Downloaded from http://jme.bmj.com/ on October 23, 2015 - Published by group.bmj.com
Commentary
On the univocity of rationality: a response to Nigel Biggar’s ‘Why religion deserves a place in secular medicine’ Xavier Symons ABSTRACT Nigel Biggar (2015) argues that religion deserves a place in secular medicine. Biggar suggests we abandon the standard rationalistic conception of the secular realm and see it rather as “a forum for the negotiation of rival reasonings”. Religious reasoning is one among a number of ways of thinking that must vie for acceptance. Medical ethics, says Biggar, is characterised by “spiritual and moral mixture and ambiguity”. We acknowledge this uncertainty by recognising rival viewpoints and agreeing to provisional compromises. In this response, I object to Biggar’s characterisation of medical ethics as “morally ambiguous” and “provisional”. I argue that Biggar has failed to provide adequate support for his conception of ethics as a “forum for negotiation and compromise”. I criticise Biggar’s attempt to ‘pluralise’ rationality, and assert that if religion is to play a role in secular medicine, it must be ready to defend itself against a universal standard of reason. In the second section of my response, I argue that ‘theistic natural law’ gives us the resources to defend using reason alone ostensibly faith-based positions in healthcare ethics. In doing so, we retain a univocal conception of rationality, while at the same time leaving space for ‘theism’ in healthcare ethics. Nigel Biggar has offered a thoughtprovoking contribution to the expanding literature on the role of religion in secular medicine.1 Biggar approaches the topic from what he calls an ‘Augustinian Christian’ perspective. Augustine, Biggar states, had a unique vision of the ‘secular’, according to which the secular realm is defined by spiritual and moral uncertainty and debate. ‘In this secular age’, Biggar writes, “peace in political society is the result, not of natural
Correspondence to Xavier Symons, University of Sydney—Philosophy, School of Philosophy and Historical Enquiry, A14 Quadrangle Building, The University of Sydney, Sydney, NSW 2006, Australia; [email protected] 870
uniformity, but of negotiation and provisional compromise between rival viewpoints” ( p. 230).1 Biggar goes on to characterise medical ethics as “morally ambiguous and sometimes tragic”. We often “may have to settle for a somewhat messy compromise” ( p. 230).1 Biggar’s central claim is that religious logic or reasoning should not be seen as irrational, but rather as one among a number of valid ‘forms of reasoning’ existing within the plural secular space. Intellectuals need to abandon current scientistic constraints on debate, and acknowledge religious perspectives where they are genuinely persuasive and illuminating. This is quite an interesting way of conceiving the secular realm. Biggar, however, fails to provide compelling reasons to adopt it.
Christian theological principles in grounding one’s medicoethical convictions. Christianity may very well offer the best ethical framework to support bioethical judgements such as this one. In a response published in Journal of Medical Ethics, Oxford bioethicist Brian D. Earp accuses Biggar of a ‘bait-andswitch’.2 The suggestion in Biggar’s article —as Earp sees it—is that religion has somehow led people to the conviction that a fetus has moral standing. Biggar does, after all, label it “a religious view, even if not exclusively so”. But, as Earp points out, the reasoning that Biggar employs to get to this position is actually philosophical—he runs a dialectical argument about the rights of a fetus in comparison with that of mother. It thus seems a stretch to characterise views about the status of the fetus, or any other point of convergence between secular and religious medical ethicists, as a religious view. Where Biggar uses the term religion, we might as well substitute the words ‘moral philosophy’. After all, Biggar states that in the secular realm religious believers need to ‘persuade’ others of the strengths of their own moral view, rather than merely appealing to some religious authority. But this leads us to the conclusion that Earp succinctly states: I still didn’t get the sense that “religion” meant anything different from “philosophy”…2
A RELIGIOUS ETHIC SANS RELIGION
Biggar dismisses ‘appeals to religious authority’ as disrespectful. This much seems sensible. But he proceeds to make a peculiar claim about the function of religious argumentation in supporting specific medicoethical judgements. Christian ethics, he observes, is one of a number of ethical codes that can underpin a person’s conviction about the wrongness of certain medical practices. He focuses specifically on a Christian account of the impermissibility of abortion. According to Biggar, this indicates the potential relevance of Christianity to bioethics: I have not yet claimed that my moral view is one that only Christian monotheistic religion can ground. My claim so far is merely that this is a view that such religion does ground, and that it is therefore a religious view, even if not exclusively so ( p. 230).1
