Superficial Ethics, Inspirational Morality
Ethics for the New Millennium
His Holiness the Dalai Lama.
New York: Riverhead Books, 1999.
237 pp. $24.95

Like the Dalai Lama himself, his books have been mostly well received-this latest one and The Art of Happiness also achieved best-seller status. Its author exudes a personal mix of charm, integrity, and saintliness, disarming to cynics and attractive to admirers alike. Ethics for the New Millennium accommodates the sensibilities of those who prefer a humanistic "spirituality" to traditional, institutionalized "religion".

All of this helps explain the Dalai Lama's appeal. Of course simplicity always runs the risk of lapsing into simplistic rhetoric, and Ethics for the New Millennium does tend toward ethical superficiality. Nevertheless I came away from this book morally refreshed.

The Dalai Lama's approach is easily summarized. He begins with the universal human wish to be happy and to avoid suffering. Moral action must be judged by whether or not it cultivates happiness and alleviates suffering in sentient beings, that is, those with "the capacity to experience pain and suffering". Compassionate concern for the well-being of others becomes both the touchstone and the paradox of the moral life, in that we gain true happiness not from seeking our own good, but from seeking the good of others. Such happiness is characterized by a deep sense of inner peace. The Dalai Lama admits that his insights are not new: "There is nothing in these pages which has not been said before". His point is that they must be said again and again, and practiced thoughtfully and diligently.

Ethics for the New Millennium addresses many moral issues from a personal to a global perspective. The Dalai Lama treats health and bioethics unsystematically, at times offering little more that pop psychosomatic diagnoses. At other times his words give pause to people in those fields.

He suggests, for instance, that all professions should be based on compassion, which can offer guidance in making choices-if an action will cause suffering, don't do it. Members of the caring professions have always clearly articulated such compassion, but it can exhaust them, as he points out. "Constant exposure to suffering, coupled occasionally with a feeling of being taken for granted, can induce feelings of helplessness and even despair. Or it can happen that individuals may find themselves performing outwardly generous actions merely for the sake of it-simply going through the motions, as it were." For such beleaguered compassionate helpers, the Dalai Lama counsels that "it is best to disengage for a short while and make a deliberate effort to reawaken that sensitivity [to others' suffering]". Good advice.

Elsewhere in the book he judges that the affection we show to the "diseased or marginalized" marks "the measure of our spiritual health, both at the level of the individual and at that of society". This is a poignant reminder as I ponder the national health insurance crisis.

The Dalai Lama's brief comments on contemporary dilemmas in science and technology comprise his most thought-provoking insights. For instance, following a summary of typical end of life scenarios where difficult moral decisions must be made, he adds an intriguing Buddhist twist by suggesting that a person might wisely choose to ride out bodily suffering now rather than end it peremptorily and face its possible prolongation into the next incarnation. As to various types of genetic experimentation, such as parental manipulation of an offspring's physical attributes, the Dalai Lama offers caution, deep humility, and compassion as guiding principles. (The book was written before, but is applicable to, the recent Internet bidding for supermodel ova). The idea that semi-human creatures might someday be bred for human spare parts utterly appalls the Dalai Lama: "Oh, terrible," he writes, because it shows no compassion for such sentient creatures. He finds animal vivisection to further scientific knowledge "equally shocking" for the same reason. He ends this chapter by reminding the reader of the importance of motivation in ethics. Of all the factors to be weighed in ethical decision-making, such as the circumstances of the situation, the action itself, and the consequences of the action, motivation is primary, what Tibetans call kun long, one's disposition "from the depths" of one's being. This must be infused with compassion.

Here we glimpse both the value and the shortcomings of Ethics for the New Millennium. If we make the broad distinction between morality as the foundational level of reflection about right action and ethics as the secondary level of systematic refinement and application of moral foundations, then the Dalai Lama-and comparable spiritual luminaries-function more as moral fountainheads than as ethicists. Thus the Dalai Lama offers a Morality for the New Millennium, based on an essential Buddhist value-compassion-from which non-Buddhists can also derive inspiration. But the important task of developing a systematic and, yes, complex ethical system from such moral underpinnings falls to others whose work will liekly not attain best-seller status. (Neither, one supposes, would an ethical treatise by the Dalai Lama).

