Why Religious Discourse Has a Place in Medical Ethics: An Example from Jewish Medical Ethics (original) (raw)
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When Religious Language Blocks Discussion About Health Care Decision Making
HEC Forum, 2019
There is a curious asymmetry in cases where the use of religious language involves a breakdown in communication and leads to a seemingly intractable dispute. Why does the use of religious language in such cases almost always arise on the side of patients and their families, rather than on the side of clinicians or others who work in healthcare settings? I suggest that the intractable disputes arise when patients and their families use religious language to frame their problem and the possibilities of solution. Unlike clinicians, they are not bilingual and thus lack the capacity to understand and negotiate differences in terms that are responsive to those who work in healthcare settings. After considering a representative case, I explore whether an ethics consultant or chaplain can function as a translator and suggest that, at best, such efforts at mediation depend on contingent aspects of a case and will only be partially successful. To appreciate limits on the role for bilingual translators, I consider a futility dispute where a parent using religious language demands that everything be done for a permanently unconscious child. I challenge the traditional interpretation that says the parent values "mere duration of biological life irrespective of quality." From a religious perspective, human life is never "merely biological." This effort to slot the dispute into standard philosophical schemas misses what is crucial in the dispute. I suggest that a better interpretation views the dispute at a meta-level as one about whether withholding and withdrawing care is morally distinguishable from killing. Curiously, this interpretation makes the advocate of futile care into an ally of those "quality of life" advocates who also challenge this distinction. The crux of their dispute now rests on the normative ethics of killing. While I think my interpretation comes much closer to the views of many who demand 'futile care,' I suggest that it still falls short because of the way it reconstructs the religious concerns in nonreligious terms. I close by considering an analogy between the language of suffering and the language of faith, suggesting that both require a much richer understanding of the narratives that orient the lives of patients and their families.
Negotiating Religious Beliefs in a Medical Setting
Journal of Religion and Health, 2012
This manuscript studies in detail, following a discourse analytical approach, medical consultations in which a patient's religious belief does not allow blood transfusion to be administered. The patient is a young Jehovah's Witness suffering myeloid leukaemia who is being treated in a Catholic cancer hospital where the practice of blood transfusion forms part of the standard protocol to treat the disease. The consultations under analysis take place in a Chilean cancer clinic where mainly the oncologist and a Jehovah's Witness Representative (JWR) present discuss and negotiate expert information on the substitute methods to be used. The exchange dynamics of the consultations differ from the usual visits where the medical knowledge and expertise is primarily in the hands of the medical practitioner. In these encounters, the JWR shares vital information with the oncologist providing the basis of the treatment to be used. This shifting of the balance of powerwhich could have been a cause of tension in the visit and a contributing factor in the disruption of communication-has instead brought light to the encounter where the negotiated treatment has been achieved with relative ease. The patient's future is in the hands of the oncologist and the JWR, and their successful negotiation of treatment has made it possible to cater for the particular needs of a JW patient. Sharing different medical practices has not been an obstacle, but an opportunity to find out ways to deliver equity access and well-informed practices to a non-conventional patient.
Oxford Research Encyclopedia of Communication, 2018
Signification of human meaning dwells in ethics and culture, finding expression in and through rhetorical practices. Ethics and culture consist of goods and practices that gather the meaningful and the important together, yielding urgency for rhetorical employment of those practices. The union of ethics, culture, and rhetoric offers a coherent dwelling for the protection and promotion of the consequential. Ethics and culture house actions of meaningfulness that compel rhetorical expression, announcing a stance attentive to the vital, reminding self and informing other of a particular account of the consequential. Ethics and culture adjudicate a sense of ground that nourishes rhetorical understanding and engagement with the world. Rhetoric explicates practices of import that reflect the performative reality of ethics and culture, retelling self and other about the crucial. Rhetoric permits self and other to interrogate a ground of distinctive goods and practices that structure the noteworthy. Rhetoric facilitates discovery, testing, and knowledgeable implementation. It moves ethics and culture from points of abstraction to knowing public coordinates in a communicative social world that is impactful on self and others. The interplay of ethics, culture, and rhetoric in their triconstruction and enactment engenders human meaning. Rhetoric thrusts unique versions of ethics and culture into the public domain, and such action renders practical awareness of the existence of contrasting content of import. Acknowledging dissimilarity exposes and probes contrasting goods and practices. Rhetoric enhances public knowledge of differences undergirding juxtaposed ethical and cultural stances.
Devotion, Diversity, and Reasoning: Religion and Medical Ethics
Journal of Bioethical Inquiry, 2015
Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethics, including fields of professional ethics like medical ethics. This assertion, of course, implicitly refers to ethical reasoning, but there is much more to the ethical life and the practice of ethics-especially professional ethics-than reasoning. It is no surprise that teachers of practical ethics, myself included, often focus on reasoning to the exclusion of other aspects of the ethical life. Especially for those with a philosophical background, reasoning is the most patent and pedagogically controllable aspect of the ethical life-and the most easily testable. And whereas there may be powerful reasons for the limitation of religion in this aspect of ethics, there are other aspects of the ethical life in which recognition of religious belief may arguably be more relevant and possibly even necessary. I divide the ethical life into three areas-personal morality, interpersonal morality, and rational morality-each of which I explore in terms of its relationship to religion, normatively characterized by the qualities of devotion, diversity, and reasoning, respectively.
