(PDF) The Secularization of Bioethics
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The Secularization of Bioethics
(Stephen) Joseph Tham
2008, The National Catholic Bioethics Quarterly
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Abstract
Since the times of the Enlightenment, traditional control of religion in vital spheres of the social order began to crumble under the secular challenge of politics, culture, science, economy, judiciary, philosophy, and education. Ethics and theology were probably the last strongholds until they eventually succumbed as well under the influence of the now secularized academia. This happened at a time when society was restless with exciting medical discoveries which brought with them the age-old questions of just distribution, legitimate use of technology and justified manipulation of nature. The debate on contraception was among the test cases of novel technology with ethical substance, and dissent against church teaching caused an exodus of scholar to join the burgeoning field of bioethics. Even though theologians made important seminal contributions in the early days of bioethics, it was philosophy that bioethics eventually fell back on because of the troubles facing theology. Principlism soon became the dominant philosophical model to be applied in policymaking and at the bedside. However, the consensus achieved by this ethic looked contrived and open to manipulation of the potent. As discontents brewed, a plethora of competing models surged on the horizon, many of them sought to relocate ethics in the context of the situation or the character of the moral agent. Unwittingly, this puts secular bioethics on the path toward ethical relativism, liberalism and nihilism. Bioethics has become a secular creature which not only rejects religion but now questions the very possibility of reason itself. Different speculations sought to provide the causes of the secularization of bioethics. At root is an uncertainty about the place of religion in democracy, and of situating religious ethics in public ethics. Secular bioethics’ inadequacy also calls for a reexamination of the possible contribution of religion and theology in terms of distinctively religious content, communities and methodologies. Hence, a ray of hope appears on the horizon for religion to reinsert itself into the bioethical debate, which has become impoverished from its absence.
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The Secularization of Bioethics
Rev. S. Joseph Tham, L.C., M.D.
There has been long-standing interest in the question of the role of religion in bioethics. In 1993, the Institute of Religion in Texas celebrated the twenty-fifth anniversary
of its first Houston Conference on Medicine and Technology by organizing a
conference on the present state of religion and medical ethics. The commemorative conference re-examined the role of religion in bioethics by “looking back and
looking forward.” The tone of this gathering was nostalgic and somewhat somber,
as reflected, for instance, in the title of a paper by Stephen Lammers, “The Marginalization of Religious Voices in Bioethics.” 1 The chagrin is understandable: in 1968,
theologians had opened up the field of bioethics; in 1993, they found themselves
slighted in academic and public discussion.
Interest in the question was also reflected in a research project titled “Theology, Religious Traditions, and Bioethics,” edited by Daniel Callahan and Courtney
Campbell and published in a 1990 supplement to The Hastings Center Report.2
Callahan, a cofounder of the Hastings Center, one of the first bioethics institutes,
lamented the loss of contributions from religion to bioethics and the consequent
impoverishment of the field:
The most striking change over the past two decades or so has been the secularization of bioethics. The field has moved from one dominated by religious and
medical traditions to one now increasingly shaped by philosophical and legal
Rev. S. Joseph Tham, L.C., M.D., Ph.D., is a professor in the School of Bioethics at
the Regina Apostolorum Pontifical University in Rome.
The proceedings were eventually published as Religion and Medical Ethics: Looking
Back, Looking Forward, ed. A. Verhey (Grand Rapids, MI: William B. Eerdmans, 1996).
The Lammers paper appears on pp. 19–43.
Hastings Center Report 20.4 (suppl., July–August 1990): S1–S24.
443
The NaTioNal CaTholiC BioeThiCs QuarTerly auTumN 2008
concepts. The consequence has been a mode of public discourse that emphasizes
secular themes: universal rights, individual self-direction, procedural justice, and a
systematic denial of either a common good or a transcendent individual good.3
The Meaning of Secularization
This essay will outline how secularization has taken place in the field of bioethics, provide some plausible causes, and offer thoughts on the future prospects
of religion in the debate. First, however, a clarification of terminology is necessary.
Theologians, churchman, statisticians, and sociologists alike have written a great
deal about secularization, but they have not reached an agreement on its meaning.4
While it is beyond the scope of this paper to enter into this debate, the meaning of
“secularization” as used today derives from the writings of sociologists Max Weber
(1864–1920), Ferdinand Tönnies (1855–1936), and Ernst Troeltsch (1865–1923), who
used the term to perpetrate the religion-in-decline thesis. For the last three centuries,
a number of secular seers predicted the fall of religion, each forecasting its demise
and eventual disappearance within their lifetimes.5 By the early twentieth century,
“secularization” has become a code word for this Enlightenment thesis, which subscribed to rationalistic, positivist, and evolutionary conjectures that religion, being
a man-made invention, would eventually give way to science.
By the late 1950s, “secularization” became a popular catchphrase with enthusiastic support from anthropologists and social scientists.6 More recently, however,
the thesis has been challenged by the fact that in many parts of the world, including
the industrialized United States, religious faith has not disappeared but remains as
vigorous as ever. As some began to abandon the secularization thesis, others proposed
further elaboration and refinement of terminologies.7 Hence, though the term remains
D. Callahan, “Religion and the Secularization of Bioethics,” Hastings Center Report
20.4 (suppl., July–August 1990): S2–S4.
See K. Dobbelaere, “Towards an Integrated Perspective of the Processes Related to
the Descriptive Concept of Secularization,” Sociology of Religion 60.3 (1999): 229–247.
Thomas Woolston, Voltaire, Auguste Comte, Thomas Jefferson, Karl Marx, Friedrich
Engels, and Sigmund Freud all offered prophesies and theories of how this would inescapably come about.
