Does Religion Deserve a Place in Secular Medicine?

By Brian D. Earp

The latest issue of the Journal of Medical Ethics is out, and in it, Professor Nigel Biggar—an Oxford theologian—argues that “religion” should have a place in secular medicine (click here for a link to the article).

Some people will feel a shiver go down their spines—and not only the non-religious. After all, different religions require different things, and sometimes they come to opposite conclusions. So whose religion, exactly, does Professor Biggar have in mind, and what kind of “place” is he trying to make a case for?

When one thinks of stories like the 2012 death of a woman in Ireland due to septicemia after being denied an abortion (“This is a Catholic country,” she was reportedly told by medical staff), one is reminded of the ways in which some people’s religious beliefs can have profound (even fatal) consequences for others who may not share those same beliefs. As Mother Jones reported in 2013:

A growing number of patients are finding their health care options governed by [religious] guidelines as Catholic hospitals, long major players in the health care market, have been on a merger streak, acquiring everything from local hospital systems to medical practices, nursing homes, and health insurance plans.

In the U.S. context, at least, Catholic hospitals are required to follow health care directives handed down by the US Conference of Catholic Bishops—a group described as “celibate older men who have become increasingly conservative over the past few decades” by the author of the Mother Jones piece.

What are the implications? What does this mean—in other words—for individuals who, say, reject Catholic doctrine on principle, but don’t have feasible alternatives for personal healthcare as a result of the “merger streak” described above? Stephanie Mencimer lays out some of the concrete effects: (1) abortion services disappear, (2) doctors may be prohibited from prescribing birth control (and hospital pharmacies won’t sell it), (3) emergency contraception may be denied to rape victims, (4) tubal ligations and vasectomies are prohibited, (5) patients’ requests to be removed from feedings tubes or life support — as expressed in living wills — may be ignored, (6) hospitals are permitted to discriminate against gays and lesbians, whether they are employees or patients … and so on.

So there seems to be some cause for concern. At least, there is if you don’t agree with the moral worldview of the “celibate older men” we’ve been talking about. But when you actually read the article by Professor Biggar—with apologies to non-subscribers, as it is behind a paywall—you may find yourself detecting a certain hint of a bait-and-switch. This is because (or so I’ll suggest) the word “religion” in the title of Professor Biggar’s piece ends up meaning something not so very different from “philosophy”—which is a lot less controversial.

Here is some evidence for my view:

First, Biggar begins by ruling out the “irrational” parts of religion (since he doesn’t see irrationality as being uniquely the province of religions, and he thinks we should stay away from it whatever its source, so long as our goal is to make a convincing argument), as well as all appeals to authority, “whether to that of the Bible or of the Pope or of the Qur’an” (p. 230).

Then, he goes on to suggest that religious people cannot just force their views on others, but instead must attempt to “persuade” them using, well, all the ordinary tools of philosophical debate. So, to illustrate, he says that:

If I, a religious believer, am going to succeed in persuading you, an agnostic or atheist or different kind of religious believer, of my moral view [about abortion, as he discusses in this passage], then I will have to show you that your view has weaknesses or problems, that these cannot be adequately repaired in your terms, but that they can be repaired in mine. (p. 230)

Ok … but so what? How is that different from just doing philosophy? You can imagine a slight adjustment to the phrasing:

If I, a utilitarian, am going to succeed in persuading you, a Kantian, or Rawlsian, or different kind of moral philosopher, of my moral view, then I will have to show you that your view has weaknesses or problems, that these cannot be adequately repaired in your terms, but that they can be repaired in mine.

You get the idea: other moral frameworks could be slotted right in. The point is, we all have certain meta-ethical commitments (whether explicit or implicit)—religious or otherwise—and we all have to try to convince those we disagree with that our meta-ethical commitments make more sense than theirs do, or do a better job of explaining a shared moral intuition, or whatever. That’s just “doing philosophy.”

So what does religion, specifically, have to do with Biggar’s argument? His answer is this:

Religion has the following to do with it. As a Christian monotheist, I esteem the lives of human individuals very highly: all individuals are equally the creatures of one divine Father, and each has a special vocation in their time and place. As a consequence, even if I believe that it can be morally right for one individual to take another’s life, I think that killing is a morally and socially hazardous business and that it should never be done casually and without cogent reason. (p. 230)

I’m not sure that answers the question. After all, any number of non-religious philosophies or moral worldviews could end up reaching the (kind of obvious) conclusion that “killing … should never be done casually and without cogent reason” without having to avail themselves of such peculiar premises as there being “divine Fathers” (of which we are all “equally the creatures,” whatever that means), or the like.

