Bioethics and the Culture Wars

I. CULTURE WARS

The term “culture wars” has been used to describe deep, apparently intractable, disagreements between groups for many years. Deep disagreements on significant moral and sociopolitical matters among persons within or across communities are not new. For example, nineteenth-century Europe saw “intense conflict between Catholics and anticlerical forces over the place of religion in a modern polity” (Clark and Kaiser, 2003, 1). The Muslim invasion of Spain in the eighth century likewise initiated a culture war. In contemporary discourse, the term refers to the kind of disputes James Davison Hunter assessed in his 1992 book Culture Wars: The Struggle to Define America, namely disputes regarding significant moral matters carried out in the public square and for which there appears to be no way to achieve consensus or compromise. Contemporary examples of culture wars include conflicts over what constitutes a family, the permissibility of abortion, whether or not flag burning should be allowed, and how religion should be accommodated in public schools (Hunter, 1992). These disagreements are not merely private differences of opinion. “At stake,” Hunter argues, “is how we as Americans will order our lives together” such that the disagreements take on a very public character (Hunter, 1992, 34). As argued below, the emphasis on making moral issues matters of public (i.e., state) concern is an essential source of fuel for culture wars. If people and groups held different positions and held that the matters in question were not matters for state involvement, the notion of a culture war most likely would not exist as we know it. We would be aware of deep differences among persons in society, but the public character of the disputes would most likely be very different.

Hunter's analysis of the culture wars identifies two principle camps or parties. He argues that “all individuals ground their views of the world within some conception of moral authority. Not only those who are religious in a traditional sense, but also those who claim to have no religious faith at all base their views of the world in unprovable assumptions about ‘being’ and ‘knowledge’. To imagine otherwise would be philosophically naive” (Hunter, 1992, 119). For some, Hunter says:

moral authority arises from a common commitment to transcendence, by which I mean a dynamic reality that is independent of, prior to, and more powerful than human experience… Of course transcendence has a different content and meaning in each tradition. In each tradition, moreover, transcendence communicates its authority through different media … yet despite these difference, there are formal attributes to their faith that are held in common with the others (Hunter, 1992, 120).

Faith in a transcendent moral authority need not reflect a commitment to religious thinking, Hunter argues. There are, for example, persons committed to:

a classic form of humanism, in which a high view of nature, natural law, or the social order itself acts as a functional equivalent to an objective and transcendent authority. What makes their view of nature or the social order “high” is a belief that nature is intrinsically rational, that it reflects a logical order that human beings are able to discern. As such, while truth and the good are subject to the change that affects nature itself, they are relatively durable over time and across societies (122).

For others, “moral authority emerges primarily if not exclusively within ‘this-worldly’ considerations.” The inner-worldly sources of moral authority may vary in at least two ways. Among these, some hold that “moral positions and influence are justified solely on the grounds of evidence about the human condition and the coherence and consistency of the arguments adduced” (125). Others hold that personal experience and intuition ground justification for moral positions (125).

The culture wars are more complex than the distinction between external and internal sources of moral authority suggests. The culture wars are evident in the United States between various groups, including between traditional Christians and secular thinkers and between traditional Christians and others who identify themselves as Christians. Battle lines among Christians can be drawn different ways. For example, as Hunter notes, “the mutual hostility of Protestants and Catholics had been implacable since the time of the Reformation and Counter-Reformation in the sixteenth Century” (1992, 35). Today, this set of disagreements may be less significant politically than the division between those who might be characterized as traditional and liberal Christians whose views on specific cultural and sociopolitical matters vary. Even among those whom many would label “traditional Christians” because of their commitment on specific cultural and sociopolitical issues (such as Roman Catholics, Orthodox Christians, and Evangelical Christians), there are very important distinctions. War-like divisions also are evident between traditional Christians and secular thinkers who believe that reason alone can deliver moral content or who hold that only moral ideas grounded in reason may be admitted to the public forum. Even among many secular thinkers we see different rankings of priorities or commitments, such as differences in how much respect to accord liberty versus equality. The battle lines are numerous and more complex than a few simple examples demonstrate. Nevertheless, these examples demarcate some critical aspects of the contemporary culture wars in the United States.

