Resources Reviewed
A New Religious America: How a "Christian Country" Has Become the World's Most Religiously Diverse Nation.
Diana L. Eck. San Francisco: Harper San Francisco, 2001. 404 pp. $27 (Hardcover).

Encountering God: A Spiritual Journey from Bozeman to Banaras.
Diana L. Eck. Boston: Beacon Press, 1993. 259 pp. $15 (Paperback).

On Common Ground: World Religions in America.
Diana L. Eck and the Pluralism Project. New York: Columbia University Press, 1997. $195 (CD-ROM).

America's New Religious Landscape.
Thirteen/WNET and Religion and Ethics Newsweekly. New York: Thirteen/WNET, 2001. $15 (Videotape and discussion guide).

Diana Eck, professor of comparative religion and Indian studies, and director of the Pluralism Project at Harvard University, begins one chapter in her latest book with a statement of fact. Jumping off from the opening words of the U.S. Constitution, she writes: "'We the people of the United States of America' are now religiously diverse as never before . . ."

Eck's book, A New Religious America, documents this unprecedented religious diversity, paying special attention to the most "different" of the new religious Americans by devoting full chapters to the largest groups—Hindus, Buddhists, and Muslims—and sprinkling other chapters with vignettes about faith communities such as Jains, Sikhs, and Afro-Caribbean religions. Since Eck explores the implications of the new religious diversity for adherents of America's historically dominant religion, she does not delve deeply into the recent, significant ethnic diversification within U.S. Christianity.

Eck concludes the above-cited sentence about America's religious diversity with: ". . . and some Americans do not like it." Examples of such disdain include an extreme manifestation in South Carolina during debate about posting the Ten Commandments in public schools, where a state board of education member blurted out: "Screw the Buddhists and kill the Muslims."

America's remarkable religious diversity confronts every sector of American society. America's response to that fact concerns Eck. Although she does not examine health care in the same depth as law, politics, education, and other sectors, both her analysis and agenda provide important food for thought for healthcare professionals.

"How will we handle the questions of our religious diversity today?" Eck asks. She examines three basic approaches in American civic history: exclusion, assimilation, and pluralism. Exclusionists want to deny new, "alien" religions access to public participation and even entry into the country. Assimilationists welcome adherents of new religions but demand that they shed all distinctiveness while adopting the dominant society's culture and faith. Pluralists welcome new religions without assimilationist strings attached, asking only that they pledge allegiance to a common civic code. Beyond that requirement, pluralists say "come as you are, with all your differences . . . and be yourselves."

Eck examined an analogous theological typology in her earlier semiautobiography, Encountering God. There she identified three theological responses to religious diversity: exclusivism, "our truth is the only truth"; inclusivism, "our truth is superior to or inclusive of other truths"; and pluralism, "truth is not exclusively or inclusively possessed by any one religion." Eck is both a theological pluralist and a civic pluralist, but in A New Religious America she separates the two issues: "No matter how we evaluate religions that are different from our own, no matter how we think about religion if we are atheists or secularists, the covenants of citizenship to which we adhere place us on common ground." American society will be better served, she contends, if we take the pluralist path into our increasingly diverse religious future rather than opt for either exclusion or assimilation.

Eck carefully delineates four characteristics of the civic pluralism she advocates in A New Religious America, closely paralleling the theological pluralism she outlined in Encountering God. First, pluralism should not be equated with diversity, which she calls "mere plurality," but rather it requires active engagement with diversity. Second, pluralism goes beyond simple tolerance of diversity in an attempt to gain real, constructive understanding of others different from oneself and one's own group. Third, pluralism is not relativism of commitments or perspectives. "Pluralism is engagement with, not abdication of, differences and particularities," Eck writes. Thus pluralism is also an ongoing engagement among diverse elements of society.

Some have criticized Eck's theological pluralism. In his review of Encountering God, the well-known comparative religion scholar Huston Smith took issue with Eck's liberal bias, which he felt assigns moral superiority to the pluralist agenda of engagement and egalitarian dialogue over either exclusivism or inclusivism. "Is it wise (or even accurate?) to morally fault those who don't engage in [pluralist] dialogue?"¹ Smith asked. Eck's theological pluralism appears overtly only minimally in A New Religious America, as when she contends that a healthy religious faith requires dialogue with other faiths. Exclusivists would disagree, and inclusivists would define interfaith dialogue differently.

