Deep conscience and accountability to God

In his last post Jon Holmlund referred to the concept of deep conscience as defined by J. Budziszewski. I think it is worthwhile to spend a little time on the implications of deep conscience. When Budziszewski writes about deep conscience he is distinguishing it from surface conscience. Surface conscience consists of our conscious moral beliefs which may vary from person to person and has similarities to the concept of convictions. Surface conscience applies to our day to day decisions and consists of derived beliefs that may have been derived in error. Deep conscience refers to a foundational first knowledge of morality that is what we derive our moral convictions from. As Budziszewski says in his book, What We Can’t Not Know, it consists of concepts such as friendship is good, gratuitous harm is wrong, and we ought to be fair.

Even though it may be called other things, the existence of deep conscience is widely accepted. Moral philosophers call it common sense morality when they use the moral convictions we all share as a test of moral theories. Beauchamp and Childress built their widely used principles of biomedical ethics on common morality, recognizing that people could agree on basic moral principles even though they cannot agree on moral theory. Mary C. Gentile uses common morality as the justification for teaching business managers to give voice to their values without specifying what those values are.

However, the existence of deep conscience or the fundamental principles of common morality presents a problem for those who do not recognize the existence of God as creator. As C. S. Lewis noted in Mere Christianity we not only recognize that there are moral values that all people share across time and across cultures, but we also recognize that we do not live up to those moral standards. If common morality was just the values that were found to be necessary for the existence of human society, then we would expect that those standards would be readily achievable. What we find is that we all know what is right, but we all fail to live up to those standards. That implies that there is a source of those standards beyond us. The existence of deep conscience does not fit with a godless world that has come about through chance and time. It says that there is a moral order to the world that is beyond us as humans. Just as the order and complexity of the physical and biological world leads to the idea that there must be a designer or creator, the existence of deep conscience implies that there is a source for our moral concepts who has made us with a purpose.

As Jon said in his post, deep conscience tells us that we are accountable to God. That is the uncomfortable thing about conscience in our society. We live in a society that worships autonomy. The idea that we are accountable to the one who is the source of conscience leads either to acceptance of that accountability, and can be the first step toward the answer to the problem of our not living up to what we know to be right that we find in Jesus, or leads to the suppression of our knowledge of right and wrong to try to remain autonomous.

Conscience, Data, and the Burden of Proof

Dr. Susan Haack’s recent posts on conscience, and the ongoing struggle over the HHS regulations on mandatory insurance coverage for contraception under the Affordable Care Act, demand more careful further reflections than will fit in a blog post, but I will dare to stick a toe in nonetheless.

In The Line Through the Heart: Natural Law as Fact, Theory, and Sign of Contradiction, J. Budziszewski argues (see pp 8-15, for example) that “deep conscience,” which is “rooted in the constitution” of all humans, is a cardinal indicator of the existence of a natural moral law.  Deep conscience “remembers” general moral norms (including, he argues, the Decalogue).  I’d take this to be Dr. Haack’s “antecedent” function of conscience.  Budziszewski then distinguishes three “modes” of conscience:  cautionary, accusatory, and (for lack of a single term) confession/reconciliation-seeking—the “consequent” functions Dr. Haack mentions.  He would certainly agree with Dr. Haack (as do I) that conscience points to a transcendent authority.

Presumably (me talking now, not Budziszewski), we form correct moral convictions by agreeing with deep conscience about moral truth.  However we arrive at those convictions, we can argue that they too have “antecedent” functions in that they are, if properly understood, sufficient to motivate ethical behavior.  (I just glossed over a major discussion in ethical philosophy that I ask the reader to accept for the sake of argument here.)  Convictions do not, however, produce a sense of guilt, accountability, or of a need for reconciliation.   Conscience does that.   Whether we recognize it or not, conscience is witnessing to our accountability before God.  People who deny God’s existence, however—and who may well also interpret “guilt” to mean a response to bad-faith intimidation by the organized church—can still coherently claim, it seems to me, to act out of conviction with accountability to the community, as long as the standard is some sort of community-recognized norm.  In a pluralistic society, one can appeal to positive law or what we can agree on; or, alternatively, one can appeal to the shared understanding of what it is to be an autonomous moral agent (as I take the German philosopher Jürgen Habermas to do).  Just don’t plead metaphysics.  But the appeal to convictions is not ripped from its community connections—it depends on them, just in a different, but critically different, way.

