Bioethics and Worldview

I recently came across this 2010 story from CBS News:

“According to a mail-in survey of nearly 4,000 British doctors, those who were atheist or agnostic were almost twice as willing to take actions designed to hasten the end of life. They were also far more likely to offer “continuous deep sedation until death” and discus end of life options with their patients.”

You can find the original JME paper HERE.

This story caused me to ask myself, “How does a person’s worldview influence his stance on bioethical issues like physician-assisted suicide, abortion, and human embryonic stem cell research?” Having discussed and debated these issues with fellow medical students, it always seems like the conversation, when continued long enough, eventually boils down to differences in ideology.

In other words, you’re never going to reason someone into changing his stance on euthanasia if he’s approaching the question from a different ideological starting point than you are.

To highlight how our religious and philosophical beliefs influence our approach to bioethics, consider this article on bioethicist Leon Kass:

“Unlike questions of segregation and, before it, slavery, where evil was clear and the only question was how to deal with it,” Dr. Kass says, “the evils that I saw close to my own area of work were ones that were embedded in very high-minded pursuits: better health, peace of mind and the conquest of nature. Yet they contained within them the seeds of our own degradation.”

The trouble wasn’t so much with science itself, he thought, as with “scientism,” by which he means “a quasi-religious faith that scientific knowledge is the only knowledge worthy of the name; that scientific knowledge gives you an exhaustive account of the way things are; and that science will transcend all the limitations of our human condition, all of our miseries.” Scientism’s primary goal, Dr. Kass says, “is to put the final nail in the rule of revealed religion.”

We can think about many of these bioethical conundrums in light of the question, “Can the end justify the means?”

Is it morally justifiable for a doctor to kill a patient in order to satisfy that patient’s wishes? Is it morally justifiable to dismember a developing human fetus in order to increase “net happiness”? Is it morally justifiable to kill a human embryo in order to discover new ways of treating disease?

According to Dr. Kass, the concept of “human dignity” carries powerful moral ramifications. Bioethical decisions shouldn’t be made strictly on utilitarian grounds; they need to account for the fundamental value of human life, regardless of age, race, gender, or other such attributes. Certain (noble) goals cannot be justified, therefore, if they require that one violate human dignity.

Yet atheist psychologist Steven Pinker offers a drastically different opinion in his 2008 article, “The Stupdity of Dignity“:

“The general feeling [of conservative ethicists] is that, even if a new technology would improve life and health and decrease suffering and waste, it might have to be rejected, or even outlawed, if it affronted human dignity.

Whatever that is. The problem is that “dignity” is a squishy, subjective notion, hardly up to the heavyweight moral demands assigned to it…Once you recognize the principle of autonomy, [“dignity”] adds nothing…”

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In Ursula K. Le Guin’s famous 1973 short story, she describes the utopian city of Omelas – a place of luxury and comfort, without sickness or fear or pain.

“A boundless and generous contentment, a magnanimous triumph felt not against some outer enemy but in communion with the finest and fairest in the souls of all men everywhere and the splendor of the world’s summer: this is what swells the hearts of the people of Omelas, and the victory they celebrate is that of life.”

Yet the happiness and good fortune of Omelas must come at a price. Beneath the city, in a dark and filthy cell, a single small child must be kept in perpetual anguish.

“They all know it is there, all the people of Omelas…They all know that it has to be there. Some of them understand why, and some do not, but they all understand that their happiness, the beauty of their city, the tenderness of their friendships, the health of their children, the wisdom of their scholars, the skill of their makers, even the abundance of their harvest and the kindly weathers of their skies, depend wholly on this child’s abominable misery.”

Upon learning this truth, most of the citizens of Omelas are temporarily horrified…but they eventually come to terms with the child’s plight, rationalizing it as a necessary evil for the good of society. A few of the citizens, however, have a very different reaction.

“At times one of the adolescent girls or boys who go to see the child does not go home to weep or rage, does not, in fact, go home at all. Sometimes also a man or woman much older falls silent for a day or two, and then leaves home. These people go out into the street, and walk down the street alone. They keep walking, and walk straight out of the city of Omelas, through the beautiful gates. They keep walking across the farmlands of Omelas. Each one goes alone, youth or girl, man or woman. Night falls; the traveler must pass down village streets, between the houses with yellow-lit windows, and on out into the darkness of the fields. Each alone, they go west or north, towards the mountains. They go on. They leave Omelas, they walk ahead into the darkness, and they do not come back.”

