Society's Choices Social and Ethical Decision Making in Biomedicine (1995) / Chapter Skim
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The Role of Religious Participation and Religious Belief in Biomedical Decision Making
The Role of Religious Participation and Religious Belief in Biomedical Decision Making
Pages 358-387
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From page 358... ...
By practice, I mean standard ways to deal with typical cases that emerge over time and are accepted by medical practitioners and society. Practices are justified by explicitly stated moral values and characteristic ways of understanding and so interpreting illness.
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From page 359... ...
These fears are strong enough to set a context for addressing the issue of the role of religious belief and participation in biomedical decision making. Clearly religion has the potential to erode, sustain, or enrich at least the ethos that nourishes standard medical practice.
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From page 360... ...
Interactions are then traced, and a concluding section follows. The Vision of God In the traditions of the West, religious beliefs are intellectual constructs grounded in an experience of the reality of God.
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From page 361... ...
If the task of theology in a strict sense is to articulate the vision of God in the form of stated beliefs so that the relation of God to the world gains specificity,3 its larger task is to elaborate this vision by addressing four issues that recur perennially.4 The four issues are the relation of good and evil, the nature of religious participation, estimates of reliable sources of knowledge, and the character of moral guidance. Each is part of religious belief, and the vision of God becomes clearer as they are answered.
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From page 362... ...
Moreover, those on the journey inevitably experience moments of grace when, surprisingly, they encounter forces of good outside their own company. The world is thus experienced as an arena of interacting good and evil forces, but without a thoroughgoing dualism.
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From page 363... ...
In any event, religious belief is clearly a source for understanding the relation of good and evil, though it does this in different ways. Religious Participation A second factor in religious belief is the relation of those who share a religious vision to those who do not explicitly acknowledge it.
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From page 364... ...
The religious community may oppose the dominant society by protest, or by seeking to change or overthrow it. Or the dominant society may be affrmed, as an inevitable necessity, by critical acceptance, or more wholehearted embrace.
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From page 365... ...
Religious participation, then, has many meanings and dimensions.~3 The basic tendencies noted by Troeltsch illustrate ways in which religious participation takes place in relation to society. Recall that the religious vision grows clearer and God's relation to the world gains specificity with each factor in religious belief.
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From page 366... ...
For example, scripture may be viewed as disclosing knowledge of the reality of God, revealing the relation of good and evil, providing guidance in the form of moral values, engendering attitudes, exhibiting virtues, providing direct answers to moral questions, and so forth. It is important to draw fairly precise distinctions in order to understand particular claims.
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From page 367... ...
Recall again that the religious vision becomes clearer when each factor of religious belief is taken into account. When the factor is sources of knowledge, God's relation to the world is specified in reference to the availability of reliable moral knowledge to the religious community and to those who do not share the religious vision.
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From page 368... ...
Religion offers rich resources with respect to these possibilities, but I concentrate here on guidance in the form of moral principles. Whether the first requirement of a religious vision is a reborn heart or obedient conduct is a perennial debate, often couched in terms of the priority given to inner or outer dimensions of life.
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From page 369... ...
With the issue of sources, reliable moral knowledge may be more exclusively available to the religious community or more universally distributed. The religious vision clearly directs these possibilities, but the vision is also shaped by these other factors in belief.
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From page 370... ...
They also serve certain purposes. These three features of guidance, in turn, are informed by the religious vision and conditioned by perceptions of good and evil, estimates of reliable sources of knowledge, and different tendencies in religious participation.
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From page 371... ...
This complex and interacting whole provides resources which are brought to everyday life, including the medical arena. Every pastor and physician is aware that those informed by a religious vision respond out of the resources provided by a way of life, sometimes courageously in the face of tragedy and some.
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From page 372... ...
The vast literature about the relation of facts and values illustrates that different types of evidence count in making decisions. A division between facts and values presupposes a model in which one type of evidence consisting of pure moral values is applied to another type of evidence consisting of factually delineated situations.
