One of the hot topics in the presidential election campaign is healthcare and healthcare reform, but is there a Christian perspective on healthcare? If so, what is it? I had the privilege of attending the annual bioethics conference hosted by the Center for Bioethics and Human Dignity and Trinity International University this past July. Guided by this year’s theme, “Healthcare and the Common Good,” some of the health profession’s leading practitioners discussed issues of healthcare and the health profession from a Christian perspective.

What Is “The Common Good”?

Dr. Edmund Pellegrino, chairman of the President’s Council on Bioethics, began the conference by distinguishing between first-order healthcare questions and second-order healthcare questions. First-order questions in this case involve the moral or ethical implications of healthcare. These questions include: What do we do with the poor and ill? What are our moral obligations to them? By what criteria do we judge healthcare programs? And, is the healthcare system providing for basic human needs? Second-order questions, often covered by the media, include economic issues, systems, and politics. Usually, this level of inquiry seeks to answer questions like “How is healthcare to be structured?”

Dr. Pellegrino used Aristotelian philosophy to discuss the idea of common good. He describes common good as everyone being enabled to fully achieve their own perfection as men. Essentially, everyone is valuable because he is a human being, and part of giving them value is to provide for them relief from suffering and the opportunity to flourish, whether they merit it or not. Dr. Pellegrino asserts that this is similar to the biblical idea of being not only your brother’s keeper, and your enemy’s keeper, but also ministering physically to those who are irresponsible. As Christians we have an obligation to care for the weak and the infirmed, and we, furthermore, cannot make value judgments on the worth of someone’s life because of their personal behavior.

Human Dignity

Underlying any area of bioethics based on a Christian worldview is the concept of man as a special part of creation made in God’s image.{1} This means that our views on healthcare should reflect the inherent dignity of the individual. Dr. Pellegrino discussed this essential element that part of common good is valuing man because he is man, and I would add that it is expressly because he is made in the image of God.

Many of the sessions at the conference, whether they were on doctor/patient relationships or public policy, centered on this point that man is made in the image of God and that individuals should be valued as unique and important. This presupposes a theistic worldview.

During my paper session at this conference, I emphasized the importance of a worldview approach for laying the foundation of how to evaluate specific bioethical issues. This is also essential in evaluating healthcare policies and our moral obligation to the weak and infirmed. How does one’s worldview affect their various views on healthcare?

As Nancy Pearcey points out in Total Truth,{2} every worldview answers three basic questions: Where did we come from? What happened to us (why is there evil)? And, how can things be made right? As Christian theists we would answer these questions with “Creation-Fall-Redemption.” Naturalists, on the other hand, would answer with the triad “Darwinism–Evil is an illusion–Survival of the fittest.” A naturalist’s creation story is that of Darwinism.{3} Therefore, man is nothing more than a product of natural selection. He does not hold a unique position above other animals, and he was not specifically created with a purpose.

One’s view on origins is fundamental to how man is regarded, and it determines which ethical system is used to determine right and wrong views on healthcare. The tension is between the theistic view that man has inherent dignity and worth, despite his capabilities or lack thereof, and the naturalistic view that man’s worth is based on whether or not he is a burden on society as a whole.

One view places an absolute value on a person while the other places a relative value. This, in turn, determines whether or not we share a moral obligation to help the weak and infirmed.

But We Vote on Second-order Questions!

While the ethical implications on healthcare are of primary importance, usually we are asked to evaluate healthcare based on second-order questions: How much does healthcare cost? Who should get subsidized? How are they subsidized? Should healthcare and health insurance be privatized? Which candidate’s plan do I agree with?

Several of the speakers at this bioethics conference addressed specific plans by candidates and their opinions about them (For more information on second-order analyses, see the Women of Faith Blog post which summarizes Dean Clancy’s discussion on McCain/Obama Healthcare plans. See also James Capretta’s discussion on policy analysis, PowerPoint® presentation from the conference and a related article.) But the emphasis at the conference was not in endorsing one candidate over another as much as evaluating healthcare from the perspective of a Christian worldview. In other words, we first must answer the primary questions and then use that analysis to guide our views on the secondary questions in healthcare.

I came away from the conference with an understanding that there are several problems with the current healthcare system, from overuse of technology to doctor/patient relationships to how the government subsidy system works. However, these problems are really the fruits of a deeper problem having to do the worldview approach that medical health professionals, politicians, and we, as a culture, take on the issue of health and healthcare. Healthcare is becoming more and more a consumer business or a commodity, and less and less a moral obligation to help those that are weak and infirmed (or a moral obligation to help prevent people from becoming weak and infirmed).