See Peter L. Berger, The Sacred Canopy: Elements of a Sociological Theory of
Religion (Garden City, NY: Doubleday, 1967); Thomas Luckmann, The Invisible Religion:
The Problem of Religion in Modern Society (New York: Macmillan, 1967); Bryan Wilson, Religion in Secular Society: A Sociological Comment (London: C.A. Watts, 1966);
T. Parsons, “Religion in a Modern Pluralistic Society,” Review of Religious Research 7.3
(Spring 1966): 125–146; David Martin, A General Theory of Secularization (New York:
Harper & Row, 1978); Harvey G. Cox, The Secular City: Secularization and Urbanization
in Theological Perspective (New York: Macmillan, 1966); K. Dobbelaere, “Secularization:
A Multi-Dimensional Concept,” Current Sociology 29.2 (1981): 3–213.
See P. Zuckerman, “Secularization: Europe—Yes, United States—No: Why Has
Secularization Occurred in Western Europe But Not in the United States? An Examination of the Theories and Research,” Skeptical Inquirer 2 (March–April 2004): 49–52; B. C.
444
Tham The seCularizaTioN oF BioeThiCs
ambiguous and is tainted with a predetermined ideology, for the purpose of this paper,
“secularization” can be defined as a description or theory of the increasing loss of
religious influence and authority at the different levels of life—on the societal level,
the organizational or institutional level, and the level of individual religiosity.8
Secularization Involving
Different Spheres of Society
Since the times of the Enlightenment, secularism has encroached upon the hegemony of religion in different public spheres of society. One by one, the traditional
control of religion in vital areas of the social order began to crumble under the secular
challenge of politics, culture, science, economy, judicial activism, philosophy, and
education. In the West, most modern democracies have taken to heart the dictum of
“separation of State and Church” or the Rousseauian proposal of a secular state of
laïcité, where laws, government programs, and education must strictly be founded
on nonsectarian principles. America differed from Europe in that the secularizing
forces did not garner sufficient support to overthrow the religious dominance in
many of these areas until the past century. Sociologist Christian Smith calls this the
“secular revolution,” which occurred not as a natural or inevitable consequence of
modernization but as “the outcome of a struggle between contending groups with
conflicting interests seeking to control social knowledge and institutions.” 9
Secularization has had the greatest impact in American higher education,
where the explicitly religious (Christian) ideals and authority that once held major
influence in the leading institutions now have little sway at all. It happened across
the board—from Ivy League schools to state universities, in Protestant colleges and
Catholic institutions. Academics all over have come to accept the unspoken Enlightenment assumptions that belief is nonrational (if not wholly irrational), that it lies
outside the bounds of intellectual inquiry, and that it is of marginal significance in
human life. This defection of colleges and universities from their denominational
loyalties is due to a series of economic, administrative, professional, and religious
factors. Different denominations originally erected Protestant schools to produce
learned clergy. At the beginning of the twentieth century, Protestant liberalism, which
colluded with secularists in orienting the educational system toward research and
professionalism, regularly overtook the evangelical thrust of these schools. Catholic
higher education withstood secularizing tendencies until the 1960s, when complex
cultural and ecclesial factors caused a crisis of identity, which boosted the desire of
Anderson, “Secular Europe, Religious America,” Public Interest 155 (2004): 143–159; R.
Stark, “Secularization, R.I.P.,” Sociology of Religion 60.3 (1999): 249–273; D. Yamane,
“Secularization on Trial: In Defense of a Neosecularization Paradigm,” Journal for the
Scientific Study of Religion 36.1 (March 1997): 109–122.
Adapted from Dobbelaere, “Secularization,” 1–213.
Christian Smith, preface, in The Secular Revolution: Power, Interests, and Conflict
in the Secularization of American Public Life, ed. Christian Smith (Berkeley: University of
California Press, 2003), vii.
445
The NaTioNal CaTholiC BioeThiCs QuarTerly auTumN 2008
university administrators to enter into the mainstream and contributed to a preference for academic excellence over their schools’ religious moorings.10
Ethics and theology were probably the last strongholds against the erosive
tide of secularity, but they eventually succumbed as well. This is predictable, since
theological speculations and research are invariably linked to the now secularized
academia. For the mainline Protestant churches, decades of collaboration with secular forces in the educational field eventually broke down when the secular forces
deemed the all-encompassing liberal Protestant ideals too “sectarian.” 11 Catholicism, drawing on its European encounter, was able to withstand the encroachment
of Enlightenment thinking for many years. Notwithstanding courageous resistance
in many parts, the discord generated by the papal encyclical Humanae vitae was
the straw that broke the camel’s back.12 Before Humanae vitae, the natural law approach of Catholic medical ethics found perfect harmony between faith and reason,
with its ultimate foundation in God. In the fallout of Humanae vitae, the uprising of
a revisionist morality challenged the adequacy of natural law reasoning to address
the moral questions of the day. Theologians such as Alfons Auer, Franz Böckle,
Louis Janssens, Bruno Schuller, Josef Fuchs, Charles Curran, and others made an
ominous proposal of “autonomous morality in a Christian context” 13 that effectively
negated any distinctively Christian contribution to ethics. Likewise, proportionalists
began to affirm that ethical decisions fall under the category of right and wrong, but
not good or evil.14 All of this spelled trouble for the Catholic Church, and even the
Protestant ethicist Paul Ramsey noted that “due to the uncertainties in the Roman
Catholic moral theology since Vatican II, even the traditional medical ethics courses
in schools under Catholic auspices are undergoing vast changes, abandonment, or
severe crisis.” 15
James T. Burtchaell, Dying of the Light: The Disengagement of Colleges and Universities from their Christian Churches (Grand Rapids, MI: William B. Eerdmans, 1998); George
M. Marsden and Bradley J. Longfield, eds., The Secularization of the Academy (New York:
Oxford University Press, 1992); and Philip Gleason, Contending with Modernity: Catholic
Higher Education in the Twentieth Century (New York: Oxford University Press, 1995).