And that, of course, is the problem.  People like me are making a metaphysical argument (actually, I want to argue for a form of natural law) in a positive law world.  Some of the “positive lawyers” claim that their convictions are objective, not relativistic, because they are available to observation, as in the natural sciences, so we can agree on them, revising our understanding as we get new information.  We are left with a sort of “naturalist’s natural law.” I think that is irredeemably relativistic, in the end—if God is dead, nothing is out of the question.   I understand Budziszewski to agree.  He criticizes the “positive/natural lawyers,” if you will, of pursuing a “second-tablet project”—that is, isolating the “second [stone] tablet” of the Decalogue (Commandments 5-10) from the more explicitly God-directed first 4 commandments of the “first tablet.”

So what?  First, I would submit that the “conscience/convictions” argument doesn’t help all that much in cases like the HHS mandate.  The issue is how much room to give to particular metaphysical stances—the public/private square problem.  Pluralistic norms vs religious freedom is still the battle.  And it will not do to say that profit-seeking makes the moral application of metaphysical commitments illegitimate.  To put the fine point on it, Hobby Lobby’s owners ought to be accorded the same freedom of conscience as are the Catholic Church, or a church-run hospital, or Wheaton College (for example).  I worry, perhaps too much, that bioethicists in particular worship at the altar of non-profit status in ways that risk serious mistakes.

Second (and cf. the recent post by Dr. Joe Gibes), statements like “[The] lack of any substantial evidence for post-fertilization effects [of emergency contraceptives] may significantly weaken conscience claims, and may militate against refusals to dispense or to refer,” [Lewis and Sullivan, Ethics & Medicine 28:113-120, 2012] will not do.  Failure to prove is not disproof.  Absent definitive data, prohibition of emergency contraceptives may be weakened.  But without definitive data—which may not be accessible by ethical experiments—sufficient to free the conscience of concerns, conscience claims of someone with a reasonable doubt about what the data mean ought to be vigorously defended, even against a strong majority consensus.   We should not let a prevailing tide of naturalistic, “data-driven” ethics confuse our use of the data in service of true moral precepts.

The New Realities of the Public Square

Today’s public presidential inauguration festivities were reported with as strenuous a level of polarization as has characterized our politics these past years. Several, representing both the gleeful and despondent that represent our poles, have evaluated the benediction delivered by Luis Levon. Whatever his flaws or merits as a “benediction-giver”, much has been made over the fact that he is not Louis Giglio, the Atlanta pastor of Passion City Church. Most know that Giglio was initially chosen to give the benediction as a result of his substantive work in the name of justice, particularly toward the recognition and elimination of human trafficking, and that he withdrew his name after a sermon from over two decades ago, critical of homosexual activity, became impossible to reconcile with a presidential speech that linked Seneca Falls, Selma, and Stonewall. It is not my interest to elaborate on this issue, though evangelical thinkers are neither monolithic nor graceless on the matter. This is part of a larger wind, one that already sends a January chill through many who think that the Bible is not a quaint historic book filled with a mix of arcane thought and unreal sublimities, but a legitimate directive on how to live a moral life, and who question their place in the public dialogue.

It was on the “Huffington Post” site, of all places, that the headline jumped out: “After Louie Giglio Bows Out, Some Ask If Conservative Evangelicals Are Welcome in The Public Square.” Lured in, I found no lamentation inside the text for the loss of these voices. Especially for the “H.P.” (and the internet in general, where nuance is replaced by red meat) I found this piece curiously dispassionate. It didn’t blast the bigoted and hateful voices of conservative evangelicalism (that was left to the comments section), but it didn’t speak of the diversity of view that will go missing in the public square without them. It closed with a bland request to offer some names that could replace Giglio.

As someone with a bunch of convictions on all kinds of issues, many of which relate to issues of bioethics, I fear this attitude more than open disdain. I see evangelical Christians engage in solid scholarship, made all the more real by its connection to heartfelt spiritual conviction. I can bear seeing their work refuted, for they often serve as modern prophets to academia, and prophets have never been the popular kids in school. What is worse is to see an entire community dismissed as utterly irrelevant and hardly troublesome to the status quo.