The exclusivism/inclusivism/pluralism theological typology has been thoroughly discussed in Christian and interfaith circles. In a paper entitled "Instrumentality, Complexity, and Reason" given at the 2000 meeting of the Society for Buddhist-Christian Studies, Terry Muck, an evangelical Christian scholar involved in Buddhist-Christian dialogue, dubbed exclusivism/inclusivism/pluralism "The Paradigm" because of its ubiquity. However, Muck finds the common ideological use of The Paradigm unhelpful—"very few people seem to really fit in any one of the three categories," he says—and suggests that attention be given to the specific ways religious people use The Paradigm instrumentally in facing religious differences. Here we find that many people employ all three positions, shifting stances depending on the context or issue at hand. A person may be a pluralist in one situation but an exclusivist or inclusivist in other situations. We may "default" toward one position, Muck says, but we will likely use all three at times.

Eck's civic paradigm of exclusion/assimilation/pluralism will no doubt elicit debate, criticism, praise, and refinement as has her theological paradigm of exclusivism/inclusivism/pluralism. For many Americans the two paradigms intertwine since an increasingly diverse religious society raises theological questions of truth claims. "How shall I live with my new Hindu, Buddhist, or Muslim neighbors?" easily leads to, "How shall I evaluate the different faith stances among us?" The discussion relocates from the theoretical realms of civics and systematic theology to the houses of residence and ritual practice next door.

And it takes place in our healthcare system. The Asian population in the United States—from which stems most of the new religious diversity—increased more than 200 percent between 1980 and 2000, primarily as a result of relaxed immigration restrictions, and is projected to increase another 200-plus percent by 2050. Many nurses, physicians, and medical technicians have arrived in the recent immigration wave, so the American healthcare system now includes more non-Christians as both providers and recipients than ever before. What does this diversity mean for American health care? Specifically, how might we apply Eck's two paradigms, civic and theological, to this sector of American society?

In civic terms, the American healthcare system at times excludes certain groups from access to adequate health care and input into decision making, at times demands assimilation to the dominant ethos and protocols, and at still other times exhibits pluralist tendencies like multicultural awareness and cultural competence. Thus, at the civic or institutional level, the system appears instrumentally selective in its responses to diversity, to borrow Terry Muck's notion. Theologically, healthcare professionals who themselves profess a particular faith interact with the new religious diversity of their patient pool from all three positions—exclusivism, inclusivism, and pluralism—perhaps also in selectively instrumental ways.

The key question becomes whether the pluralist response to religious diversity is best in health care, or whether we can have an adequate healthcare system without it being pluralist or without its participants becoming pluralists. In Eck's terms, a pluralist healthcare system and its participants would (1) go beyond acknowledgment of mere plurality to active engagement with diversity; (2) seek real, constructive understanding of differences rather than settle for simple tolerance of diversity; (3) avoid relativism of commitments or perspectives; and (4) establish an ongoing process of engagement among diverse constituencies. When we recall the caveat that pluralist acceptance of differences presupposes allegiance to a common civic, or in this case institutional, code, little in this agenda raises eyebrows—at least theoretically. Practically, of course, in contexts of diversity it takes a great deal of negotiation to determine the boundaries of the common ground and areas of distinctiveness. In health care this challenge surfaces in countless negotiations between cultural accommodation and ethical, legal, and medical requirements. Accommodating cultural and religious differences is a good working principle, but it is not absolute. Sometimes rules demand that conformity override diversity. But this is the strength of civic pluralism: its willingness to put in the hard work of consensus building. It is a theme with deep roots in American history, as Eck points out.