Outside the United States, other culture wars exist as well. For example, in China differences over whether and how to incorporate traditional Confucian values or traditional Buddhist values into modern life are among the significant marks of a culture war (Sun and Shi, 2009). In the Muslim world, different Muslim sects hold sometimes radically different positions, and even within a sect there are different readings of the Koran and its implications regarding daily life (e.g., whether women may drive or what punishments a Muslim state should utilize). In Western Europe, we see stark differences among secularists, Muslims, and nominal Christians, such as French laws banning burqas in public passed in part to protect women from what the French government referred to as a form of slavery and women's dignity and to demonstrate the equality of men and women. Clearly many in the French government and Muslims who believe that women should or at least may wear a burqa have different conceptions of dignity, equality, respect, and freedom. These differences are intractable (See Engelhardt, 1996, chapter 2). As Engelhardt has argued:

There is no canonical account of the morally rational or politically reasonable that can conclusively be established through secular sound rational argument, because the disputants start from disparate foundational premises and rules of evidence. There is no common morality. There are substantively different moral views about when it is licit or obligatory to have sex, take property, and kill fellow humans. There are also foundational disagreements about how a political structure should rank cardinal concerns such as liberty, equality, prosperity, and security. … Moral pluralism and the pluralism of views of the politically reasonable are real and intractable (Engelhardt, 2010, 91).

Differences in the commitments individuals and groups within a society hold are necessary but not sufficient to fuel the culture wars we see in the United States or around the globe today. A second source of fuel for the culture wars is attempts by persons and groups who disagree deeply to use the state to privilege enforce a particular morality and to use a particular morality to order public life in the state. Such efforts are not unique to religious thinkers. Secular thinkers who attempt to use the state to institutionalize and enforce their commitments also fuel the culture wars. Claims of neutrality notwithstanding, any effort to use the state to privilege one morality or to coerce others to live by a particular understanding of morality contributes to the culture wars. The attempt to use the state and its coercive force is essential fuel for the culture wars fire as Hunter describes it. The gulf that separates various groups is essential as well, for if there were no deep moral differences, there would be less difficulty associated with privileging or enforcing the shared morality. This essay examines these two conditions that together fuel and sustain the culture wars with a special focus on issues in bioethics.

II. CONDITION 1: DEEP DIFFERENCES IN HOW WE UNDERSTAND THE WORLD

Hunter distinguishes between persons for whom moral authority rests in something outside of themselves and human experience and those for whom moral authority is grounded in human experience or intuition. Among those who acknowledge a transcendent moral authority or source of authority outside of themselves and their own experience or intuition, there are deep differences in how they understand morality. First, as Hunter points out, some of them are not religious at all. Beyond that, even among those who are, there are significant differences. Among persons who identify themselves as Christians, we find radically different views about sexuality, abortion, death, and the family. For example, whereas some Christians accept third-party–assisted reproduction as licit even when it involves the use of donor gametes, others recognize this as deeply problematic. Some Christians support physician-assisted suicide and euthanasia, others recognize these practices as immoral. Some believe abortion is morally permissible, some believe it is always impermissible, and among those who recognize abortion as at least sometimes permissible there are numerous views about the circumstances under which they believe it is licit. Consider the depth and breadth of these differences. In the 1970s, the Roman Catholic position on abortion (that has not changed) was radically different from that of the Southern Baptist Convention (SBC). The latter in 1971 called upon Southern Baptists to support legislation to allow abortion in cases of rape, incest, severe fetal anomalies, or for the psychological or physical health of the mother (see Mitchell, 2004, 103) Over time, the SBC became increasingly critical of abortion and today its position is widely categorized as prolife (Mitchell, 2004). Someone who does not recognize the fetus, let alone the embryo, as a possible victim of murder would find these views incomprehensible. Similarly, persons who view abortion as an important means of “treating” diseases and disorders by preventing the birth of children afflicted with particular conditions would similarly find these religious views implausible. One who recognizes abortion as murder will find it impossible to speak of it as a medical treatment, especially because no other medical interventions have as their goal to kill a person (with the exception of physician-assisted suicide and euthanasia) (for further discussion of differences between various religious perspectives on bioethics issues, see Peppin, Cherry, and Iltis, 2004).

Even among persons who identify themselves as members of the same Christian denomination, we see such differences. For example, the Roman Catholic Church clearly condemns assisted suicide and euthanasia:

It is necessary to state firmly once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly, nor can any authority legitimately recommend or permit such an action. For it is a question of the violation of the divine law, an offense against the dignity of the human person, a crime against life, and an attack on humanity. (Congregation for the Doctrine of the Faith, 1980, section II).