A couple of things should be said about this. First, we knew it was coming, but it sure came fast—the biblical worldview espoused by many evangelicals is no longer welcome in the public square. Speech will increasingly be offered by invitation only, and we won’t be invited. I agree with the premise that a liberal democracy will allow all viewpoints to be presented on whatever basis—religious or secular—the presenter chooses, a Nicholas Wolterstorff view. I just can’t see that happening, when the public square for such arguments is limited to the insular world of faith-based websites and still-protected pulpits and not the wider avenues that reach our culture. The invitations will be fewer to public debate, except to serve as caricatures or foils to the flow of popular sentiment. Christian bioethicists that can’t make cogent arguments to secularists will find themselves as intellectual circus curiosities, as anachronistic as the Amish, but without the charm. If someone who gathers 60,000 people at one time to speak boldly against human slavery can be quickly disinvited by the president, should we assume a seat at the table?

Second, what is the role of a blog site like this, or even of Bioethics program like that Trinity offers? Last week, Chris Ralston and, before him, Joe Gibes, more eloquently (and, indeed, more briefly) than me addressed the sweeping secularization of bioethics as an opportunity, not an obstacle. I do not think what we do here to be an inside game, a list of “house rules” that impact nobody outside our circle. The error of an evangelicalism that strays from biblical conviction is that it has no anchor; it can, at best, supplement an existing secular argument, but not serve as a prophetic voice that to some offers conviction and to others, the sweet aroma of life that Christ provides. If we don’t know our stuff, in its fundamental form, then we have nothing to offer for the increasingly rare opportunities we have to address the public square.

Sentience, the Image of God, and Human and Animal Souls

Not to steal Jerry Risser’s topic, but I think a further response to his last two posts on sentience warrant a separate post, not just a comment…

To start:  I heartily endorse Jerry’s analysis, and I agree with him that human moral agency seems to be a fruitful approach to addressing the moral status of animals.  As Dr. John Kilner suggested in his comment last week, one may be concerned that the AAHA’s statement cloaks an agenda, in which the uniqueness of human status in creation is obscured by a sort of mirage in which the raising of animals’ status serves, in part, to pull human status down, creating, as it were, a blurred “horizon line” between man and beast.  But the issue is one of metaphysics, if you will, not just ends and means.

Jerry’s key point is that anthropology is the correct starting point.    This means asking what is the essential nature of humans, not “just” what is their standing in creation.   Here, I believe that reflection on the soul, such has been done by J.P. Moreland, may help.  Recall that Moreland takes a “Thomist” view of the soul, understanding it to be the “substantial, unified reality” that informs an individual’s entire being, grounds all of that individual’s ultimate capacities, is capable of existing in different states, and possesses different faculties.  Also, if I understand Moreland (and Scott Rae) correctly, we should distinguish between a being’s ultimate capacities—what it is capable of when fully developed and functioning—and its “capabilities,” which are “realized” or actualized capacities that can be actualized to greater or lesser degrees at different points in an individual’s existence.  It seems to me that this distinction between capacities and capabilities is real.  We are on shaky ground indeed when we attempt to ground moral status on capabilities (realized capacities), which are degreed properties.

Now, Moreland—and, if I am correct, Aristotle and Thomas before him, and, in contemporary days, Leon Kass—holds that animals do indeed have souls.  Indeed, Moreland says, so teaches the Bible.  But Moreland identifies several human capacities that do not characterize animals’ souls (for what follows, see Moreland’s booklet “What is the Soul?”, especially chapter 4):

  • Libertarian freedom of the will—and therefore, moral agency (as Jerry pointed out)
  • Ability to distinguish between desire and duty
  • Ability to entertain abstract thoughts
  • Ability to distinguish true universal judgments from mere generalizations
  • Awareness of themselves as selves, which envelopes [animals’ lack of] “desires to have desires, beliefs about their beliefs, choices to work on their choices, thinking about their thinking, and awareness of their awareness”
  • Finally, Moreland does not accept that animals possess language, which he argues requires symbols and not just signs.

Note that none of these bullet points is necessarily theistic in origin and none comes from a straightforward exegesis of Scripture.  But the implication, Moreland says, is that animals have souls and value before God, but not the intrinsic human dignity people, who are made in God’s image, have.  Humans “do not have duties to animals, [but] duties with respect to animals.”

