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Beyond Values: Bioethics Critically Reconsidered – Herman Tristram Engelhardt, Jr.*

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            We have said in a previous article that bioethics depends a lot on how the bioethicist sees life. There is a lot of talk about the possibility of a Godless morality, but in fact an atheist and a believer can hardly reach common moral grounds, they can hardly share the same ethics. To say nothing of the possibility of sharing the same bioethics. Because they simply value life differently. Looking at life as a journey ending in death cannot determine the same behaviour as when one sees life as eternal.

            At the time, we wrote that there are world-renowned bioethicists who have befriended Romania, but are kept in a corner of shade. They are not promoted, despite the fact that their academic caliber is much higher than some names whom the Romanian academic environment has chosen as “beacons of light”.

            The most recent edition of the International Seminar on Bioethics and Theology held in Bistrita had Herman Tristram Engelhardt Jr. as a guest. He is one of the founders of American bioethics and has repeatedly attended this annual event in Bistrita. His ties to Romania are quite close: family ties (one of his daughters has married a Romanian) and religion ties. Since 1991, he has shared the same religion with us, Romanians, having converted to the Christian Orthodox faith. You can read below, exclusively online, the paper which this Christian bioethicist presented at the 13th edition of the international seminar in Bistrita. (The Editors)

            There is a decisive cleft between Christian and secular bioethics. Christian bioethics is not about values. It is about Christ. Christian bioethics is a part of the Christian pursuit of salvation. It is about how Christians know one should use medicine and the biomedical sciences. This is not to deny that there are persons who refer to themselves as Christian bioethicists and who may even mention Christ, but whose arguments do not depend on recognizing Christ as the Messiah of Israel and the Son of the living God (Matthew 16:16). These brief reflections on Christian bioethics shoulder four tasks. The first is to show the misleading character of values discourse that falsely suggests that humans share a common morality or indeed even common values. Second, I will briefly indicate that values discourse has no deep roots in Christianity. This will be done by arguing that traditional Christianity embraces the theological horn of Euthyphro’s dilemma: the good, the right, and the virtuous can only be adequately understood in terms of the holy. Third, it examines why a values discourse despite its misguided character is attractive to many. Such discourse serves to support the dominant secular culture’s marginalization of Christianity. It does this in particular by discouraging a public confession of Christ as the Messiah of Israel and the Son of the living God (Matthew 16:16). What is sought is a religion-neutral values language. Finally, such a values discourse distorts what is Christian about Christian bioethics, which is Christ. Christian bioethics is not a system of values but a dimension of a life aimed at salvation.

            First, appeals to common values tend to be misleading and fail adequately to recognize that seemingly similar values have substantively different meanings when they are placed within different moral frameworks. That is why in the face of declarations on human rights and human dignity there is intractable moral pluralism, and why bioethics is a plural noun. The point is that the same terms when set within different moral and metaphysical frameworks take on different meanings. One can see the force of this by comparing how the same terms have different meanings within different scientific accounts. For example, physicians practicing medicine within the now-dominant scientific paradigm understand diseases in ways radically different from homeopaths who practice a form of medicine that is tantamount to a remnant sect that split off from traditional Western medicine in the 18th century (i.e., shaped by Samuel Hahnemann [1755-1843], who contrary to allopaths taught similia similibus curantur, similars cure similars). As a consequence, physicians of the now-dominant paradigm, whom homeopaths refer to as allopaths, are not allopaths.[i] So, too, accounts of reality within an Aristotelian, Newtonian, and Einsteinian physics may seem to use the same terms in speaking of space and time, mass and energy. But within each account of physics, the terms have substantively different intensions and extensions. At best, there are only family resemblances associating the same words, which are embedded in different accounts.

