Ethics committee members generally don't wear religion on their sleeves. In a field so rigorously secular, they don't dare. Only twice in the past fifteen years have I seen it happen. Once, a member justified a recommendation using a sacred text and was met with silence—as if the speaker had said nothing at all, or had uttered a curse. Either way, the result was the same: no discussion, no comment, no engagement of the religious reasons.
Ignoring religious arguments provides a non-confrontational way to assert that religion has no part in public conversations about ethical issues. Those whose reasoning is informed by religious ideas are reluctant—fearing ridicule or marginalization—to voice their convictions.
Religion informs and influences many people who work within health care; even if it is outwardly ignored it may still be operating covertly. For those who believe that religion has no place in such conversations, it is difficult to ignore the proverbial elephant in the center of the table.
Those with religious convictions must ask themselves: should my beliefs be left at the door of the work place? If not, what difference will expressing them make in health care? How far should believers press their views and how much cooperation and tolerance should they have for opposing views?
This issue of the Bulletin seeks to render visible religious reasoning in healthcare discussions. Thirty years ago, religious thinkers led the nascent field of applied medical ethics. But the academic field of bioethics, as well as discussions within healthcare institutions, have become progressively more secularized. Some lament the exclusion of religion from healthcare ethics discussions, pondering why it happened or wondering about the difference religious voices would make. Would patient care improve? Would it facilitate the work of ethics committees? Would healthcare professionals and institutions act differently if they paid more attention to religious convictions?
Some expect religious voices would widen the outlook by attending to additional values that are often absent from ethics conversations—values such as generosity, altruism, sacrifice, compassion, community, and love. Others expect that religious values will lead to reinterpretations of secular ideals, such as informed consent. Still others hope that religious voices will give a broader—perhaps even utopian—view of what can be hoped for in caring.
If healthcare professionals want to expand their outlook, they will need to commit to ensuring that religious voices count. Not only will they want to consider what the religious perspective can bring, but also pay attention to the process of rendering audible religious voices. To that end you might want to muse on the following questions, to situate your own views on this matter, or to estimate the weight of religious voices in ethics committees or other locations where health, faith, and ethics converge.
Can you identify conversations where explicitly religious reasons have been offered in resolving an ethics dilemma?
How have others welcomed the person and their religious ideas?
Were the ideas taken seriously or simply ignored?
Whether the institution is secular or faith-based, has the ethics committee ever discussed what part, if any, religious reasoning plays in their deliberations?
Has the committee ever compared a moral analysis provided by a traditional bioethics of autonomy, justice and beneficence, to one explicitly derived from a faith perspective?
How would religious considerations give standing to values such as compassion, generosity and the like?
Religious voices in health care will remain "in the closet" until there has been explicit public examination of these and similar questions.