I take the claim to be something like the following: religious and non-religious ‘reasonings’ converge on the same medicoethical judgements—for example, that a fetus has moral standing and possesses rights. This ‘convergence of opinion’ is an indication of the potential role of
I think Earp draws our attention to a very interesting insight—there is a sense in which many arguments about religion’s place in secular bioethics are reducible to claims about moral philosophical debate. Positions often labelled ‘Christian’ are actually underpinned by philosophical reasoning, rather than theological content. What we are left with is not a religious position, but rather a philosophical position compatible with certain religious convictions. In light of this, is there any role left for religion to play in secular bioethics? Strictly speaking, no. But there is certainly still a role for theism to play. Which is to say, I believe there is an important distinction we need to make between theism on the one hand and religiosity on the other. Religion, in the strict sense, denotes a system for divine worship, and, at least in the Christian dispensation, faith. Theism, on the other hand, includes not only religious belief but also a worldview based on rational assertions about the existence of God and his relationship to world. Earp’s critique defeats Biggar’s arguments for ‘religious reasoning’ in secular bioethics. But I don’t think it rules out ‘theistic
Symons X. J Med Ethics November 2015 Vol 41 No 11
Downloaded from http://jme.bmj.com/ on October 23, 2015 - Published by group.bmj.com
Commentary reasoning’ based on rational convictions about God and his relevance to moral philosophy. In the next section, I will are that ‘theistic natural law’ is a middle way between the problematic pluralism of Biggar and Earp’s account of secular moral philosophy.
THEISTIC NATURAL LAW I contend that one can develop a ‘theistic moral philosophy’ by virtue of natural reason alone. From this edifice, one can make a good argument for the place of theism in secular bioethics. I take this to be a better approach than Biggar’s attempt to justify the role of theistic ethical frameworks in secular medicine. Biggar’s account reflects a particular interpretation of Augustine’s writings, according to which human reason was ‘blinded’ following Original Sin. Certainly, Augustine asserted that human nature was to some degree corrupted— but only some interpreters take this to mean something similar to Martin Luther’s understanding of the fallenness of human reason.i Biggar strikes me as one such interpreter. The idea is, more or less, that we have a very limited ability to reach rational certitude concerning matters of religion, for Original Sin has sullied our rational faculties. In contrast to this distrustful view of human rationality, many thinkers in the history of philosophyii have asserted that we can use reason to justify certain basic theological claims. These thinkers have confidence in the ability of reason to reach fundamental theistic principles. Three of these basic principles are the following: that there is a God; that he is personal and that he is the source and foundation of a moral law expressed in
i
For a discussion of the relevant passages in Augustine and different interpretations that have been offered, see ref. 3. ii See, for example, the following canonical works in natural theology (though I am not claiming that you will find uniformity in the ideas expressed in these works): Bonaventure. Sentences II. In: St. Bonaventurae Opera Omnia. Florence: Quaracchi, vol. II; Udayanaacaarya. Nyaayakusumaañjali. New Delhi: Indian Council of Philosophical Research, 1996; Avicenna. Liber de Philosophia Prima. Leiden: E.J. Brill, 1977; Aquinas T. Summa Theologica I. In: St. Thomae Aquinatis Doctoris Angelici Opera Omnia. Vatican: Leonine, 1882-, vols. IV-V; Leibniz GW. Theodicy: Essays on the Goodness of God, the Freedom on Man and the Origin of Evil. Trans. Huggard EM. La Salle, IL: Open Court, 1985; Swinburne R. Is There a God? Oxford: Oxford University Press, 1996. Symons X. J Med Ethics November 2015 Vol 41 No 11