This is all a longer way of endorsing Jerry’s “moral agency” approach.  But I must also add this: to get there, whatever one concludes about a narrow exegesis of the term “image of God” in scripture, one must allow that being in the image of God means something about the essence of man and woman—about what kind of beings we are.  I think that point is an indispensable starting point of a biblical approach to bioethics, and I find what I understand to be a more minimalist reading that the image of God is “a status and a standard” to be deeply, deeply unsatisfying.  I also think—forgive me, Dr. Kilner, for casting all humility aside here—that “the conclusion that animals matter much less than people because they are not God’s image” is NOT fallacious.  If you really believe that position is fallacious, then I submit you need to be prepared to negotiate with Jerry’s grizzly bear.

PS: Jerry’s emphasis on “responsible stewardship” echoes the current Presidential Commission on the Study of Bioethical Issues, which proposed “responsible stewardship” as a guiding principle in its statement on synthetic biology a couple of years ago.

Irreligious Bioethics

There’s a fascinating article in the December issue of the American Journal of Bioethics entitled, “In Defense of Irreligious Bioethics,” available free here. In the article, philosopher Timothy Murphy argues that the stance of bioethics towards religion should be not just neutral, but actively skeptical, even adversarial. The gold standard for bioethics should be secular moral reasoning, by which he means reasoning “based solely on regard to the well-being of mankind in the present life, to the exclusion of all considerations drawn from the belief in God or in a future state.” (footnote 2, p. 4) Such an approach, he avers, will “have a particular benefit in tamping down ideological effects.” (p. 6) He also asserts that irreligious bioethics can expose “indefensible approaches and standards” in bioethics, and provides as an example the “conceptually confused and epistemologically uncertain” notion of intercessory prayer. He concludes that “the most valuable approach to religion is to repudiate in all its manifestations the idea that there is a transcendent reality to which the immanent world is beholden.” (p. 8)

A few points: Murphy appears not to understand the nature and purpose of intercessory prayer, making the portion of his article dealing with prayer quite muddled. And secularity is certainly no defense against the excesses of ideology, as the history of the twentieth century with its almost countless victims of secular ideologies shows us. But more fundamentally, Murphy appears to believe that the secular approach to bioethics will somehow be more objective and normative, less tainted by subjective presuppositions, than bioethics practiced from a religious worldview. However, a secular or skeptical methodology is as fraught with unproven premises as any other, religious or otherwise. Even Murphy’s definition of secularity relies upon unproven assumptions and judgments of value to make any sense: for instance, in his phrase, “the well-being of mankind,” how do we define what well-being is? That definition will ultimately rest on a basic assumption that must be accepted without proof (see C. S. Lewis’s The Abolition of Man for an explanation of why this is true). Or, Who does “mankind” include? Are embryos included? One’s answer to that question will be based at least in part on preconceptions that will likely be assumed, not proven.

Murphy writes, “for bioethics the limiting factor is that religions ultimately rely on assumptions and claims that evade secular evaluation because they are typically unfalsifiable, infinitely mutable in the face of objections, rooted in personal experiences that defy independent analysis, or rooted in the murk of human history.” (p. 8)  I do not agree that this statement is entirely true; but to the extent that it is, this same description could be used for the assumptions and claims supporting any underlying worldview, even the secular and skeptical one that Murphy advocates.

(Along with the article is free access to several open peer commentaries from the same journal. I have not had the chance to read through all of them yet, so I apologize if what I wrote her inadvertently echoed some of their points.)

Christmas and bioethics: 2012

This advent season our church has been reflecting on Jesus coming into the world as the light of the world. We rejoice in the coming of Jesus to this world as God revealing himself to us and showing us the way that we can be reconciled to our Father. However, even though shepherds rejoiced, not every one was pleased to have the light of God come into the world. Herod tried to kill the newborn king in a massacre of innocent children, and eventually the light of the world was crucified and the sun became dark at mid-day.

