cells,” August 17, 2000, https://www.bioethics.org.gr/03_c.html#6. From the Patriarchate of Romania, he
cites “Transplant of Organs,” https://patriarhia.ro/transplant-of-organs-6021-en.html.
41. Archbishop Glenn N. Davies, Archbishop Anthony Fisher, Metropolitan Makarios, “Letter to the
Honorable Scott Morrison, MP,” August 20, 2020, d8231ace-cb4b-4c14-9d01-88aedb7b5ded (static9.
net.au).
42. Webster, “Moral Peril of Taking Most COVID-19 Vaccines.”
LeMasters 119

Webster argues that since Orthodoxy views abortions as “objectively, intrinsically evil,” to
profit “from such abominations for any reason, even lifesaving in the present or future” is morally
prohibited. He fears that benefiting from such evil deeds amounts to embracing a consequentialist
ethic that could justify any action for the sake of the greater good. In contrast, Webster states that
“Orthodox-informed consciences all testify to the uncontestable moral maxim that we may not do
evil to achieve good. There is no ‘lesser evil’ that is tolerable to achieve, ostensibly, a ‘greater
good.’”
Webster’s critique of the use of COVID vaccines overlooks the crucial factor of intention in
discerning the moral import of actions. Surely, ethically relevant points of distinction exist between
the actions of those who intentionally kill the innocent in order to achieve a desired end and of
those who wish only to make use of potentially lifesaving vaccines that have a remote connection
to abortion. Though Webster asserts that “time and distance are irrelevant to profiteering from such
abominations for any reason,” he does not make a persuasive case that receiving a vaccine in this
context equates to doing evil so good may come of it.43
Engelhardt’s analysis of the use of tissue from dead fetuses, written two decades before the
pandemic, places these matters in an illuminating context. He does not prohibit

using for a good end something that has been acquired by heinous means, as long as one has not been
involved in (1) employing these evil means, (2) encouraging their use, (3) avoiding their condemnation, or
(4) giving scandal through their use.

He cautions, however, against endorsing or encouraging any immoral actions and notes, “Use of
such materials must at the very least be approached penitentially as a concession to human
weakness.”44
Webster criticizes Engelhardt for having a “sanguine, even cavalier attitude toward” aborted
fetuses and for mounting “a strictly secular, un-Orthodox consequentialist argument” that ignores
the “evil intent” and “violent destruction of human persons” intrinsic to intentional abortion. He
accuses Engelhardt of employing “a consequentialist mantra” that absolves those who knowingly
benefit from an abortion and claims that a person “who willfully benefits from such abortions pro-
vides a tacit post-factum encouragement of the original act and similar acts in the present and
future.” He charges that “anyone who utilizes aborted baby cells even for an ostensibly good end,”
by definition, gives scandal, as “the ‘scandal’ is inherent in the intrinsically evil act and the hands
of anyone who exploits that act are also dirty.”45
Webster’s critique is unpersuasive, as he simply asserts that those who benefit from an abortion,
even quite indirectly, by definition encourage it and give scandal. He gives fair consideration nei-
ther to Engelhardt’s clear condemnation of abortion nor to his view that a penitential attitude is
necessary in such cases. A similar sentiment is present in the Orthodox Theological Society of
America’s reference to “the sad reality” of the origins of the cell lines coming from the tissue of
aborted fetuses. In addition to not attending critically to the crucial differences in intention between
abortionists and those receiving vaccines for COVID-19, Webster also fails to grapple with the
inevitably complex challenges of preserving the life and well-being of neighbors in a fallen world,
especially in the midst of a deadly global pandemic. Orthodoxy does not teach that using resources
connected to earlier evil deeds to save lives is intrinsically wrong. For example, people who would
otherwise die of thirst may drink water from a well obtained by its owner through murder without