our teleologically structured human nature. Some have gone further and argued that we can use these basic theological tenets to develop a moral philosophy (as opposed to a moral theology, which tends to be grounded in scripture and the teaching of religious authorities).iii The view I am referring is essentially a variant of what is known as natural law theory (NLT). In this particular version of NLT, natural theology—the study of God through observing nature and using reason—is merged with a natural law ethic. In merging the two disciplines, philosophers consider the implications that natural theology has for the foundations of ethics. For the purposes of this response, I will call this ‘theistic natural law’.iv Theistic natural law assumes that a transcendent being has structured human nature and directed it towards certain ends (teloi). Human beings are fulfilled in realising these ends (also known as ‘basic goods’ or ‘actualities’). These ends of human life pertain at one and the same time to material and moral dimensions of the human person—which is to say, theistic natural law perceives in human nature and flourishing an intersection between ontology and morality, fact and value. Life, health, friendship, knowledge and aesthetic and religious experience all have both material and moral dimensions.v If one adopts a natural law ethic such as that just described, one can potentially provide a coherent philosophical justification for the basic tenets that underpin controversial and ostensibly faith-based positions in healthcare ethics. The moral ontology of theistic natural law can be used to ground arguments against
iii See, for example, Aquinas T. St. Thomae Aquinatis Doctoris Angelici Opera Omnia. Vatican: Leonine, 1882-. ST 1a, q.2, art.3 (IV, 31–32); q.19, art.1 (IV, 231); 2a, q.91, art.2 (VII, 154); Oderberg D. Morality, Religion and Cosmic Justice. Phil Inv. 2011; 34(2): 189– 213; Linville M. The Moral Argument. In: Craig WL, Mooreland JP, eds. The Blackwell Companion to Natural Theology. West Sussex: Wiley-Blackwell, 2009:391–446; Wolterstorff N. Justice: Rights and Wrongs. Princeton: Princeton University Press, 2007. See particularly ch.8. iv Importantly, not all versions of new natural law presuppose the existence of God. See, for example, refs. 4 and 5. v These are the ‘basic goods’ enumerated in J Finnis’s Natural Law and Natural Rights.6 I acknowledge that this list is contentious, but it is worth stating if only because it has been the most influential in the field of new natural law.
controversial medical procedures such as abortion, euthanasia, surrogacy and IVF. Ethicists such as Finnis and Sulmasy, for example, work within this framework when they marshal arguments against euthanasia and abortion.7–9 This position is not trivial. The claim these ethicists make is that a healthcare ethic often assumed to be based on religious faith can (and indeed should) be defended on philosophical grounds. They argue that there is no need to refer to evidence that goes beyond the ambit of philosophy (though personally I would suggest that theology can enrich one’s ethics). The one thing necessary to retain is a concept of God as the source and foundation of a moral law enshrined in the teleological structure of the human nature. And this is something that many philosophers claim can be reached by reason alone. It is beyond the scope of this response to expound in depth a vision of ‘theistic natural law healthcare ethics’. All I have attempted to show is that there is a third way between Biggar’s pluralism and Earp’s account of secular moral philosophy. This via media is grounded in the following claim, which I have briefly discussed: using reason alone we can arrive at certain conclusions about God and human nature, and from these basic principles we can develop a coherent, rationally defensible moral philosophy. From this point, it is not a difficult task to develop a theistic bioethics.
CONCLUSION It is hopefully clear where Biggar’s attempt to defend religious bioethics goes awry. Biggar provides an account of rational debate in which logic is ‘plural’ and discourse ‘ambiguous’ and ‘awkward’. He attempts to open up a space for religion in the secular bioethical discussion, but in the process places religion in the realm of uncertain opinion rather than representing it as a rationally defensible ethical framework.vi If theistic perspectives are to make any contribution to secular bioethics, it will not be through challenging belief in our capacity to make clear and correct moral judgements. On the contrary, religion will need to show itself as rationally defensible
vi
This is not to downplay the importance of the virtue of epistemic humility. I am conscious of the fact that practical ethics is sometimes an imprecise science. Nevertheless, one need to beware of taking this observation too far and lapsing into a stultifying moral scepticism. 871
Downloaded from http://jme.bmj.com/ on October 23, 2015 - Published by group.bmj.com
Commentary and ethically informative. It will need to be judged against a universal standard of rationality, not some self-referential hermeneutic. I have gestured towards one way in which this can be done: through developing an healthcare ethic informed by theistic natural law. Competing interests None declared. Provenance and peer review Not commissioned; externally peer reviewed.