11
See C. Smith, “Secularizing American Higher Education,” in Secular Revolution,
97–159.
12
See Janet E. Smith, Humanae Vitae: A Generation Later (Washington, D.C.: Catholic
University of America Press, 1991); Robert McClory, Turning Point: The Inside Story of the
Papal Birth Control Commission (New York: Crossroad, 1995); and William H. Shannon,
The Lively Debate: Response to Humanae Vitae (New York: Sheed & Ward, 1970).
13
See C. E.Curran, R. A. McCormick (eds.), The Distinctiveness of Christian Ethics,
Readings in Moral Theology no. 2 (New York: Paulist Press, 1980).
14
See Bernard Hoose, Proportionalism: The American Debate and Its European
Roots (Washington, D.C.: Georgetown University Press, 1987), and John Paul II, Veritatis
splendor (August 6, 1993).
15
Paul Ramsey, The Patient as Person: Explorations in Medical Ethics, 2nd ed. (New
Haven, CT: Yale University Press, 2002), xlix.
10
446
Tham The seCularizaTioN oF BioeThiCs
The Appearance and Secular Turn of Bioethics
Bioethics received its legacy from a tradition of medical ethics dating back to
the Hippocratic tradition, spiced with Jewish and Christian inspiration, supplemented
by scholasticism, natural law, and moral theology, and subsequently codified to personify a godly, virtuous, gentlemanly comportment of the medic.16 Thus, religion
played an important role as a precursor discipline of medical ethics until the late
1960s. The rise of the new discipline, later coined “bioethics,” can be attributed to
many factors. Above all, medicine in the post-World War II period provided a new
arsenal of treatment options that were not previously available or imaginable. For
the first time in history, medicine gave humanity the possibility of controlling and
manipulating its nature and destiny in the areas of procreation, prolongation of life,
genetic enhancement, and creation of clones, hybrids, and the like. With new medical advances came new challenges in ethics on many fronts. New-found resources
brought with them the age-old questions of just distribution, legitimate uses of
technology, and justified manipulation of nature.17 The debate over contraception
was among the test cases of novel technology and ethical substance.
Naturally, theologians and religious ethicists were the first to tackle these
puzzles, and many of them, including Joseph Fletcher, Paul Ramsey, and Richard
McCormick, later became significant spokespersons for early biomedical ethics.
However, the timing could not have been worse. Secularity had cast its ominous
shadow over the enterprise, as theologians in their attempt to engage in dialogue
with the world sometimes compromised their doctrines. Some adapted their message,
thereby diluting it; others sought a neutral nonpartisan language in philosophy; and
quite a few dropped their clerical garb and eventually their faith on this treacherous
journey. Stanley Hauerwas complains that
even though religious thinkers have been at the forefront of much of the work
done in the expanding field of “medical ethics,” it is not clear that they have
been there as religious thinkers. Joseph Fletcher, Paul Ramsey, James Gustafson,
Charles Curran, [and] Jim Childress, to name just a few, have done extensive
work in medical ethics, but often it is hard to tell how their religious convictions
have made a difference for the methodology they employ or for their response
to specific quandaries.18
The repercussions of these secularizing tendencies in disputes on methodology and
content in both Catholic and Protestant theology had important consequences for the
See David F. Kelly, The Emergence of Roman Catholic Medical Ethics in North
America: An Historical, Methodological, Bibliographical Study (New York: Edwin Mellen,
1979); Albert R. Jonsen, A Short History of Medical Ethics (New York: Oxford University
Press, 2000).
17
Albert R. Jonsen, The New Medicine and the Old Ethics (Cambridge, MA: Harvard
University Press, 1990).
18
Stanley Hauerwas, Suffering Presence: Theological Reflections on Medicine, the
Mentally Handicapped, and the Church (Notre Dame, IN: University of Notre Dame Press,
1986), 70.
16
447
The NaTioNal CaTholiC BioeThiCs QuarTerly auTumN 2008
burgeoning field of bioethics. The debates absorbed the best minds of philosophy and
theology, and a good number of them, bitter from the debate over Humanae vitae,
eventually careered into bioethics and eschewed further theological “double-talk.”
Among some prominent examples are André Hellegers, who served on the papal
birth control commission but later dissented and founded the Kennedy Institute
of Ethics at Georgetown, and Daniel Callahan, who, disillusioned with Humanae
vitae, became an atheist and co-founded the Hastings Center. Both these institutions
with their now secular orientation contributed to the marginalization of religion
in the bioethical discussion.19 An example of how secularization occurred at the
personal level comes from bioethics pioneers who were laicized from their clerical
states, including Joseph Fletcher, Warren Reich, Albert Jonsen, John Fletcher, and
Daniel Maguire.
For the general population, the contraceptive controversy was but a passing
issue. Medical delivery was undergoing drastic restructuring due to innovations,
and patient care suffered from inattention, lack of communication, dehumanization, and outright unscrupulous abuses. The public and the government frantically
called for ethical guidance. Traditional Hippocratic ethics, natural law, virtues, and
moral theology all appeared somewhat passé, unfit for the current circumstances.20
To be fair, theology and theologians did come up with some key insights. But it was
philosophy that the budding field of bioethics fell back on, perhaps because theology
was itself vacillating at the moment.
