The Role of Christian Belief in Public Policy

Abstract

It seems intuitive to the believer that God intended through instruction in the Law to define morality, intended to lead humankind to “the right and the good.” Further, God's love for humankind, exemplified by the incarnation, atonement and teachings of Jesus, and empowered by the Holy Spirit, should lead to a better world. Indeed, the Christian worldview is a coherent and valid way to look at bioethical issues in public policy and at the bedside. Yet, as this paper explores, in a pluralistic society such as the United States, it is neither possible nor desirable for Christians to try to force their views on others. Still, it is obligatory for Christians to stand up and articulate their views in the public square. We should try to persuade others using either prudential or moral arguments. While we must be willing to live with “the will of the people,” at the same time, we must not be intimidated into accepting the position that our voice is not valid because it has a religious basis.

Keywords:

• abortion
• physician-assisted suicide
• public policy
• tolerance

I. INTRODUCTION

In the second letter to Timothy we read that “All scripture is inspired by God and profitable for teaching, for reproof, for correction, for training in righteousness; so that the man of God may be adequate, equipped for every good work” (II Timothy 3:15–16, NASB). But this admonition is clearly aimed at “the man of God.” Do the Hebrew scriptures to which the writer referred, and the Christian Bible into which this letter would subsequently be incorporated, offer instruction for everyone or just for those who believe?

In addition to scripture, how does Christian tradition and experience inform debate about acceptable behavior, especially behavior outside the church? What is the role of “the Christian ethic” in public policy today? Are other moral viewpoints equally valid? Even more pointedly, what is the role of the Christian's voice in public policy debates and in addressing bioethical issues at the bedside?

Christians who rely on scripture to guide belief, and on belief to guide behavior, often make a case for believers to discern public policy norms from scripture and thence for those believers to seek an influential voice in public policy. Theologian Carl F. H. Henry, while acknowledging that modern society is not comparable to the ancient Hebrew theocracy, asserted that the God of the Jews and Christians is “the source, stipulator, and sanction of the right and good. He is the ultimate ground of law and morality” (1984). This attribution of the source of the right and the good to the Judeo-Christian God would suggest that this faith tradition trumps other moral views. Based on a belief that human rights are endowed by God, and that civil government was established by God, Henry went on to view political involvement of believers as a service to God.

It seems intuitive to the believer that God intended through instruction in the Law to define morality, intended to lead humankind to “the right and the good.” Further, God's love for humankind, exemplified by the incarnation, atonement, and teachings of Jesus, and empowered by the Holy Spirit, should lead to a better world. And historically, evangelism and social action often went hand in hand. From John Wesley and William Wilberforce in England to Charles Finney and Theodore Weld in North America, the nineteenth century saw amazing social reform initiated by Christian faith and adopted by secular society.

However, historian Timothy L. Smith describes what he calls “The Great Reversal” in the early twentieth century, especially in the decade following World War I, by which he means a separation between Christians who focused primarily on personal transformation and those more dedicated to social action (in Stott, 1984, p. 6). Though not a clear dichotomy, many Christians in the twentieth century continued to seek peace and justice while others decried this as “the social gospel” and chose instead to focus on evangelism. The former approach is perhaps best exemplified in North America by the Reverend Martin Luther King, Jr. and other people of faith who began the political movement of desegration as a morally based correction for racial injustice and discrimination.

Christian influence on social issues has not been smooth or easy, and it has not always been positive. Tragically, and to the modern mind paradoxically, there were “Christian voices” in the nineteenth century who supported slavery and in the twentieth century who wanted to preserve segregation. Also on the negative side of the ledger, it was primarily Christians who promoted the failed social experiment of prohibition by imposing their understanding of morality on society as a whole.

In addition to the difficulties posed by this split in the twentieth-century Christian voice, in the 1970s Francis Schaeffer noted a shift from a consensus on Christian values in Western society to a focus on the two values of personal peace and affluence in what he termed the “post-Christian” era (1983, p. 205). Schaeffer's call to action was instrumental in motivating some Christians who had been focused on evangelism to become involved in the issues of abortion, infanticide, and euthanasia, not only by speaking out on these issues, but by supporting or providing morally acceptable alternatives (Schaeffer and Koop, 1980).