Received 23 March 2015 Revised 4 June 2015 Accepted 15 June 2015 Published Online First 2 July 2015
▸ ▸ ▸ ▸
http://dx.doi.org/10.1136/medethics-2013-101776 http://dx.doi.org/10.1136/medethics-2015-102786 http://dx.doi.org/10.1136/medethics-2015-102917 http://dx.doi.org/10.1136/medethics-2015-102945
REFERENCES 1
872
3
4
J Med Ethics 2015;41:870–872. doi:10.1136/medethics-2015-102805
To cite Symons X. J Med Ethics 2015;41:870–872.
2
Biggar N. Why religion deserves a place in secular medicine. J Med Ethics 2015;41:229–33.
5 6 7 8
9
Earp BD. Does religion deserve a place in secular medicine. J Med Ethics 2015;41:865–6. Stump E, Kretzmann N, eds. The Cambridge Companion to Augustine. London: Cambridge, 2001: chs.2–4. Moore M. Good without God. In: Robert P. George ed. Natural Law, Liberalism, and Morality. Oxford: Oxford University Press, 1996. Foot P. Natural Goodness. Oxford: Oxford University Press, 2001. Finnis J. Natural Law and Natural Rights. 2nd edn. London: Oxford, 2011:59–97. Finnis J. The rights and wrongs of abortion. Philos Public Aff 1973;2:117–45. Finnis J. A philosophical case against Euthanasia. In: Keown J, ed. Euthanasia examined: ethical, clinical and legal perspectives. London: Cambridge University Press, 1995:23–35. Sulmasy D. Informed consent without autonomy. Fordham Urban Law J 2002;30:207–30.
Symons X. J Med Ethics November 2015 Vol 41 No 11
Downloaded from http://jme.bmj.com/ on October 23, 2015 - Published by group.bmj.com
On the univocity of rationality: a response to Nigel Biggar's 'Why religion deserves a place in secular medicine' Xavier Symons J Med Ethics 2015 41: 870-872 originally published online July 2, 2015
doi: 10.1136/medethics-2015-102805 Updated information and services can be found at: http://jme.bmj.com/content/41/11/870
These include:
References Email alerting service
This article cites 4 articles, 2 of which you can access for free at: http://jme.bmj.com/content/41/11/870#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
Commentary
On the univocity of rationality: a response to Nigel Biggar’s ‘Why religion deserves a place in secular medicine’ Xavier Symons ABSTRACT Nigel Biggar (2015) argues that religion deserves a place in secular medicine. Biggar suggests we abandon the standard rationalistic conception of the secular realm and see it rather as “a forum for the negotiation of rival reasonings”. Religious reasoning is one among a number of ways of thinking that must vie for acceptance. Medical ethics, says Biggar, is characterised by “spiritual and moral mixture and ambiguity”. We acknowledge this uncertainty by recognising rival viewpoints and agreeing to provisional compromises. In this response, I object to Biggar’s characterisation of medical ethics as “morally ambiguous” and “provisional”. I argue that Biggar has failed to provide adequate support for his conception of ethics as a “forum for negotiation and compromise”. I criticise Biggar’s attempt to ‘pluralise’ rationality, and assert that if religion is to play a role in secular medicine, it must be ready to defend itself against a universal standard of reason. In the second section of my response, I argue that ‘theistic natural law’ gives us the resources to defend using reason alone ostensibly faith-based positions in healthcare ethics. In doing so, we retain a univocal conception of rationality, while at the same time leaving space for ‘theism’ in healthcare ethics. Nigel Biggar has offered a thoughtprovoking contribution to the expanding literature on the role of religion in secular medicine.1 Biggar approaches the topic from what he calls an ‘Augustinian Christian’ perspective. Augustine, Biggar states, had a unique vision of the ‘secular’, according to which the secular realm is defined by spiritual and moral uncertainty and debate. ‘In this secular age’, Biggar writes, “peace in political society is the result, not of natural
Correspondence to Xavier Symons, University of Sydney—Philosophy, School of Philosophy and Historical Enquiry, A14 Quadrangle Building, The University of Sydney, Sydney, NSW 2006, Australia; [email protected] 870
uniformity, but of negotiation and provisional compromise between rival viewpoints” ( p. 230).1 Biggar goes on to characterise medical ethics as “morally ambiguous and sometimes tragic”. We often “may have to settle for a somewhat messy compromise” ( p. 230).1 Biggar’s central claim is that religious logic or reasoning should not be seen as irrational, but rather as one among a number of valid ‘forms of reasoning’ existing within the plural secular space. Intellectuals need to abandon current scientistic constraints on debate, and acknowledge religious perspectives where they are genuinely persuasive and illuminating. This is quite an interesting way of conceiving the secular realm. Biggar, however, fails to provide compelling reasons to adopt it.
