This essay reflects on 25 years since Christian Bioethics began publication and, in somewhat autobiographical fashion, engages two core concerns. First, although “non-ecumenism” may often appear a pretext for contention and division, I suggest that a respectful non-ecumenism may provide the opportunity for dialogue and the occasion for employing certain tools from religious studies. Second, although many are skeptical about the possibilities of identifying a “common morality,” a defense of that notion provides a plausible explanation for the development of limited (...) consensus on some issues in bioethics. (shrink)

H. Tristram Engelhardt has made profound contributions to both philosophical and religious bioethics, and his philosophical and religious works may be read in mutually illuminating ways. As a philosopher, Engelhardt has mustered a powerful critique of secular efforts to develop a shared substantive morality. As a religious scholar, Engelhardt has affirmed a Christian bioethics that does not emanate from human rationality but from the experience of God found in Orthodox Christianity. In this collection of essays, both defenders and critics of (...) Engelhardt's religious bioethics have their say, and the spirited nature of their discussion attests, in its own right, to Engelhardt's enduring influence. (shrink)

Despite a variety of “non-ecumenical” features in Christian arguments about suicide, assisted suicide, and euthanasia, there are obvious “ecumenical” aspects to be found in the general Christian prohibition of these practices. A fair reading of the Christian tradition requires that we acknowledge both the differences that distinguish particular perspectives and the fundamental themes that allow an identifiably Christian position to emerge in stark contrast to the secular discussion of these issues. Central to Christian interpretations of dying and death are an (...) acknowledgment of God's sovereignty over human life, an understanding of suffering that stresses identification with Christ as the source of Christian hope, and the recognition that God's creative and redemptive purposes are generally (or always) at odds with the deliberate choice of assisted suicide or euthanasia. (shrink)

Abortion is an especially salient issue for considering the general problematic of religiously based conversation in the public square. It remains deeply divisive, fully thirty-four years after Roe v. Wade. Such divisiveness cannot be interpreted as merely an expression of profound differences between “secular” and “religious” voices, because differences also emerge among Christian denominations, reflecting different sources of moral authority, different accounts of moral discernment, and different judgments about the appropriate relations between law and morality in the context of pluralism. (...) As this paper explores, however, despite those differences, a generally identifiable “Christian” position concerning the moral status of abortion can be distinguished from secular philosophical judgments on the issue, which is important for Christian engagement with public policy debate. (shrink)

Several scholars have recently criticized the dominant emphasis upon mid-level principles in bioethics best exemplified by Beauchamp and Childress's Principles of Biomedical Ethics . In Part I of this essay, I assess the fairness and cogency of three broad criticisms raised against ‘principlism’ as an approach: (1) that principlism, as an exercise in applied ethics, is insufficiently attentive to the dialectical relations between ethical theory and moral practice; (2) that principlism fails to offer a systematic account of the principles of (...) nonmaleficence, beneficence, respect for autonomy, and justice; and (3) that principlism, as a version of moral pluralism, is fatally flawed by its theoretical agnosticism. While acknowledging that Beauchamp and Childress's reliance upon Ross's version of intuitionism is problematic, I conclude that the critics of principlism have failed to make a compelling case against its theoretical or practical adequacy as an ethical approach. In Part II, I assess the moral theory developed by Bernard Gert in Morality: A New Justification of the Moral Rules , because Gert has recommended his approach as a systematic alternative to principlism. I judge Gert's theory to be seriously incomplete and, in contrast to principlism, unable to generate coherent conclusions about cases of active euthanasia and paternalism. Keywords: active euthanasia, applied ethics, Beauchamp and Childress, intuitionism, paternalism, principlism, W.D. Ross CiteULike Connotea Del.icio.us What's this? (shrink)

In response to my earlier critique of recent attempts to rebut principlism as an ethical approach, Green, Gert, and Clouser (GG&C) have in turn offered their own critique of my appraisal. This essay identifies eight major criticisms GG&C raise in their response and offers a rejoinder to each. Among them, three are especially important: (1) that the label of ‘deductivism’ fails to capture GG&C's ethical method and should be replaced by ‘descriptivism’; (2) that pluralistic accounts, including principlism, fail to offer (...) any systematic way to resolve moral conflicts; and (3) that appeals to broader ‘moral’ principles beyond the moral rules are deceiving, since apparent differences in ‘moral’ judgment invariably involve disagreement about empirical facts rather than further moral considerations. In response to (1), I defend my earlier label by emphasizing the stipulated and invariant status of the moral rules GG&C invoke, even as I question the adequacy of their putative ‘descriptivism’. In response to (2), I suggest the plausibility of pluralist approaches and reiterate the modified just-war criteria that Beauchamp and Childress invoke in situations when principles conflict. In response to (3), I suggest that a ‘descriptivism’ worthy of the name must systematically accommodate the appeal to moral principles that remains central to metaethical and normative discussions. Keywords: deductivism, descriptivism, inruitionism, pluralism, principlism, publicity, specification of norms CiteULike Connotea Del.icio.us What's this? (shrink)

