Suffering and interpersonal meaning: commentary

I would like to suggest that to describe suffering as a psychological phenomenon is still too general. It leaves the door open to the belief that suffering is an individual phenomenon, experienced because of dynamics arising out of the individual psyche as the pain arises out of the individual body. Instead of describing suffering as a psychological phenomenon, we should describe it as an interpersonal, even communal phenomenon....If the task of reestablishing, continuing, and creating interpersonal meaning within the context of suffering is accepted, the problem often arises concerning how the health professional can accomplish this task with the patient under the extraordinary circumstances that pain and illness, as well as the health-care environment, provide. Beyond sensitive and thoughtful dialogue, we may have to return to a sense of ceremony within health care, especially since the rationalistic naiveté of nineteenth-century positivism did so much to encourage the belief that the best health care is the one that does things efficiently and "unceremoniously"....     

Christian bioethics, secular bioethics, and the claim to cultural authority.

Though the papers in this volume for the most part address the question, "What is Christian about Christian Bioethics", this paper addresses instead a closely related question, "How would a Christian approach to bioethics differ from the kind of secular academic bioethics that has emerged as such an important field in the contemporary university?" While it is generally assumed that a secular bioethics rooted in moral philosophy will be more culturally authoritative than an approach to bioethics grounded in the contingent particularities of a religious tradition, I will give reasons for rejecting this assumption. By examining the history of the recent revival of academic bioethics as well as the state of the contemporary moral philosophy on which it is based I will suggest that secular bioethics suffers from many of the same liabilities as a carefully articulated Christian bioethics. At the end of the paper I will turn briefly to examine the question of how, in light of this discussion, a Christian bioethics might best be pursued.     

Sin and bioethics.

The essay starts out with defining the biblical concept of sin in the Old and the New Testaments. The literal knowledge of divine truth is distinguished from its truthful and spiritual interpretation. A further distinction should be made between the Creator of life (God) and the medium or "intermediary creator" (man) of life. I argue for the "single wholeness" of the human race and for the unity of human responsibility in bioethics. In delineating the teaching of the Church on abortion and family planning, I show that the healing of all human diseases, from traditional interventions to genetic ones, is a Christian duty and is in accordance with Christ's mission on earth as long as one has not been directly or indirectly involved in "reproducing" or "designing" one's descendants or destroying or damaging human life even at its very beginnings.     

Widows, women, and the bioethics of care.

Widows, women, and the bioethics of care must be understood within an authentic Christian ontology of gender. Men are men and women are women, and their being is ontologically marked in difference. There is an ontology of gender with important implications for the role of women in the family and the Church. The Christian Church has traditionally recognized a role for widows, deaconesses, and female monastics, which is not that of the liturgical priesthood, but one with a special relationship to care and therefore with particular implications for health care and a Christian bioethics of care in the twenty-first century. In the shadow of early male mortality, women as wives should turn to support their husbands and as widows to support those in need. Widows, in becoming authentic Christian monastics, can bring into the world an icon of rightly ordered women providing rightly ordered Christian care for those in need. They can enter the moral vacuum created by misunderstandings of the place of women and the service vacuum created by a disappearance of religious nuns in Western health care facilities with a presence that is at one with the Church of the Fathers.     

Feminism, law, and bioethics

Feminist legal theory provides a healthy skepticism toward legal doctrine and insists that we reexamine even formally gender-neutral rules to uncover problematic assumptions behind them. The article first outlines feminist legal theory from the perspectives of liberal, cultural, and radical feminism. Examples of how each theory influences legal practice, case law, and legislation are highlighted. Each perspective is then applied to a contemporary bioethical issue, egg donation. Following a brief discussion of the common themes shared by feminist jurisprudence, the article incorporates a narrative reflecting on the integration of the common feminist themes in the context of the passage of the Maryland Health Care Decisions Act. The article concludes that gender does matter and that an understanding of feminist legal theory and practice will enrich the analysis of contemporary bioethical issues.     

Literal meaning, conventional meaning and first meaning

Literal meaning is often identified with conventional meaning. In A Nice Derangement of Epitaphs Donald Davidson argues (1) that literal meaning is distinct from conventional meaning, and (2) that literal meaning is identical to what he calls first meaning. In this paper it is argued that Davidson has established (1) but not (2), that he has succeeded in showing that there is a distinction between literal meaning and conventional meaning but has failed to see that literal meaning and first meaning are also distinct. This failure is somewhat surprising, since it is through a consideration of Davidson's notion of radical interpretation that the distinction between literal meaning and first meaning becomes apparent.I am grateful to the Social Sciences and Humanities Research Council of Canada for its financial support, and to Mark Mercer, Tom Patton and Gary Wedeking for their helpful comments. I would also like to thank David Checkland, who discussed A Nice Derangement of Epitaphs with me at length some years ago.     