John reminded us that not everyone desires the light when he wrote “Light has come into the world, but people loved darkness instead of light because their deeds were evil. Everyone who does evil hates the light, and will not come into the light for fear that their deeds will be exposed.” (John 3: 19-20 NIV)

The light of truth that Jesus brought gives us a solid foundation for bioethics. We have a place to turn to help us resolve the difficult moral decisions we face today. But we should not be surprised that there are many who would rather leave the light of Jesus out of bioethics. We should remember that the first thing his light does is to show us all where we fall short. We all like to think that we are good people or at least “good enough”. The light that came into the world showed us that we are not good. None of us likes that. None of us wants to humble ourselves before our God. Until we do and we find that the God of light is also the God of love who sent his son into the world so that we could live eternally with him (see a few verses earlier in John).

Living in the light of God will mean that some of the things we need to say will not be accepted by many people who have avoided God’s light. May God help us to be gentle in how we express the truth revealed by his light, understanding how we were first hesitant to step into the light. May we be as gentle as the light of the world who came to earth as a baby born in a stable.

Being honest with ourselves

I recently finished reading the book The (Honest) Truth about Dishonestly: How We Lie to Everyone – Especially Ourselves by Dan Ariely. It had been recommended to me by a business executive who is the compliance officer for a large financial firm as we were talking about the Center for Ethics that I am helping to develop at Taylor University. Ariely is a behavioral economist who researches how irrational factors impact human behavior. The idea that he writes about as the conclusion from his research is that human dishonesty or cheating is not the result of a rational decision that weighs the beneficial and harmful consequences of such behavior. Instead he has found that we lie or cheat when we can benefit by doing so while still maintaining an image of ourselves as a good person. Since how we think about ourselves is not fully rational our decisions are also irrational.

His research on cheating has shown some interesting things. One is that people (usually college students in his research) do not cheat as much as they could get away with, but the large majority of people do cheat some. In experiments designed so that cheating can be detected as a group but their individual actions are not recorded, people given the opportunity to report higher scores on a task and thus receive higher compensation do not report the highest possible score even when there would be no way to detect that they had done so, but do report scores a predictable percentage above the scores of an objectively measured control group. His research also shows that the amount that a group of people inflates their scores is impacted by numerous things such as being reminded that they ought to be honest just before doing the task, being exposed to someone else cheating, and whether their cheating benefits someone other than themselves.

A significant part of ethics (and bioethics in particular) is understanding what is right and wrong in our complex world. Ariely’s research reminds us that another large part of ethics is living by what we already know is right. He suggests that if we can justify to ourselves that we can do something that we know is wrong but still be a good person then we are likely to do it. He has shown that we human beings have an amazing ability to rationalize our actions. That is not new to the human race. I seem to recall King Saul rationalizing that he had spared the best livestock for sacrificing to God when Samuel asked why he could hear sheep bleating and oxen lowing when Saul had been told to destroy them all (1 Samuel 15).

Christian discipleship includes effective ways to address our human (fallen) tendency to rationalize our actions. Those include regular study and meditation on scripture, confession, and accountability within the body of Christ. Ultimately it is our transformation by God’s spirit working in our lives that enables us to become like him in character so that we live what we believe and do not deceive ourselves.

On the Boundaries of Moral Complicity

Last week’s lively exchange about the moral legacy of “the father of space medicine” invokes the broader issue of how to decide when one is being complicit in an immoral act.  (Please note that I am NOT attempting to weigh in further on the individual discussed last week—whose name I will not write here, in hopes that I can protect this post from further exchange about him personally.)

We all agree that what the Nazis did in the name of “human subject research” was evil.  At least, I think we all agree.  But would it be evil to use an anatomy text whose illustrations had been derived from the Nazis’ efforts?  Or, to be more contemporary about it, would it be unethical to take a new drug whose development included laboratory tests using stem cells from embryos specifically created or destroyed for use in those tests?   The Nazis are easy targets, but not a shield from more thorny issues that might strike closer to home.

Dr. Robert Orr addressed the issue of moral complicity at length in an article posted in 2003 on the website of the Center for Bioethics and Human Dignity.  In it, he posed several scenarios of moral complicity, and argued that they are not ethically equivalent.  To distinguish among them, he proposed five criteria:

1)      Timing—Association with a future immoral act is worse than association with one that is past.

2)      Proximity or remoteness—The more closely one is involved, the worse it is.