I wrote earlier that, despite its tendancy toward ethical superficiality, I nevertheless came away from Ethics for the New Millennium morally refreshed. I suspect most readers will be likewise refreshed. I hope they will also feel compelled to move from the Dalai Lama's moral foundations to hard ethical examination. The new millennium needs both.

Feminism's Surprising Ally
Feminist Ethics an d Natural Law: The End of the Anathemas
Cristina L.H. Traina.
Georgetown University Press, 1999.
389 pp. $27.95

Feminism has always had an ambivalent attitude toward embodiment. Many feminists have sought to challenge reductionistic and deterministic accounts of women's relationship to bodies and nature, particularly those accounts that would restrict women to their "natural" biological functions as mothers and caregivers. Other feminists seize on precisely these biological differences between men and women to argue for an affirmation of women's maternal and caring capacities. Because of this division, appeals to nature, biology, and embodiment have been problematic in feminist circles.

Traina's book offers new perspective on these concerns and on the broader relevance of natural law to feminist rhetoric and argues that feminist ethics needs a new philosophical and theological backing grounded in an Aristotelian-Thomistic approach to embodied experience through a "telic anthropology" which Traina defines as "one with convictions about the ends toward which human beings individually, and human society generally, are to strive." Traina's "telic anthropology" or study of human nature and human ends, would thus seek to balance the need to make common, universal claims about human beings with the need to take account of the particularity and the pluralism of human experience- particularly women's experience-in determining what leads to human flourishing. With this natural law anthropology Traina challenges the idea that bodies don't matter-that gender and sex are both wholly socially constructed. Her strategy entails a feminist revisiting of natural law, which reduced to its barest Aristotelian-Thomistic rudiments refers to the idea that humans possess in their nature capacities for practical reasoning that lead them to act in conformity with their natural functions and the dictates of the divine and eternal law of God.

To make this argument, Traina attempts a reconstruction of the Roman Catholic natural law in feminist terms. As she notes, the task initially appears formidable, since to much feminism, "natural law is an unlikely ally." Yet Traina appeals to the Aristotelian and Thomistic traditions-despite their flawed biology and frequent misogynistic claims-for resources that will allow feminists to grapple with problems that arise from our embodied natures. Indeed, she argues that "feminist reconstructions of natural law are 'more adequate' than earlier versions of it not only by feminist and natural law standards but also before the demands of contemporary global moral conversation." In particular, she praises the emergence of a "new naturalism" that claims that "universally, the psychological, environmental, and bodily circumstances of human life provide loose criteria for human flourishing" and "that human flourishing has central (though not exclusive) normative importance."

Traina's argument begins with an overview of contemporary feminist moral discourse. It then moves to an examination of natural law thinking before and since Thomas Aquinas. It plumbs the thought of revisionist Catholic theologians Josef Fuchs and Richard A. McCormick and of liberation theologian Gustavo Gutierrez for feminist resources within contemporary Catholic moral thought. Finally, but most importantly, it derives critical principles for feminist ethics from the natural law tradition and assesses their adequacy in addressing the major theological concerns of that tradition and the concerns of feminist ethics. Traina then concludes with a feminist natural law analysis of reproductive technologies and breastfeeding practice in order to test the efficacy of her feminist critical principles at deriving universal claims in a pluralistic age and at taking feminism from pure critique to prophetic action.

In her survey of the landscape of contemporary feminist thought, Traina defines feminism as "a practical and intellectual dedication to the discovery and uprooting of ideologies, relationships, and institutions that thwart women's flourishing and to the creation of new ideologies, relationships, and institutions that promote it." It is this commitment to women's flourishing that Traina identifies as a common claim across many varieties of feminist thought. In Traina's view, the achievement of women's flourishing requires both "a critical approach to women's experience" and, borrowing the phraseology of liberation theology, "a preferential option for women, a primary commitment to women's well-being."