Yet there are scholars writing in the Roman Catholic tradition who attempt to argue that within the tradition euthanasia is acceptable and that Roman Catholic hospitals may licitly engage in euthanasia (Gastmans, Van Neste, and Schotsmans, 2006). Similarly, there are substantial data suggesting that persons who identify themselves as Roman Catholic often disagree with and ignore the Roman Catholic Church's teaching proscribing the use of contraception (for the prohibition of contraception, see Pope Paul VI 1968; see Catholics for Choice 1998 and for information on internal dissent among Roman Catholics, Curran, 2006.)

Differences on specific issues in bioethics between traditional Christians and secular thinkers as well as between traditional Christians and others who identify themselves as Christians are an effect of holding significantly different moral, metaphysical, and epistemological commitments. These commitments are a major reason we see culture wars. These differences emerge from a collection of fundamental differences in metaphysics, epistemology, and morality, differences which cannot be resolved. Traditional Christian metaphysical commitments include knowledge that the ultimate purpose in life is the pursuit of holiness rather than health and well-being and the understanding that moral knowledge emerges only in the pursuit of holiness and knowledge of God through right worship. This will make no sense to one who does not know God exists or who relies on himself to create an image of God through personal prayer and scripture interpretation independent of the holy tradition of the Church. These commitments also will make no sense to one whose understanding of theology is rooted in a rigorous natural law or other discursive means of securing moral insight.

Traditional Christians hold foundational commitments that are at odds not only with secular commitments but also with many modern interpretations of what it is to be Christian. Traditional Christians are neither ashamed of those commitments nor do they think that a failure to defend those commitments to nonbelievers or in terms nonbelievers can appreciate is problematic (see Iltis, 2010). Traditional Christians recognize that justification of moral commitments through reason leads to a regress of assumptions that ultimately are not grounded in reason alone and are not accessible universally but rather to reason informed by some set of assumptions or beliefs. They too recognize that their commitments involve an infinite regress, but in the sense that those commitments lead back to an infinite God. A regress that lead to an infinite, transcendent God is welcomed above one that leads back to persons and their personal preferences, inclinations, and biases.

It is worth recognizing that even among persons who do not recognize the existence of a transcendent God or any source of morality outside themselves (Hunter's second category), we see the makings of a culture war. A Maoist will be committed to very different fundamental ideals, values, and goals than a Randian, even though they may well both be secular thinkers. On specific issues in bioethics, we see disagreements among secular thinkers as well. Consider the difference between views such as that of Savulescu (2001) and Sandel (2004) on preimplantation genetic diagnosis (PGD). Savulescu argues not only the PGD is licit but that it ought to be used by couples to “select the embryos or fetuses which are most likely to have the best life, based on available genetic information, including information about non-disease genes” (2001, 413). Sandel, on the other hand, argues that “If bioengineering made the myth of the ‘self-made man’ come true, it would be difficult to view our talents as gifts for which we are indebted, rather than as achievements for which we are responsible. This would transform three key features of our moral landscape: humility, responsibility, and solidarity” (Sandel, 2004). He states that these concerns are explicitly secular and elaborates each of the losses to which interventions such as PGD would lead. Yet others object to PGD because it allows parents to impose a particular life on children in a very new and different ways (see, e.g., Davis, 2001). Others are concerned about what PGD says about societal attitudes toward persons with disabilities or that PGD will be used as a form of discrimination to select against disability. Yet others object to some uses and not others of PGD (see Robertson, 2005) and articulate different frameworks for evaluating particular uses of PGD. In short, even secular thinkers do not share a basis for judging PGD. Fundamentally different starting assumptions will generate fundamentally different views of society and morality. As a result, there are multiple deep gulfs that divide society. There is no singular secular morality, just as there is no single religious morality espoused by persons categorized as religious thinkers.