Christian theological principles in grounding one’s medicoethical convictions. Christianity may very well offer the best ethical framework to support bioethical judgements such as this one. In a response published in Journal of Medical Ethics, Oxford bioethicist Brian D. Earp accuses Biggar of a ‘bait-andswitch’.2 The suggestion in Biggar’s article —as Earp sees it—is that religion has somehow led people to the conviction that a fetus has moral standing. Biggar does, after all, label it “a religious view, even if not exclusively so”. But, as Earp points out, the reasoning that Biggar employs to get to this position is actually philosophical—he runs a dialectical argument about the rights of a fetus in comparison with that of mother. It thus seems a stretch to characterise views about the status of the fetus, or any other point of convergence between secular and religious medical ethicists, as a religious view. Where Biggar uses the term religion, we might as well substitute the words ‘moral philosophy’. After all, Biggar states that in the secular realm religious believers need to ‘persuade’ others of the strengths of their own moral view, rather than merely appealing to some religious authority. But this leads us to the conclusion that Earp succinctly states: I still didn’t get the sense that “religion” meant anything different from “philosophy”…2
A RELIGIOUS ETHIC SANS RELIGION
Biggar dismisses ‘appeals to religious authority’ as disrespectful. This much seems sensible. But he proceeds to make a peculiar claim about the function of religious argumentation in supporting specific medicoethical judgements. Christian ethics, he observes, is one of a number of ethical codes that can underpin a person’s conviction about the wrongness of certain medical practices. He focuses specifically on a Christian account of the impermissibility of abortion. According to Biggar, this indicates the potential relevance of Christianity to bioethics: I have not yet claimed that my moral view is one that only Christian monotheistic religion can ground. My claim so far is merely that this is a view that such religion does ground, and that it is therefore a religious view, even if not exclusively so ( p. 230).1
I take the claim to be something like the following: religious and non-religious ‘reasonings’ converge on the same medicoethical judgements—for example, that a fetus has moral standing and possesses rights. This ‘convergence of opinion’ is an indication of the potential role of
I think Earp draws our attention to a very interesting insight—there is a sense in which many arguments about religion’s place in secular bioethics are reducible to claims about moral philosophical debate. Positions often labelled ‘Christian’ are actually underpinned by philosophical reasoning, rather than theological content. What we are left with is not a religious position, but rather a philosophical position compatible with certain religious convictions. In light of this, is there any role left for religion to play in secular bioethics? Strictly speaking, no. But there is certainly still a role for theism to play. Which is to say, I believe there is an important distinction we need to make between theism on the one hand and religiosity on the other. Religion, in the strict sense, denotes a system for divine worship, and, at least in the Christian dispensation, faith. Theism, on the other hand, includes not only religious belief but also a worldview based on rational assertions about the existence of God and his relationship to world. Earp’s critique defeats Biggar’s arguments for ‘religious reasoning’ in secular bioethics. But I don’t think it rules out ‘theistic
Symons X. J Med Ethics November 2015 Vol 41 No 11
Downloaded from http://jme.bmj.com/ on October 23, 2015 - Published by group.bmj.com
Commentary reasoning’ based on rational convictions about God and his relevance to moral philosophy. In the next section, I will are that ‘theistic natural law’ is a middle way between the problematic pluralism of Biggar and Earp’s account of secular moral philosophy.