There is no one solution; thus, no one candidate has the solution to all of our healthcare problems. And deciding between expanding government subsidies and privatization is not the root of the problem, so it is not the ultimate solution. As Dean Clancy, former member of the President’s Council on Bioethics, pointed out in his session on “Solutions,” society can achieve four levels of “happiness”: 1) the ultimate good, 2) good beyond oneself, 3) personal achievement, and 4) immediate gratification.

As a culture we are stuck at levels 3 and 4 (personal achievement and gratification), and this means our priorities and decisions are stuck there. This is directly tied to our worldview. From a naturalistic vantage point, it would be logically inconsistent to move beyond levels 3 and 4. However, on a theistic worldview, 1 and 2 follow from the biblical perspective on priorities such as, “You shall love the Lord your God with all your heart and with all your soul and with all your mind…You shall love your neighbor as yourself.”{4} God is the ultimate good, and then we are to love others by doing good beyond what benefits ourselves.

What Can I Do?

We can serve a witness to our culture by modeling the biblical perspective on healthcare and human dignity. Maybe not necessarily on the voting ballot, but oftentimes this mindset is modeled on a very personal level by providing for the weak and infirmed in our churches and communities. Or by treating individuals with value, even if they are irresponsible with their health. Or through the way doctors and nurses treat their patients. These are all very tangible ways that people can see the love of Christ and may very well be one way to change some of the problems in our healthcare system from the grassroots level.

Notes

1. “So God created man in his own image, in the image of God he created him; male and female he created them” Genesis 1:27 (ESV).
2. Pearcey, Nancy, Total Truth: Liberating Christianity from Its Cultural Captivity, Crossway Books, 2004, pgs. 45-46.
3. This is referring to Darwinism as a philosophy: The presupposition that there is no God, only nature.
4. Matt 22:37, 39 (ESV).

© 2008 Probe Ministries

If you are a Westerner, an American, a non-Muslim, or a Muslim of a different stripe than they, then some radical Muslims hate you.

Why? The complex answer involves history, culture, politics, religion and psychology. Of course, many–some would say most–Muslims are peace loving and deplore terrorism. Islam is quite diverse. Extremist Muslims do not represent all Muslims any more than white supremacists represent all Christians. Not all “radical” Muslims are violent or hateful. But understanding extremist Muslim hatred is essential to interpreting our post-9/11 world.

Osama Bin Ladin calls on Muslims to “obey God’s command to kill the Americans and plunder their possessions…to kill Americans and their allies, both civil and military….” He and his sympathizers want to eliminate Western influence and restore their version of Islam to the world.

Would you believe that dancing in American churches helped fuel some radical Muslim anger today? Princeton Near East scholar Bernard Lewis illustrates.

In 1948, Sayyid Qutb visited the United States for Egypt’s Ministry of Education. His stay left him shocked with what he perceived as moral degeneracy and sexual promiscuity.

He wrote that even American religion was tainted by materialism and consumerism. Churches marketed their services to the public like merchants and entertainers. Success, big numbers, “fun” and having “a good time” seemed crucial to American churches.

He especially deplored clergy-sanctioned dances at church recreation halls. When the ministers lowered the lights, the dances became hot. Qutb’s PG description: “The dance is inflamed by the notes of the gramophone…the dance-hall becomes a whirl of heels and thighs, arms enfold hips, lips and breasts meet, and the air is full of lust.” He cited the famous Kinsey Reports as evidence of American sexual debauchery.

Qutb, who was dark skinned, also experienced racism in America. Back in Egypt, Qutb joined the Muslim Brothers organization. Imprisonment and torture made his writings more militant. Qutb became what Georgetown University religion and international affairs professor John Esposito calls “the architect of radical Islam.”

Some Muslim Brotherhood groups, offshoots, and alumni are mainstream and nonviolent. Others have a violent legacy. A militant offshoot, Islamic Jihad, assassinated Egyptian president Anwar Sadat. Esposito notes that Abdullah Azzam, a radicalized former Muslim Brother, significantly influenced Osama bin Ladin. Former CIA Middle East case officer Robert Baer observes that a Kuwaiti Muslim Brother, Khalid Sheikh Muhammad, became a bin Ladin terror chief.