This essay analyzes Roman Catholic social teaching on the right to health care and the legitimacy of healthcare rationing. It considers that discussion at two levels: (1) the specific warrants that undergird key terms; and (2) the accessibility and applicability of those warrants to policy choices in a secular society. The essay concludes with a number of broader reflections meant to reserve an appropriate place for religious voices in the process of policy-making, as distinguished from its justification.

There are numerous challenges posed to Roman Catholic health care institutions by recent developments in health care delivery. Some are practical, involving the acceptable limits of accommodation to and collaboration with secular networks of health care delivery. Others, quite often implicated in the first set, are explicitly theological. What does it mean to be a distinctively Roman Catholic health care institution? What are the nature and the scope of Roman Catholic institutional identity? More broadly, what is the moral relevance of (...) themes in Roman Catholic social teaching to the provision of health care? This issue of Christian Bioethics addresses these questions with a spirited exchange among its authors. They offer noticeably different perspectives on the general cogency of Roman Catholic social teaching and different strategic recommendations for Roman Catholic institutions to maintain, or recover, their distinctive presence in health care delivery. (shrink)

In a spirit of critical appreciation, this essay challenges several core aspects of the critique of secular morality and the defense of Orthodox Christianity offered by H. Tristram Engelhardt in After God. First, I argue that his procedurally driven approach to a binding morality based solely on a principle of permission leaves morality without any substantive definition in general terms, in ways that are both conceptually problematic and also at odds with Engelhardt’s long-standing distinction between non-malevolence and beneficence. Second, I (...) question the accuracy or adequacy of Engelhardt’s critique of the Enlightenment project for his unwarranted privileging of a particular version of Enlightenment thinking at the expense of other Enlightenment perspectives less amenable to Engelhardt’s working generalizations. Third, I challenge the theoretical cogency of Engelhardt’s insistence on the ubiquity and intractability of moral controversies and his depiction of moral strangers and moral friends as, in effect, mutually exclusive terms. Finally, I question Engelhardt’s embrace of a divine command model of ethics as the appropriate resolution of Euthyphro’s dilemma and suggest that there may be intermediate approaches to the usual starkly drawn contrasts between divine command and naturalist accounts. (shrink)

Despite reservoirs of moral discourse about duties in religious communities, professional caregiving traditions, and philosophical perspectives, the dominant moral language in contemporary biomedical ethics is that of `rights'. Duties to Others begins to correct this imbalance in our ethical language through theoretical expositions of the ideas of duty and of the `other', and by applied exemplifications of particular duties to identified others that arise in the context of health care. A pronounced multidisciplinary orientation informs this analysis of our moral call (...) to respond to the needs of others. The essays in this volume offer a stimulating intellectual freshness through a continual engagement of theological, professional, and philosophical understandings of the duties that arise in our relationships with others in medicine, nursing, and social contexts. Duties to Others provides provocative challenges about the terrain of our moral world for both students and professionals in biomedical ethics, medicine, philosophy, and theology. (shrink)

Clouser and Gert’s 'A Critique of Principlism’ (1990) has ignited debate over the adequacy of substituting principlism for moral theory as a means for dealing with biomedical dilemmas. Clouser and Gert argue that this sort of substitution is not adequate to the task. I examine their argument in light of recent defences of principlism on this score, those of B. Andrew Lustig (1992), David Degrazia (1992), and Beauchamp and Childress (1994). I argue that both sides in the debate have (...) assumed differing conceptions of a moral theory that virtually guarantee their respective conclusions. These differing conceptions are motivated by antecedent epistemological commitments. The present debate over principlism is therefore inconclusive. Future discussion should focus on the underlying epistemological issues. (shrink)

Two years ago in two articles in a thematic issue of this journal the three of us engaged in a critique of principlism. In a subsequent issue, B. Andrew Lustig defended aspects of principlism we had criticized and argued against our own account of morality. Our reply to Lustig's critique is also in two parts, corresponding with his own. Our first part shows how Lustig's criticisms are seriously misdirected. Our second and philosophically more important part picks up (...) on Lustig's challenge to us to show that our account of morality is more adequate than principlism. In particular we show that recognition of morality as public and systematic enables us to provide a far better description of morality than does principlism. This explains why we adopt the label “Dartmouth Descriptivism.”. (shrink)

Two cardinals are said to beindistinguishableif there is no sentence of second order logic which discriminates between them. This notion, which is defined precisely below, is closely related to that ofcharacterizablecardinals, introduced and studied by Garland in [3]. In this paper we give an algebraic criterion for two cardinals to be indistinguishable. As a consequence we obtain a straightforward proof of an interesting theorem about characterizable cardinals due to Zykov [6].

