Proceed with Caution: Religion in Politics
God's Name in Vain: The Wrongs and Rights of Religion in Politics.
Stephen L. Carter.
New York: Basic Books, 2000. 288 pp. $26 (Hardcover).

With God's Name In Vain, Yale law professor Stephen Carter revisits the relationship of religion and public life, the topic of his 1993 best-seller The Culture of Disbelief. That earlier book argued that "American law, politics, and culture trivialize religious devotion" and that religion should have a larger and more serious role in civic matters. Culture benefited not only from a rave review by President Bill Clinton, but also from the freshness of seeing public religion defended vigorously by a political liberal rather than the stereotypical conservative. (Carter, a moderate liberal, was a former law clerk to Justice Thurgood Marshall.) Culture coincided with, and gave impetus to, the Democrats' rediscovery of public religious language, characterized by Clinton's speeches in black churches and Al Gore's theologically-informed book on the environment.

A lot has happened in the intervening eight years—including, on the civic morality front, the impeachment of Clinton over the Lewinsky scandal and his very public confession of sin before a group of ministers at the National Prayer Breakfast. Some observers of the latter smelled a rat: Clinton, they said, was manipulating religious emotions to avoid political consequences while making an "incomplete repentance."

Carter's new book delves into these two worries about how religion might be trivialized in public life, first by excluding it from political debate and action, and second by manipulating it to serve partisan goals. He presents two related theses: first, "that there is nothing wrong, and much right, with the robust participation of the nation's many religious voices in debates over matters of public moment," but second, that religions "will almost always lose their best, most spiritual selves when they choose to be involved in the partisan, electoral side of American politics."

On the first thesis—that it is perfectly legitimate for religious views to seek to affect politics—Carter's arguments are not new, but they are clear and, to this reviewer at least, unanswerable. He quickly dismisses as "clunkers" the familiar arguments that religion should stay out of politics; religious views are no more undemocratic, irrational, or dangerous as a class than are secular political views. In worthwhile chapters about the nineteenth-century abolitionists, the early twentieth-century social gospelers, and the 1960s civil rights marchers, he shows that Christian fervor has fueled important movements for social justice—while each time the opponents, from slaveholders to robber barons to segregationists, raised the bugaboo of the "separation of church and state."

Carter's second thesis—that religions tend to lose their integrity and distinctiveness if they become too enmeshed in electoral politics and specific policies—is also well argued and no doubt often true. Carter tells of the encounter at the 1964 Democratic convention between Fannie Lou Hamer, leader of the Mississippi Freedom Democratic Party, and Hubert Humphrey, dispatched by Lyndon Johnson to try to convince the MFDP not to derail the convention by challenging the all-white Mississippi delegation. "Humphrey, believing that he was undertaking a political negotiation, asked Fannie Lou Hamer what she wanted. Mrs. Hamer, a devout evangelical Christian, responded: 'The beginning of a New Kingdom right here on earth'"—and refused to back down. Carter compares this uncompromising stand with the approach of many black clergy activists today, who seem bound merely to the fortunes of the Democratic Party, as when Jesse Jackson suddenly switched from being "passionately pro-life" to pro-choice on abortion. Does anyone doubt that Jackson, who quickly announced his opposition to President Bush's recent plan for aiding religious social services, would have warmly endorsed the plan had it come from a President Gore?

The "integrity" thesis does raise some questions. Although there are many theological reasons for religions to maintain a "prophetic" distance from the details of politics, there are also theological reasons to get into the details, and Carter gives them short shrift. Reinhold Niebuhr, for example, constantly warned Christians against identifying partial solutions with the kingdom of God; yet he also interpreted in The Nature and Destiny of Man, the Christian doctrine of "justification by grace not works," as applied to politics, to mean that "we cannot purge ourselves of the sin and guilt in which we are involved by the moral ambiguities of politics without also disavowing responsibility for the creative possibilities of justice." Thus Carter seems a bit unfair when he suggests that the reason the Christian Coalition toned down its Biblical language in its 1995 Contract with the American Family is that the group "tired of being accused of costing the Republican Party votes." Some political compromises may reflect not expediency or power-lust, but a responsible move for a "proximate" solution in an imperfect world.

