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Talking of God - but with whom?

When my son asked me many years ago what it was I did, what it was that I was, I told him quite innocently that I was a teacher and a theologian. He knew what teachers were and the sons of things they did, but he was puzzled by "theologian." "What do theologians do?" he asked, and I replied, "They talk of God." He had evidently noted that when he saw me working I was usually alone-and usually wanted to be left alone-for this talk of "talk" puzzled him anew, and he asked, "With whom?"

I find myself coming back to that question from time to time. As a moral theologian interested in questions of medical ethics, I find myself sometimes in the middle of questions about abortion or euthanasia or the allocation of resources and wanting to talk about God-but with whom?

The answer that I will shortly defend is this: First and fundamentally, theologians may and must talk of God with the community of faith. They may talk of God as well with any who will. They may even dare to speak of God among those who would not or may not speak of God themselves. But in all these conversations there are times and places that the theologian must be still as well. Before I make such belated reply to my son's question, however, I want to sketch a context for the same question and for my response to it in the developments in medical ethics.

There are long and worthy traditions of theological reflection about sickness and healing, about death and dying, about nature and its mastery, about care for the suffering, respect for human agency, and concern for the poor. Long before medical ethics became a distinct field of inquiry, let alone a growth industry in the academy, Christians and others with religious convictions were engaged with the moral questions posed by medical care and trying to answer them in ways appropriate to the ways they talked of God and of the cause of God. There was plenty of foolishness mixed in with the wisdom of these traditions, of course, but there were traditions: resources for the doctors and nurses who tried conscientiously to bring their practice into line with their religious profession, and for the patients attempting to make decisions about their medical care faithful to their religious commitments and loyalties, and for the ministers and other leaders who struggled to find a word of God that would appropriately encourage or admonish the medical professional or the patient.

It is not surprising, therefore, that those who have cared to look have found such religious traditions for this "new" discipline of medical ethics. There is plenty of material for "selective retrieval." Nor is it surprising that, as Leroy Walters observed, religious thinkers played an important role in the "renaissance of medical ethics" in 1965 to 1970.[1] When Paul Ramsey made his "explorations in medical ethics" in the Lyman Beecher lectures,[2] he wrote, to take him at his word, as "a Christian ethicist, and not as some hypothetical common denominator."[3] Ramsey and other religious "bricoleurs" had at their disposal traditions for selective retrieval that others simply did not have when new powers of medicine posed novel moral problems. The question of with whom one talks when one talks of God was not at the beginning of the discipline an important question evidently; one simply spoke one's mind and gave one's reasons, and the indebtedness of a mind or of reasons to a theological tradition was not assumed (not by Ramsey, at any rate) to limit the relevance of one's normative conclusions.

After the "renaissance," however, came the "enlightenment" of medical ethics. It did not come, of course, by any inexorable design of history, nor even by design of the philosophers who entered the field, but it came. If Stephen Toulmin's provocative thesis that applied medical ethics saved moral philosophy from its arid debates about metaethics is true,[4] then one can understand a certain impatience with speculative questions; but for whatever reason, the discipline turned to the consideration of moral quandaries in narrowly circumscribed circumstances and to questions of public regulation. The quandaries seemed to call for an application of principles concerning which one could (and would) presume consensus, and the regulatory questions seemed to call for an appreciation of pluralism and an appropriation of the minimal requirements necessary for people with different convictions to live together peaceably. The discipline undertook the enlightenment project--sometimes to justify but always to identify and apply moral principles that all people can and must hold independently of their particular communities and histories, quite apart from their specific loyalties and identities, unbiased by any particular narrative which they remember or by any partial vision of human flourishing for which they hope. There was, for a time, an enlightenment suspicion of particular traditions, an enlightenment confidence in the progress of human science and unqualified reason, and an enlightenment celebration of individual autonomy over against the "authority" of priest and politician and that new figure of arbitrary dominance, the physician. The importance of an arena of "privacy" was underscored, a space for autonomy and preference, but it was also underscored that what mattered publicly was simply that there be such space, not how it was filled. Talk of God was assigned to the private arena, and theologians ended up talking with themselves, as my son suspected of me many years ago. People trained as Christian moral theologians still wrote on medical ethics and contributed to public discourse about the new powers of medicine, but their distinctively theological voice was muted; they were more easily identified as followers of Mill or Kant than as followers of Jesus.