American philosophy, now thoroughly secularized with the analytical approach
of Anglo-American ethics inherited from David Hume, Immanuel Kant, and John
Stuart Mill, reformulated bioethics in terms of prima facie principles.21 among the
different approaches, principlism, proposed by Tom Beauchamp and Jim Childress,
became the most popular model of bioethical decision making to be applied in policy
making and at the bedside, especially after receiving semi-official recognition in
the Belmont Report.22 Even though the philosophy’s four principles were supposedly
on equal footing, the principle of autonomy eventually overshadowed the discourse
See L. Walters, “Religion and the Renaissance of Medical Ethics in the United States:
1965–1975,” in Theology and Bioethics: Exploring the Foundations and Frontiers , ed. Earl
E. Shelp (Dordreicht: D. Reidel Publishing, 1985): 3–16.
20
David J. Rothman, Strangers at the Bedside: A History of How Law and Bioethics
Transformed Medical Decision Making (New York: Basic Books, 1991), and Albert R.
Jonsen, The Birth of Bioethics (New York: Oxford University Press, 1998).
21
Jonsen, Birth of Bioethics, 65–89.
22
Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics (New
York: Oxford University Press, 1979). See also Tom L. Beauchamp, “The Origins, Goals,
and Core Commitments of The Belmont report and Principles of Biomedical Ethics,” in
The Story of Bioethics: From Seminal Works to Contemporary Explorations, ed. Jennifer K.
Walter and Eran P. Klein (Washington, D.C.: Georgetown University Press, 2003), 17–46;
and National Commission for the Protection of Human Subjects of Biomedical and Behavioral research, Belmont Report: Ethical Principles and Guidelines for Protection of Human
Subjects of Biomedical and Behavioral Research (Washington, D.C., 1979).
19
448
Tham The seCularizaTioN oF BioeThiCs
of bioethics. The possibility of a true moral consensus founded on principlism and
its variants was at best problematic. By toppling the paternalist ideal, it had inadvertently fueled blatant individualism with a reductionist concept of the person that
was ultimately unsatisfactory as an ethical system.23 Discontent soon brewed, as the
consensus achieved by this ethic appeared contrived, and its uncritical support of
the status quo as a possible façade masked the ideologies and interests of those in
power.24 Bioethics no longer looked like a dialogue to discover truth. Legal concerns
began to trump ethical ones.25 Thus, in response to the insufficiency of principlism,
a plethora of competing models gained prominence—virtue ethics, casuistry, narrative ethics, feminist care ethics, phenomenology, and utilitarian ethics, to name
a few—all seeking to relocate ethics in the context of the situation or the character
of the moral agent.26
To its credit, principlism still presupposed common morality and based itself on
foundationalist reliance of norms. The challengers, in eschewing principles, tended
to view morality as relative to the particular context and in no way generalizable to
other situations. Casuists and contextualists, in their zeal for rejecting principles,
become prone to situational ethics.27 Utilitarians ended up justifying anything under
the sun, and were not very far from hedonism and libertarianism.28 Principlism and
See Edwin R. DuBose, Ronald P. Hamel, and Laurence J. O’Connell, eds., A Matter of
Principles? Ferment in U.S. Bioethics (Valley Forge, PA: Trinity Press International, 1994); D.
Callahan, “When Self-Determination Runs Amok,” Hastings Center Report 22.2 (March–April
1992): 52–55; C. S. Campbell, “Bioethics and the Spirit of Secularism,” in Secular Bioethics
in Theological Perspective, ed. Earl E. Shelp (Boston: Kluwer Academic, 1996): 3–18.
24
The tendency of bioethics to become an ideology has been noted by several authors.
John Evans’ important sociological study demonstrated how the bioethics profession rose
to prominence precisely because it served as a buffer between the concerned public on the
one hand and the political and economic agendas of the rich and powerful on the other. See
John Evans, Playing God? Human Genetic Engineering and the Rationalization of Public
Bioethical Debate (Chicago: University of Chicago Press, 2002), and D. Callahan, “Bioethics
and Ideology,” Hastings Center Report 36.1 (January–February 2006): 363.
25
See C. L. Bosk, “Professional Ethicist Available: Logical, Secular, Friendly,”
Daedalus 128.4 (Fall 1999): 47–68, and George J. Annas, Standard of Care: The Law of
American Bioethics (New York: Oxford University Press, 1993).
26
See Jeremy Sugarman and Daniel P. Sulmasy, eds., Methods in Medical Ethics (Washington, D.C.: Georgetown University Press, 2001), and E. D. Pellegrino, “The
Metamorphosis of Medical Ethics: A 30-Year Retrospective,” Journal of America Medical
Association 296.9 (March 3, 1993): 1158–1162.
27
See K. Montgomery, “Medical Ethics: Literature, Literary Studies, and the Question
of Interdisciplinarity,” in The Nature and Prospect of Bioethics: Interdisciplinary Perspectives, ed. Franklin G. Miller, John C. Fletcher, and James M. Humber (Totowa, NJ: Humana
Press, 2003): 141–178, and D. Callahan, “The Social Sciences and the Task of Bioethics,”
Daedalus 128.4 (Fall 1999): 275–294.
28
See Anne Maclean, The Elimination of Morality: Reflections on Utilitarianism and
Bioethics (London: Routledge, 1993).