II. A CALL TO ACTION

Carl Henry, Francis Schaeffer, and other Christian thinkers have sounded a call to action for Christians to become involved in politics, presumably with the intent of elevating the role of morality, specifically Christian morality, in public policy. This would suggest that a Christian worldview should trump others, that Christians have “the right answers” and should use Christian morality to delimit public policy and/or personal behavior. However, this assumption is not clearly evident and is often demonstrably incorrect.

Even before Schaeffer's observations and encouragement to action, William Barclay noted the difficulty of enforcing or even defining right behavior in a permissive society. “Thirty years ago no one ever really questioned the Christian ethic. Thirty years ago no one ever doubted that divorce was disgraceful; that illegitimate babies were a disaster; that chastity was a good thing; that an honest day's work was part of the duty of any respectable and responsible man; that honesty ought to be a part of life. But today, for the first time in history, the whole Christian ethic is under attack. It is not only the theology that people want to abandon—it is the ethic as well” (Barclay, 1971, p. 13).

While picking up on Schaeffer's theme, Charles Colson and Nancy Pearcey later noted that the current cultural clash is not so much between three traditional worldviews—the Western world, the Islamic world, and the Confucian East—(their categorization), but within Western civilization itself, “between those who adhere to a Judeo-Christian framework and those who favor postmodernism and multiculturalism” (Colson and Pearcey, 1999, p. 19). This division was clearly demonstrated to me several years ago when I was invited to participate in a conference at the University of West Virginia entitled “The Spiritual Dimension of Illness, Suffering and Dying.” Speakers were invited from a diverse spectrum of the three monotheistic faith traditions—Judaism, Christianity, and Islam. What became evident as the conference progressed was a surprisingly univocal perspective among those who claimed a “traditional,” “orthodox,” or “scriptural” view of faith. A foundational belief in the sovereignty of God and the sanctity of human life based on the imago Dei was clear in all three faith traditions, and this led to very similar positions on matters of public policy. Differences appeared, however, with participants from the same named traditions who claimed a more modern, or even postmodern, perspective.

One postmodern perspective would have us believe there is no natural law or common morality. Each person's morality is of equal standing, since truth is relative and knowledge is really a matter of interpretation. Issues in the public arena are then said to be “morally neutral.” The myth of moral neutrality becomes quickly evident, however, in discussions of Hitler's atrocities, using napalm on innocent children, or pedophilic priests. Even in the discussion of abortion, a woman's absolute right to end her pregnancy for whatever reason becomes less than solid when the issue of abortion for sex selection is raised. And among the many postmodern cultural relativists, very few indeed are willing to support the practice of female circumcision, often labeled with the value-laden term “genital mutilation.”

A less extreme view of postmodernism adheres to a Christian orthodoxy but allows room for continued conversation with other worldviews that have in the past been judged as competing with or even mutually exclusive from Christianity (McLaren, 2004).

III. WHAT KIND OF ACTION?

In addressing how Christians should be involved in such public debates, John Stott describes three possibilities. First, Christians could impose their beliefs and values on society as a whole. He cites the thirteenth-century European Inquisition to combat heresy and the twentieth-century U.S. prohibition of alcohol as prominent examples.

A second and opposite approach is laissez faire—noninvolvement. The disastrous example Stott cites is the failure of the German church to speak out against the Nazi treatment of the Jews.

Rather than these two unjust and ineffective methods, he argues for persuasion by argument. “Because God is who he is, we cannot be indifferent when his truth and law are flouted, but because man is who he is, we cannot try to impose them by force” (Stott, 1984, pp. 43–57).

This approach might encourage argumentation about public policy from a perspective of consequences rather than right versus wrong; from prudence rather than morality.

IV. LEGLISLATING RIGHT AND WRONG: PRUDENCE VS. MORALITY

It is very common in debates on public policy for someone opposed to a restrictive law, e.g., a proposal to increase the penalty for selling drugs to children, to say “But you can't legislate morality. You can't make people be good.” It is certainly true that a society cannot legislate personal virtue. You can't force people to have good character. But can we legislate morality? Like virtue, it may be difficult to legislatively prescribe good behavior, but it may be more realistic to legislatively proscribe bad behavior.

Some laws are based on principles of morality. Murder, rape, child abuse, incest, bigamy, and theft are criminal offenses because they are morally wrong. Knowing there is a stiff penalty for breaking one of those laws may or may not act as a deterrent. But if an individual breaks such a law, whether because of a sociopathic character disorder, or in the midst of an irrational rage, or even based on a distorted assessment of consequences, society has decided that he must be punished. The punishment may even include enforced rehabilitation, e.g., for repeat sex offenders.