Self-criticism is a trait associated with increased psychopathology, but self-criticism is also a personality state reflecting an action that people do in moments of time. In the current study, we explored factors associated with heightened self-criticism in daily life. Participants (N = 197) received five random prompts per day for one week on their mobile phones, where they reported their current affect (negative and positive affect), willpower self-efficacy, distress intolerance, degree of support and criticism from others, current context (location, activity, (...) hunger, tiredness) and momentary self-criticism. We first demonstrated that self-criticism varies over time and across contexts, and is associated with heightened trait self-criticism. Then, using multilevel modelling, we explored the contextual factors associated with greater self-criticism. We found that self-criticism was higher when people were at home, and more tired. We also found higher self-criticism to be associated with greater negative and lower positive affect, greater distress intolerance, lower willpower and greater perceived criticism from others. In addition, self-criticism predicted subsequent distress intolerance, willpower and positive affect in lagged analyses. This study provides evidence that both environmental and psychological factors are associated with the dynamics of self-critical thoughts. (shrink)

Proposed educational outcomes for the health humanities in medical education range from empathy to visual thinking skills to social accountability. This lack of widely agreed-upon high-level curricular goals limits humanities educators’ ability to design purposeful curricula toward clear, common ends and threatens justifications for scarce curricular time. We propose a novel approach to the hoped-for outcomes of health humanities training in medical schools, which has the potential to encompass traditional health humanities knowledge, skills, and behaviors while also being concrete and (...) measurable: humanistic practice. Humanistic practice, adapted from the concept of ethical sensitivity, is an intentional process of applying humanities knowledge and skills to a clinical scenario by 1) noticing that the scenario requires humanities knowledge or skills, 2) informing one’s clinical and interpersonal strategy and behavior with humanities knowledge or skills, 3) reflecting on the effectiveness of the strategy and behavior, and 4) reorienting to develop new approaches for future practice. The construct of humanistic practice may help address some of the foundational problems in health humanities outcomes research since it transcends the traditional diverse content domains in the health humanities, can link patient and provider experiences, and may bridge the divide among the additive, curative, and intrinsic epistemic positions of humanities to medical education. (shrink)

Immediately after the publication of Darwin's book on the origin of species, Engels, having familiarized himself with it, wrote to Marx on December 12, 1859: "All in all, Darwin, whom I am reading right now, is superb. Teleology had hitherto not yet been destroyed in one of its aspects, and now this has been done. Moreover, hitherto there has never been so sweeping an attempt to prove historical development in nature, especially with such success." Soon Marx enlarged upon the evaluation (...) of Darwinism. In his letter of December 19, 1860, he commented that this theory "provides a foundation in natural history for our views." It is therefore no accident that Engels, in developing the principles of dialectical materialism and problems of the dialectics of nature, interested himself so deeply and comprehensively in the theory of evolution. (shrink)

Contemporary liberal thought is increasingly baffled by the question of what kinds of moral obligations we ought to attribute to our common civic ties. Liberal patriotism is often seen as an obsolete inheritance, fundamentally in tension with values of liberty, equality, and impartiality. This paper examines the moral theory of David Hume in order to counter this assertion of incompatibility and uncover the roots of a view of modern patriotism that can incorporate impartiality, interest, and partial benevolence.

Concentrating on the thought of Canada's major scientists, philosophers, and clerics - men such as William Dawson and Daniel Wilson, John Watson and W.D. LeSeur, G.M. Grant and Salem Bland - A Disciplined Intelligence begins by reconstructing the central strands of intellectual and moral orthodoxy prevalent in Anglo-Canadian colleges on the eve of the Darwinian revolution. These include Scottish common sense philosophy and the natural theology of William Paley. The destructive impact of evolutionary ideas on that orthodoxy and the major (...) exponents of the new forms of social evolution - Spencerian and Hegelian alike - are examined in detail. By the twentieth century the centre of Anglo-Canadian thought had been transformed by what had become a new, evolutionary orthodoxy. The legacy of this triumphant intellectual movement, British idealism, was immense. It helped to destroy Protestant denominationalism, provide the philosophical core of the social gospel movement, and constitute a major force behind the creation of the United Church of Canada. Throughout the nineteenth century and continuing into the twentieth, however, the moral imperative in Anglo-Canadian thought remained a constant presence. (shrink)