“Values” when invoked in different moral and political accounts have different extensions and intensions. Proponents of a secular constitutional social democracy and those of a one-party capitalist oligarchy as in Singapore and Hong Kong may both use terms such as security, prosperity, and liberty, while engaging a meaning different from their meaning in liberal social-democratic accounts. Liberal secular constitutional social democracies, for example, will give prior ranking to liberty followed by equality, and only then give attention to prosperity, insofar as prosperity is compatible with liberty and equality, and insofar as differences in economic and social status redound to the benefit of the least-well-off.[ii] In contrast, a morally well-formed Confucian will give first ranking to security and then to family prosperity, and last to liberty, insofar as this is compatible with security and family prosperity (Fan 2011 and 2010; Lim 2012). Concerns about equality will be approached with puzzlement in the absence of any two persons actually being equal, which empirically they never are. The point is that embedded within different moral frameworks, the meaning of values will not be the same. Given their different contexts, the value terms will have a different meaning, in that liberty will not ground for Confucians the same civil rights that liberty demands for social democrats. Physicians within different medical-scientific paradigms may use the same words, but the words will not mean the same thing.

Regarding the diversity of understandings of liberty, consider how liberty for Texans demands as integral to human dignity the private possession of firearms and the right to hold one’s ground with deadly force. Liberty for Germans generally lacks this important content and essential richness. Texans and Germans do not share a common value of liberty. People from different moral communities who do not share the same values may still find complex family resemblances among value terms used within different moral communities. This state of affairs is the ground of the intractable moral and bioethical pluralism we face. The gulf separating the intension and extension of the seemingly shared normative terms is also greater when the terms are embedded in profoundly different metaphysical understandings. One might especially note the difference in the intension of normative terms when used by traditional Christians who recognize the existence of the very particular God of the Christians (i.e., the unapproachable Father Who begets the Son and gives procession to the Holy Spirit), and those who live and act guided by an atheistic methodological postulate. For the latter, right conduct must be understood in terms of a universe that is ultimately meaningless. The result is that values, if examined with care, separate persons, rather than unite in a common discourse. One might think, for example, what “free” means when Christ says, “You will know the truth and the truth will make you free” (John 8:32), versus what freedom means for the libertarian philosopher Robert Nozick (Nozick 1974). We do not agree as to when to have sex, reproduce, transfer property, or take human life. Without a canonical God’s-eye perspective, there is no way to resolve the moral pluralism we face without begging the question, arguing in a circle, or engaging an infinite regress (Engelhardt 2014).

Second, Christianity is not about values. Instead, Christianity is about a Person, a human who is also God, and who is uniquely “the Way and the Truth and the Life” (John 14:6). To be Christian is to direct one’s life to God through Christ, the only Son of the Father, in union with the Holy Spirit Who proceeds from the Father. Christianity is first and foremost not the affirmation of certain moral goals or values or of a moral-philosophical viewpoint, but rather the confession and affirmation of a very particular God Who entered into history at a particular time and particular place. He identifies Himself as the God of particular persons, of Abraham, Isaac, and Jacob, because of whose faith He selected the Jews as His chosen people (Deuteronomy 7: 6-10). The result is that God entered the world as a Jewish man in Palestine, Who did not come to bring values but forgiveness to those who repent. Although Christianity is to be preached to all men, Christianity is not a religion of universal values, but a religion united to an incarnate God with a particular genealogy. Because two thousand years ago, God incarnate lived in the Levant, not in Texas, Indians in Texas at the time of Christ did not have the opportunity to encounter Jesus, the incarnate God, as did the Canaanite woman who begged for crumbs from the table (Matthew 15:21-28).