Some laws, however, are based not on morality, but on prudence; i.e., they are in place only, or at least primarily, to maintain public order and avoid potentially bad consequences, e.g., traffic laws and most civil laws.

Most public policy issues have overlapping components of morality and prudence. One example is capital punishment. Proponents assert that Godly justice allows, or even commands, “a life for a life.” In addition, they may try to make a prudential argument that the death penalty is a deterrent to crime. Opponents, on the other hand, counter with prudential arguments that capital punishment has not been demonstrated to be a deterrent, and because it is administered with apparent racial and socioeconomic bias, the death penalty is inherently unjust. They might even go on to make a moral argument that killing a criminal precludes his subsequent repentance and/or rehabilitation.

But as Stott asserts, it is not always necessary to invoke moral beliefs to produce good results. Sometimes religious belief is unnecessary or irrelevant to public policy debate. On some issues, different individuals, coming from different religious belief systems and/or using different methods of moral reasoning, may reach the same conclusion on public policy. For example, in 1974, Congress established the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The eleven appointed commissioners had various backgrounds and interests, coming from science and the humanities, from several different religious (or nonreligious) traditions. Observers Albert Jonsen and Stephen Toulmin noted with some surprise that the commissioners generally agreed on the practical conclusions of their three years of deliberations (the Belmont Report). However, they did not agree on the reasons for those conclusions and recommendations. “Serious differences of opinion began to appear only when individual commissioners went beyond the stage of formulating practical proposals and explained their individual reasons for participating in the collective recommendations” (Jonsen and Toulmin, 1988, p. 18).

Perhaps it is possible to reach public consensus on what should or should not be allowed by relying on prudence instead of morality. Maybe we can agree on principles and use them to seek desirable “good” consequences (vs. “bad”) of various policy options rather than the underlying “right” reasons (vs. “wrong”).

If our society sought to use this nonreligious approach to public policy, how could we agree on the principles, or even on the desirable end results? Some would argue that public policy is or should be based on “natural law.” This tradition traces its history from Plato and Aristotle, through St. Thomas Aquinas and John Locke, and on to several contemporary scholars who share in common the idea that human moral beliefs have a moral foundation in the form of general principles of right conduct that reflect a rational human nature (Buckle, 1991). Professor J. Budziszewski provides a contemporary Christian view of natural law (1997).

Others would rely instead on a “common morality,” defined by Bernard Gert as “a public system applying to all rational persons governing behavior which affects others and which has the minimization of evil as its end, and which includes what are commonly known as the moral rules as its core” (1988, p. 6). He lists “don't kill,” “don't steal,” and “don't lie” as moral rules about which there is general agreement, while recognizing there is not complete agreement about what constitutes other moral rules.

But sometimes the debate can focus merely on the consequences of a particular public policy without identifying the underlying principles or moral rules.

V. AN EXAMPLE: DEBATING PHYSICIAN-ASSISTED SUICIDE

Let's look at the current public debate on the legalization of physician-assisted suicide (PAS) to see how morality vs. prudence might play out.

Proponents argue for legalization of PAS from three perspectives:

1. Based on the Moral Principle of Autonomy: Each person should have the ability to control his or her own destiny, including the timing and manner of death.

2. Based on the Virtue of Compassion: Healthcare professionals have an obligation to alleviate suffering and to help a patient accomplish his or her goals.

3. Based on Consequences (prudence): Legislative proposals include safeguards to limit PAS to individuals who are terminally ill with less than six months to live, are not depressed, and are making a free and voluntary choice.

Opponents of this statutory change also offer three types of arguments:

1. Based on the Immorality of Suicide: Each person bears the image of God. Intentionally taking one's own life is an immoral act that attempts to exert human control over an event that should remain in the hands of a sovereign God.

2. Based on Professional Virtue: According to an official AMA opinion, assisted suicide “is fundamentally incompatible with the physician's role as healer” (Council on Ethical and Judicial Affairs, Opinion E-2.211). For 2,500 years the Hippocratic tradition has maintained that physicians should help patients in their distress, but must not help patients to end their lives.

