No Religious Cleansing of Bioethics

Wesley J. Smith
American Journal of Bioethics
December 30, 2012
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“In Defense of Irreligious Bioethics” (Murphy2012) was one of the most perplexing articles I have ever read in a bioethics journal. Mostly, the author complains bitterly about the unjust and unpredictable manner in which the nonexistent deity answers or ignores prayer. Indeed, the article struck me as the written equivalent of a man standing on a box in Hyde Park railing against the pernicious “influence of the churches.”

But for what purpose and toward what end? It’s hard to tell, since there are no concrete policy proposals presented. So, let’s ignore the article’s stereotypical superficial depictions of complicated theological concepts—such as religious views about the meaning of suffering—and instead focus on the article’s discernible false suppositions, to wit:

1. Religion has not contributed substantively to secular bioethics.

2. Religious bioethicists seek to impose their dogmas on greater society.

3. It is the duty of “bioethics” to exclude the religious from the discipline’s public work.

RELIGION-INSPIRED BIOETHICS HAS CONTRIBUTED GREATLY TO CIVIL SOCIETY

One of bioethics’ greatest societal contributions came early with the establishment of the right of patients to refuse unwanted life-sustaining or extending medical treatment—even if doing so results in death. In the popular parlance, bioethics ended the old paternalistic tyranny of patients being “hooked up to machines” against their will, and good on it for that. But secular bioethicists didn’t lead the charge against vitalism. To the contrary: Two of the most vigorous and early advocates of this crucial bioethical reform—Dame Cecily Saunders, the creator of the modern hospicemovement, and bioethics founding father Paul Ramsey—were both openly devout and motivated to pursue their public work by their private faith.

“Irreligious Bioethics” contends that religion does not provide “an acceptable foundation for normative understanding of pain and disease.” But no one in or out of bioethics comprehended human suffering more than Saunders, one of the great medical humanitarians of the 20th century.

 

 According to her biographer, David Clark, Saunders’s hospice vision was inspired by a powerful religious epiphany experienced after befriending a dying Holocaust survivor after the war. Saunders embraced improving care for the dying as “a personal calling, underpinned by a powerful religious commitment.” Her zeal to reform the care of the dying transformed Saunders’s life: She went to medical school in her 30s, worked indefatigably to raise funds, met with medical and governmental leaders, and worked at a hospice run by Catholic nuns, where she brought her innovative ideas of treating “total pain” to the bedside. For those many years, her faith sustained her strength and fueled her commitment. Indeed, she wrote openly about the religious nature of her work, for example, telling one correspondent: “I have thought for a number of years that God was calling me to try to found a home for patients dying of cancer” (Clark 1998, 46).

St. Christopher’s Hospice was originally planned as a “sequestered religious community solely concerned with caring for the dying.” But, as often happens with religiously motivated reforms, the idea expanded, in Clark’s words into “a full-blown medical project acting in the world” (Clark 1998, 48). Saunders opened her first hospice in 1969 and the hospice movement spread around the world. The benefit that flowed directly fromher religion-inspired vision cannot be measured.

As a theologian, Paul Ramsey propounded his bioethical views from an explicitly articulated Christian perspective. He is probably best remembered for his 1969 lectures and resulting 1970 book

 

 

 

The Patient as a Person, in which he argued forcefully, among other matters, against imposing medical treatments upon patients against their will—a view wholly uncontroversial now but startling at the time. Ramsey predicated his advocacy upon a distinctly religious understanding of life, for example, that man is “an embodied soul,” whose “sacredness in the natural biological order” required that patients be “treated as a person,” which included being allowed to refuse unwanted intrusive and painful medical interventions. “The sanctity of human life,” Ramsey wrote, “prevents ultimate trespass upon him even for the sake of treating his bodily life” (Ramsey 2002, xlvi). And so it came to pass.

The question must thus be asked: Should Saunders and Ramsey have been excluded from participation in the  bioethics discourse of their time simply because they were religiously motivated? I can’t imagine anyone so saying. Look what would have been lost. Nor should similarly inspired participants be excluded from bioethics today.

 

 

 

 

 

 

 

RELIGIOUS BIOETHICISTS DO NOT ADVOCATE PRIMARILY FROM DOGMA

“Irreligious Bioethics” also mistakenly assumes that religiously oriented bioethicists seek to impose their creeds on general society, asserting that morality as defined by bioethics should be “based solely on regard to the wellbeing of mankind in the present life.” Excuse me, but who argues otherwise? I have not come across a significant bioethical proposal of general application,made by a prominent bioethicist known to be religious, that was predicated upon his or her eschatological expectations.

For example, the openly devout Eastern Orthodox bioethicist H. Tristram Engelhardt advocates a vigorous Christian bioethics—

 

for Christians. In part to protect the right of Christians to remain true to their creeds, he also proposes a self-consciously libertarian bioethics for the wider community that would protect “moral diversity” by giving differing views the legal space to follow their own drummer’s beat. “The establishment through state coercion (i.e., by law) of a comprehensive view of morality and justice is an illegitimate use of force,” he writes. “Therefore, a secular morality must be a framework for peaceable moral diversity and collaboration based on permission, not a concrete ethos to be imposed coercively” (Engelhardt 2006, 24).