23
449
The NaTioNal CaTholiC BioeThiCs QuarTerly auTumN 2008
its contenders all suffered from the germ of intuitionism, which is tantamount to
moral emotivism.29 When moral skepticism abounds, nihilism or relativism becomes
inescapable—a conclusion that pragmatists willingly accepted and put into practice.30
Bioethics, as Gilbert Meilaender puts it, lost its soul in the process:
Bioethics fashioned for this purpose will offer a lowest common denominator
agreement. It will bracket matters on which we might intensely disagree—the
nature of the human person, the meaning of suffering, the foundation of human
dignity. Its focus is public, and, aiming at consensus on policy, it is more likely
to lead to moral routinization than to prophetic witness.31
Clearly, the moral high ground has been lost when renowned ethicists justify infanticide, bestiality, eugenics, the production of human clones, the harvesting of
organs from the not-yet-dead, and the creation of human-animal hybrids to work
as slaves.32 Bioethics has become a secular creature that not only rejects religion
but now questions the very possibility of reason itself.33 This puts the entire ethical enterprise in jeopardy, as it can no longer give moral guidance to the pressing
questions of the day.34
29
See Alasdair C. MacIntyre, After Virtue: A Study in Moral Theory (London: Duckworth, 1981), 22.
30
H. Tristram Engelhardt, Jr., Bioethics and Secular Humanism: The Search for a
Common Morality (London: SCM Press, 1991), 110–111.
31
Gilbert C. Meilaender, Body, Soul, and Bioethics (Notre Dame, IN: University of
Notre Dame Press, 1995), 18.
32
For examples of those who have seriously made these proposals, see Helga Kuhse
and Peter Singer, Should the Baby Live? The Problem of Handicapped Infants (Oxford,
UK: Oxford University Press, 1985); “Animal Crackers: An Ivy League Professor Defends
Bestiality,” editorial, Wall Street Journal (March 30, 2001), A14; J. Savulescu and J. Harris,
“The Creation Lottery: Final Lessons from Natural Reproduction—Why Those Who Accept
Natural Reproduction Should Accept Cloning and Other Frankenstein Reproductive Technologies,” Cambridge Quarterly of Healthcare Ethics 13.1 (Winter 2004): 90–95; J. Savulescu,
“Deaf Lesbians, ‘Designer Disability,’ and the Future of Medicine,” British Medical Journal
325.7367 (October 5, 2002): 771–773; “Procreative Beneficence: Why We Should Select the
Best Children,” Bioethics 15.5–6 (October 2001): 413–426; and “Human-Animal Transgenesis and Chimeras Might be an Expression of Our Humanity,” American Journal of Bioethics
3.3 (Summer 2003): 22–25; A. L. Caplan, G. McGee, and D. Magnus, “What Is Immoral
about Eugenics?” British Medical Journal 319.7220 (November 13, 1999): 1284–1285; J. A.
Robertson, “The Dead Donor Rule,” Hastings Center Report 29.6 (November–December
1999): 6–14; and Joseph Fletcher, Humanhood: Essays in Biomedical Ethics (Buffalo, NY:
Prometheus Books, 1979), 85. For a critique, see Wesley J. Smith, Culture of Death: The
Assault on Medical Ethics in America (San Francisco: Encounter Books, 2000).
33
H. Tristram Engelhardt, Jr., Foundations of Christian Bioethics (Salem, MA: M & M
Scrivener Press, 2000), and Richard Rorty, Contingency, Irony, and Solidarity (Cambridge,
UK: Cambridge University Press, 1989).
34
E. D. Pellegrino, “Bioethics at Century’s Turn: Can Normative Ethics Be Retrieved?”
Journal of Medicine and Philosophy 25.6 (December 2000): 655–675.
450
Tham The seCularizaTioN oF BioeThiCs
Some Theories on the
Secularization of Bioethics
Secular bioethics is a sick patient in need of intensive therapy; however, the
diagnosis turns out to be rather complicated. After an extensive review of the literature, three sets of theories can account for the secularization of bioethics. The
first postulates a macro-historical process of modernization under the social theory
of Max Weber mentioned previously. As society advances and takes on a modern
rather than a superstitious mind-set, it must substitute some secular equivalents
for religion. Therefore, in the area of ethics, responsibility will necessarily change
hands from the theologians to the secular experts.35 The second set of theories sees
secularization as a consequence of an expanding democracy in pluralistic societies.
Since different communities have different understandings of the good, the role of the
government is to provide a neutral ground of agreement, based on the lowest common denominator. This “overlapping consensus,” a concept taken from the political
theory of John Rawls, would have no place for religion in a naked public square.36
A third theory understands secularization as a competition for jurisdiction among
different professions, much like a turf war. The new profession of bioethicists was the
winner of this contest, wresting away the traditional jurisdiction of the theologians,
but acting as a buffer for the scientists before the anxious public.37
No one theory explains all the intricacies of the secularization of bioethics. Conceivably, more sociological empirical research in this area would be worthwhile. But
the question is a deep one, and no easy answer will suffice. At root is an uncertainty
about the place of religion in democracy, and about situating religious ethics in public
ethics. A thorough analysis would require remarkable familiarity with the different
disciplines of history, sociology, political theories, theology, and philosophy. alasdair
MacIntyre, John Rawls, Jürgen Habermas, Richard Rorty, H. Tristram Engelhardt,
Stanley Hauerwas, and Jeffrey Stout have written extensively on these subjects and
contributed lofty insights, but each comes from his own background and has been
unable to cover all the angles with an all-embracing synthesis.38
Resurgence of Religion
Daniel Callahan, a herald of the field, laments that the “marginalization of
religion in bioethics effectively downgraded one potential source of vigor to explore
the larger questions,” which includes the cultural questions of bioethics, the roles
V. Lidz, “Secularization, Ethical Life, and Religion in Modern Societies,” Sociological Inquiry 49.2–3 (April 1979): 191–217.