3. Based on Consequences (prudence): PAS is not needed because good palliative care can adequately relieve suffering at the end of life. Safeguards are inadequate because the art of prognostication is remarkably inaccurate; depression is seriously underdiagnosed; coercion may be subtle. Another demonstrable bad consequence is that expansions and abuses of the practice have occurred in jurisdictions where PAS has been allowed.

Thus this public debate can occur at several levels. When arguing against legalization of PAS in Vermont, I generally focus on the bad consequences of such a major social change. While participating on a pro-and-con panel discussion at a county medical society meeting several months ago, I invoked arguments based on professional virtue and those based on prudence. A supporter of PAS then stood and said, “Dr. Orr is being dishonest. He is a Christian and is trying to force his morality on everyone else.” My response was that everyone in the room had a worldview that likely influenced his or her position on this issue. My Christian worldview is consistent with the longstanding professional position and also with the prudential concerns. I had chosen not to invoke the moral argument that evening since I suspected not everyone in the room shared my Christian perspective, but I invited everyone to apply his or her own moral base to the arguments.

Many issues with moral implications may be argued from a position of prudence in the public forum. However, others are inherently issues of morality. For example, proponents of embryonic stem cell research argue from a prudential perspective (such research offers great potential to help people afflicted with many diseases). Opponents may also use a prudential argument (adult stem cells have similar potential), but their stronger argument is a moral one (it is wrong to kill developing embryos because they are already human beings).

VI. WHAT IS THE ROLE OF TOLERANCE? … COMPROMISE?

The postmodernist preaches tolerance as the ultimate virtue. And clearly it is an important virtue. All too often public discourse takes on an intolerant and uncivil tone. I sometimes become embarrassed and want to hide when Christians use strident, even militant, tones in trying to “persuade” others. It is perhaps understandable that, because religion involves beliefs about truth, some religious people tend to be intolerant. But what is the object of the intolerance? I believe it was from Bishop Fulton Sheen that I first heard the idea “Tolerance applies only to persons, never to truth. Intolerance applies only to truth, and never to persons.”

In trying to define those boundaries to tolerance as we seek “the truth,” even Christians will not necessarily come to the same conclusions. S. D. Gaede says such diversity can be a strength “if it operates under a unity of purpose, for it improves our collective judgments and enables the Christian community to act with greater wisdom” (1993). But Richard J. Mouw reminds us that such diversity must come with an attitude of Christian civility in an uncivil world (1992).

One might hope that a tolerant, multicultural society would give equal voice to multiple worldviews. However, there has developed an antireligious bias in contemporary North American culture. ¹ Charles Colson and Nancy Pearcey note that as recently as 1952, U.S. Supreme Court Justice William O. Douglas wrote “We are a religious people whose institutions presuppose a Supreme Being” without causing a stir. But when Justice Antonin Scalia said publicly in 1996 that he was a Christian who believed in miracles and the resurrection of Jesus, he was castigated for his “bias” and his qualifications were questioned (Colson and Pearcey 1999, p. 22). The current interpretation of the separation of church and state has evolved from the original intent of avoiding either church dominance of government or governmental dominance of religion into the ongoing debate about the use of Christmas songs in “seasonal” celebrations in public schools, display of the Ten Commandments in public buildings, etc.

As if finding a public voice were not already hard enough, the difficulty of following the admonition for Christian involvement in public policy debates is compounded in a major way because contemporary Christians disagree on so many issues. As Barclay noted, some Christians support divorce, others do not. Some support a woman's choice to end an unwanted pregnancy, others do not. Similar differences are easily identified among Christians on many issues of public policy debate such as capital punishment, cloning, contraception and reproductive technology, embryonic stem cell research, evolution vs. creation, gambling, genetic reengineering, physician-assisted suicide, sex education, sexual practices, stewardship of the environment, war, welfare—and more. Is there an identifiable “Christian ethic”? Was there a Christian ethic that has been lost? Has the postmodern trend toward the authority of the self made church authority and/or denominational positions irrelevant? Has technology made Christian consensus impossible?

Given that we live in a pluralist society, and if we accept that Christians should not impose their beliefs on nonbelievers, is there room for compromise? Many Christians begin to twitch at the suggestion of compromise on moral issues. Some would even call it immoral to accept a rule of law that seeks to limit immorality. If a Christian believes that every abortion is wrong because it takes a human life, should he or she agree to a compromise that limits access to abortion to certain gestational ages, or lobby for laws requiring parental notification? Some would not be willing to sign on to any such compromise. Others would accept some limits as better than unlimited access. Pope John Paul II addressed this question by saying “… when it is not possible to overturn or completely abrogate a pro-abortion law, an elected official whose absolute opposition to procured abortion was well known, could licitly support proposals aimed at limiting the harm done by such a law and at lessening its negative consequences at the level of general opinion and public morality. This does not in fact represent an illicit cooperation with an unjust law, but rather a legitimate and proper attempt to limit its evil aspects” (1995, p. 135, emphasis in original).

