What can religion offer bioethics?
In comparison with well-entrenched disciplines in the modern university, bioethics is a young field where people from many backgrounds-including religious ones--can carve out niches. No entrance requirements exist to screen out people who wish to draw upon religious or theological perspectives. Moreover, many of the field's early shapers were theologians or people open to discourse about theology.
Yet the discipline of bioethics came of age just as secularism crested as a social movement (the 1960s) and was formed by people-including some theologians-who often found secular institutions and causes more promising than religious ones. The ethos of bioethics is now pronouncedly secular. That is due in part to its subject matter and social location. Its issues arise within and between medical, scientific, legal, economic, and political worlds--contexts where technical, professional, and secular ways of thinking and speaking are most in vogue. This secular tone is also attributable to the socialization patterns of most of those drawn to bioethics. By and large they are products of graduate and professional schools that nurture and reward secular habits of thought. Further, those who address bioethics issues are acutely aware of modern pluralism and seek a public discourse that transcends worlds of particular beliefs and commitments. They feel the pressure of new life-or-death problems that demand immediate response and are wary of debates that can bog down in the minutiae of insiders' conversations. Thus, despite openness to religious perspectives and a historic indebtedness to a distinguished generation of theological ethicists, it remains unclear just what religion can offer the young and complex field of bioethics. Is it possible to identify some potential contributions that religion might make to our current bioethical discourse?
An Honest Appraisal
It is best to begin cautiously and honestly. Some will fear-for biographical and historical reasons--that religion's main contributions to bioethics will be chaos, confusion, and hostility. These critics will point to the package of problems we call "pluralism." Religion and theology bring to public discourse particular truth claims, private languages, and special warrants that do not convince people who do not share heritages and basic assumptions about the world. Thus to invite religious traditions to contribute to public bioethics discourse seems like an invitation to conflict and entanglement in unresolvable debates. The spectre of lethal religious conflict haunts both our newspapers and our history books. What contributions could possibly be so important that we would risk letting this menacing genie out of the two-hundred-year-old bottle fashioned by the Enlightenment?
Such a view overlooks the fact that pluralism has more than a contentious downside-much more. If we consider the 218 denominations, the more than 200 seminaries, the many religion departments in U.S. colleges and universities, and the more than 340,000 local congregations that various statisticians monitor,  the breadth and pervasiveness of American religiosity becomes apparent. To attempt to deal with life and death decisions, with matters of health and suffering-the special interests of bioethics-as if this teeming religiousness did not exist is therefore to engage in a self-deception of monumental proportions. Their secular "everydayishness" notwithstanding, the majority of Americans express themselves religiously. They come to their moments of medical decisionmaking (both personal and political) with particular beliefs and commitments.
Attending to religion requires us both to be honest about who we are as a people and to be more responsive to the full humanity with which we deal in bioethics. Religion's first contribution, then, is to furnish a more accurate view of the human beings whom we encounter in the secular worlds of the academy, health care, and public policy. if, as many argue, our secular ethical language of rights and duties screens out the religious interpretations and perspectives people carry into these settings, the result is human fragmentation and alienation. Patients, policymakers, and health care professionals do not park their beliefs at the bioethical door. Instead they smuggle them in--in plain wrappers-beneath the surface of much of our technical secular discourse. An honest encounter with religious pluralism can make us more responsive to human particularity, more compassionate, able to offer more complete care.
At their best, religious communities and their theologians can contribute to the emergence of fuller, more complete views of the human. Religious communities have views of humanity that are often higher and lower than our conventional wisdom. These traditions know limits and face them (an ability that is still quite underdeveloped in our culture.) Some remind us of finitude and fallenness at the same time that they draw upon deep reservoirs of hope. Many challenge false optimisms and undermine the many determinisms that are part of our collective consciousness. They reflect experience with surprise and tragedy, and foster self-criticism and openness to corrective vision from others.
In articulating their fundamental visions and purposes these communities and traditions can contribute to a more variegated or motley view of humanity, helping us see more of the full marvel present in each human being. Instead of a restrictive or reductionistic view they can suggest more expansive ones, ones that remind us of mystery and possibility.
It must be admitted that to welcome this contribution is to open the door to complexity. Bioethics will become more colorful and less tidy. But it will also deal more adequately with human intersubjectivity; it will move closer to human experience and to the agents' interpretations of that experience. It will also mean a stronger commitment to the hermeneutical, interpretive dimensions of the bioethical task-dimensions championed by philosophers like Daniel Callahan, sociologists like Renee Fox, physicians like Arthur Kleinman, and theologians like Don S. Browning.