Fostering Ethical Engagement Across Religious Difference in the Context of Rhetorical Education
The The Journal of the Assembly for Expanded Perspectives on Learning, 2021
At a moment in which religious diversity is ever-increasing in the United States and more than three-quarters of the world's population identifies with a religious tradition, it is important for writing teachers to consider how to best cultivate writers who are equipped to build identifications across religious difference. This essay traces my efforts to engage this exigence in my advanced undergraduate writing course at Baylor University entitled Religious Rhetorics and Spiritual Writing (RRSW). In what follows, I outline my pedagogical goals, course design, and approach to teaching RRSW. I then share the results of a qualitative pilot study that used teacher-research methodology to develop an understanding of what students learned about engaging across religious difference in RRSW. Results of this study show that students learned the value of approaching rhetorical engagement across religious difference with dispositions of hospitality, curiosity, and humility. Specifically, they came to see 1) the importance of using language that is grounded in writers' personal histories and accessible to (religiously) diverse audiences; 2) the value of approaching religious and spiritual writing as a process of inquiry; and 3) the significance of holding capacious notions of religious and spiritual rhetorics. After discussing the implications of students' learning in RRSW, I conclude the essay by articulating ways that more intentional engagement with scholarship in interfaith studies can assist teachers of writing in our efforts to enrich writers' capacities to engage with religious difference in productive ways. 5 DePalma / Fostering Ethical Engagement across Religious Difference S cholars in rhetoric and writing studies have long been committed to discovering how we might best equip rhetors to engage across difference in ways that promote understanding, connection, and empathy while also allowing space for dissonance and disagreement (see, for example, Baca, et al.; Bizzell and Herzberg; Blankenship; Canagarajah; Hum and Lyon; Pratt; Ratcliffe; Trimbur). Conceptions of rhetoric that have for decades remained vital to the work of the field reflect enduring concerns about how to productively negotiate difference. Wayne Booth, for example, offers his notion of "rhetorology" as a form of "listening rhetoric" that seeks to "reduc[e] misunderstanding by paying full attention to opposing views" (10). Rhetorology, Booth hopes, "teaches that learning to listen, and encouraging our opponents to listen, can sometimes yield moments of sheer illumination: a trustful pursuit of truth replacing what had appeared to be a hopeless battle" (172). Kenneth Burke conceptualizes rhetoric as a symbolic means of inducing cooperation among interlocuters who are "both joined and separate, at once a distinct substance and consubstantial with another" (21). Efforts to traverse our divisions and achieve consubstantiality, he argues, necessitate identification. Sonja J. Foss and Cindy L. Griffin, too, theorize invitational rhetoric as "an invitation to understanding as a means to create a relationship rooted in equality, immanent value, and self-determination." In the midst of our ongoing encounters with a diversity of perspectives, invitational rhetoric is offered as a framework for interaction that seeks for rhetors and audiences to gain "understanding that engenders appreciation, value, and a sense of equity" (5). Exigent questions concerning how best to foster the kinds of writing knowledge, abilities, and dispositions that are essential for thoughtful engagement across difference in our twenty-first century context have likewise influenced current approaches to rhetorical education in generative ways (see, for instance, Clifton; Duffy; Glenn et al.; Roberts-Miller). Scholarship in this vein offers valuable pedagogical insights concerning ways to prepare writers to engage in ethical deliberation. A dimension of difference that we have yet to adequately account for in our discussions of twenty-first century rhetorical education, however, is engagement across religious difference. Religious diversity is a major facet of our contemporary context in the United States and around the world. Sociologists of religion widely assert that the United States is more religiously diverse in our present moment than in any other previous era in recorded history (Jones and Cox 10). On a global scale, there are equally dramatic shifts in religious affiliation underway that are altering the world's religious landscape. Not only is this ever-increasing diversity of the world's religious composition significant to the more than 84 percent of the world's population who identify as religiously affiliated (Pew Forum on Religion and Public Life, "Global" 9) or the more than 75 percent of Americans who claim religious affiliation (Pew Forum on Religious and Public Life, "Religious"), but these shifting dynamics pertain to all who are concerned with how to promote peaceful, respectful, and ethical forms of engagement across difference in our present moment. Readers are all too familiar with the long record of tragedies in which clashes over religious difference have fueled wars, genocide, oppression, demagoguery, violent hate crimes, harassment, and other such ills. These religious conflicts erode human dignity, sever bonds, undermine deliberation, and threaten the very foundations of democracy. Such outcomes, however, are in no way a given and indeed may be subject to intervention through rhetorical education.