What insights does the thought of Thomas Aquinas, which at times seems to blend both Aristotelian and Augustinian brands of misogyny, have to provide to feminism? A great deal, in Traina's assessment. First, it provides a theological anthropology of law leading to virtue and a good that is "neither a deterministic power, nor an arbitrarily imposed requirement, nor a guide generated exclusively by human creativity." Second, it offers a method of practical reason in which "experiential knowledge is bodily knowledge" and in which " a degree of bodily health . . . allows for the sharpness of mind and sense that prudence requires." Third, it sets forth a notion of bodily health as a proximate and premoral good that avoids "tying concrete moral dictates merely to internal impulses or the shape of the body." Finally, it leaves a legacy of social thought that emphasizes the coherence of nature and grace, the need for social justice, and the important role of human law and human institutions in securing virtue, justice, and the good for both men and women.

While Traina finds in Thomistic thought "more that is friendly to feminism than most feminist ethicists likely expect," she also cautions that "nostalgic revivalism is misleading." In her view, the true tests of Thomistic natural law are the "responses the natural law tradition has made to profound, cumulative changes in our sense of ourselves and our surroundings, changes of which any viable contemporary ethics must also take account." Traina assesses the Thomistic tradition's capacity for change by examining four crucial developments in post-Thomistic natural law thinking that have important implications for feminism: casuistry, personalism, liberation theology, and postmodernism.

Casuistry, in Traina's view, is a mode of inductive, experiential, and interdisciplinary thinking. Casuistry subjects norms to "critical reformulation in light of charity, justice, and the requirements of integral flourishing" and thus allows it to "mediate marvelously between the metaphysical and moral traditions and the exigencies of both everyday and no-so-everyday life." Liberation theology brings crucial attention to the concrete and material conditions for human flourishing by asking "what sorts of social, political, and economic relationships honor human dignity and promote interdependent human flourishing." Personalism is likewise valuable because it is holistic, plural, diverse, and historical-treating the person as an "embodied whole," admitting the "possibility of genuine historical change in human nature," and insisting that "the variety of human experience must lead to variety in moral conclusions." Traina does, however, warn against "uncritical" forms of personalism that seek "to generate new justifications for old authoritative structures and moral norms." She sees postmodern deconstruction of moral positions as a double-edged sword as well-one that "can easily destroy natural law's anthropology, its epistemology, and even its capacity to engage in pluralistic conversation" or allow natural law, so long as it reveals the religious and thus nonneutral status of its claims, "to retain the double claim of universal perspicuity and Christian identity." This latter point is particularly significant for revealing how both natural law and feminism share the common concern to balance the universal and the particular. All in all, the tenets of holism, historicity, and pluralism that underlie these post-Thomistic natural law movements make natural law reasoning ideal, in Traina's view, for "reconsidering the indications of the 'natural' for human behavior, and therefore altering the concrete implications of biology for ethics."

From these Thomistic and post-Thomistic themes, Traina gleans several critical principles for the method, procedure, and content of a feminist natural law ethics. These include many of the old feminist standbys: acknowledging the links between public and private, testing theory against actual practice, evaluating truth claims from the perspective of the marginalized and oppressed, instituting open and participatory discourse, advancing women's moral agency, fostering solidarity among women, rooting norms in a "thick" anthropology, and ensuring that principles serve feminist ends. What is novel in Traina's assessment is her identification of important links between feminism and natural law emphases on legitimate self-regard, concern for virtue, reliance on practical reason, attention to the common good, and the idea of ethical reflection as a communal endeavor. These linkages, spelled out in detail, allow Traina to argue that the feminist critique of natural law ethics is ultimately an "inside critique" and that while "Thomas may be no 'proto-feminist,' yet liberative, feminist arguments that may go beyond and even contradict some of Thomas's concrete conclusions nonetheless fall within the space carved out by his most basic theological claims."

Having summarized these developments in post-Thomistic natural law, Traina turns her attention to Josef Fuchs, Richard A. McCormick, and Gustavo Gutierrez, in a chapter apiece, expanding upon the themes of personalism, casuistry, and liberation theology in contemporary Catholic moral thought. The trio of thinkers appears yet again in Traina's chapter on feminism and an adequate contemporary natural law, though Traina does take care to note each man's limitations as a feminist thinker. Specifically, Fuchs and McCormick demonstrate an "ambivalence toward the body." Gutierrez "goes furthest in making embodied social relationships part of the definition, and not just the context, of the human subject." Yet ultimately in Traina's assessment, none of these theologians "deals adequately with the bodily dimension of the human being or with the related phenomenon of commitment to those with whom, through biology, proximity, or choice, one has a special but perhaps not institutionalized relationship."

