Sin and suffering in a Catholic understanding of medical ethics.

Drawing chiefly on recent sources, in Part One I sketch an untraditional way of articulating what I claim to be central elements of traditional Catholic morality, treating it as based in virtues, focused on the recipients ("patients") of our attention and concern, and centered in certain person-to-person role-relationships. I show the limited and derivative places of "natural law," and therefore of sin, within that framework. I also sketch out some possible implications for medical ethics of this approach to moral theory, and briefly contrast these with the influential alternative offered by the "principlism" of Beauchamp and Childress. In Part Two, I turn to a Catholic understanding of the nature and meaning of human suffering, drawing especially on writings and addresses of the late Pope John Paul II. He reminds us that physical and mental suffering can provide an opportunity to share in Christ's salvific sacrifice, better to see the nature of our earthly vocation, and to reflect on the dependence that inheres in human existence. At various places, and especially in my conclusion, I suggest a few ways in which this can inform bioethical reflection on morally appropriate responses to those afflicted by physical or mental pain, disability, mental impairment, disease, illness, and poor health prospects. My general point is that mercy must be informed by appreciation of the person's dignity and status. Throughout, my approach is philosophical rather than theological.     

Why patients should give thanks for their disease: traditional Christianity on the joy of suffering.

Patristic teaching about sin and disease allows supplementing well-acknowledged conditions for a Christian medicine with further personal challenges, widely disregarded in Western Christianities. A proper appreciation of man's vocation toward (not just achieving forgiveness but) deification reveals the need to cooperate with the Holy Spirit's offer of grace toward restoring man's pre-fallen nature. Ascetical exercises designed at re-establishing the spirit's mastery over the soul distance persons from (even supposedly harmless) passion. They thus inspire the struggle towards emulating Christ's (self-crucifying) kenotic love, and to accept even secularly "undeserved" suffering as spiritually deserved in view of his (forever) lacking fervor in that struggle. Only in the spirit of that love can the evil Adam's sin brought into this world work its therapeutic impact, the eschatological purpose of which explains God's lovingly permitting that evil. This therapeutic impact is physically manifested already in this life through the transforming energies granted the saints of the church.     

Sin, sickness, and salvation.

This article seeks to provide commentary and rationale for Orthodox Christian rites and prayers for the sick as found in the Euchologion, or Book of Needs. The reader needs to understand that the prayers of the Orthodox Church prayed at times of sickness and suffering will often strike the non-Orthodox as harsh and even unjust. References to God willing suffering do not sit well with most Western Christians. However, this is the Orthodox Christian belief, and it is expressed in the prayers of the Orthodox Church. Sickness and suffering are understood to be avenues of salvation and a participation in the glory and joys of the resurrection of Christ and life in the Kingdom of God. This is why the Orthodox Church teaches her faithful to accept suffering as something that has the potential to bring them further along in the process of theosis.     

Sin,shame, and the subject

In this chapter I revisit construals of sin and shame, beginning with a moment of auto-investigation. I then set this data in conversation with historical, theological, and philosophical configurations of shame to reconceive sin and shame. I describe sin as curvatus ex carne (turning from the flesh) to signal sin as a refusal of both our embodied existence and a commodification of the land on which it lives. I then use a carnal hermeneutic to argue for a positive understanding of discerning shame as a resource for an ethical life that contrasts with shame of disgrace.     

America and the Eighth Deadly Sin

In this article, I argue that the cultivation of innocence in the United States, coupled with policies of free market expansionism, the acquisitiveness of capitalism, rising militarism, the hubris of democratic evangelism, free market fundamentalism, and the immense U.S. militaristic and economic power, is an especially fatal sin. In general, I contend that nurturing innocence involves overlooking the inadvertent and advertent destruction and suffering that has resulted from U.S. interventionist policies and actions in the 20th and 21st centuries. Finally, I argue that the cultivation of innocence, which is often supported by Christian theological language, contradicts central Christian beliefs. Dr. LaMothe has published two books, Revitalizing Faith through Pastoral Counseling and Becoming Alive: Psychoanalysis and Vitality as well as numerous articles, Correspondence to Ryan LaMothe, rlamothe@saintmeainrad.edu     

Life history, sin, and disease.

On the basis of experiences in pastoral hospital care, the relationship between disease, sin, and guilt in the life of patients is explored. Against the disregard of this subject in medicine, and even in most of pastoral care, it is argued that patients' interest requires that their hidden or manifest questions be addressed, rather than their being exposed to efforts at "helping" through mere attempts at "debt clearance." Only by openly confronting sin and guilt can the patient be taken seriously in his role as subject of his disease. Theological and anthropological background considerations revealing the essence of sin as a disruption or even destruction of the Divine gift of life in its realization through a lived relationship to God and other humans are offered as evidence for this claim.     