Responding to Religious Patients: Why Physicians Have No Business Doing Theology
Journal of Medical Ethics, 2019
A survey of the recent literature suggests that physicians should engage religious patients on religious grounds when the patient cites religious considerations for a medical decision. We offer two arguments that physicians ought to avoid engaging patients in this manner. The first is the Public Reason Argument: we explain why physicians are relevantly akin to public officials. This suggests that it is not the physician's proper role to engage in religious deliberation. This is because the public character of a physician's role binds her to public reason, which precludes the use of religious considerations. The second argument is the Fiduciary Argument: we show that the patient-physician relationship is a fiduciary relationship, which suggests that the patient has the clinical expectation that physicians limit themselves to medical considerations. Since engaging in religious deliberations lies outside this set of considerations, such engagement undermines trust and therefore damages the patient-physician relationship.
Medical Ethics in Religious Traditions: A Study of Judaism, Catholicism, and Islam
J IMA, 2006
Multiculturalism and its associated plurality of value systems is rapidly becoming the norm in modern medical practice. Given this increasing diversity, greater emphasis upon cultural and ethical competence in physician training is necessary in order to provide culturally sensitive and ethically sound care. Religious values shape ethical codes and are expressed in the cultural norms of subcommunities in a society. Thus, an understanding of religious values that may influence the clinical encounter is important. This paper provides an overview of the ethical constructs of the sacred law traditions of Judaism, Catholicism, and Islam and will outline approaches taken by each faith regarding medical ethics. It is hoped that the insights gained will aid both clinicians and ethicists to better understand these religious paradigms of medical ethics and thereby positively affect patient care through increased tolerance and understanding.
Interfaith dialogue in medicine
Baylor University Medical Center Proceedings, 2019
A moral crisis has swept through the United States dividing social, political, and religious organizations with corrupt and ineffectual leadership. However, the present moral crisis has its roots in the technological and cultural shifts of the last half century. The goal of interfaith dialogue is not merely to exchange pleasantries, but to build a mutual collaboration addressing the moral and ethical issues with a unified voice. Interfaith dialogue has the potential to pull us out of our individualism and, in focusing on our relationships, create a new sensibility about being human. And were that new sensibility understood to reflect some of the fundamentals of science, it would strengthen the ability of religions to pursue a more healing inclusivity and reveal a rich unity among religious faiths, stretching down from our personal relationships with each other to the divine and the very fabric of reality. KEYWORDS Dialogue; interfaith; medicine; religion W ith social media, mass communication, and computers, polarization between opposing groups and traditions has only deepened. Amid this polarization, the separation and exclusive claims of the various religious traditions have prevented the formation of a unified voice to tackle modern social and political divides. Humans have a natural tendency to form groups with those who share similar beliefs, hobbies, and goals. In general,
The Place for Religious Content in Clinical Ethics Consultations: A Reply to Janet Malek
HEC Forum, 2019
Janet Malek (2019) argues that a "clinical ethics consultant's religious worldview has no place in developing ethical recommendations or communicating about them with patients, surrogates, and clinicians." She offers five types of arguments in support of this thesis: Arguments from (i) consensus, (ii) clarity, (iii) availability, (iv) consistency, and (v) autonomy. This essay shows that there are serious problems for each of Malek's arguments. None of them is sufficient to motivate her thesis (nor are they jointly sufficient). Thus, if it is true that the religious worldview of clinical ethics consultants (CECs) should play no role whatsoever in their work as consultants, this claim will need to be defended on some other ground.
Cultural and Religious Studies, 2016
Given that preaching is the primary mode of public theological discourse for most Christian ministers, an intellectual virtue of verbal restraint is required when practicing public theology and it is wise to address the ways that homilies can shepherd public discourse practices. A theology of rhetoric includes the homilist’s moral purpose. Homilies either enhance public discourse or pervert it. This essay sketches a pattern of sermon movement that respects the logic operative in public theology, given the social context of America. Homilies can help cultivate the pastoral care of public rhetoric by modeling discourse that nurtures the politics of accountability. While many call for a public ethos where divergent moral voices engage each other in highly contested arenas, a precondition to practicing effective public theology requires that one exercises discourse in a way that respects the social limits on the free exercise of religion. It is important that a public theology of rhetoric clarifies the original social agreement for acceptable religious discourse in the public arena. Homiletics, as a dimension of practical theology, can teach preachers methods of pastoral care for public discourse. The social agreement in liberal democracies to contain the combative nature of religious discourse assumes a logic that is circumscribed by commitments to (1) religious pluralism, (2) theological agnosticism, and (3) epistemological pragmatism. Here we propose that a sermon’s form, which implicitly touches upon these commitments, can tap into the basic modes of persuasion in secular liberal societies. This respects the moral purposes previously agreed upon and expected of partisans during highly contestable times. This calls for incarnational humility on the part of the Christian public theologian and it guides her/his practice.