In 1978 James Gustafson publicly lamented the fact that so little of the commentary on medical ethics by people trained as theologians made any explicit appeal to religious convictions or to theological traditions.[5] He acknowledged that the task of theological reflection about medical ethics would not be an easy one. He did not claim that either quandaries or public policy problems would be resolved if only people would talk of God and others would listen. He admitted that there were sometimes good reasons for silence about one's theological convictions. But he more vigorously pointed out reasons to lament that silence, and chief among them was the simple truth that faithful members of religious communities want to live and die and give birth and suffer and care for the suffering with religious integrity, not just with impartial rationality. Gustafson's lament was echoed by others,[6] and it signaled renewed attention to both the relevance of theological traditions and religious convictions for medical ethics and religious congregations as communities of moral discourse, character formation, and moral action with respect to questions about medical care.

Moral theologians rediscovered the congregation as a context for their work and the community of believers as partners in discourse. When moral theologians talk of God, they may and they must talk with a congregation of those who believe in God and who would be faithful to God. That this obvious point should have to be discovered suggests how deeply some moral theologians were affected by the enlightenment's division of life into a private arena of autonomy and preference and a public arena of impartial reason.

The church is a public for the moral theologian, a place for moral discourse and deliberation and discernment. But it is a public not by requiring people to disown or to disregard the convictions and loyalties that give them a moral identity but by requiring people to bring such convictions and loyalties and identities into coherence with their religious conviction and loyalty and identity. Moral theologians may talk of God first and fundamentally with communities of faith, where talk of God is not consigned to the margins but acknowledged as central. In communities of faith, by some grace there is an effort to attend to God and to respond appropriately to God, to attend to all things as related to God and to respond to all things in ways appropriate to their relations to God. There the tradition exists not merely as an archaic relic in an age of science and reason but as that which continues to evoke and to shape the loyalties and the identities of the community and its members, even as they make use of science and reason. There faithful people orient themselves in their worship-and in their living and their dying and their suffering and their caring for the suffering-to God and to the cause of God. There people transfigure questions of conduct and character into questions of the deeds and dispositions worthy of the story they love to tell and long to live. There people ask how religious convictions can guide and limit new medical powers. There in the middle of struggles with infertility and in the muddle of the technological apparatus that surrounds the dying, people ask about the resources and requirements of their religious convictions and commitments. There they ask about the shape of Christian integrity in giving and receiving and sharing the resources of health care.

Of course, few congregations match such a description; many congregations have been no less influenced by the privatization of religious and moral choices than their moral theologians.[7] In such congregations personal choices are treated as private" matters, as no one else's business, as properly settled by the tastes and preferences of the free individual, as outside the appropriate range of the community's discourse and mutual instruction. But even such congregations can and do retain some common loyalty to God, some common commitment to the cause of God, some shared concern expressed in acts of confession that the community and its members are not yet all they are gifted and called to be. There are resources for the renewal of these communities and of their moral discourse. And moral theologians, gifted and called to be members and teachers of such communities, responsible to provide both priestly nurture and prophetic correction of the community's practices and vision of God as such bear on the making of decisions and the formation of character, have as much at stake in the renewal of the congregations as the congregations have in the renewal of moral theology. They can and they must help to nurture and to sustain discourse and deliberation and discernment in the context of the community's religious traditions and loyalties.

Such discourse need not result in unanimity, and probably won't. But reason-giving and reason-hearing within the community can test decision and character by the community's common memory and shared identity. When doctors and patients attend together to the stories of Jesus, for example, they may still disagree about the wisdom of certain treatment decisions. A doctor may see in the stories of Jesus' healings and in the resurrection a sign of God's cause and a warrant for her own commitments to life and health, even as she acknowledges that the victory over death and disease is finally a divine and eschatological triumph. A patient may see in the story of the cross a permission and a command not to make his own survival or ease the law of his being but to weigh the good of others and other goods against a longer life if that longer life would be empty of opportunities for reconciliation with one's enemies or fellowship with one's friends or simply fun with one's family. Where there are disagreements, however, the conversation about what should be done or left undone might continue in this community beyond the point when in other contexts the discourse would be stopped by appeal either to the authority of the physician or to the autonomy of the patient. [8]