In other words, if P entails Q, and Q is true (here, “Q” means: we shouldn’t kill people willy nilly without good reason), we have little reason to think that P (Christianity?) is true, too – simply on account of the fact that A, B, C, and D (and all the rest of the alphabet for that matter) could just as well entail Q, and one of those might be the one that’s correct. Biggar actually concedes this point a little later on.

Accordingly, it is about as persuasive to say “As a Christian monotheist” before delivering a moral argument as it is to say “As a Marxist” (or whatever else you please): what matters is whether your premises are reasonable, and whether your conclusions follow from your premises. Whether your premises are reasonable is, yes, the million-dollar question—and to convince me, you’ll have to do some meta-ethics. But that doesn’t have anything to do specifically with religion.

As you might expect, Biggar does have some additional arguments up his sleeve, and his paper goes on for a while longer. Nevertheless, I still didn’t get the sense that “religion” means anything different from “philosophy” by the end of it—but perhaps you’ll have a different impression. In fact, I’m reminded of Sam Harris’s recent attempt to argue that “science can determine human values,” where by “science” he apparently means “moral philosophy plus facts” (as I argue in this forthcoming paper).

When you grab your reader’s attention by saying “religion” (in Biggar’s case) or “science” (in Harris’s case) — and all you really mean is “moral philosophy,” your reader could be forgiven for feeling a little bit misled.

Further reading

Biggar, N. (2015). Why religion deserves a place in secular medicine. Journal of Medical Ethics, 41: 229-233. Available at http://jme.bmj.com/content/41/3/229.full.

Earp, B. D. (in press). Science cannot determine human values. Think: A Journal of the Royal Institute of Philosophy, in press. Available at https://www.academia.edu/10290501/Science_cannot_determine_human_values.

Mencimer, S. (2013). Do bishops run your hospital? Mother Jones. Available at http://www.motherjones.com/politics/2013/10/catholic-hospitals-bishops-contraception-abortion-health-care.

Quinn, B. (2012, November 13). Scandal in Ireland as woman dies in Galway ‘after being denied abortion.’ The Guardian. Available at http://www.theguardian.com/world/2012/nov/14/ireland-woman-dies-after-abortion-refusal.

About the author: 

Brian D. Earp is a researcher in science and ethics at the University of Oxford, and an incoming Associate Editor at the Journal of Medical Ethics. He blogs regularly at the Practical Ethics blog hosted by the Uehiro Centre for Practical Ethics at the University of Oxford, and will now be contributing a monthly blog here at the JME Blog as well. Follow Brian on Twitter at @briandavidearp.

* Note that this entry is being cross-posted at the Practical Ethics blog.

  • Akim McMath

    There’s something very agreeable about Professor Biggar’s interpretation of Christianity, although I’m sceptical of some of the conclusions he draws from it. I think it should be welcome at the table of secular medicine any day. It embraces broadly liberal values—a commitment to persuasion and reason, tolerance for dissenting views, a rejection of mere dogma, and the like. To put it in Rawlsian terms, Biggar’s Christianity is a liberal comprehensive doctrine.

    But if only liberal varieties of religion are allowed a seat at the table, the varieties of religion that many (perhaps most) people hold will inevitably be excluded. The Catholic Church, for instance, relies heavily on dogma, which it is perfectly willing to impose when it can. Catholic hospitals are a case in point. So is the Church’s unwavering stance on birth control. Apparently, if Catholicism wants a place in secular medical ethics, it will have to reform itself internally. The same could be said for popular interpretations Islam, Judaism, and nearly any other religion.

    Rawls didn’t think these internal changes would be necessary. He thought that illiberal comprehensive doctrines could nevertheless be reasonable. People who held these illiberal-yet-reasonable doctrines could, supposedly, cling to illiberal values and dogmas privately, while embracing political liberalism publicly. Nothing more was required for a seat at the table.

    There is something very appealing in this idea, but I’m not convinced that it can work. People who have deep private commitments to illiberalism just don’t want to embrace liberalism publicly. On the other hand, I think Biggar’s Christianity is congenial to secularists because it is broadly liberal both internally and externally. I’m not sure if there is a space in which private illiberalism can coexist with public liberalism—but if it exists, it is probably quite small.

    So I think Biggar is right that his version of Christianity can sit comfortably at the table of secular ethics. But his version of Christianity is probably not representative of religion as a whole. The real challenge is for him to persuade his fellow believers to reform their comprehensive doctrines so that they too can come to the table.