Language, meaning, and social cognition.

Social cognition is meant to examine the process of meaningful social interaction. Despite the central involvement of language in this process, language has not received the focal attention that it deserves. Conceptualizing meaningful social interaction as the process of construction and exchange of meaning, the authors argue that language can be productively construed as a semiotic tool, a tool for meaning making and exchange, and that language use can produce unintended consequences in its users. First, the article shows a particular instance of language use to be a collaborative process that influences the representation of meaning in the speaker, the listener, and the collective that includes both the speaker and listener. It then argues that language use and social cognition may have reciprocal effects in the long run and may have significant implications for generating and maintaining cultural differences in social cognition.     

Principles and theory in bioethics.

The following citations were selected from BIOETHICSLINE, the online database prepared at the Kennedy Institute of Ethics for the National Library of Medicine's MEDLARS system. Searching the keywords autonomy, beneficence, casuistry, justice, and virtues, as well as the text word principlism produced more than 400 citations. Only the citations concerned with theory and principle in the practice of bioethics are included here -- e.g., works about justice in resource allocation have been deleted.     

Nanotechnologies, bioethics and human dignity

Nanoscale science, research, and technology present a complex set of circumstances. First of all, this field involves many different subjects, including biology, chemistry, physics, and environment sciences. Secondly, although scientists are working increasingly at a molecular level, nanotechnology is about much more than a reduction of scale. Indeed, nanoscience and Nanotechnologies offer an unprecedented ability to control and manipulate nature, offering hope for progress. Ethical perspectives vary considerably in this field, but commentators and researchers share a concern about a specific worrisome issue: the lack of appropriate ethical and legal principles and processes (associated with issues including health risks, human body manipulation, and private life violation), to guide nanotechnological R&D, commercialization, and final use. Some authors partially reject this concern by suggesting that Nanoscience and Nanotechnologies do not constitute an autonomous category, and that they are instead just the operative result of combining other traditional areas of study. However the nanotechnological debate brings up the semantic and content issues of bioethics and foments a contentious discussion emphasizing human dignity. Issues include enhancement versus therapeutic intervention, traceability versus privacy, and societal benefits versus risks. From these preliminary considerations, we will move on to discuss (I) the traditional, although still controversial, relationship between bioethics and human dignity, and (II) return to the subject of nanotechnology. We will discuss how today in Europe, although still indefinite, the principle of respect for human dignity is a welcomed contributor to "ethical vigilance" about the uncertain development of new nano-scale technologies. We will also note how U.S. strategy in this regard is simply lacking and appears only as a purely discursive "key issue in long term ".     

Suffering, Prayer, and Miracles

Unrelieved suffering leads many to ask, “How can I trust a miracle-working God, who will not help me or my loved ones?” From brief exegeses of Jesus' healing of a man born blind (Jn 9) and of Jesus' response to Pilate's murderous oppression (Lk 13), I argue that (1) God uses suffering to call its witnesses to repentance and to acts of steadfast love that fulfill the creation of humanity; (2) miracles are real, rare, and ambiguous; (3) God is good and powerful enough to deliver everyone decisively, but God's patient commitment to human freedom and universal reconciliation preclude it; (4) all suffering is sacrificial and will become meaningful; and that (5) there are at least three faithful and coordinate responses to suffering.     

Spirituality,health care,and bioethics

This article explores the relationship of spirituality to health care and bioethics in terms of the need and efforts of people to make sense of their lives in the face of illness, injury, or impending death. Moving beyond earlier associations with specific religious traditions, spirituality has come to designate the way in which people can integrate their experiences with their sense of ultimate meaning and related values. The holistic model of health care also affirms that one should not simply treat a body in pain, but respond to the suffering of the whole person within his or her full life. A narrative emphasis in ethics also maintains that ethical decisions occur within the framework of interacting life-stories, each of which embodies a certain core vision and set of values. In each instance it is the life stories of people, their lived narratives, that provide a common thread. The telling of these stories and the discernment of the lived spirituality they contain may assist persons in the process of achieving understanding, making decisions, and finding purpose in the experience of illness, injury, or disability.Maureen Muldoon, Ph.D., is Associate Professor in the Department of Religious Studies, University of Windsor, Windsor, Ontario, and Norman King, Ph.D., is Professor in the same department.