Again, the focus of Christianity is not on values. The good, the right, and the virtuous are known through an encounter with the holy.[iii] The Great Commission is not to go out and teach values to all peoples or to conduct philosophical seminars, but rather to proclaim “everything I have commanded you” (Matthew 28:20). One is to teach the mitzvoth of Christ. Christianity responds to a God Who speaks in commandments, Who gives the law. Christianity is not grounded in moral-philosophical reflection. Jesus is recorded by St. John as saying, “My command is this: Love each other as I have loved you” (John 15:12). Even more provocatively, consider the letter to the Gentile converts from the Council of Jerusalem, which includes among its prohibitions the prohibition of eating blood and the prohibition of sexual immorality. “You are to abstain from food sacrificed to idols, from blood, from the meat of strangled animals and from sexual immorality” (Acts 15:20, 29). The point is that Christians are not offered a philosophical framework that gives a canonical ordering of particular values, such as liberty, equality, prosperity, and security, along with a particular content for such values. Nor does Orthodox Christianity have a consistent ethic of life.[iv] On the one hand, the Church has not condemned capital punishment (Jubilee Bishops’ Council 2000, Sec. IX.3, pp. 35–36). On the other hand, abortion has been forbidden independently of any view of the ensoulment of the embryo, recognizing simply that the killing of an embryo is forbidden sui generis (Basil, Letter 188).

The point is that Christian bioethics should be grounded in the recognition that the anchor for all reflection concerning how one should live one’s life as well as use medicine lies in God, Who transcends all human categories. This gulf between created and uncreated being constitutes a barrier of opaqueness that separates traditional Christians and their bioethics from secular bioethics. There is no common viewpoint to serve as the basis for substantive agreement about right conduct with the other until the other, the non-Christian, converts. Conversion involves a metanoia, a change of mind, which requires an entry into the mind of the Apostles and the Fathers, grounding a willingness to abide by the commands given to all men through Christ. An implication of this state of affairs is that dialogue across this gulf of difference defines the otherness of the dialogue partners as other to each other. In their reflections on matters of bioethics, they will not share a common ground secured through moral philosophical reasoning. To escape intractable moral and bioethical pluralism, to know which account is canonical, one must know what is required by the canonical God’s-eye perspective. This is not to say that a peaceable modus vivendi cannot pro tempore be established. After all, one can through contracts and through the market make agreements even with moral enemies.

Third, there is the question as to why a values discourse has become so popular. For the most part, this popularity reflects the attempt of a post-Christian culture to demand from all secular reason-giving, not just in the public forum, but in the public square. The dominant secular culture requires that it not be confronted with a religious community that forwards religious grounds for public deportment and public policy that are opaque to those within the dominant secular culture. This secular reduction of religious grounds has been in particular prominent in the transformation of European Christian democratic parties from parties explicitly connected to Christianity and the demands of Christ into parties committed to “Christian values”. In Germany, this has been described as “der lange Marsch der CDU nach links”. Apart from any issues of political conservatism, this transformation has involved an abandonment of the religious discourse of Konrad Adenauer (1876–1967) in favor of the secular discourse of Helmut Kohl and especially Angelika Merkel (Gottfried 2007, p. 163; Nolte 2014). In this, there has been a political triumph of the Roman Catholic philosophical school of new natural law that presumes that the norms of right conduct can be known apart from knowing God (Finnis 1980 and 1983; Gomez-Lobo 2002; Grisez 1965 and 2001). The result is that a group of Christians has emerged who hold that they can talk about Christian norms without ever speaking of God, much less of Christ, and instead talk only about Christian values. The consequence is a substantial secularization of Christian public discourse, as well as of Christian bioethics.

Finally, what does all this mean for Christian bioethics? As already argued, Christian bioethics is not equivalent to secular bioethics, because Christian bioethics is not grounded in a particular set of philosophical or moral assumptions, but in Christ. Christian bioethics is therefore not about values or about a set of philosophical arguments and analyses, but about Christianity. To appreciate the content and force of Christian bioethics, one needs to live within the mind of the Apostles and the Fathers. This will supply enough guidance to lay out a bioethics for the 21st century (Engelhardt 2000). In all of this, the integrity of Christian bioethics is guided by an epistemology unlike that of secular bioethics, in that traditional Christianity’s theologians in the strict sense are those who know God, not about God. As a result, traditional Christian bioethics shares no philosophical common ground with secular bioethics. One must recall that there is no common view of proper moral conduct or of human flourishing, with the result that secular bioethics is marked by a moral and bioethical pluralism that sound rational argument cannot set aside (Engelhardt 1996 and 2014). This state of affairs lies at the root of the crises of secular morality and bioethics after the Enlightenment’s failure to establish a canonical rationality. Now more than ever an authentic Christian bioethics must provide direction.