The muted voice in electoral politics might reflect not only responsibility, but also humility. The tone of the Contract may show that the Christian Coalition has learned from other citizens, that in dialogue and argument with other worldviews it has found elements in them worthy of respect and even adoption. Learning from others is often good for both a religion and a democracy. Carter implicitly discounts this, arguing that religions that become involved in electoral politics tend to lose humility rather than gain it: "The prophet, facing a resisting world, must struggle with uncertainty and rejection . . . The one who wields the sword, however, struggles less, for he possesses the authority to force others to yield to his vision."

Again, though, the story has another side. On the very next page, Carter discusses the fundamentalist Bob Jones University, whose "racist and virulently anti-Catholic ideology" stumbled into the national spotlight during the 2000 presidential campaign. Given that quote, Carter presumably does not think that Bob Jones's ideology reflects much humility: yet the ideology was almost certainly tied to the school's posture of "separation from the world," while in 2000 the school began to open up on race relations precisely because it had to engage with the world. If Bob Jones has lost some integrity, it may have gained some humility. Carter is surely right, though, that such "engagement" generally should not be forced by law.

But if Carter's judgments sometimes need to be qualified, they generally are very sensible. The book occasionally hits a sour note factually; for example, I doubt his claim that the main reason southern Protestants attacked John Kennedy's religion in 1960 was for fear of "the Catholic Church's forceful opposition to racial segregation." But on the whole, Carter confronts his difficult subject—if religion may and should interact with politics, how can it best do so?—with his typical thoughtfulness, liveliness, and honesty.

Orthodox Christianity and Libertarian Cosmopolitanism?
The Foundations of Christian Bioethics.
H. Tristram Engelhardt, Jr.
Lisse, The Netherlands: Swets and Zeitlinger Publishers, 2000. 438 pp. $39.95 (Hardcover).

Tristram Engelhardt is the author of The Foundations of Bioethics, the editor of The Journal of Medicine and Philosophy, and the founder and chief editor of Christian Bioethics: Non-Ecumenical Studies in Medical Morality. He is a major figure in bioethics and a preeminent figure both academically and organizationally in religious, and particularly in Christian, bioethics. In this book Engelhardt articulates and defends his vision of Christian bioethics—the bioethics that emerges from the practice and the teaching of Orthodox Christianity.

Engelhardt's defense of Orthodox bioethics is undertaken on a very large canvas: the development of postmodern skepticism about the ability of reason to settle moral questions and disagreements. This crisis of morality began with the development of the abstract, rationalistic morality of the enlightenment from the scholasticism of Western Christianity. The universalist, rational aspirations of the western church came into crisis with the Reformation. Enlightenment thinkers, especially Kant, sought to preserve the universal and rational basis of morality but cut loose from religious conviction and even theistic belief. This development has come to maturity in the contemporary recognition that there is no canonical ranking of values that compels the assent of the moral strangers who must cooperate and agree in modern institutions; modern secular reason and the discursive reason of the scholastics fail to settle moral disagreements. What is true at this foundational level of the development of moral theory is also verified by the inability of bioethics to settle hard questions or to overcome serious disagreements.

This dialectic, detailed here as elsewhere in Engelhardt's work with dazzling detail and erudition, is the foundation for Engelhardt's well known version of contractarian ethics: in the absence of rational standards to settle moral disagreements, only an ethics of freely given permissions is possible among moral strangers and justified to govern their transactions. As Engelhardt emphasizes, this ethics is minimalist. It lacks content, and it cannot pretend to rank values. It does not trace the contours of a morally good life, only the shape of authoritative agreements for the transactions among those who disagree about the good life. But it does limit what people can do to one another, and so justifies elements of patient autonomy in health care, including allowing social space for consensual activities that Engelhardt and many others believe immoral.

The ethic that emerges from this set of agreements and permissions can be called libertarian cosmopolitanism; it is distinct from liberal cosmopolitanism, which does rank values, in particular, valuing autonomy above all other values, for example, in the works of John Stuart Mill and John Rawls. The theories and bioethical applications inspired by these philosophers do not command the rational assent of others, and are further examples of the failures of modern secular reason to provide rational moral guidance in biomedical contexts as elsewhere.

Engelhardt's alternative to western and secular efforts to understand and live a good life is an ethics that is neither universalist nor rationalist. It is the ethics of Orthodox Christianity: this ethics is rooted in the life of a particular community. Its normative source is the experience of God in the liturgy and in the miraculous dimension of life that is never far from the awareness of those who self-consciously live within the communion of saints. Engelhardt calls this awareness of God "noetic knowledge" to contrast it with the discursive reason so banefully cherished in Western Christianity. This knowledge achieves transcendence; discursive reason cannot. This limitation of discursive reason explains why the bioethics of the western churches is indistinguishable from secular moralizing about bioethics and has nothing distinctive to offer.