36
See John Rawls, A Theory of Justice (Cambridge, MA: Belknap Press of Harvard
University Press, 1971), and Political Liberalism, John Dewey Essays in Philosophy (New
York: Columbia University Press, 1993). See also Richard J. Neuhaus, The Naked Public
Square (Grand Rapids, MI: Eerdmans, 1984).
37
See Evans, Playing God?
38
D. Denz, “Bioethics and the Literature of Pluralism,” Christian Bioethics 7.3
(December 2001): 403–423.
35
451
The NaTioNal CaTholiC BioeThiCs QuarTerly auTumN 2008
Figure 1. religious publications as a percentage of total bioethics publications
by year (1955–2005). Data from the ETHX database, National Reference Center for Bioethics Literature, Georgetown University.
and possibilities of medicine, our understanding of human health, and our thinking
about the living of a life.39 Despondently, he resigns himself to the thinning of the
bioethics debate. As important questions on the goals of medicine receive scarce attention, he even finds himself on the margin by bringing up these issues.40 Without
a doubt, secular bioethics, with its excessive attention to crisis issues, has ignored
the deeper interrogatories of human suffering and death, the quest for the true good
without which ethical inquiry is fruitless, relevant questions of justice and charity, cost
containment and overpaid specialties, and other concerns of sociological import.41
The inadequacy of secular bioethics calls for a re-examination of the possible
contributions of religion and theology. The pendulum swings again, however, and
much has been written on this subject in the last decade, as witnessed by a cursory
search of the bioethics literature of the last fifty years (Figure 1).42 in terms of
content, religion can provide the historical nexus that is shared by a majority of the
society, by furnishing symbols and narratives that everyone can understand even
D. Callahan, “The Hastings Center and the Early Years of Bioethics,” Kennedy
Institute Ethics Journal 9.1 (March 1999): 66.
40
Callahan received a cold shoulder from the bioethics community in discussing these
issues, which he eventually published in Setting Limits: Medical Goals in an Aging Society
(New York: Simon & Schuster, 1987).
41
See R. C. Fox, “Is Medical Education Asking Too Much of Bioethics? Teaching
the ‘Nonbiomedical’ Aspects of Medicine: The Perennial Pattern,” Daedalus 128.4 (Fall
1999): 1–25.
42
Using the ETHX database at the Kennedy Institute of Ethics (http://www.georgetown.edu/research/nrcbl/databases/ethx.htm) on August 10, 2006, the author determined the
number of religious publications as a percentage of total bioethics publications each year
from 1955 to 2005. The results are summarized in Figure 1. The original data and details
of the search are available from the author.
39
452
Tham The seCularizaTioN oF BioeThiCs
if they no longer practice their faith. Religion can also provide the ends or telos of
human existence, giving meaning to human nature, the good life, suffering and
death, health, and the ends of medicine.43 religious communities can offer bioethics
a model of unity in diversity, and a covenant model of health care. They can take
on a prophetic witness of justice, emphasize the importance of virtues and holiness
in the providers, and give testimonies of caring and self-sacrifice in medicine.44 in
terms of methodology, the debate has centered on whether it is possible, or even
desirable, to translate the theological language into a secular one.45 While it may be
true that content, community, and methodology can be replaced by some secular
counterparts, it is only organized religion with its structures and convictions that
can make a consistent, substantive, and serious proposal to bioethics.
Hence, a ray of hope appears on the horizon for religion to re-insert itself into
the bioethical debate, which has become impoverished by its absence. Nevertheless,
the challenge is great for churches and believers to make such a difference. Theology must reclaim orthodoxy without compromising with secularism. The religiously
inspired academies need to re-discover their original inspiration and search for
truth through faith combined with reason. it would mean a re-examination of the
much-ignored themes of virtues and justice, spirituality and obedience, and sin and
holiness in morality and in bioethics.
Richard Neuhaus once remarked in this context that “successful revolutions are
vulnerable to, and sometimes provoke, counterrevolutions.” 46 What we need today,
therefore, are counter-revolutionaries who are not afraid to speak out and engage the
secular world of bioethics in unequivocal terms, using sound philosophical reasoning, and—why not?—even unabashed theological insights.
See Dena S. Davis and Laurie Zoloth, eds., Notes from a Narrow Ridge: Religion and
Bioethics (Hagerstown, MD: University Publishing Group, 1999); C. S. Campbell, “Religion
and Bioethics: Taking Symbolism Seriously,” Second Opinion 7 (2001): 4–26; Meilaender,
Body, Soul, and Bioethics; Verhey, ed., Religion and Medical Ethics.
44
See Hauerwas, Suffering Presence; Edmund D. Pellegrino and David C. Thomasma,
Helping and Healing: Religious Commitment in Health Care (Washington, D.C.: Georgetown
University Press, 1997); C. S. Campbell, “Prophecy and Policy,” Hastings Center Report 27.5
(September–October 1997): 15–17; D.P. Sulmasy, The Rebirth of the Clinic: An Introduction
to Spirituality in Health Care (Washington D.C.: Georgetown University Press, 2006).
45
James M. Gustafson, “Styles of Religious Reflection in Medical Ethics,” in Intersections: Science, Theology, and Ethics (Cleveland, OH: Pilgrim Press, 1996): 56–72.
46
Richard J. Neuhaus, “Secularization Doesn’t Just Happen,” First Things 151 (March
2005): 61.
43
453
References (11)
Stanley Hauerwas, Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church (Notre Dame, IN: University of Notre Dame Press, 1986), 70.