Fine Tuning and Retrospective Probabilities

The fine tuning argument for the existence of God is based on the observation that there are numerous physical parameters (the mass and charge of a proton, the gravitational constant, matter-antimatter asymmetry, etc.) which appear “finely tuned” to produce a universe capable of harboring life. What fine tuning effectively shows is that, given random chance, it seems astronomically improbable that these parameters would align in such a way as to produce a universe with galaxies, stars, planets, and life.

I recently asked 23 atheists how they account for fine tuning (question #3 in the survey). Several respondents made a point that I found interesting, and wanted to address. They compared fine tuning to “winning the lottery”, and our own existence to that of “lottery winners”. For the lottery winner, the odds against winning the lottery are meaningless in retrospect…because he’s obviously already won. Thus, probability arguments like fine-tuning are worthless, because they can’t be applied to events that have already been actualized. One respondent put it this way:

“The term ‘finely tuned’ is an anthropomorphic spin on ‘it just is the way it is’. If things were any different we wouldn’t be here to ask the question. We have the power of hindsight and from our point of view, can see what looks like impossible odds of our existence. However, with any possibility of it being the way it is, no matter how small the chance is, then it’s possible. And since we are here to ask the question, the possibility was obviously realized, no matter the odds.”

The problem with this “lottery objection” is that it discounts alternative explanations, and assumes that we MUST have overcome these astronomical probabilities. But that puts the cart before the horse by presupposing a naturalistic explanation.

Imagine that your buddy Joe shows up to work one day, and starts throwing stacks of hundred dollar bills at everyone he sees. You know he’s not a rich guy, so clearly he recently acquired a huge sum of money. It’s possible that Joe just won the lottery (because even though the odds of winning are small, someone obviously has to win). Yet it’s also possible that Joe stole the money, or received it as a gift, or inherited it from a relative, or found it in a suitcase next to a dead guy in the middle of the desert.

Seems legit.

Hopefully you see where I’m going with this. The point is that none of us can really “know” with empirical certainty exactly how our life-permitting universe got here. The statistical improbability of fine tuning can’t be waved off as “inevitable good luck” unless one has already ruled out the alternative explanation to “luck”. So the fine tuning argument is effective because it (indirectly) lends credence to this “alternative explanation”: that these fundamental physical constants were intentionally and intelligently set by a Fine Tuner.

Capstone Marriages and Cornerstone Marriages

My wife and I belong to that peculiar, sometimes-applauded, often-scorned, steadily-shrinking club of “Christian kids who married young”. We’d both turned 21 within a few weeks of the wedding. So naturally I’ve taken a passing interest in the recent controversy over youthful marriages (sparked, I think, by the “Knot Yet” report and Karen Swallow Prior’s article in The Atlantic).

In her article, “The Case for Getting Married Young”, Prior points out that the average age for marriage has reached historic highs (29 and 27 for men and women, respectively). She cites some interesting statistics (“unmarried twenty-somethings are more likely to be depressed, drink excessively, and report lower levels of satisfaction than their married counterparts”), then explains how the prioritization of education and career objectives has led to a shift in society’s conception of marriage:

“The religious framework for marriage is also crumbling. Marriage has become, therefore, to use Thompson’s apt term, “hedonistic,” based on the exponential amount of pleasure—material, emotional, sexual, familial, you name it—that can be derived from the coupling of two individuals.”

Like myself, Prior rejects this modern view of marriage, in which young people are encouraged to spend the first decade of their adult lives “finding themselves”…attaining an education and career, clubbing and barhopping, traveling the world, experimenting with multiple romantic relationships, cohabitating, and eventually getting married once they “figure out who they are”. Instead, like myself, Prior views marriage as a “cornerstone” rather than a “capstone”.

“We invested the vigor of our youth not in things to bring into the marriage, but in each other and our marriage.”

Although I’m not arguing that everyone should marry young (or even that everyone should marry, period), I do think there’s something to be said for navigating the challenges of early adulthood with a teammate.