3)      Degree of certitude—how surely are the facts of the case known?  If not known, does one need to steer clear to avoid the possibility of appearing complicit?

4)      Degree of knowledge of the facts—Knowing them makes one more responsible than not knowing them (although I suppose we should be concerned about hiding behind a sort of “ignorance is bliss” argument).

5)      Intent—or, to be more exact, whether the intent of the person performing the immoral act and of a potentially complicit person are the same or different.

Dr. Orr explicitly rejected the possibility of “hand washing” in an attempt to absolve oneself from complicity (see: Pilate), and he counseled humility in judging the complicity of others.  Finally, he pointed out that hard and fast rules will be elusive, and that sensitivity to issues of the heart is paramount.

Read the whole thing.

The Whitewashed Tombs of the Right

“Woe to you, scribes and Pharisees, hypocrites! For you are like whitewashed tombs, which outwardly appear beautiful, but within are full of dead people’s bones and all uncleanness.”– Matthew 23:27

I received several comments on last week’s post about Hubertus Strughold, so I thought I’d follow up with another post.  The fact that Strughold has been well-respected in American medical circles despite his leadership in medical experimentation in Nazi Germany may shed light on deep-seated philosophical problems that undergird America’s healthcare crisis.  It is no secret that the Allies marveled at the technological and scientific capabilities of the Germans as they marched through that country in the final days of World War II.  Though it used the scientists of the Third Reich to the ultimate success of putting a man on the moon, American medicine may also have adopted harmful philosophical ideas that cripple U.S. medicine to this day.  The technological and scientific accomplishments of American medicine may be the whitewash that hides the philosophical problems that are the dead people’s bones that affect patient care and make us incapable of solving systemic healthcare problems.

Dachau, notorious for its human experimentation

Several writers on this blog have commented on the failures of the “business model” of medicine.  Joe Gibes has written several posts on the subject (see his “Black Friday” post), and Steve Phillips has recently mentioned the “manufacturing efficiency” that has been brought to human reproduction.  It is well-known that many Americans sided with the National Socialists in Germany in the 1920s and 30s because they saw them as a bulwark against the tide of communism that seemed to be sweeping over Europe (Russia fell to the Communists in 1917).  In the culture wars in America the last two decades, it appears the right-wing has propelled the “business model” of medicine to the fore as a bulwark against the Left’s move to bring government-run healthcare to America.  It is a classic case of the end justifies the means.  Why Christians allied themselves with the right-wing to form the “Religious Right” in the 1980s I’ll never know.  But it looks like a deal with the Devil.

Is emergency contraception abortion?

Emergency contraception (EC) — the “morning-after pill” — is taken by a woman after an episode of unprotected intercourse in order to try to prevent pregnancy.  It contains a hormone that acts to prevent pregnancy by preventing ovulation (the release of an egg from the ovary). However, theoretically, if ovulation has already occurred, EC might prevent pregnancy by preventing implantation, the attaching of an already-fertilized egg to the lining of the uterus. This second, conjectural mechanism raises ethical problems for those of us who consider that life begins at the moment of conception, since preventing the implantation of a fertilized egg could be viewed as inducing an abortion. Should we oppose EC because it might in theory cause an abortion?

The authors of a review article in the Fall 2012 issue of Ethics & Medicine address just this question. They review the best available scientific evidence and conclude that  there is “sufficient motivation” to believe that EC does not prevent implantation, and therefore does not cause abortion. (p. 116)

Good ethics begins with good facts. But our understanding of scientific facts is constantly changing; so even though we use the same moral reasoning (“It is wrong to deliberately take a human life, so one should not use a medication to cause an abortion”), our ethical conclusions may change as our understanding of the facts progresses  (i.e., if the facts indicate that EC causes abortion, we should not advocate its use; on the other hand, if the best data indicates that EC does not cause abortion, it may be ethically justifiable to use in certain circumstances ).

In a fallen world, our knowledge of the truth will always be imperfect; but it is the best we have to work with. Given the current state of knowledge, it appears that EC is not tantamount to abortion, and that I should not use “It might cause an abortion” as a reason not to prescribe it in certain circumstances (such as rape). I am open to changing this stance as knowledge grows and changes; what I am not willing to change is my commitment to not deliberately take a human life.

(See my post here for more on this topic.)