Among the things Orthodox Christianity brings to morality is a conception of what morality is and does in human life: it is primarily directed not to virtue but to holiness, and the moral task is the spiritual, therapeutic one of overcoming passions or anything else that stands in the way of fully living the life of a Christian in unity with God and the saints.

After spending four chapters and roughly half the book on these very general and metaethical matters, Engelhardt details the normative content of bioethics as seen from the Orthodox perspective he has defended and elaborated. What follows in the next three chapters is, in comparison to the grand argumentation of the first half of the book, pedestrian and tame, but is likely to be of rather greater interest to religious bioethicists.

One reason for this interest is that Engelhardt's presentation shows how similar in content Orthodox morality is to that of the western church. Indeed, the similarities are so striking that Engelhardt engages in much intricate explanation of how this body of moral teaching really is different from that of the Roman Catholic Church. But the contours are plainly those of Catholic moral teaching, until fairly recently the common moral outlook of all western and maybe eastern Christians. Some readers may be surprised at the ringing affirmations and powerful defense of what are now considered conservative positions on abortion, suicide, sexual morality, and so on.

Of course, the expected debates about the absoluteness of some specific norms—usually affirmed by Roman Catholic authorities—show up in Engelhardt's presentation. He deals with some of these in a fresh and interesting way, for example, those concerning lying and sex ethics. Engelhardt's distinctive take on these matters arises from his reflection on the Orthodox conception of morality's therapeutic function and from his citation of authorities of the eastern churches and the development of their reasoning. Nevertheless, for all its interest, I find Engelhardt's performance as a Christian casuist—especially on matters of truth-telling and deception—less than compelling, since neither his authorities and their reasoning nor his invocation of morality's therapeutic purpose plainly override the reasons supporting the norms in question, even in the hardest cases. But then perhaps Engelhardt has no interest in persuading western Christians like me.

A second reason for the interest to religious bioethicists of Engelhardt's presentation of Orthodox morality is the rationale he articulates for various bioethical norms from within the Orthodox tradition. His presentation reveals that the eastern churches have articulated moral considerations that are sometimes overlooked or downplayed in western Christian treatments, even though the accounts are compatible. For example, his discussions of sexual morality and reproduction and especially of suffering illuminate these issues in ways all Christians will find helpful.

I am not qualified to assess the accuracy of Engelhardt's presentation as an account of Orthodox ethics. On the terms presented in this work, however, it is certainly credible and worthy of attention. Let me end by entering several reservations: Engelhardt em-braces the Church's characterization of abortion as murder (and of suicide as self-murder). Yet his libertarian cosmopolitanism does not allow the legal proscription of abortion and other homicidal actions, as the traditional characterizations certainly imply or strongly suggest. Where in Orthodox theory or practice is this limitation of Christian morality by the requirements of a contractarian political philosophy justified? Surely, the libertarianism is subordinate to the Christianity here, and Christian morality seems not to contain libertarian constraints.

Finally, I have a question about the audience and communicative intent of this book. Engelhardt dubs himself a sectarian, claims that a morality to live by is the way of life of a very particular community, denies the value of discursive reason as he engages in it, and heaps abuse on western Christian thought and practice. Yet this work does not appear directed at Orthodox Christians alone. Engelhardt "knows" that his perspective on bioethics and Christianity is true, but he writes, "it is hoped that even those who do not share the author's conviction, even atheists, will garner a fresh appreciation of contemporary bioethical controversies, when regarded from a perspective a millennium distant from Western Christian thought." But why should Orthodox Christianity care about giving atheists and others outside the Church a fresh appreciation of bioethics? I think the answer is that Christianity, East or West, is not as sectarian as Engelhardt's theory requires, but evangelical in ways Engelhardt cannot avoid in his work as a bioethicist, whether in this book or elsewhere. The evangelical practice of Christians points to a practical reason that reaches beyond particular communities, not simply to provide warrant for agreements worthy of moral strangers who share human dignity but also to invite those strangers into fellowship—the intelligibly, and so universally, good fellowship of the communion of the saints.

Bioethics within Pluralism: How Deep the Differences?
Moral Acquaintances: Methodology in Bioethics.
Kevin Wm. Wildes.
Notre Dame, Ind.: University of Notre Dame Press, 2000. 214 pp. $20 (Paperback).