Theologians may and must nurture such discourse and contribute to it, but they may not monopolize it. Moral theology is not a substitute for that discourse but its servant. Discernment in discourse involves the diversity of gifts of a congregation-the gifts of some for rational inference and of others for the wisdom learned from experience and of still others for creativity, the gifts of some for indignation at injustice and of others for sympathy with the suffering, the gifts of knowledge of a person or a place, of awareness of an opportunity or an obstruction, of medicine or economics or some other technical knowledge or special skills-all enlightening the way to the particular deeds worthy of the community's devotion to God and to the cause of God. Sometimes in the discourse, oftentimes, the theologian must be still-and learn. Moreover, the personal decision remains personal; personal choices and individual responsibility for them are not surrendered to the community-and surely not to its theologians-when exercised within a community rather than secretly and privately. And the theologian must sometimes at the end of the conversation, oftentimes, be still.

Even so, with communities of faith theologians may talk at once of God and of medical ethics. For duly humble and responsible moral theologians, such conversations may be enough to keep them busy. There is another audience, however; moral theologians may speak of God to any who willingly listen, and that number includes many doctors and nurses and patients who are not members of any particular community of believers or identified with any particular religious tradition. Even in a culture as noisily secular as our own, attention to the relation of piety and medicine is hardly idiosyncratic, for piety evidently still surrounds the undertaking and the practice of medicine and nursing for many. Some who enter the professions, even if they do not invoke any God by name, still enter and practice them with a lively sense of gratitude for the givenness (the gifts) of life and health, with a humble sense of dependence upon some dimly known but reliable order, with a sad sense of a tragic flaw that runs through our world and through our lives, with a hopeful sense of new possibilities on the horizon, and with a keen sense of responsibility to some inscrutable power who gives the gifts, sustains the order, judges the flaw, and provides new possibilities.[9] Moreover, there are many others who use medicine, who are not members of any community of faith, for whom the events of birth or suffering or death are surrounded not only by technology but by piety as well, by a sense of their dependence upon and their indebtedness to a transcendent Other that bears down on human life and human powers and sustains them as well.

One can do worse, I think, than to name this Other wrongly or to fail to name it at all. One might (mis)understand this power as a deluding power, as the enemy of its own work; or one might deny or simply ignore this Other and these senses.[10] Those who do not adopt such responses to that which evokes such senses can attend to talk of God, and moral theologians may talk of God with them as well as the believing communities. As members of believing communities and as their spokespersons theologians may claim to know something of God and the cause of God which might orient both the piety and the medicine of these partners in discourse. Of course, such claims take courage, and such courage is ever only a small step from the foolhardy presumption of claiming to know too much, of rendering the transcendent Other not only scrutable but serviceable to our projects (including our ecclesiastical projects). That danger should move the theologian in this conversation sometimes, often times, to silence before the mystery each partner experiences and both finally trust. Moreover, the theologian may no more monopolize this conversation than the moral discourse of the church, for the theologian's talk of God has its test in the senses and experiences of the doctor or nurse or patient, not the doctor or nurse or patient their test in the theologian's talk of God. Nevertheless, with courage and humility theologians may and must talk of God with any who will.

Finally, moral theologians may talk of God, and sometimes must, in the presence of those who would rather not and in the presence of those who may not. There are, to be sure, sometimes good reasons for silence about one's religious convictions. When a professional group a moral theologian hopes to convince is composed of some who share the theologian's convictions and some who do not, it may be prudent to find arguments not tied directly to those convictions. And when the public-policy makers one hopes to influence have been sworn to protect the freedom of religion and not to establish a particularly or peculiarly religious policy, then it may be necessary to be silent about one's religious commitments. In such settings arguments based candidly on Christian convictions may be regarded as at least insufficient, and perhaps as irrelevant. It is little wonder that the conventional wisdom has counseled moral theologians, in such contexts at least, to talk not of God but of universal moral principles, to speak not in the language of a distinctive religious tradition but in some moral Esperanto.

The recommendation here, however, is theological candor. It may be banal to observe that genuinely pluralistic societies profit from the candid articulation and vigorous defense of particular points of view, but when a society is at some risk of reducing morality to a set of minimal expectations necessary for pluralism, then the public significance of particular accounts of the meaning of "life" and "health" and freedom," and of the goals worth striving for medically and morally and the limits to be acknowledged in or imposed on attempts to reach them ought not to be underestimated. Perhaps the enlightenment project has failed, as many critics of foundatiolialism claim, but if not, it has surely been pretentious about its successes. The defenders of some moral Esperanto err, in my view, not so much when they claim that some minimal moral standards can be defended rationally as when they deny or ignore the minimal character of such standards. When they pretend such standards give us a full or adequate account of the moral life, then they distort the moral life. At any rate, more modest claims about the possibilities and promises of a common moral language may free religious persons and communities to recover their own voices and to speak more eloquently in their own moral languages about medicine and morals, and more candidly theological talk about medical ethics may at least remind a pluralistic culture of the minimal character of the standards it presumes are universal and rational.