This assessment does not, in my opinion, address the more common position of some politicians who say they are “personally opposed, but …” An attempt to limit evil by compromising on legal parameters is substantively and morally different from trivializing the issue by being unwilling to take a stand against the evil when it is time to vote. The banality of this stance can be readily seen by substitute wording: “I am opposed to pedophilia [or slavery], but …”

It may sometimes be a difficult and even undefinable line between supporting an effort to limit an immoral law and relinquishing moral responsibility. The issue of moral complicity with evil involves a calculus of many variables with no clear boundaries (Orr, 2003, pp. 1, 5).

VII. CHRISTIAN BIOETHICS?

From the profusion of books, journals, and websites on “Christian bioethics,” one might deduce there is not a single “Christian approach” to contentious issues in medical ethics today. The spectrum of views among Christians in medical ethics is nearly as wide as that in the secular arena. Even among those who claim a common belief in creation, a sovereign triune God, the fall of humankind, stewardship, atonement, judgment, and eternity, there exists today a diversity of opinion on the many ethical issues mentioned above that have moral implications.

My Christian beliefs color my beliefs and practices as a physician. Those views also color my perspective on moral issues in clinical ethics. But I must sometimes strive to avoid allowing my personal conclusions about these issues to delimit the practices of others. Let me offer two examples.

I believe it is ethically permissible (not obligatory) to withdraw artificially administered fluids and nutrition from a patient in a confirmed permanent vegetative state who has previously expressed a wish to not be maintained in such a condition. I believe this is consistent with a Christian view of stewardship and of life and death (Orr, 2004). Other Christians disagree (Meilaender, 2004). When I am doing an ethics consultation on this issue, I seek to determine the moral beliefs of the patient, his or her family, and the position of their own faith tradition. I will lay out the range of ethically permissible options, and support the choice of the patient as long as it is within that range.

The matter is more difficult if the issue is one on which I hold a more restrictive view than others. I believe that human life is sacred from the moment of conception and that intentionally aborting an embryo or fetus is morally troublesome. Fortunately, elective abortion as a matter of individual choice is rarely a matter of ethics consultation. However, it is not uncommon to be asked an opinion as a clinical ethicist about abortion of a late gestation anomalous fetus. I believe that the heavy psychological burden on a woman who is carrying a fetus with an absolutely certain diagnosis of a lethal anomaly (e.g., anencephaly) may sometimes be sufficient to justify termination of that pregnancy by early induction of labor. I am less willing to endorse the termination of a pregnancy if the diagnosis is less than certain, or if the diagnosis is of an anomaly that is not life-threatening. I am particularly distressed about a request to abort a fetus with Down syndrome based on a parental decision that they do not want to raise a child with developmental disability. So how do I write recommendations in a clinical ethics consultation on such a request? I include in the discussion the spectrum of the moral views on the issue, and I include my understanding of relevant state laws. I may or may not include my own personal opinion on the morality of the question, based primarily on whether I have been specifically asked my view. I conclude by suggesting the parents consider their own moral views and those of their faith tradition.

VIII. CONCLUSION

The Christian worldview is a coherent and valid way to look at bioethical issues in public policy and at the bedside. In a pluralistic society, it is neither possible nor desirable for Christians to try to force their views on others. It is not only preferable, but I believe obligatory, for Christians to stand up and articulate their views in the public square. We should try to persuade others using either prudential or moral arguments. We must be willing to live with “the will of the people.” At the same time, we must not be intimidated into accepting the position that our voice is not valid because it has a religious basis.

Notes

1. On a personal note, I was the subject of a local TV news investigation entitled “The Ethics of the Ethicist” in which it was asserted that a hospital ethicist should be morally neutral. My ability to provide bedside ethics consultation was questioned because of the presumed bias of my Christian beliefs.

Council on Ethical and Judicial Affairs. Opinion E-2.211. Physician Assisted Suicide. American Medical Association.