References

Chrysostom, St. John. Homilies on Romans, in Nicene and Post-Nicene Fathers, First Series, ed. Philip Schaff. Peabody, MA: Hendrickson Publishers.

Engelhardt, H. T., Jr. 2014. Dopo dio: Morale e bioetica in un mondo laico. Turin: Claudiana.

Engelhardt, H. T., Jr. 1996. The Foundations of Bioethics, 2nd ed. New York: Oxford University Press.

Fan, Ruiping (ed.). 2011. The Renaissance of Confucianism in Contemporary China. Dordrecht: Springer.

Fan, Ruiping. 2010. Reconstructionist Confucianism. Dordrecht: Springer.

Finnis, J. 1983. Fundamentals of Ethics. Washington, DC: Georgetown University Press.

Finnis, J. 1980. Natural Law and Natural Rights. Oxford: Clarendon Press.

Gomez-Lobo, A. 2002. Morality and the Human Goods: An Introduction to Natural Law Ethics. Washington, DC: Georgetown University Press.

Gottfried, Paul Edward. 2007. Conservatism in America. New York: Palgrave Macmillan.

Grisez, Germain. 2001. Natural law, God, religion, and human fulfillment, The American Journal of Jurisprudence 46: 3–46.

Grisez, Germain. 1965. The first principle of practical reason: A commentary on the Summa Theologiae, 1-2, Question 94, Article 2, Natural Law Forum 10: 168–201.

Jubilee Bishops’ Council of the Russian Orthodox Church. 2000. The Orthodox Church and Society: The Basis of the Social Concept of the Russian Orthodox Church. Belleville, MI: St. Innocent Publishers.

Lim, Meng-Kin. 2012. Values and health care: The Confucian dimension in health care reform, Journal of Medicine and Philosophy 27.6: 545–555.

Nolte, Paul. 2014. Christliche Leitkultur – das ist vorbei, Frankfurter allgemeine Zeitung, Christ & Welt 22 (May 22): C&W5.

Rawls, John. 1971. Theory of Justice. Cambridge, MA: Belknap Press.


*               H. Tristram  Engelhardt, Jr., Ph.D., M.D., is professor in the department of philosophy, Rice University, and professor emeritus in the department of medicine, Baylor College of Medicine, Houston, Texas.

[i]               Traditional Western medicine presumed there were four elements: earth, air, fire, and water. These elements embodied the four basic qualities: hot, cold, wet, and dry, which were expressed in the four humors: black bile, yellow bile, blood, and phlegm. Within this paradigm, traditional Western medicine used contraries to cure contraries. For example, it would attempt to dry out a man who was too wet.

[ii]               For a reconstruction of the thin theory of the good underlying social-democratic accounts of the proper way of constituting communities, see Rawls 1971, §60, pp. 395–399 and also §46, pp. 298–303.

[iii]              As St. John Chrysostom emphasizes in his commentary on Romans 2:10-16 regarding those Greeks who have the law written on their hearts, this applies only to those who engage in right worship.

But by Greeks he [St. Paul] here means not them that worshipped idols, but them that adored God, that obeyed the law of nature, that strictly kept all things, save the Jewish observances, which contribute to piety, such as were Melchizedek and his, such as was Job, such as were the Ninevites, such as was Cornelius (Chrysostom 1994, vol. 11, p. 363).

[iv]              The term “consistent ethic of life” was coined in 1983 by Joseph Cardinal Bernardin (1928–1996), who was Cardinal Archbishop of Chicago.


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