In another recent article on Slate, Julia Shaw illustrates this point:

“Marriage wasn’t something we did after we’d grown up—it was how we have grown up and grown together. We’ve endured the hardships of typical millennials: job searches, job losses, family deaths, family conflict, financial fears, and career concerns. The stability, companionship, and intimacy of marriage enabled us to overcome our challenges and develop as individuals and a couple.”

…as does Collin Garbarino over at First Things:

“I married relatively young and managed to get three graduate degrees while married. Marriage provided my wife and me an anchor that helped us focus on our goals while we were in our twenties.”

Again: I’m not saying that everyone should get married at 21 like myself. I think the real issue here, rather than “age”, is the attitude that one brings into marriage (the “cornerstone model” vs. the “capstone model”).

In light of my own experiences, I’m actually opposed to one-size-fits-all statements like “everyone should marry young” or, to quote one of the feminist responses that I read, “women, don’t marry young”. Given the advances women have made in education and career opportunities, I think most people are quick to recognize the injustice of telling a young woman “you need to give up (or postpone) your career in order to marry and raise a family”…but are less quick to recognize the injustice of telling a woman, “you need to give up (or postpone) marriage in order to first pursue your career.” Shouldn’t feminists be encouraging the prototypical young woman to decide for herself what’s important to her?

But I digress. I’ll close with an excerpt from a 2009 report from sociologist Mark Regnerus:

“[The] age at which a person marries never actually causes a divorce. Rather, a young age at marriage can be an indicator of an underlying immaturity and impatience with marital challenges — the kind that many of us eventually figure out how to avoid or to solve without parting. Unfortunately, well-educated people resist this, convinced that there actually is a recipe for guaranteed marital success that goes something like this: Add a postgraduate education to a college degree, toss in a visible amount of career success and a healthy helping of wealth, let simmer in a pan of sexual variety for several years, allow to cool and settle, then serve. Presto: a marriage with math on its side.

Too bad real life isn’t like that. Marriage actually works best as a formative institution, not an institution you enter once you think you’re fully formed. We learn marriage, just as we learn language, and to the teachable, some lessons just come easier earlier in life. “Cursed be the social wants that sin against the strength of youth,” added Tennyson to his lines about springtime and love.”

Noteworthy Links: April 2013

Do you remember that time last October when I was too busy to write a new blog post, so I passed along some interesting links instead? Well, I’m at it again:

  1. The Adventure of the Elected Man (Dead Heroes Don’t Save)
    Mike over at Dead Heroes Don’t Save has posted a fictional encounter between Sherlock Holmes and Charles Spurgeon, in a convincing imitation of one of Sir Arthur Conan Doyle’s famous short stories. Written from the perspective of Dr. Watson, we’re treated to an intellectual and theological exchange when the famous preacher pays a visit to 221B Baker St. [Note: this story is being published in installments, and is currently still a work in progress.]
  2. The Crusades: Wanton Religious Violence? (J.W. Wartick)
    The Crusades are often presented as an archetype of “violence in the name of religion”. My friend J.W. examines this claim in light of the larger geopolitical context of that time period, and offers some thoughtful commentary on the nature of religious and secular violence. “The Crusades have been used as a kind of polemic device against Christianity. Whenever it is argued that Christianity is reasonable, someone inevitably brings up this historical period…I have argued for the notion that these events were historically complex, involving a number of factors beyond purely war for the sake of a faith.”
  3. An Open Letter to the Church from a Lesbian (Sententias)
    This one pretty much speaks for itself. “Have you been Christ-like in your relationships with us? Would you meet us at the well, or restaurant, for a cup of water, or coffee? Would you touch us even if we showed signs of leprosy, or aids? Would you call us down from our trees, as Christ did Zacchaeus, and invite yourself to be our guest? Would you allow us to sit at your table and break bread? To those of you who would change the church to accept the gay community and its lifestyle: you give us no hope at all. To those of us who know God’s word and will not dilute it to fit our desires, we ask you to read John’s letter to the church in Pergamum…”
  4. What to Believe About Miracles (Nature)
    This excellent commentary appeared in the journal Nature way back in 1986. “It is not logically valid to use science as an argument against miracles…Miracles are unprecedented events. Whatever the current fashions in philosophy or the revelations of opinion polls may suggest, it is important to affirm that science (based as it is upon the observation of precedents) can have nothing to say on the subject.”