THEISTIC NATURAL LAW I contend that one can develop a ‘theistic moral philosophy’ by virtue of natural reason alone. From this edifice, one can make a good argument for the place of theism in secular bioethics. I take this to be a better approach than Biggar’s attempt to justify the role of theistic ethical frameworks in secular medicine. Biggar’s account reflects a particular interpretation of Augustine’s writings, according to which human reason was ‘blinded’ following Original Sin. Certainly, Augustine asserted that human nature was to some degree corrupted— but only some interpreters take this to mean something similar to Martin Luther’s understanding of the fallenness of human reason.i Biggar strikes me as one such interpreter. The idea is, more or less, that we have a very limited ability to reach rational certitude concerning matters of religion, for Original Sin has sullied our rational faculties. In contrast to this distrustful view of human rationality, many thinkers in the history of philosophyii have asserted that we can use reason to justify certain basic theological claims. These thinkers have confidence in the ability of reason to reach fundamental theistic principles. Three of these basic principles are the following: that there is a God; that he is personal and that he is the source and foundation of a moral law expressed in
i
For a discussion of the relevant passages in Augustine and different interpretations that have been offered, see ref. 3. ii See, for example, the following canonical works in natural theology (though I am not claiming that you will find uniformity in the ideas expressed in these works): Bonaventure. Sentences II. In: St. Bonaventurae Opera Omnia. Florence: Quaracchi, vol. II; Udayanaacaarya. Nyaayakusumaañjali. New Delhi: Indian Council of Philosophical Research, 1996; Avicenna. Liber de Philosophia Prima. Leiden: E.J. Brill, 1977; Aquinas T. Summa Theologica I. In: St. Thomae Aquinatis Doctoris Angelici Opera Omnia. Vatican: Leonine, 1882-, vols. IV-V; Leibniz GW. Theodicy: Essays on the Goodness of God, the Freedom on Man and the Origin of Evil. Trans. Huggard EM. La Salle, IL: Open Court, 1985; Swinburne R. Is There a God? Oxford: Oxford University Press, 1996. Symons X. J Med Ethics November 2015 Vol 41 No 11
our teleologically structured human nature. Some have gone further and argued that we can use these basic theological tenets to develop a moral philosophy (as opposed to a moral theology, which tends to be grounded in scripture and the teaching of religious authorities).iii The view I am referring is essentially a variant of what is known as natural law theory (NLT). In this particular version of NLT, natural theology—the study of God through observing nature and using reason—is merged with a natural law ethic. In merging the two disciplines, philosophers consider the implications that natural theology has for the foundations of ethics. For the purposes of this response, I will call this ‘theistic natural law’.iv Theistic natural law assumes that a transcendent being has structured human nature and directed it towards certain ends (teloi). Human beings are fulfilled in realising these ends (also known as ‘basic goods’ or ‘actualities’). These ends of human life pertain at one and the same time to material and moral dimensions of the human person—which is to say, theistic natural law perceives in human nature and flourishing an intersection between ontology and morality, fact and value. Life, health, friendship, knowledge and aesthetic and religious experience all have both material and moral dimensions.v If one adopts a natural law ethic such as that just described, one can potentially provide a coherent philosophical justification for the basic tenets that underpin controversial and ostensibly faith-based positions in healthcare ethics. The moral ontology of theistic natural law can be used to ground arguments against
iii See, for example, Aquinas T. St. Thomae Aquinatis Doctoris Angelici Opera Omnia. Vatican: Leonine, 1882-. ST 1a, q.2, art.3 (IV, 31–32); q.19, art.1 (IV, 231); 2a, q.91, art.2 (VII, 154); Oderberg D. Morality, Religion and Cosmic Justice. Phil Inv. 2011; 34(2): 189– 213; Linville M. The Moral Argument. In: Craig WL, Mooreland JP, eds. The Blackwell Companion to Natural Theology. West Sussex: Wiley-Blackwell, 2009:391–446; Wolterstorff N. Justice: Rights and Wrongs. Princeton: Princeton University Press, 2007. See particularly ch.8. iv Importantly, not all versions of new natural law presuppose the existence of God. See, for example, refs. 4 and 5. v These are the ‘basic goods’ enumerated in J Finnis’s Natural Law and Natural Rights.6 I acknowledge that this list is contentious, but it is worth stating if only because it has been the most influential in the field of new natural law.