Most openly devout public bioethicists do not take Engelhardt’s live-and-let-die approach. But in promoting their own views, they primarily argue bioethics from rational bases consistent with a philosophical upholding of the intrinsic dignity of all human life. Richard Doerflinger, a spokesman for the American Conference of Catholic Bishops, is a splendid example of the type. For example, testifying on behalf of Congressional legislation that would have strengthened legal protections for doctors who pursue aggressive pain control, while also prohibiting the use of federally controlled substances in assisted suicide, Doerflinger did not castigate suicide as a sin or claim that “only God can take a life.” Rather, he testified:

 

 

 

When we accept assisted suicide as a “good enough” solution for these patients, we preach a counsel of     despair to all terminally ill patients. We tell them that we find it easier to kill them than to findways to kill their pain. By rejecting the “quick fix” of assisted suicide, however, we reaffirm to ourselves and to the medical profession that these patients have lives worth living, and that they deserve real solutions for the pain, depression and isolation that they may experience. (House Judiciary Subcommittee 1999)

One can disagree withDoerflinger’s opinion. But surely, such advocacy deserves a respectful hearing in the public square.

Few areas of bioethical contention have divided the “religious” from the irreligious as the moral standing of human embryos. Robert P. George, the Princeton professor who served on the President’s Council on Bioethics, is well known to be a believing Catholic. Yet, in 

 

Embryo (coauthored book with Christopher Tollefsen), George does not defend embryonic life based on belief in the existence of the soul. Rather, he and Tollefsen predicate their arguments upon “the scientific question of when the life of a particular human being begins.” Indeed, the authors assert:

Human beings are perfectly capable of understanding that it is morally wrong and unjust to treat embryonic human beings as less than fully human.We need religion to support such claims in this domain no more than we need them to support claims of racial justice or the rights of the disabled.

These two brief examples are the rule, not the exceptions. Charging that religious bioethicists seek to impose dogma, or the blatantly unsupported assertion (among many) that “religious believers see nonreligious analyses and conclusions as ultimately subversive to theology,” is facile strawmanism.

THE CONSEQUENCES OF IRRELIGIOUS BIOETHICS

What of substance would a self-consciously irreligious bioethics accomplish? The article doesn’t say, but the changes could be deleterious. For example, the Joint Commission requires that hospitals and residential health facilities take patients’ spiritual needs into account when assessing care needs.

 

For some patients, this includes free access to intercessory prayer with facility-provided chaplains. Should that spiritual succor be denied? Indeed, since the article urges “bioethics” to “repudiate in  all its manifestations the idea that there is a transcendent reality to which the immanent world is beholden” (8, emphasis added), wouldn’t an irreligious bioethics require the exclusion of staff chaplains from hospitals, nursing homes, and hospices? Moreover, if people of faith are to be excluded from the public work of bioethics, the religious beliefs of potential appointees to advisory boards would have to be scrutinized to protect society against the subversive taint of faith. Do we really want to engage in blatant neo McCarthyism?

Think of what would be lost. For example, religiously cleansing bioethics would deprive the discourse of the wisdom of such prominent and productive public intellectuals as Leon Kass (observant Jew),William Hurlbut (nondenominational Christian), and Gilbert Meilaender (Lutheran),while retaining contributions from controversial “secular” bioethicists such as Peter Singer (moral propriety of infanticide; see, e.g., Singer, 1995), Julian Savelescu (promoter of “human enhancement”), and Jacob M. Appel (pay women to gestate longer before aborting so fetal remains can be harvested for medicinal use).

 

Ah, perhaps we have finally identified the point. I suspect the real agenda behind all the anti-God talk of “Irreligious Bioethics” is the expulsion of conservative, not just religious, advocacy from the discourse. But as we have seen, such an imposed moral homogeneity would deprive the bioethics of some of its most robust voices and deny society the broad diversity of viewpoints necessary to the proper functioning of the public square.

 

 

 


 

 

 

 


 

 

 

REFERENCES

Clark, D. 1998. Originating a movement: Cicely Saunders and the development of St. Christopher’s Hospice, 1957–1967. 

 

Mortality 3(1): 46.

Engelhardt, H. T., Jr. 2006. Global bioethics: An introduction to the collapse of consensus. In

 

 

Global bioethics: The collapse of consensus, ed. H. T. Engelhardt, Jr. Salem, MA: M & M Scrivener Press.

House Judiciary Subcommittee on the Constitution. 1999. Testimony of Richard M. Doerflinger on behalf of the National Conference of Catholic Bishops in support of H.R. 2260, the Pain Relief PromotionAct of 1999.Available at: http://www.cmda.org/wcm/CMDA/Issues2/EndofLife1/AssistedSuicideEuthanasia1/LegislationandTestimonies4/TestimonyofRichard.aspx

Murphy, T. F. 2012. In defense of irreligious bioethics.

 

 

American Journal of Bioethics 12(12): 3–10.

Ramsey, P. 2002.

 

 

The patient as a person: Explorations in medical ethics, 2nd ed. New Haven, CT: Yale University Press. Singer, P. 1995.

Rethinking life and death: The collapse of our traditional ethics. New York, NY: St. Martin’s Press.