Princeton’s Lewis notes that Sayyid Qutb’s denunciation of American moral character became incorporated into radical Islamic ideology. For instance, he says Iran’s Ayatollah Khomeini, in calling the U.S. the “Great Satan,” was being consistent with the Koranic depiction of Satan not as an “imperialist” or “exploiter” but as a seducer, “the insidious tempter who whispers in the hearts of men.”

The founder of the faith I follow, Jesus of Nazareth, told people to “Love your enemies and pray for those who persecute you.” It is not emotionally easy for me to love Osama bin Ladin or to pray for him. I have to ask God for strength for that.

Certainly bin Ladin’s hatred of me and my compatriots–flawed though we may be–does not justify his campaign of terror. His campaign rightly prompts national vigilance, a proverbial cost of freedom. But as we keep the powder dry, might it also be appropriate to individually reflect on the character that seems so offensive to him and his colleagues?

© 2003 Rusty Wright

Liberal Idealism’s Approach to Ethics

Ben and Jerry’s ice cream is renown for being the ice cream for those who want to be friendly to the environment. Ben and Jerry’s Homemade Inc. built a national reputation by (1) claiming to use only all natural ingredients and (2) sending a percentage of the profits to charities. The company’s Rainforest Crunch ice cream supposedly uses only nuts and berries from the rain forests.

But there is a lot more to ethical behavior than a laid-back, socially correct agenda. An audit of Ben & Jerry’s Homemade Inc. revealed the use of sulfur dioxide preservatives and use of margarine instead of butter in some of the flavors. Ben Cohen of Ben & Jerry’s Homemade Inc. also served on the editorial board of Anita Roddick’s Body Shop, another company expounding the use of natural products. It took an article in Business Ethics to expose Body Shop’s false advertising claims and other ethical failures. Synthetic colorings, fragrances, and preservatives were being used in Body Shop products.{1}

Today we live in a world engrossed in the ideas flowing from a socially correct agenda, and it is overshadowing the time proven priority of basic business ethics. It is an agenda centered in tolerance and environmentalism. (Interestingly, those on the environmental side are not very tolerant of those who do not hold to their rigid perspective, such as their stand on not using animals in product testing.)

Levi Strauss is another interesting case in point. The company has a strong politically correct mindset, and diversity and empowerment are central for their organizational ethics. They have demonstrated a strong concern for human rights, yet they are clearly on the liberal side of family values. They have been boycotted by the American Family Association for their support of homosexuality providing benefits for the “domestic partners” of their employees.

Although this socially correct movement expounds the idea of tolerance for all, proponents tend to be very intolerant of anyone who may support a position they do not agree with. Kinko’s Copies found this out the hard way when they advertised on the Rush Limbaugh show. A boycott was quickly threatened until Kinko’s promised not to advertise on Rush’s show again.

There is great danger in using political views to measure business ethics because social goals can become equated with business ethics. This is not right. Business ethics is concerned with the fair treatment of others such as customers, employees, suppliers, stockholders, and franchisees. Truth in labeling and advertising is paramount in establishing a business enterprise and is even more important than the issues of animal testing and commitment to the rain forest, as important as they may be.{2}

This approach to ethics comes from liberal idealism. We see this perspective in Robert Bellah’s book, The Good Society. Liberal idealism seeks to transform society by social engineering. The liberal idealist looks for ways of managing a modern economy or developing broad social policiesthat will meet the needs of society as a whole. This system believes in the innate goodness of mankind, the worldview of enlightenment thinking, that men and women are fully capable of reasoning what is good and right, i.e., the autonomy of human reason. There is no felt need for revelation or any authority beyond themselves. Liberal idealism is marked by a lot of faith in government and the ability of organizational programs to orchestrate a healthy society.

We will be contrasting this line of thought with a more bottom up view that emphasizes personal integrity and greater concern for individual moral convictions.

Bottom up Ethics

But there is another more traditional way of looking at ethics. It is an individual model, rather than an organizational one. It demonstrates a greater concern for the moral conviction of individuals. This view emphasizes that institutions don’t make ethical decisions, people do. It stresses that virtue comes from the individuals who make up the many small groups and larger institutions, from families to voluntary associations to multinational corporations. The goal is to convert the individual in order to change the institution. Answers are sought more through education and/or religion to reach the individual in the belief that transformed individuals will transform their institutions.