See Edwin R. DuBose, Ronald P. Hamel, and Laurence J. O'Connell, eds., A Matter of Principles? Ferment in U.S. Bioethics (Valley Forge, PA: Trinity Press International, 1994);
D. Callahan, "When Self-Determination Runs Amok," Hastings Center Report 22.2 (March-April 1992): 52-55;
C. S. Campbell, "Bioethics and the Spirit of Secularism," in Secular Bioethics in Theological Perspective, ed. Earl E. Shelp (Boston: Kluwer Academic, 1996): 3-18. 24 The tendency of bioethics to become an ideology has been noted by several authors.
John Evans' important sociological study demonstrated how the bioethics profession rose to prominence precisely because it served as a buffer between the concerned public on the one hand and the political and economic agendas of the rich and powerful on the other. See John Evans, Playing God? Human Genetic Engineering and the Rationalization of Public Bioethical Debate (Chicago: University of Chicago Press, 2002), and D. Callahan, "Bioethics and Ideology," Hastings Center Report 36.1 (January-February 2006): 363.
See C. L. Bosk, "Professional Ethicist Available: Logical, Secular, Friendly," Daedalus 128.4 (Fall 1999): 47-68, and George J. Annas, Standard of Care: The Law of American Bioethics (New York: Oxford University Press, 1993).
See Jeremy Sugarman and Daniel P. Sulmasy, eds., Methods in Medical Ethi- cs (Washington, D.C.: Georgetown University Press, 2001), and E. D. Pellegrino, "The Metamorphosis of Medical Ethics: A 30-Year Retrospective," Journal of America Medical Association 296.9 (March 3, 1993): 1158-1162.
See K. Montgomery, "Medical Ethics: Literature, Literary Studies, and the Question of Interdisciplinarity," in The Nature and Prospect of Bioethics: Interdisciplinary Perspec- tives, ed. Franklin G. Miller, John C. Fletcher, and James M. Humber (Totowa, NJ: Humana Press, 2003): 141-178, and D. Callahan, "The Social Sciences and the Task of Bioethics," Daedalus 128.4 (Fall 1999): 275-294.
See Anne Maclean, The Elimination of Morality: Reflections on Utilitarianism and Bioethics (London: Routledge, 1993).
H. Tristram Engelhardt, Jr., Foundations of Christian Bioethics (Salem, MA: M & M Scrivener Press, 2000), and Richard Rorty, Contingency, Irony, and Solidarity (Cambridge, UK: Cambridge University Press, 1989).
E. D. Pellegrino, "Bioethics at Century's Turn: Can Normative Ethics Be Retrieved?" Journal of Medicine and Philosophy 25.6 (December 2000): 655-675.
February 02, 2025
(Stephen) Joseph Tham
ATENEO PONTIFICIO REGINA APOSTOLORUM, Department Member
Catholic priest, bioethicist, theologian, of Chinese origin, interested in cultural dialogue
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The Secularization of Bioethics—A Critical History
(Stephen) Joseph Tham
The Secularization of Bioethics—A Critical History, 2007
Since the times of the Enlightenment, traditional control of religion in vital spheres of the social order began to crumble under the secular challenge of politics, culture, science, economy, judiciary, philosophy, and education. Ethics and theology were probably the last strongholds until they eventually succumbed as well under the influence of the now secularized academia. This happened at a time when society was restless with exciting medical discoveries which brought with them the age-old questions of just distribution, legitimate use of technology and justified manipulation of nature. The debate on contraception was among the test cases of novel technology with ethical substance, and dissent against church teaching caused an exodus of scholar to join the burgeoning field of bioethics. Even though theologians made important seminal contributions in the early days of bioethics, it was philosophy that bioethics eventually fell back on because of the troubles facing theology. Principlism soon became the dominant philosophical model to be applied in policymaking and at the bedside. However, the consensus achieved by this ethic looked contrived and open to manipulation of the potent. As discontents brewed, a plethora of competing models surged on the horizon, many of them sought to relocate ethics in the context of the situation or the character of the moral agent. Unwittingly, this puts secular bioethics on the path toward ethical relativism, liberalism and nihilism. Bioethics has become a secular creature which not only rejects religion but now questions the very possibility of reason itself. Different speculations sought to provide the causes of the secularization of bioethics. At root is an uncertainty about the place of religion in democracy, and of situating religious ethics in public ethics. Secular bioethics’ inadequacy also calls for a reexamination of the possible contribution of religion and theology in terms of distinctively religious content, communities and methodologies. Hence, a ray of hope appears on the horizon for religion to reinsert itself into the bioethical debate, which has become impoverished from its absence.
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Bioethics and Reason in a Secular Society: Reclaiming Christian Bioethics
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Bioethics evolved from traditional physician ethics and theological ethics. It has become important in contemporary discussions of Medicine and ethics. But in contemporary secular societies the foundations of bioethics are minimal in their content and often rely on procedural ethics. The bioethics of particular communities, particularly religious communities, are richer than the procedural ethics of a secular society. Religious bioethics, situated within religious communities, are richer in content in general and in the lived reality.
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4 The Role and Influence of Religions in Bioethics *
Denis Müller
Iproposeto treatthequestionoftheroleand influence ofreligions in bioethics from three successive points of view. After (I) sketching a general framework for taking into account the theoretical dilemmas posed by the relationships between religion, basic ethics, and applied bioethics, I briefly offer (II) the example of the transplantation of organs and the understanding of gift that illustrate the stakes and implications of the theoretical controversy, and then (III), speaking from the Protestant tradition, I propose my own normative thesis with respect to these relationships.