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From page 373... ...
The adequacy of these forms, as well as the adequacy of their content, is conditioned by their purposes. In sum, the uses of situational analysis and moral values in decision making inevitably serve human purposes.
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From page 374... ...
Loyalties take institutional form and embody cultural values.22 For the parent, institutional forms of the family embody the values of parenthood. For the patriot, institutional forms of government embody the values of democracy.
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From page 375... ...
Human Agency Stated briefly, assumptions which guide conduct are made about the capabilities of human agents, their motives, and their possibilities and limitations within the courses and workings of nature, history, culture, and society. Human beings are a highly diverse lot equipped with a remarkable range of capabilities.
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From page 376... ...
Since health is a condition for other aspects of human flourishing, and these aspects are now beyond attainment, there is reason to allow the patient to die. A fourth reason appeals to human agency: Allowing a person to die accords with the finite nature of humanity and, one presumes, coheres with the dying patient's motives and intentions.
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From page 377... ...
A result is the formation of identity as a pattern of life which orients, motivates, and directs agents in the world. When a religious vision interacts with human loyalties, its basic import is to distinguish the ultimate from the proximate by subordinating other allegiances to devotion to God.
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From page 378... ...
God is conceived as the direct giver and "taker" of life since the divine presence in the world is identified with the natural life processes of cause and effect. A loyalty to health as physical existence is of little worth when ordered in relation to this center of value.
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From page 379... ...
With respect to sources of knowledge, a more exclusive stance could ignore scientific accounts of cause and effect and object to the statement that a patient is irreversibly dying. With respect to moral guidance, conscientious obedience to a rigorous higher law could instruct the religious community to disregard the limits of technology and foster attempts to always preserve life.
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From page 380... ...
Allowing an irreversibly dying patient to die, on the other hand, may also be supported by the factors of religious belief. With respect to good and evil forces, a moderated dualism could discern God's ordering presence in the world amid these interacting powers, though the divine purposes of existence in the varied arenas of life are beyond attainment for the patient.
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From page 381... ...
Trained by an establishment, these leaders may be conservative in two senses: first, they set forth a religious message from the past in the context of worship, and second, along with influential laity, they have a stake in maintaining the status quo. By contrast, the urgency of a prophetic message objects to liturgical practice when it sanctions a way of life unresponsive to God's active presence and provides moral guidance in the form of moral principles which point to a true way of life in the world.
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From page 382... ...
The criteria used to test these judgments are drawn from the religious vision, the factors of belief, and the components of decision making.3O Sunday These comments provide the occasion for a summary which focuses on the link between forms of religious participation and beliefs about God's ordering presence in the world which, in turn, interact with the ethos which supports medical practice. Again, the patterns delineated are regrettably abstract.
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From page 383... ...
Since the factors of religious belief are not always qualified from an explicitly religious point of view, nonreligious reasons could also be adduced for a broader view. Second, contributions by religion to biomedical decision making are more likely when religious participation is more affirmative, sources of knowledge are more inclusive, moral guidance is directed toward the world, evil is conceived as universal and radical, and God's active presence in the world is discerned in an interacting field of good and evil forces without a thoroughgoing dualism.
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From page 384... ...
Since no neutral standing point or privileged perspective exists, a theologian may be forgiven for observing that a "confessional" dimension inevitably enters discourse. The four factors of religious belief profoundly condition decision making, and no point of view exists from which to qualify them which is not historically conditioned and perspectival.
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From page 385... ...
Olive Wyon (Louisville: Westminster/ John Knox Press, 1992)
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From page 386... ...
Potter, War and Moral Discourse (Richmond: John Knox Press, 1970)
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From page 387... ...
Both Mary Midgley, Beast and Man: The Roots of Human Nature (Ithaca: Cornell University Press, 1978) and Melvin Konner, The Tangled Wing: Biological Constraints on the Human Spirit (New York: Holt, Rinehart and Winston, 1982)
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