Communities of Moral Discourse
The statistical size of American religiousness suggests a second contribution. If we add up the congregations, seminaries, denominations, and religion departments--not to mention all the religious groupings that escape the church watchers' eyes-we will find the largest collection of communities of moral discourse in our society. Religious communities provide already existing places where people can talk about some of the most vexing issues that we encounter. In our court rooms, legislatures, and hospital rooms we regularly find people confronted by decisions for which they are unprepared. Our existing religious communities could be places of preparation, places where people are morally and ethically equipped for times of decisionmaking.
It is important to be candid about the health of these communities of discourse. While they bear traditions of moral discourse much older and much richer than the thin tradition that currently shapes our public conversation, they also find themselves partially estranged from the very traditions they seek to embody and represent. Many of our religious communities have so accommodated themselves to the American ethos of individualism that they no longer risk serious moral conversation. And some of them have fostered bigotry, closemindedness, and tunnel vision. So their contribution must be labelled as "potential," not automatic.
Yet even if many religious communities seem morally anemic there are significant reasons for taking seriously their potential contribution. Such communities provide an alternative to a simplistic approach to American public life. Too often we mistakenly divide American life into two realms: public and private. We assume that there is one megapublic world where each speaks to all, and countless private worlds where each speaks to the like-minded. It is a commonplace to lump congregations and other religious communities into this private zone and to miss their public character. Many, if not all, American religious communities are publics in their own right. In a society accustomed to segmenting people along lines of class, race, profession, gender, etc., these institutions cross lines of age, ethnicity, educational background, profession, income and the other barriers that subtly ghettoize our moral discourse.
As theologians like Stanley Hauerwas have noted, religious communities, when they are true to their distinctive characters, can offer "contrast models" to a culture's habitual ways of perceiving and acting. Such traditions can provide ways first to face and then address the deepest of human questions, such as our response to suffering, questions of ultimate meanings that our current functional rationality steadfastly avoids. And these traditions provide access to fundamental claims that, while taking various particular forms, may open out into universal concerns and commitments.
Embedded in religious communities and theological traditions are "alternative imaginations" that allow us to approach enduring human riddles like suffering, health, death, procreation, and the like from different vantage points. For example, most of the religious communities of our land bear traditions of love for the neighbor and concern for creation that can serve as healthy contrast models to the individualism and anthropocentrism that shape so much of our common life. In essence these communities and traditions can increase our imaginative repertoire, making it possible to envision new options and solutions.
Religious communities may also function to widen current bioethical horizons. An example of such widening is provided by a Caner Center conference in October, 1989 at which former President Jimmy Carter invited leaders of America's religious communities to consider "The Church's Challenge in Health Care." The conference participants devoted little if any time to the individual quandaries that take up so much space on conventional bioethics agendas. Rather they addressed major ethical issues like access to health care, or personal and societal responsibility for healthy behavior, as well as national policies that support exporting cigarettes to the third world or inadequately foster safety in home and workplace. Such topics seem remote from conventional bioethics discussions about termination of treatment or organ transplantation, but the challenge presented by this religious conversation is whether our bioethics agenda is too often oriented by quandaries.
Another potential contribution, although it is much less immediate than the ones proposed so far, is the possibility that religious communities might help us develop a more adequate ethical language. Here I allude to Jeffrey Stout's recommendation that religious ethicists be invited back into our moral discourse. If that invitation were accepted, Stout believes, several things would occur. First, we would discover what Mary Midgely calls the "sad little joke" that almost no one speaks the universal moral language of the experts. If theologians and religious scholars re-enter the conversation Stout believes that our "first moral language" will be seen as a pidgin (a sparse dialect used only for communicating with strangers) or a creole (a mixture of fragments from other linguistic traditions) rather than a full blown linguistic tradition. That discovery would help those Stout calls "esperantists" (the designers of universal languages) to discover their own location within larger ethical traditions.
Such discoveries would have considerable implications for bioethics. The enterprise would become more comparative and historical; it would include a kind of "reflexive ethnography" that takes seriously the traditions and cultural contexts which stand behind all ethical constructs.