A corporation that has established an ethics department with an approach more along the lines of the individual model is Texas Instruments. Their theme is “Know What’s RightDo What’s Right.” Their emphasis is on training individuals within the corporation to know the principles involved in each unique ethical dilemma that may present itself and motivating the individuals involved to make good ethical decisions. The company maintains various avenues of support to assist individuals within the corporation in making difficult decisions. Carl Skoogland, vice president of the Ethics Department at Texas Instruments, has said, “In any relationship an unquestionable commitment to ethics is a silent partner in all our dealings.” Their seven-point ethics test is oriented toward individual initiative:

 

1. Is the action legal?
2. Does it comply with our values?
3. If you do it, will you feel bad?
4. How will it look in the newspapers?
5. If you know it is wrong, don’t do it!
6. If you’re not sure, ask.
7. Keep asking until you get an answer.{3}

Although critics might say these types of simple maxims lack in specific guidance, when combined with an overall educational program they help individuals think through issues and make the right decisions themselves, multiplying the base of ethical agents within the corporation.

 

Traditional Western culture, which has given us the most advanced and free lifestyle of any culture, has been based on both a Greek model of transcendent forms and a Judeo-Christian model of God- given objective standards. This tradition has taught us that we are all flawed and need a personal transformation before we can be of any true value in transforming society.

Religion and Education in Ethical Development

Earlier we mentioned Robert Bellah’s book, The Good Society, and its support of liberal idealism, or the ability of government and organizational programs to orchestrate a healthy society through broad social agendas.

William Sims Brainbridge, in writing a review of Bellah’s book, makes a statement that could well apply to so many of the modernist writings: “The book’s prescription sounds like a highly diluted dose of religion, when what the patient needs might be a full dose.”

This “organizational model” fails to fully appreciate the need for integration of religion and education in order to provide a united front against the materialism and self-centeredness of our present culture. As long as we allow our educational system to teach that we are evolved animals, here by chance and of no eternal significance, we can only expect short-sighted self-interest. If fundamentally all there is is matter, energy, time, and chance, why can’t one believe in anything such as apartheid, or ethnic cleansing, or euthanasia, or genocide? Where is liberal idealism’s source for personal integrity and convictions other than in cultural relativism? Under a theory of cultural relativism all intercultural comparisons of values are meaningless.

The need, of course, is for transcendent truths. By transcendent, we mean an ethical ideal independent of any given political system or order. This ethical ideal can then serve as an external critique of corporate or political aspirations or activities. Is this not what Plato was referring to when he discussed his theory of universal forms, that there are ideals beyond the reality of this physical world? In this postmodern world we are now experiencing a complete rejection by many of any objective truth. In fact, anyone who still believes in the search for truth is often labeled as ethnocentric, i.e., the liberal idealism of our present age refuses to accept that someone might find a truth that has universal application.

The ethics of enlightenment thinking do not appear to be the answer. Crane Brinton, in his book, A History of Western Morals says, “the religion of the Enlightenment has a long and unpredictable way to go before it can face the facts of life as effectively as does Christianity.”{4} We appear to have an implosion of values in a society that is seeking to teach that there is no God and no afterlife, but if you live an ethical earthly life somehow it will pay off.

British historian, Lord Acton, is best remembered for his warning that power tends to corrupt and absolute power corrupts absolutely. He believed that liberty was the highest political end. But, he also recognized that liberty can’t be the sole end of mankind. There must also be some kind of virtue, and virtue has its roots in religion. Lord Acton’s work showed that no society was truly free without religion.{5} Professionals must be educated to understand the moral worth of their actions and the roles religion and education play in promoting self-control.

Religion and Education at Odds

We have been discussing the need for both religion and education in establishing an ethical base for all our actions. But the question arises, how will we find the needed balance in an American society in which public education and traditional religions are at odds with one another over very basic presuppositions such as the nature of the universe, humanity, ethics, culture, evil, truth, and destiny?

The liberal solution has been to remove the traditional truths and make our institutions humanistic. The conservative response has been to establish an independent educational system in which those who hold to more traditional values can integrate religious truth with educational aims. We now have two major educational tracks, the public track based on the religion of secular humanism and the private track based on the religion of biblical Christianity. The professionals involved in the educational institutions must decide how to deal with the tension between the two tracks. The need is to resolve tension and build bridges of understanding, rather than intensify the cultural war. But, as Christians, we must not compromise truth. There must be cooperation without compromise.