In this book, Kevin Wildes engages topics of fundamental importance to bioethics in its self-conscious reflections on its status as a discipline. The book is structured in two parts. Part One provides a useful critical summary of major methods in recent bioethics. Part Two sets out Wildes's constructive effort to develop the notion of "moral acquaintances" as the substantive grounding of consensual judgments in procedural ethics. Wildes's critical reading of other approaches is generally fair-minded and perspicuous, while his defense of moral acquaintanceship as preferable to the methods he criticizes fails to be fully persuasive. Let me speak in turn to the critical and constructive aspects of his project.

Part One provides a helpful overview of representative major foundational and nonfoundational methods in recent bioethics, including utilitarianism, Alan Donagan's deontological account, revised natural law approaches, contractarianism, virtue theory, principlism, and secular casuistry. According to Wildes, echoing themes developed by H. Tristram Engelhardt, two issues plague all foundational accounts when they are deployed for the resolution of moral controversies in the context of secular pluralism. First, because "there is no view from nowhere . . . each foundational theory must make some assumptions about the structure (form) of moral reasoning" and provide "some order to the different possible elements in moral choice and justification." Second, each foundational account "requires some set of moral values, and some ranking of values" in order to resolve moral disputes. Yet unless such values (and/or their ranking) are shared, "neither the structure of the theory nor the solutions it develops will provide rationally convincing resolutions of moral controversies" for those who do not share a particular view. In a similar vein, Wildes critiques Beauchamp and Childress's nonfoundational principlism for its reliance upon a putative "common morality" from which mid-level principles can be derived, as well as for the uncertain status of the principles themselves, which Wildes finds "so general in meaning that specification [in particular cases] is bound to produce conflict." Likewise, Wildes criticizes the secular casuistry developed by Jonsen and Toulmin. According to Wildes, there is no common moral framework to "identify which cases are candidates for moral controversy"; furthermore, "without shared moral values, sensibilities, or intuitions, we will not be able to resolve moral controversies or develop principles and rules from such cases."

In Part Two, Wildes develops his notion of moral acquaintances as an intermediate class between Engelhardt's categories of moral friends and moral strangers. Wildes concludes that Engelhardt's account fails to acknowledge the need for even a procedural bioethics to "be justified on common moral assumptions (e.g., the dignity of persons, the importance of freedom, or the value of peace in a peaceable society)." In turn, procedural bioethics "provides a basis for bioethics to explore common morality in a secular society" because procedures, as moral practices, "embody certain moral commitments."

Wildes prefers the language of moral acquaintances to that of common morality, the latter a prominent feature of principlism. In Wildes's judgment, the language of common morality promises more than it can deliver, since "day-to-day moral controversies … indicate that [such] a morality is less and less common." Moreover, "an appeal to common morality seems to put us in the category of moral friends [while] moral acquaintanceship keeps us a bit more distant and tentative." Nonetheless, Wildes's own approach is subject to criticisms similar to those he raises against other nonfoundational methods. The same pluralism of moral content and understandings of moral reason that he invokes against alternative approaches seems equally evident in the procedural ethics he champions. For example, various theorists, despite their apparently shared substantive commitment to the dignity of persons, develop quite different understandings of informed consent requirements. And given Wildes's own emphasis on pluralism, it is important to note that procedural solutions will themselves exhibit diversity. Sooner or later, when procedures diverge, the underlying principles and values that shape them will necessarily re-emerge in critical and justificatory roles in order to make sense of such differences. Thus, while Wildes is to be commended for his insistence that procedural ethics is "thicker" than many of its proponents and critics suggest, when conflicts between procedures arise, his own method will not avoid the pitfalls that he finds in more robust accounts.

Illness as Transformation
Hidden Spring: A Buddhist Woman Confronts Cancer.
Sandy Boucher.
Boston: Wisdom Publications, 2000. 209 pp. $16.95 (Paperback).

Buddhism is famously concerned with death and dying. The sight of a human corpse was a pivotal moment in the life of young prince Siddhartha, impelling him on the path to enlightenment. After his awakening, the Buddha made contemplation on death and impermanence a cornerstone of his path to the cessation of suffering. Still today, many centuries after the Buddha's own death, skeletons and illustrations of the wheel of life and death greet visitors at monasteries from Thailand to Tibet. Penetrating the meaning of life and death remains central to Buddhist cultures. As death comes out of the closet in Western cultures, more people are coming forward with memoirs of their own life-threatening illnesses and near-death experiences. Hidden Spring is a landmark in bringing Buddhist perspectives to the universal experiences of illness and of death, life's inescapable conclusion.