From a feminist natural law perspective, Traina further observes that none of these thinkers adequately addresses the "possibility of a permanent difference between the sexes that yields the potential for ongoing, experientially based differences in moral outlook." Likewise, none of these men "develops norms that self-consciously take into account gender differences in the needs that must be met for people truly to flourish" or "explicitly tests his argument against particular other women's or men's experience." Traina could have examined the work of Lisa Sowle Cahill, Cynthia Crysdale, Christine Gudorf, Jean Porter, Margaret Farley, or any of a growing number of contemporary feminists who are working within the natural law tradition. Indeed, in a significant revision to the book's earlier iteration as her doctoral thesis, Traina devotes a considerable portion of her preliminary overview to a comparison of the natural law theories of Lisa Sowle Cahill and Martha Nussbaum. One wonders, then, why Fuchs, McCormick, and Gutierrez, given their shortcomings in addressing issues of embodiment, particular relationships, and gender, were selected as the focus of a book seeking to articulate a feminist natural law ethic in which these concerns are paramount.

In the end, for Traina, feminist natural law is all about "integral human flourishing" as experienced and expressed through "self-consciously embodied subjects," whose equal value and dignity are to be "interpreted through the lens of their common humanity, not through the lens of their difference." Ultimately, Traina maintains, "the feminist critique shows not that Thomas or natural law revisionists lost sight of the integral person, but that they did not always fully understand or articulate the continuing dynamic interdependence of all the dimensions of integral personhood or the inherent and cultural differences in men's and women's experiences of their connection."

What of the body-that bundle of appetites and passions that is the medium of our sensory knowledge of the world and the vehicle for our inclination to action? The telic anthropology and practical mode of moral reasoning so characteristic of the natural law perspective present problems for contemporary feminists wary of moral theories that would "permit physical description of bodily relations to be morally determinative gauges of complex human relationships." Reproductive technologies and breastfeeding practices are cases in point. Traina concludes her book with analyses of official Catholic positions on reproductive technologies and the current vogue for breastfeeding in which conjugal or mother-child relationship becomes "an entity whose good seems to supersede even that of the persons who compose it." She criticizes positions that omit analysis of the ways in which desires for children and desires to breastfeed children are socially constructed, giving rise to ideals of biological motherhood that may be unwittingly or uncritically imposed on women in ways that may be "at best ignorant and at worst oppressive." Traina calls on natural law feminists to "examine rather than discard these 'natural' arguments, preserving them in anticipation of a time when they will not be used oppressively."

The potential reader of Feminism and Natural Law should be reminded that the book is a reworking of a doctoral dissertation aimed primarily at a scholarly audience. Traina helpfully instructs the reader who, like this reviewer, is interested primarily in her constructive feminist argument that some chapters-particularly those on Fuchs, McCormick, and Gutierrez-may be omitted without detracting from her argument. The book contains some specialized terminology and arguments from the natural law and contemporary Catholic moral traditions that may not be part of the working knowledge of the average reader. For those who are interested in a cutting edge feminist reconstruction of the Aristotelian-Thomistic natural law tradition that makes insightful remarks on possible feminist approaches to biology, embodiment, and nature, it is well worth a careful read.

As scientific and technological advances give us greater knowledge of the natural and biological bases of sexuality and gender, feminists and other observers will be pressed to address biology, nature, and embodiment in ways that avoid deterministic and reductionistic interpretation. In the end, as Traina maintains, "the 'natural' person has a telos, but 'natural' desires have no inevitability or ends or even independent existence that exert moral authority over the wisdom and freedom of the person whom they inhabit. Human nature in the fullest sense is the whole range of capacities and powers, interpreted differently everywhere, that we can marshal for the pursuit of our ends. Neither fixed nor arbitrary, it is the field of possibility within which we construct and pursue concrete visions of integral flourishing." Our bodies do not determine our ethics, but neither can they be ignored as components of our moral formation. This, it seems, is a sensible message to heed to ensure the flourishing of women, men, and all humanity. Traina's work is a valuable scholarly contribution to this aim and to showing that biology, nature, and embodiment need be neither anathema nor penultima in modern feminism.