43. Webster, “Moral Peril of Taking Most COVID-19 Vaccines.”

44. Engelhardt, Foundations of Christian Bioethics, 261–62.
45. Webster, “Moral Peril of Taking Most COVID-19 Vaccines.”
120 Review and Expositor 119(1-2)

condoning or sharing in the guilt of murder. People have no obligation to refrain from using the
methods available to save the lives of others simply because earlier wrongdoing by others played a
role in making those methods available. Employing those means, while regretting the brokenness
of the circumstances by which they became available, does not necessarily make one culpable of,
indifferent to, or an advocate of the prior wrongs.
Indeed, love of neighbor and concern for the physical well-being of others are so intrinsic to the
Orthodox Christian faith that one could make a case that those who refuse vaccination risk are commit-
ting grave evil. Metropolitan Hilarion, when serving as chair of the department for External Church
Relations for the Moscow Patriarchate, stated that those refusing to vaccinate were committing

a sin for which they will have to atone throughout their lives. . . . I see situations every day where people
visit a priest in order to confess that they had refused to vaccinate themselves or their close ones and
unwillingly caused someone’s death. . . . The sin is thinking of oneself but not of another person.46

While a theological consultation of the Russian Orthodox Church “concluded that the decision to
get vaccinated must remain an individual choice,” it also taught, “concerning the use of cells
derived from aborted fetal tissue,” that people may receive the vaccine “in the absence of other
alternatives.”47 Ecumenical Patriarch Bartholomew of Constantinople described his own decision
to receive a vaccination as “not only a matter of necessity or choice; it is also a responsibility to
fellow human beings.” Concerning those who reject scientifically based measures to contain the
spread of the pandemic, the Patriarch stated,

The New Testament affirms that whoever does not love [humankind], cannot love God. These people are
indifferent to the protection of fellow human beings. The rejection of the mask and all precautionary
measures does not arise simply from ignorance but from the necrosis of love within them.48

Conclusion
The response of the Orthodox Church to the pandemic not only reflects deep theological and
moral sensibilities that demand caring for the sick but also provides examples of resistance
against following public health measures and receiving vaccines by clergy and laity. Restrictions
on some of the most characteristic practices of Orthodoxy, such as attendance at the Divine
Liturgy and receiving communion from a common spoon, fueled controversies that exposed
points of tension concerning the relationship between the sacramental life of the Church and the
obligation to care for the sick out of love for neighbor. Debates within Orthodoxy on whether
diseases may be contracted through communion remain especially controversial and indicate a
need for further reflection that is both theologically sound and informed by contemporary medi-
cal science. An incarnational faith that views the embodied person as a living icon of God must
not refuse to meet this challenge.

46. “Vaccinate or Repent, Russian Church Says Amid Hundreds of Daily COVID-19 deaths,” Reuters, July 5,
2021, https://www.reuters.com/world/europe/vaccinate-or-repent-russian-church-says-amid-hundreds-daily-
covid-19-deaths-2021-07-05.
47. Agadjanian and Kenworthy (“Resistance or Submission?”) note, regarding the quote above in “Vaccinate
or repent,” that “Metropolitan Hilarion’s remark concerned people who refused to be vaccinated and then
passed on COVID to someone who died as a result—indicating that they were in some sense responsible, that
they were thinking only about themselves in choosing not to get vaccinated and not thinking about others.”
48. Patricia Claus, “Ecumenical Patriarch Bartholomew Encourages Faithful to be Vaccinated,”
Greek Reporter, January 12, 2021, https://greekreporter.com/2021/01/12/ecumenical-patriarch-
bartholomew-encourages-faithful-to-be-vaccinated/.
LeMasters 121

Author biography
Philip LeMasters is Professor of Religion at McMurry University and an archpriest of the Antiochian Orthodox
Christian Archdiocese of North America. He is also a Senior Fellow in the Orthodoxy and Human Rights
Project of the Orthodox Christian Studies Center of Fordham University. He has published several books and
articles on moral theology and applied ethics in Eastern Orthodoxy on topics including marriage, peacemak-
ing, politics, and bioethics.