Sociobiology and Original Sin

This paper argues that the creation narrative of the Fall in Genesis 2:4b–3:24 is not history and does not contain a doctrine of original sin. The doctrine of original sin as a theory of human nature needs a new foundation. The contemporary science of sociobiology has a theory of human nature that is remarkably similar to major versions of the Christian doctrines of original sin. To incorporate sociobiology's theory of human nature into Christianity is to lay the foundation for a new, ecumenical understanding of original sin.     

Entropy,the Fall,and Tillich: A Multidisciplinary Approach to Original Sin

The focus of this paper is to present a bridge between the theological notion of original sin and the scientific concept of entropy. Physics has firmly established that the universe is moving towards increasing entropy, whereby the cosmos is in a state of decay and growing disorder. At the same time, traditional theology has perceived that the world is in a state of chaos, resulting from the sin of Adam and Eve. While these notions have a number of significant similarities, the causal explanation for both theories poses a problem for any correlation between the two. Theology has struggled to explain how human action produced entropic phenomena without enacting anachronistic explanations that discount scientific data. This paper intends to close the gap by positing the principle of entropy as an existential dynamic of the Fall, thus reasserting the universality of original sin and evading the narrowness of anthropocentrism. Paul Tillich's interpretation of the Fall provides important insights that can affirm the corrosion of the world from a scientific and a theological perspective, potentially bringing these two disciplines into a position for a more fruitful dialogue.     

Religion-specific resources for meaning-making from suffering: defining the territory

The purpose of this review paper is to present a case for more proximal and emic approaches to the study of religious meaning-making in suffering. Meaning-making is an important way in which religion and spirituality contribute to adjustment in the context of encountering difficult life events. However, much of the available research on religious meaning-making ignores the contributions of specific religions to the meaning-making process. We begin by presenting a rationale for more sustained attention to religion-specific resources for meaning-making in suffering. Using Park’s meaning-making model as the organising framework, we then articulate how religions contribute unique global beliefs, situational beliefs, meaning-making processes, and valued outcomes to meaning-making. We illustrate these using existing research. Next, we suggest a refinement to Park’s model, offering a preliminary recursive model involving these identified components. We conclude with a brief prospectus informed by our model for future research.     

Constitutivism and the virtues

In Self-Constitution, I argue that the principles governing action are “constitutive standards” of agency, standards that arise from the nature of agency itself. To be an agent is to be autonomously efficacious, and the categorical and hypothetical imperatives arise from those two attributes. These principles are also “constitutive” of agency in two more specific ways. First, they meet the “constitution requirement”: the object must meet the standard in question, at least to some extent, in order to be the kind of object that it is. Second, they meet the “self-constitution requirement”: the object makes itself into the kind of object that it is by conforming to the standard. That is, the agent makes herself into an agent, and into the particular agent who she is, by conforming to those standards. Some neo-Aristotelians believe that Aristotelian virtues are constitutive standards. In this paper, I first ask why moral philosophers should focus on the virtues at all, considering the views of David Hume, Philippa Foot, and Aristotle. I then ask whether Aristotelian virtues meet the constitution requirement, and suggest that there are grounds for this view in the Nicomachean Ethics. But Aristotelian virtues do not meet the self-constitution requirement, which leaves Aristotle unable to explain moral responsibility. I end by examining the role that Aristotelian virtues could play in a Kantian ethic.     

Anger and the virtues: a critical study in virtue individuation

Aristotle and others suggest that a single virtue – ‘good temper’ – pertains specifically to anger. I argue that if good temper is a single virtue, it is constituted by aspects of a combination of other virtues. I present three categories of anger-relevant virtues – those that (potentially) dispose one to anger; those that delay, mitigate, and qualify anger; and those required for effortful anger control – and show how virtues in each category make distinct contributions to good temper. In addition to clarifying the relationship between anger and the virtues, my analysis has theoretical implications for virtue individuation more generally, and practical implications for character cultivation.     

Responsibility, Passion, and Sin: A Reassessment of Abelard's Ethics

This article reassesses Peter Abelard's account of moral intention,or, better, consent, in light of recent work on his own thought and on the twelfth-century background of that thought. The author argues (1) that Abelard's focus on consent as the determining factor for morality does not rule out, but, on the contrary, presupposes objective criteria for moral judgment and (2) that Abelard's real innovation does not lie in hisdoctrine of consent as the sole source of merit or guilt, but, rather, in his exploration of the ways in which this doctrine affects our understanding of the objective criteria for moral judgment. In particular, Abelard is led by his doctrine of consent to a thoroughgoing reassessment of the moral significance of the passions, which, in turn, leads him to reject the view that actions should be evaluated in terms of the praiseworthy or vicious character of the passions they express.     

Sin and bioethics: why a liturgical anthropology is foundational.