Sins of Omission
The Fiction of Bioethics: Cases as Literary Texts.
Tod Chambers
Routledge, 1999.
389 pp. $22.99

If Tod Chambers wrote a libretto for his new book, a suitable leitmotiv might be Mary Chapin Carpenter's refrain, "It isn't what you said, / it's what you didn't say." Chambers legitimately criticizes bioethics authors for remaining silent about how cases are constructed. Through explication of narrative characteristics common to fiction and bioethics, he critiques the latter discipline. This, Chambers notes, takes a step beyond literary theory as handmaiden to philosophy, in which scholars provide source material or interpret texts.

The author begins by observing that all cases are retellings requiring choice of elements such as perspective, authorial distance, and chronotope (interrelation of time and space). He chides bioethics authors for maintaining a fact/value distinction in case presentation, perpetuating "the myth that there are clear, unmediated presentations of moral problems". Literary theory, Chambers maintains, is fundamental to understanding bioethics as a discipline because it exposes central philosophic features, including the notion that "real" cases are free from convention.

While he draws heavily on Gerard Genette and other literary scholars, prior knowledge of their work is not required, since Chambers clearly explains their relevance to his text. In addition to wisely chosen examples from literature and popular culture, he refers to events and articles well-known in bioethics. For example, Howard Brody's presentation of Tarasoff illustrates how ostensibly objective descriptions of fact may include artful insertion of exposition.

The primary issue in Tarassoff was whether a therapist has an obligation to warn a person whom a patient has threatened to kill. Chambers asserts that Brody's second-person narrative "entraps" the reader in the psychologist's mindset, as in this statement: "You know that the businss of predicting violent behavior is not as clear-cut as some would like to think". Rather than leaving it up to the reader to judge whether the killer's therapist could have reasonably anticipated the murder, Chambers argues that Brody forces the reader to agree with his own opinion that predicting a predilection for violence is an imprecise call. Such examples make The Fiction of Bioethics important for readers and authors, particularly in light of Chamber's observation that bioethics cases are almost always "writerly" (requiring active readers who provide narrative closure) rather than "readerly" (in which readers are passive).

To show how writers reveal their philosophical and theological perspectives through choice of narrator, plot character, and point of view, Chambers devotes the entire eighth chapter to four presentations of a single event-the widely reported case of Dax Cowart. After barely surviving an explosion, Cowart demanded to stop therapy. Although deemed competent, he was nonetheless treated. Cowart continues to maintain that he should have been allowed to die.

Chambers reveals how, in representing Dax's case, psychiatrist Robert White removes himself from the narration. Rather than discussing Dax's "little boy rage" and power struggles with his mother from the viewpoint of a consulting psychiatrist, White presents his interpretation of the case as an objective narrator, thus making his conclusions seem to flow logically from the "facts" of the case. Chambers then contrast White's psychologically complex exposition of the case to a presentation by Culvert and Gert containing no emotional nuance.

Emphasizing Dax's medical condition without providing information as to his emotional response to injury and reatment flattens him as a character. Dax becomes an abstract, which Chambers contends makes it easier to resolve the case using analytical concepts-the model of case analysis Culvert and Gert propound. Chambers notes the authors' emphasis on Dax's rational abilities, and their argument that as long as he was rational his autonomy should have trumped physician paternalism. However, this ignores the possibility that rational patients may have motivations other than pure reason for demanding removal of treatment. While acknowledging the problem of White presenting his interpretation as objective fact, Chambers credits White's rounded characterization of Dax for raising the question of whether Dax's demand was nothing more than autonomous choice, or an attempt by a rational patient to exert control in a situation rendering him helpless.

After the careful discussion in chapter eight, Chamber's final two chapters seem rushed. He introduces interesting topics (such as using performance to critique texts, and the gender of voice), but without the same level of detail or illustration. This is a minor flaw, however, and explained to some extent by the fact that, as Chambers acknowledges, some presentations he advocates have yet to appear.

Chamber's quarrel is not with any one style or interpretation of bioethics cases, but the discipline's general failure to acknowledge that all narrative construction requires articulation and imposition of a worldview. This omission, he asserts, perpetuates the erroneous notion that whereas cases philosophers write are hypothetical, hence manipulative, bioethics cases are "real," therefore purely objective and reliable.