This recommendation for theological candor is sympathetic with the criticisms of enlightenment foundationalism, but it is tied more closely to a conviction about the inalienably religious character of life and death and giving birth and enduring suffering. When, for example, some "nonreligious" patient has idolatrous expectations of medical technology, when he petitions the doctor/priest for a piece of medical wizardry to be provided with technological grace to rescue him from his finitude and deliver him to his flourishing, it is then that the moral theologian may and must talk of one God and call an idol an idol. Again, the public-policy maker who may not talk of God nevertheless makes decisions about a research budget with certain quasi-theological assumptions about the nature, fault, and prospects for human beings and their communities. Suppose the assumptions are that human beings arc by nature "tool-makers," that the fault is in nature, not in humanity, that it is nature that keeps humanity from what it wants and needs, that the prospects for humanity are bright as long as human curiosity and inventiveness are unencumbered by the fears of those who have no taste for them, that laissez innover! Then the moral theologian may and must be candid about a different set of assumptions, assumptions no less rational even if they are nurtured in convictions about God as creator and judge and redeemer.

Sometimes the moral theologian may look for and speak for consensus, for agreement, but not always. Sometimes the moral theologian should look for and speak for the ineliminable conflict. Theologians may no longer presume that public institutions will presuppose the truth of talk of God, but they need not and may not infer that talk of God will, therefore, be irrelevant to the public life or to the society's discourse about medical ethics.[11] The voices of Martin Luther King, Jr., Dorothy Day, and Elie Wiesel were heard, after all-and not in spite of their talk of God. To raise a theologically articulate voice in protest and in hope may be a sign of life in the culture, and preserve a memory or stir an image that may make a difference.
 [1] LeRoy Walters, Religion and the Renaissance
 of Medical Ethics," in Theology and
 Bioethics: Exploring the Foundations and
 Frontiers, Earl E. Shelp, ed. (Philosophy and
 Medicine 20; Dordreicht: D. Reidel Publishing
 Company, 1985), 3-16.
 [2] Later published as Paul Ramsey, The Patient
 as Person: Explorations in Medical Ethics (New
 Haven: Yale University Press, 1970).
 [3] Paul Ramsey, "The Indignity of `Death with
 Dignity,'" Hastings Center Studies 2:2 (1974),
 47-62 at 56.
 [4] Stephen Toulmin, "How medicine Saved the
 Life of Ethics," Perspectives in Biology and
 Medicine 25 (1982), 736-50.
 [5] James M. Gustafson, "Theology Confronts
 Technology and the Life Sciences," Commonweal,
 16 June 1978,386-92.
 [6] E.g., Stanley Hauerwas, "Can Ethics Be
 Theological?," Hastings Center Report 8:5
 (1978), 47-49, and Richard A. McCormick,
 "Notes on Moral Theology," Theological
 Studies 40 (1979), 98-99.
 [7] James P. Wind, "One Congregation's
 Experience: An Introduction," Second
 Opinion 13 (1990), 77-88.
 [8] Allen Verhey, "Christian Community and
 Identity: What Difference Should They
 Make to Patients and Physicians Finally?"
 Linacre Quarterly 52:2 (1985), 149-69.
 [9] This account of a "natural piety" is
 dependent upon James M. Gustafson, Ethics
 from a Theocentric Perspective: Theology and
 Ethics (Chicago: University of Chicago Press,
 1981), 129-36.
 [10] H. Richard Niebuhr, The Responsible Self
 (New York: Harper and Row, 1963), 115-18.
 [11] Jeffrey Stout, Ethics After Babel: The Languages
 of Morals and Their Discontents (Boston:
 Beacon Press, 1988), 187.




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Title Annotation:Theology, Religious Traditions, and Bioethics: a Special Supplement
Author:Verhey, Allen D.
Publication:The Hastings Center Report
Date:Jul 1, 1990
Previous Article:What can religion offer bioethics?
Next Article:Foreclosing the use of force: A.C. reversed.

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