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Religious corrective to secular bioethics
(Stephen) Joseph Tham
Studia Bioethica - vol. 2 (2009) n. 3 , pp. 48-54
This paper discusses the place religious ethics has in current bioethical discussions. Relgious input can supplement and complement the contemporary debates in different ways, by offering alternative imagination and wisdom on questions regarding health, sickness, suffering, and death.
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Religion and bioethics: toward an expanded understanding
Arlene Macdonald
Theoretical Medicine and Bioethics, 2013
Before asking what U.S. bioethics might learn from a more comprehensive and more nuanced understanding of Islamic religion, history, and culture, a prior question is, how should bioethics think about religion? Two sets of commonly held assumptions impede further progress and insight. The first involves what ''religion'' means and how one should study it. The second is a prominent philosophical view of the role of religion in a diverse, democratic society. To move beyond these assumptions, it helps to view religion as lived experience as well as a body of doctrine and to see that religious differences and controversies should be welcomed in the public square of a diverse democratic society rather than merely tolerated.
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Exorcising Doubts about Religious Bioethics
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Bioethics, Theological Bioethics, and Human Life
Fausto Gomez
Philippiniana Sacra
On this study, I will reflect on "Bioethics, Theological Bioethics, and Human Life." I will deal first with the nature of bioethics; then with theological bioethics; and, finally, with human life as the central concern of bioethics. There is not need to insist on the relevance of bioethics. We read newspapers, magazines and journals of public interest; we watch the news on television or movies; we navigate on the web..., what do we read and see very often? Issues and problems directly connected with bioethics. A few examples: Dolly the sheep and human cloning, Dr. Kevorkian, and physician assisted suicide (PAS), the Human Genome Project (to map and sequence our genetic code), IVF and ET (in vitro fertilization and embryo transfer, respectively), Baby Fae with a baboon heart and organ transplants and xenotransplants (or organ transplants from other species of animals to humans), surrogate motherhood (imagine: a child today may have five parents), genetic engineering and so forth. And the latest issue? A possible implantation of brain chips to improve mental capacity and memory. Facing these issues, the ethical question is: What can he done should it be done? Is it right, good? A challenging question in our world dominated by science and technology!
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Foundations of Christian Bioethics: Metaphysical, Conceptual, and Biblical
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How can we definitively determine which biomedical choices are morally correct and which engage in seriously wrongful acts? Depending on whom one asks, one is informed that choices such as abortion, euthanasia, and significant body modification involve real moral harm (either as forms of murder or as denying the goodness of the body that God has provided), or that disallowing such “medical care” violates the basic rights of persons (where abortion, active euthanasia, and body modification are appreciated as positive expressions of personal autonomy). Secular bioethics appears no longer able to appreciate what could possibly be wrong with such activities, provided that the individuals involved consent in some fashion. Indeed, many actions that were once openly and easily recognized as sinful have become so commonplace, as well as politically desirable, as to appear as if they were obviously good. As the authors in this issue of Christian Bioethics explore, fully to appreciate the ser...
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Biomedical ethics. Contributions of religion in the field of research and biomedical practice.pdf
Bioethics Observatory - Life Sciences Institute - Catholic University of Valencia (Spain)
As a general rule, bioethical debates deal with the questions raised by scientific-technical breakthroughs in the field of research and biomedical practice. The swiftness with which these advances take place calls into question whether moral philosophy —and in particular theological ethics— can provide answers to the new questions raised, or whether it should capitulate to strategic ethics. Can a ethics without principles solve all the matter in these area and valorize the dignity of human person without damaging the rights of conscience? In the last few months, the Journal of Medical Ethics has reignited the debate about the place of religion in medical ethics.
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Will to Power
(Stephen) Joseph Tham
The new bioethics, 2013
Abstract This paper analyses the underlying tendencies and attitudes towards reproductive medicine borrowing the Nietzschean concepts of nihilism: ‘death of God’ with secularization; ‘will to power’ with reproductive liberty and technological power; and the race of ‘supermen’ with transhumanism. Medical science has advanced in leaps and bounds. In some way, technical innovations have given us unprecedented power to manipulate the way we reproduce. The indiscriminant use of medical technology is backed by a warped notion of human freedom. With secularization in the West, freedom has taken on greater significance in society, but with a heavy emphasis on individual choices and rights. As technology joins forces with sexual liberty, it is not difficult to understand why the public accepts the latest novelty from the reproductive industry. As a result, many find Catholic teaching behind the times and incomprehensible, if not downright anti-scientific. In fact, this coupling of reproductive liberty (will) with reproductive technology (power) echoes the famous dictum ‘will to power’ Nietzsche predicted would characterize post-modern societies. When liberty becomes absolute and technology unchecked, transhumanism is the logical outcome. As a response to these nihilistic tendencies, the article will end with a critique drawing from theological insights.
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Applied Ethics
(Stephen) Joseph Tham
Springer eBooks, 2014
Applied ethics is an academic discipline that inquires about the correctness of certain practical human activities, primarily using philosophical methods. This inquiry can be traced to antiquity since ethics is mostly concerned with the practical actions of daily life, and different professions have codes guiding such actions. As an academic discipline, it was conceived in the West in the 1960s due to secularization, technological advances, and a void in public policy. The global dimension in recent years makes these issues more acute. Applied ethics can be further specialized into bioethics, environmental ethics, sexual ethics, business ethics, and social ethics, in additional to newly emerging areas. From a global perspective, this entry will address the debates on the existence of objective moral truths, the sources of morality, the proliferation of competing models, the role of science and technology, the role of religion, and the tension between universal ethics and cultural diversity.
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