controversial medical procedures such as abortion, euthanasia, surrogacy and IVF. Ethicists such as Finnis and Sulmasy, for example, work within this framework when they marshal arguments against euthanasia and abortion.7–9 This position is not trivial. The claim these ethicists make is that a healthcare ethic often assumed to be based on religious faith can (and indeed should) be defended on philosophical grounds. They argue that there is no need to refer to evidence that goes beyond the ambit of philosophy (though personally I would suggest that theology can enrich one’s ethics). The one thing necessary to retain is a concept of God as the source and foundation of a moral law enshrined in the teleological structure of the human nature. And this is something that many philosophers claim can be reached by reason alone. It is beyond the scope of this response to expound in depth a vision of ‘theistic natural law healthcare ethics’. All I have attempted to show is that there is a third way between Biggar’s pluralism and Earp’s account of secular moral philosophy. This via media is grounded in the following claim, which I have briefly discussed: using reason alone we can arrive at certain conclusions about God and human nature, and from these basic principles we can develop a coherent, rationally defensible moral philosophy. From this point, it is not a difficult task to develop a theistic bioethics.
CONCLUSION It is hopefully clear where Biggar’s attempt to defend religious bioethics goes awry. Biggar provides an account of rational debate in which logic is ‘plural’ and discourse ‘ambiguous’ and ‘awkward’. He attempts to open up a space for religion in the secular bioethical discussion, but in the process places religion in the realm of uncertain opinion rather than representing it as a rationally defensible ethical framework.vi If theistic perspectives are to make any contribution to secular bioethics, it will not be through challenging belief in our capacity to make clear and correct moral judgements. On the contrary, religion will need to show itself as rationally defensible
vi
This is not to downplay the importance of the virtue of epistemic humility. I am conscious of the fact that practical ethics is sometimes an imprecise science. Nevertheless, one need to beware of taking this observation too far and lapsing into a stultifying moral scepticism. 871
Downloaded from http://jme.bmj.com/ on October 23, 2015 - Published by group.bmj.com
Commentary and ethically informative. It will need to be judged against a universal standard of rationality, not some self-referential hermeneutic. I have gestured towards one way in which this can be done: through developing an healthcare ethic informed by theistic natural law. Competing interests None declared. Provenance and peer review Not commissioned; externally peer reviewed.
Received 23 March 2015 Revised 4 June 2015 Accepted 15 June 2015 Published Online First 2 July 2015
▸ ▸ ▸ ▸
http://dx.doi.org/10.1136/medethics-2013-101776 http://dx.doi.org/10.1136/medethics-2015-102786 http://dx.doi.org/10.1136/medethics-2015-102917 http://dx.doi.org/10.1136/medethics-2015-102945
REFERENCES 1
872
3
4
J Med Ethics 2015;41:870–872. doi:10.1136/medethics-2015-102805
To cite Symons X. J Med Ethics 2015;41:870–872.
2
Biggar N. Why religion deserves a place in secular medicine. J Med Ethics 2015;41:229–33.
5 6 7 8
9
Earp BD. Does religion deserve a place in secular medicine. J Med Ethics 2015;41:865–6. Stump E, Kretzmann N, eds. The Cambridge Companion to Augustine. London: Cambridge, 2001: chs.2–4. Moore M. Good without God. In: Robert P. George ed. Natural Law, Liberalism, and Morality. Oxford: Oxford University Press, 1996. Foot P. Natural Goodness. Oxford: Oxford University Press, 2001. Finnis J. Natural Law and Natural Rights. 2nd edn. London: Oxford, 2011:59–97. Finnis J. The rights and wrongs of abortion. Philos Public Aff 1973;2:117–45. Finnis J. A philosophical case against Euthanasia. In: Keown J, ed. Euthanasia examined: ethical, clinical and legal perspectives. London: Cambridge University Press, 1995:23–35. Sulmasy D. Informed consent without autonomy. Fordham Urban Law J 2002;30:207–30.
Symons X. J Med Ethics November 2015 Vol 41 No 11
Downloaded from http://jme.bmj.com/ on October 23, 2015 - Published by group.bmj.com
On the univocity of rationality: a response to Nigel Biggar's 'Why religion deserves a place in secular medicine' Xavier Symons J Med Ethics 2015 41: 870-872 originally published online July 2, 2015
doi: 10.1136/medethics-2015-102805 Updated information and services can be found at: http://jme.bmj.com/content/41/11/870
These include:
References Email alerting service
This article cites 4 articles, 2 of which you can access for free at: http://jme.bmj.com/content/41/11/870#BIBL Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