John Adams, our first vice-president, said, “Our constitution was made only for a moral and a religious people. It is wholly inadequate to the government of any other.”{6} Meaning is the living fabric that holds us together with all things and meaning for life will only be found through the transcendent values of religion. In his article, “The Globalization of Business Ethics: Why America Remains Distinctive,” David Vogel writes, “Thanks in part to the role played by Reformed Protestantism in defining American values, America remains a highly moralistic society.”{7}

At this point, in realizing the need to be fair, we must be willing to give a critical assessment of the gross behavioral failures that have occurred in the realm of the religious. The most blatant examples are probably the numerous TV evangelists who have fallen prey to greed and other temptations that have destroyed their lives and ministries. Another example is the many ministers and priests who have practiced sexually deviant behavior with children in their care. Many of these religious leaders are now or have been serving time in prison for their personal moral failures.

These examples highlight the moral depravity of mankind. But this does not mean that we need to adopt the sixteenth century views of Thomas Hobbes (1588-1679) who had a very low view of human nature. Unfortunately, much of the world has been heavily influenced by the amoral perspective of a Hobbesian foundation of ethical behavior. Hobbes decided that what is good or bad is based on what society likes or dislikes. This is cultural relativism, the rejection of any standard beyond that established by the present culture. Hobbes, like so many others, seems to have had an innate fear of the possibility that there might be a transcendent truth out there worth pursuing. Because of our personal inner moral failure, we must look outside ourselves to find the standards by which we are to live and establish those standards in our laws and in our educational systems.

Does a Rising Tide Lift all Boats?

President Kennedy said, “A rising tide lifts all boats.” But think about it! Does a rising tide lift all boats? Not if some of the boats have holes in them.

In this essay we have been discussing the contrast between a politically correct ethical approach to dealing with our ethical concerns against a more bottom up individual responsibility approach.

The historic roots of the American experience are bound up in the idea of individualism, a political tradition that enshrines individual liberty as its highest ideal. But democracy requires a degree of trust, and unfortunately, our heritage of trust is eroding. American businesses have been transformed from comfortable and stable rivals into bloodletting gladiators.{8} There is a problem in emphasizing individual freedom and the pursuit of individual affluence (the American dream) in a society with an economy and government that has rejected the principles of natural law. Too many of our boats have holes in themi.e., little or no personal integrity. We must work at restoring the principles of individual integrity and personal responsibility before we try to establish an ethical agenda for our organizations. Unless we realize our own morally flawed state, we will seek to repair the institutions without the humility and personal transformation necessary to afford any hope of ultimate success. Organizational ethical behavior is very important, but it must be elevated through an upsurge of individual ethical behavior.

Those coming from a liberal idealism approach to ethics hold noble ideas of common good based on a belief in the inherent goodness of men and women. They believe that if we just change the structures of society, the problems will be solved. Their perspective is that greater citizen participation in the organizational structures of our government and economy will result in a lessening of the problems of contemporary social life. What they neglect to consider is that government attempts to make people good are inherently coercive. Our constitution rests on the premise that virtue comes from citizens themselves, acting through smaller groups, such as the family, church, community, and voluntary associations. The stronger these small, people-centered groups are, the less intrusive the government and other large organizations need to be.

But how do you deal with the need for individual transformation? A common phrase we often hear is “You can’t legislate morality.” In reality all laws are a legislation of morality. All we are doing is changing an “ought to do/ought not to do” into a “must do/must not do” by making it a law. A solid base of moral law helps to establish the standard for individual behavior, but as the New Testament so clearly tells us, the law is inadequate to the task at hand. It is the power of the gospel of Jesus Christ that enables us to overcome the forces within and without that seek to destroy our God-given abundant life. Only by placing our trust in Christ can we begin to repair the holes in our life. When the internal integrity of our life is as it should be, we are then ready for the tides of life to come. A rising tide does lift all boats that have internal integrity.

Notes

1. Marianne M. Jennings, “Manager’s Journal,” Wall Street Journal, 25 September 1995.
2. Ibid.
3. Texas Instruments, publication TI-28172.
4. Crane Brinton, A History of Western Morals (New York: Paragon House, 1990), 462.
5. Charles Oliver, “Leaders & Success,” Investor’s Business Daily, 14 December 1993.
6. Quoted in John R. Howe, Jr., The Changing Political Thought of John Adams (Princeton: Princeton University Press, 1966), 185.
7. David Vogel, “The Globalization of Business Ethics: Why America Remains Distinctive,” California Management Review (Fall 1992), 44.
8. Robert Reich, “Corporate Ethic: We can change behavior by altering mix of incentives,” The Dallas Morning News, 14 January 1996, 5J.

© 1996 Probe Ministries.