What Bioethics Can Offer Religion
Stephen Toulmin has written that the encounter with concrete cases and issues in medicine and biomedical research helped reorient philosophical ethics from a drift toward abstraction and irrelevance. It is only fair, after suggesting potential contributions that might flow from religion to bioethics, to ask if someday a religious thinker might write a similar article about medicine's impact upon religion. I raise this prospect to signal a mutual enriching that might be hoped for between realms that have been increasingly estranged from each other. In interactions with each other, medicine and religion might come to fresh appreciations of the distinctive and limited contributions each has to offer humanity.
For religious communities, this means that encounters with the life and death quandarics of modern medicine present opportunities to dust off the enduring genius of a particular tradition and to reconnect to moorings that have been lost from view. It is a commonplace in modern discourse to talk about the pervasive identity confusion that exists within religious communities. In the face of a bewildering variety of religious and secular interpretations, it is difficult to speak with certainty about religious meanings and beliefs.
Yet the majority of our religious traditions came to life in equally confusing encounters with human suffering and dying. The religious figures who first articulated distinctive interpretations that later became "great traditions" (Moses, Jesus, Mohammed) arrived at their insights through dark nights of the soul, in times of great ethical and cultural confusion. When confronted with modern questions about the meaning of suffering or the possibility of a good death, the religious interpreter is offered an existential bridge into the heart or core of a tradition. Delving there can result in a fresh perception that allows religious communities to see that they are different from the surrounding culture and why their differences matter.
Such shocks of recognition can ripple across a tradition or religious community. Academic theological reflection, for example, might Oust as Toulmin argued with respect to philosophy) reorient itself away from some of the fine points, abstractions, and specialized interests that keep religious journals and graduate schools humming tunes few in America's religious communities sing. A fresh confrontation with the primal reality of a tradition and with modern medical experience can turn religious institutions away from the many concerns of institutional self-preservation and toward human need. In a time when most American denominations are feeling the weight of rising costs and parallel diminishment of support from their constituency, life and death encounters can remind beleaguered leaders and followers of fundamental reasons for being.
Finally, religious traditions and communities, like individual patients and whole societies, can become ill. They can become so entangled in pathological situations that they too need healing. Almost all the religious traditions in our society have a fundamental commitment to love God and neighbor at their core. Even those communities that do not affirm the existence of a particular deity seek to awaken compassion and care in their members. Yet modern religious communities have found it ever more difficult to keep such commitments lively and central. They too have accepted the modern division of labor that delegates caring" to certain professionals and "religion" to others.
The encounter with life and death worlds of members and strangers points out the unhealthy side affects of such ways of life. It sets inquirers out in search of other, healthier, patterns. And it can revive those who find themselves weary from life along modernity's dividing line. Such inquirers may even find that experiences of a shared mandate to care and heal that crosses the lines of faith traditions and religious communities makes possible new alliances on behalf of a public good for a land with a serious case of individualism and privatism.
References  Constant H. Jacquet, Jr., Yearbook of American and Canadian Churches 1990 (Nashville: Abingdon Press, 1990.)  Daniel Callahan, Setting Limits: Medical Goals in an Aging So" (New York: Simon and Schuster, 1987); Renee C. Fox, The Sociology of Medicine: A Participant Observer's View (Englewood Cliffs, NJ: Prentice Hall, 1989); Arthur Kleinman, The Illness Narratives: Suffering, Healing and the Human Condition (New York: Basic Books, Inc., 1988); Don S. Browning, "Hospital Chaplaincy as Public ministry," Second Opinion 1 (March 1986), 66-75.  For the contribution to be realized, religious communities must revitalize their traditions and strengthen their abilities at moral discourse. How they might accomplish such revitalization is too complex a subject to be addressed here. Graduate schools, seminaries, denominations, and independent research institutes like the Park Ridge Center for the Study of Health, Faith, and Ethics are attempting to respond to these needs.  Stanley Hauerwas, Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church (Notre Dame, IN: University of Notre Dame Press, 1986). Jeffrey Stout, Ethics After Babel: The Languages of Morals and Their Discontents (Boston: Beacon Press, 1988).  Stephen Toulmin, "How Medicine Saved the Life of Ethics," Perspectives in Biology and Medicine 25:4 (1982), 736-50.
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|Title Annotation:||Theology, Religious Traditions, and Bioethics: a Special Supplement|
|Author:||Wind, James P.|
|Publication:||The Hastings Center Report|
|Date:||Jul 1, 1990|
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