This article appears in the August 2000 edition of the Catholic Medical Quarterly

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Are Catholic doctors tragic optimists?

Christopher Maxwell-Stewart

Based on a Talk delivered at the Symposium of the Scottish Catholic Medical Association and Guild of Catholic Doctors, May 2000


Catholic doctors are finding themselves at the ethical front line, facing some of the most difficult moral issues of our times. Crucial decisions have to be made in the midst of profound emotional, legal and professional pressures. Doctors, therefore, are more aware than most that no moral decision is ever purely individual.

All moral decisions have a social dimension and a universal reference. This is not only because 'no man is an island , but just as importantly because we are not the authors of our own existence. We cannot simply invent our own moral universe. We are born into a world which has its own objective reality, so doctors’ actions have real effects which are determined by the meanings which are built into nature - including our own shared human nature.

Yet we all know that such an objective view of morality goes against the grain of our post Christian society. We live in a culture of subjectivity which confuses conscience with preference or feeling, and thinks of autonomy in terms of mere self_assertion. True personal autonomy is not a matter of each of us being free to assert our individual version of the truth, but consists rather in that inner peace which comes from freely embracing the real Truth. So while personal conscience is indeed our essential daily guide to individual decision making, it also needs to be formed and informed with sound principles of objective moral teachings.

Conscience is like a compass pointing out for us the direction in which good and evil lie in particular circumstances; but in order to be of any use on life’s journey we also need a decent map of the whole moral landscape through which we must travel.

On the social level, in a similar way, democracy is undoubtedly a valuable tool for running a reasonable society; but democracy cannot determine right from wrong for itself: the moral law is not determined by majority vote. A stable society needs to be built on the bedrock of objective human values, not just the prevailing sentiments of the times. There must be a point of reference beyond the bickering community, a clear map of the shared goods and truths of human living.

Although we have no written constitution in the United Kingdom, historically, of course, it was Christianity which provided that foundation for us. Without these Christian foundations it is no surprise that the commissions set up to advise government on key ethical issues (whether at Westminster or Holyrood) struggle to find objective points of reference. We cannot deal with literally life and death issues on the basis of so called ‘ethical pluralism’ from conflicting ‘models of morality’. As we are all only too well aware, any attempt to argue from Christian morality these days is commonly met with the objection that we are trying to impose our views on other people s consciences.

In reality, what we are seeking to do is to appeal to the conscience of people of good will, by offering sound principles on which the communal conscience can work to protect our very own dignity and freedom. In the light of revelation we know that this world is not an autonomous order, nor is it just our private playground or research laboratory. We are the stewards of creation under God. There are no limits to our dominion, and not all possibilities are to be followed up, for not all possibilities are constructive.

There must be moral absolutes - fixed points on the moral map - because there are absolutely valuable truths about ourselves which we ignore at our own peril, however tempting or convenient it might appear to break them, whether in the name of progress or compassion. If a doctor advises you to give up smoking or lose weight, or to adhere strictly to the dosage on the drug bottle, it is not because he or she is trying to be a kill_joy, but that they are warning you of a medical fact of your own constitution and its possible consequences. God’s commandments refer equally and even more urgently to the facts of our own nature with regard to our spiritual health.

We find that we must ask ourselves what are the limits of our autonomy, our control over our own lives and the lives of others.

Society will not be able to answer these questions nor resolve these issues without a return to an understanding of the world which re_unites both Science and Religion in one world view. This is why our stance on particular moral issues like abortion and euthanasia must be seen as an integral part of the wholesale re_evangelisation of our society, bringing it back to Jesus Christ as the source of all truth and goodness, the authentic standard of humanity, care and compassion. We find ourselves in a society which has been seduced by the secular myth of moral neutrality and agnostic pluralism - the idea that there are no fixed points, that there can no longer be any unified world view, no certain moral vision.

The favourite pop song of middle_aged, liberal minded, Islington man is fast coming true in modern Britain: "Imagine there’s no heaven ... and no religion too ... nothing to die for ..." The only trouble is that if there’s nothing to die for, then there s nothing to live for! If there are no absolute values, then nothing is absolutely valuable! If there is no heaven - then this must be hell!

Secularism doesn’t work because it actually believes in nothing and holds nothing sacred but its own grip on power and influence. The curious lie at the heart of secular liberalism is that it is anything but liberal. Moral liberalism soon enough ceases to be ‘open_minded’ and begins to impose its own agenda impatiently on us all. We can see this happening with several moral issues at the moment. This is usually done in the name of what is presumed to be the unstoppable direction of "progress"; but this really means that most people have already unconsciously accepted the utilitarian view that there are no natural boundaries which may not be crossed in the name of some perceived benefit, and nothing which is absolutely to be valued in all circumstances - not even the human person.

The human spirit, like the rest of nature, abhors a vacuum. So pluralism is only ever a temporary phase in any culture: sooner or later only one moral agenda will triumph. As Catholics, we are what I like to call "tragic optimists".

We believe that the Truth will triumph in the end, but the victory will not come without persecutions and setbacks, perhaps even crucifixion before the final resurrection. But we always go on working and praying for that authentic vision of human dignity which is revealed in Christ, because it remains a fact of the social order as much as of the personal moral realm, that only the Truth sets us free.

Fr Christopher Maxwell-Stewart is a priest of the Diocese of Arundel & Brighton.

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