The project of articulating a coherent, canonical, content-full, secular morality-cum-bioethics fails, because it does not acknowledge sin, which is to say, it does not acknowledge the centrality of holiness, which is essential to a non-distorted understanding of human existence and of morality. Secular morality cannot establish a particular moral content, the harmony of the good and the right, or the necessary precedence of morality over prudence, because such is possible only in terms of an ultimate point of reference: God. The necessity of a rightly ordered appreciation of God places centrally the focus on holiness and the avoidance of sin. Because the cardinal relationship of creatures to their Creator is worship, and because the cardinal corporate act of human worship is the Liturgy, morality in general and bioethics in particular can be understood in terms of the conditions necessary, so as worthily to enter into Eucharistic liturgical participation. Morality can be summed up in terms of the requirements of ritual purity. A liturgical anthropology is foundational to an account of the content-full morality and bioethics that should bind humans, since humans are first and foremost creatures obliged to join in rightly ordered worship of their Creator. When humans worship correctly, when they avoid sin and pursue holiness, they participate in restoring created reality.     

Abnormality, cognitive virtues, and knowledge

Causal analyses of one’s knowing that p have recently emphasized the involvement of cognitive virtues in coming to believe that p. John Greco suggests that in order to deal with Gettier-type cases, a virtue analysis of knowing should include a requirement that one’s knowing does not in a certain way involve abnormality. Yet Greco’s emphasis on statistical abnormality either renders his analysis subject to a generality problem or to objections regarding certain Gettier-type cases. When we instead consider abnormality in the sense of a causally differentiating factor in relation to a causal contrast situation, the account remains unclear concerning its application to an interesting non-Gettier-type case concerning chance. The exploration of these shortcomings casts doubt on the epistemological usefulness of the schema, ‘If you know, then there is no abnormality in your being right.’     

Attitudes to suffering: Parfit and Nietzsche

Abstract

In On What Matters, Derek Parfit argues that Nietzsche does not disagree with central normative beliefs that ‘we’ hold. Such disagreement would threaten Parfit’s claim that normative beliefs are known by intuition. However, Nietzsche defends a conception of well-being that challenges Parfit’s normative claim that suffering is bad in itself for the sufferer. Nietzsche recognizes the phenomenon of ‘growth through suffering’ as essential to well-being. Hence, removal of all suffering would lead to diminished well-being. Parfit claims that if Nietzsche understood normative concepts in Parfit’s objectivist sense, he would not disagree with the claim that suffering is bad in itself – that intrinsic facts about suffering count in favour of our not wanting it. I argue that Nietzsche would disagree. Suffering for Nietzsche is not merely instrumentally necessary for psychological growth, nor is it easy to construe it as something bad in itself that contributes value as part of a good whole. Suffering that can be given meaning through growth is something we have reason to want. Suffering that remains brute and uninterpreted is something we have reason not to want. But for Nietzsche, suffering as such has no invariant value across all contexts.     

Who Dares,Speaks: Critical psychotherapy and the poetics of suffering

It is proposed that a critical psychotherapy could be developed by combining ideas from psychoanalysis with concepts from poetics, as Lacan originally suggested. Taking a narrative and personal style, and using examples of two men silenced by trauma and a clinical vignette, the author combines Laplanche’s psychoanalytic concept of fourvoiement with some examples of the poetics of ambiguity as an example of how such a critical psychotherapy could develop. Studying how words express more than their literal meaning is combined with the idea that we are continually going astray from the original decentring concept of the unconscious that Freud introduced to psychotherapy.     

Suicide and masochism: The evolving relationship between guilt,suffering, self-attack and suicide

Masochism is a complex and intriguing phenomenon. Self-attack may serve many purposes. Some patients suffer through harsh self-criticism, bodily harm, or even tormenting thoughts of death, without actually killing themselves. Some of these patients ultimately may go on to die by suicide, but for many, the self-torturing aspect may exist independently in acute or chronic forms. This paper addresses the complex relationship between masochism and suicide as two separate yet interconnected phenomena.     

Positive psychology on character strengths and virtues. A disquieting suggestion

The Values in Action (VIA) classification of character strengths and virtues has been recently proposed by two leading positive psychologists, Christopher Peterson and Martin Seligman as “the social science equivalent of virtue ethics.” The very possibility of developing this kind of an “equivalent,” however, is very doubtful in the light of the cogent criticism that has been leveled at modern moral theory by Alasdair MacIntyre as well as the well argued accusations that positive psychology, despite its official normative neutrality, is pervaded by specifically Western individualism and instrumentalism. In order to evaluate whether the VIA project can be considered as substantially rooted in virtue ethical tradition, the classification was assessed against two fundamental features of the classical version of the latter: (1) the substantial interconnectedness of individual virtues, as expressed by the thesis of the unity of virtue, and (2) the constitutive character of the relationship between virtue and happiness. It turned out, in result, that the two above features are not only absent from but also contradicted by the VIA framework with the latter's: (1′) construal of individual virtues and character strengths as independent variables and (2′) official endorsement of the fact/value distinction. As soon as the arguments for the superiority of the classical virtue ethical perspective are provided, the potential responses available to the VIA's proponents are discussed.