Despite this criticism of bioethics, however, Chambers is no cynic. He suggests that its sins of omission are redeemable-not by abandoning case presentation, or by better writing, but through a better way to read. Writers should initiate "a series of readings of ethics cases that uncovers the rhetorical force of the case," and they should "become their own critical readers". This entails paying attention to narrative constructs, which reveal some things and conceal others. Chambers makes a convincing argument that a more self-reflexive bioethics will follow.

The Other Mother Eddy
God's Perfect Child: Living and Dying in the Christian Science Church.
Caroline Fraser
Metropolitan Books/Hery Holt Co., 1999.
432 pp. $30.00

What does it mean to respect a person's religious faith when that faith goes against conventional medical wisdom? To what extent do we allow parents to raise their children in a faith that a majority of people may believe to be misguided? What happens when the practices of that faith may result in physical harm to those children? Is reliance upon faith healing for children an exercise of religious freedom or child abuse?

God's Perfect Child, Caroline Fraser's new history of Mary Baker Eddy (Mother Eddy) and the Christian Science Church, raises these and many other questions. With contemporary health care is seeing a resurgence of the types of spiritualism and alternative health care practices present at the founding of the Christian Science Church, this book comes at an opportune time. According to a 1998 study published in the Journal of the American Medical Association, in 1997 more than 42 percent of all Americans claimed to have seen an alternative practitioner. More visits were made to alternative practitioners that year than to conventional ones. Often religiously or spiritually based, these alternative practices, notes by Fraser, frequently lack the type of scientific proof demanded of conventional medical practices. How should society respond to this phenomenon?

Unfortunately, Fraser's book doesn not help answer these questions. It is instead such a raw scream of anguish and rage that it becomes self-defeating as an argument against Christian Science (and, by the author's analogy, against other alternative medical practices). While the book may be cathartic for former Christian Scientists like Fraser, as evidenced by blurbs on the book jacket, the tone is so hostile that one begins to distrust comments that are ostensibly statements of fact.

The book begins with an extended reminiscence of what it was like for the author to grow up a Christian Scientist: the guilt that it caused her and the deadly consequences of Christian Science treatment for one of her young contemporaries. Fraser then turns her attention to Mary Baker Eddy, founder of Christian Science Church. In an extended biographical treatment, Fraser is extremely critical of Mother Eddy and many subsequent Christian Science leaders. She then attempts to extend her criticisms of the faith healing practices of Christian Science to all forms of alternative medicine.

Although the book is heavily footnoted, I found myself questioning its objectivity and what is being left out. Fraser acknowledges that many of her sources are prior biographies whose authors relied heavily upon opponents and critics of Mother Eddy as their primary sources of information. Yet she curiously dismisses allegations of bias raised by Christian Scientists against these sources. For example, she asserts that a biography was "fact-checked" and supported by "sworn affidavits." This does not, of course, answer the question of whether those who swore to the affidavits were biased or motivated by malice.

One must also question Fraser's apparent equation of personal character with truth. There is much to suggest that Mother Eddy was a poor mother to her child, that she drew many of her ideas from others, and that she was a domineering and power-seeking woman. Representatives of the Christian Science Church do appear to have used the power of the church to repress criticisms of it. Nonetheless, the fallibility of the leaders of a movement does not necessarily disprove the validity of what they teach. The well-known accusation that Einstein plagiarized the work of his wife or a claim that he was not a good husband does not disprove the theory of relativity. Nonetheless, that seems to be the premise of Fraser's approach.

Fraser's cursory treatment of the claims made by contemporary practitioners of alternative health practices is even more curt, conclusory, and filled with cliché condemnations. For example, in attacking Larry Dossey's arguments about the effects of prayer on health, she simply opines: "Thousands of years of recorded human history have shown…that thoughts alone cannot kill".

Conflict between the indications of faith and conventional medicine is an important topic, but Fraser's book will do little to advance the discussion. For critics, like her, God's Perfect Child may give voice to their rage. For Christian Scientists, it will do little more than reaffirm their feelings of persecution by outsiders. For those of us in the middle, it is a missed opportunity to explore pressing issues in contemporary health care and religious freedom.