Thus, at the civic or institutional level, our healthcare system improves under a pluralist agenda since pluralism offers more hope of distributive justice and flexible accommodation than either outright exclusion or inflexible assimilation. We do not need to become maximal pluralists like Eck, but optimal pluralism is a good strategy for addressing the growing religious diversity of the American healthcare system. Even minimal pluralism would suffice. The intensity and extent of pluralist measures may vary, but we are better off with anything than with nothing. Cultural competence initiatives, for instance, are pluralist efforts to enhance patient care. As the American Medical Association puts it: "Culturally competent physicians are able to provide patient-centered care by adjusting their attitudes and behaviors to account for the impact of emotional, cultural, social, and psychological issues on the main biomedical ailment."² It is worth noting that the healthcare literature has been ahead of the pluralist curve in this country, exploring the implications of diversity at least back to the 1980s when the great influx of Southeast Asian refugees following the Vietnam War began to affect the healthcare system.

At the theological level, however, I see no need to privilege pluralism, even though I am at heart a theological pluralist who, like Eck, seems to be working out my own "salvation" diligently through engagement and egalitarian dialogue with non-Christian "others." Perhaps I still retain vestiges of my nonpluralist upbringing, but I believe that exclusivists and inclusivists can provide the same level of health care to a patient of a different faith as pluralists. This must be emphasized as pluralist initiatives proliferate throughout the healthcare system. We must not instill resentment by demanding or even insinuating that theological pluralism accompany civic pluralism.

One of the principles of diversity interaction that I recommend to healthcare providers is to "Know yourself," that is, to recognize personal perspective and judgment on religious diversity. Exclusivist physicians, for instance, who believe that certain patients are going to hell need to acknowledge that perspective and value it personally, yet bracket it out in their provision of health care. Such bracketing is standard procedure in the scholarly study of religious groups and individuals.

I know of a Pluralism Project affiliate who visited his doctor wearing a Harvard shirt and carrying a copy of the Park Ridge Center Bulletin's issue on "Health Care and the New Immigration."³ When the Harvard man explained that he studies religious diversity, his doctor replied: "Satan loves religious diversity. The more diversity, the better Satan likes it." "No, God loves religious diversity," the Harvard man retorted pluralistically, to which the doctor advised: "Study the Bible, not Harvard."

That doctor was being a good theological exclusivist but not a good civic pluralist. The Harvard patient received his medical prescription but told me that he thought the doctor had acted unprofessionally and stepped over a line in the physician-patient relationship.

In the 1960s some civil rights leaders made an important distinction: We don't necessarily want the dominant society to love us, just to stop oppressing us. In responding to the demands of America's new religious diversity, I don't necessarily want healthcare providers to love that diversity enough to become Eck's kind of theological pluralist. I only want them to adopt a sufficient amount of Eck's civic pluralism in meeting the needs of their increasingly diverse clientele.

Readers wishing to pursue the implications of Diana Eck's civic pluralism audiovisually may consider the Pluralism Project's cd-rom, On Common Ground. The U.S. military chaplaincy has used On Common Ground in its training programs, bespeaking its potential in training healthcare chaplains as well. The cd-rom includes resources specifically about the healthcare sector, such segments titled "Hospitals in a New Era" and "Space and Spiritual Resources." Before investing the significant purchase price, however, readers should consult Frederick Denny's thorough review in the Journal of the American Academy of Religion.⁴ The Pluralism Project staff is currently preparing a re-engineered and updated version of the cd-rom; for more information check www.pluralism.org.

The one-hour video, America's New Religious Landscape, compiles previously broadcast feature stories about American religious diversity from the best-kept secret on PBS, the Religion and Ethics Newsweekly program. Here theological pluralism comes to the fore, perhaps reflecting the influence of the Alban Institute, an independent support organization for congregations that advised production and distributes the video and its companion discussion guide. The material seems geared toward study groups in pluralist Christian congregations, although it may also appeal to pluralist Jewish congregations. Eck wrote an introductory piece to the discussion guide and is featured in two segments of the video.

At one point in the video Eck references the saying that to know only one religion is to know no religion. That saying originated with F. Max Muller, the father of the scholarly discipline of the comparative study of religion in which Eck, Huston Smith, Terry Muck, and I trained. Muller argued that comparison is crucial to the objective—he called it "scientific"—nontheological investigation of religion as a universal human phenomenon. Comparative religion scholars do not necessarily need to become theological pluralists, either.

NOTES
1. Huston Smith, "Interfaith Dialogue: Who's doing it and why," The Christian Century 111, no. 8 (March 9, 1994): 252–253.