The book chronicles Sandy Boucher's cancer diagnosis and the catapulting personal consequences. Brutally honest, the author juxtaposes Buddhist ideals and her own instinctive human responses, minutely dissecting her frailties, fears, and feelings of failure, as well as her conscientious attempts to transform her responses on the basis of her Buddhist training.

Hidden Spring is textured with several intertwined themes. One is the pain, fear, and uncertainties of living with a devastating illness. Another is the fragility of the human body. A related theme is the emotional and sensory vulnerability of the seriously ill and the challenges illness brings to human relationships. Connecting these themes, Boucher recounts her continual struggle to connect Buddhist ideals and human frailties, to make meaning of her suffering. She continually raises the bar for herself, lapsing repeatedly into despair and eventually coming to terms with her limitations and disappointments.

The book's strength is the variety of practices it offers to confront, mitigate, or transform the sufferings that attend physical decay. Descriptions of medical procedures and practices provide a stark reality check, not for the faint-hearted reader. Side by side with these medical accounts, descriptions of Buddhist perspectives and practices provide a valuable resource for the ill, aging, and dying, as well as caregivers of all categories. Meditations on breathing, loving-kindness, and transforming negativity are presented as means of coping with colonoscopies, catheter insertions, and the tedium of getting a spoon to one's mouth. All these techniques aim at living authentically in the moment and being "fully present to one's own experience," especially when facing the terror of pain, death, and nonbeing.

One conclusion is inescapable. All human beings deserve decent facilities and compassionate care in times of debility and medical emergency. If Boucher had contrived a political platform urging universal health care, she could not have done a better job. At the very time that human beings are most psychologically and mentally vulnerable, the poorest are subjected to the glaring inhumanities of the American public health system. It is doubtful that anyone could read this book without wishing for adequate medical coverage for all.

As Boucher practices relaxing gently into the moment, rather than avoiding, distorting, or manipulating it, her attention wanders from a pervasive blur to sharp focus and then back. Relentless attempts at achieving "unfabricated" states of awareness alternate with utter despair—an emotional roller coaster of her own creation. Gradually she moves beyond her own suffering by recalling the sufferings of all who live: victims of Auschwitz, ward mates and fellow patients in public medical facilities, and unknown strangers. Empathy leads to insight: "The conviction of my own ultimate survival had been wiped away like condensation from a glass, and I could see into the truth of my coming disintegration." Compassion is the "hidden spring" of understanding for the frail and dying. She concludes that even the seriously ill can experience another reality, "a dimension of us that is intact and healthy," whether through nature, the creative arts, interpersonal relations, or spiritual practice.

Hidden Spring presents many metaphors for death and approaches the stark reality of it from every conceivable angle. It would seem that, out of compassion heightened by her own traumas, Boucher wishes to provide a directory of tools and images that patients may select to relieve their existential pain. In this effort, she does a tremendous service not only to the dying, but also to the living. She offers ideas and insights that most of us, left to our own devices, would never get around to contemplating until we reached a similarly critical state. The book therefore forces us to confront the tenuous nature of life and to view it as a magnanimous gift.

Like Buddhism itself, the book undermines the conceptual fiction of the self and all its resultant tangles. Clearly, we are all dying all the time—each day, each breath—and the Buddhist legacy is to remind us to remind ourselves of this ghoulish fact repeatedly until we get it. The details of medical aggression are particularly unnerving, especially because they are not unique to Boucher's experience, but are part and parcel of the unspoken reality that awaits patients who choose to rely on the allopathic medical system. Even without confronting death, it is still necessary to confront painful medical realities—the prescribed poisoning of chemotherapy, the collapsed veins, and the multidimensional grief that attends the course of western medicine.

Thankfully, Boucher lives through her ordeal to tell the tale for the benefits of others facing serious illness. The book culminates in reflections on the unanticipated rewards she reaps from her miserable experiences: gratitude, joy, emotional resilience, spiritual friendships, and greater compassion for the sufferings of others. With a new lease on life, imperiled as it may be, she understands her illness as an opportunity for personal transformation. Rendered vulnerable by her proximity to death, she recognizes her own flaws, failings, and limitations as a gateway to enhanced awareness and loving-kindness. Insight into the transitory nature of all cherished illusions purifies all her complaints.