Consider another example of deep, apparently intractable disagreement among secular thinkers. Ever since the advent of intensive care units where patients who previously would have died are maintained using advanced life support technology and pharmaceuticals, there has been intense discussion of who is dead and when life-sustaining interventions may be withdrawn (or withheld). Traditional criteria for determining death—permanent cessation of cardiorespiratory function—no longer were “good enough.” Legal questions emerged: would physicians who removed life-sustaining interventions from patients who subsequently died be charged with homicide or murder? Ethical questions emerged as well: was withholding or withdrawing life-sustaining interventions tantamount to euthanasia? Was withholding or withdrawing life-sustaining interventions a violation of the basic ethical obligations of health care professionals? In some cases, cardiorespiratory functions could be maintained for relatively long periods of time even though there was no prospect of a meaningful recovery. What legal and ethical obligations did physicians have with regard to patients who were unconscious, whose cardiorespiratory functions were maintained artificially, and who showed no prospect of recovery? The following question emerged: Was it possible that these patients were dead before the artificial means of maintaining cardiorespiratory and other functions were removed? The ability to transplant organs from cadavers to save or improve the lives of living patients also prompted much discussion about precisely when people die. The sooner an organ is removed from a cadaver, the less likely it is to suffer ischemic damage and hence the more likely it is to serve an organ recipient well. The importance of rapid organ harvesting subsequent to death led many to want to know precisely when people were dead so that organs could be removed as soon as it was legal and ethical to do so. The understanding was that organs could not be removed prior to death nor could death be the result of organ removal. This is the basis of the so-called dead donor rule: individuals from whom vital organs are removed must be dead prior to organ removal; organ removal may not be the cause of death. (There are special provisions for living organ donors who, e.g., may donate one of two healthy kidneys but not a heart.) The desire to address both the question of when life-sustaining interventions could be legally and ethically withheld or withdrawn as well as the desire to know when organs could be removed led to the Harvard Ad Hoc Committee to Examine the Definition of Brain Death (Beecher and Harvard Ad Hoc Committee, 1968). This group's recommendations regarding the definition of death were taken up for further discussion by the Presdient's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1981). The President's Commission affirmed the Harvard Ad Hoc Committee's assessment and urged states to adopt the then-recently proposed Uniform Determination of Death Act published (1981) by the National Conference of Commissioners on Uniform State Laws. The definition of death using neurological criteria was adopted into state laws and reflect what is widely called “whole brain death.” State laws generally allow physicians to diagnose death using either cardiorespiratory or neurological criteria.1 The former reflects the traditional way death was determined, and the latter provides a way to determine that death has taken place when all functions of the brain, including the brain stem, have ceased irreversibly (Uniform Determination of Death Act, 1981). When either set of criteria are met, a death certificate may be issued and organs harvested.

There has been much debate in the medical and bioethics literature regarding the “whole-brain death” criterion for declaring death. Some have argued that the criterion is too stringent and that, for example, death may be declared when the higher brain has died. Defenders of “higher brain death” believe that requiring “whole brain death” delays declarations of death past the point of actual death (see, e.g., Veatch, 1993, 2004, 2005). Others have argued that even patients declared dead using whole-brain death criteria may not be dead. Among these, some have argued that we should remove organs from such patients anyway, eschewing the “dead donor rule” (see, e.g., Truog and Fackler, 1992; Truog, 1997; Truog and Miller, 2008). These debates continue, and there is deep disagreement even among secular thinkers. They are not merely debates about facts. They are, instead, to a large extent debates about values and moral priorities.

These deep divisions cannot be bridged through reason alone. Numerous scholars have attempted to do so or argued that reason is the path to peace, yet time and again such efforts fail because a common morality does not emerge from Reason's metaphorical hat. Reliance on reason alone is implausible for a Christian; even Roman Catholics whose moral theology is rooted in reason acknowledge that it is reason informed by faith (as opposed to something else). The conclusions many Roman Catholic scholars come to allegedly by relying on reason are at odds with secular claims of reason. For example, natural law thinkers such as Joseph Boyle, John Finnis, and Germain Grisez who hold that the precepts of the natural law are universally accessible to all persons through reason. There are basic, intrinsic goods the “pursuit of which seems of itself to promote persons and bring them together” (what they call “human full-being”) and that give us reasons to make certain choices and act in particular ways (Grisen, Finnis, and Boyle, 1987; Grisez, Boyle, and Finnis, 2001). One of these basic goods is life (Grisez et al., 1988), and contraception, they argue, violates this basic good. No doubt there are many who would argue that reason delivers quite the opposite conclusion. Contraception not only does not violate life, they might argue, but also promotes overall “human full-being” by allowing couples to have only the number of children they believe they can love and raise well (for further discussion, see Iltis, 2011). When we examine their conclusions regarding the morality reason purportedly discloses, we might be struck by the contrast between this morality and that which others hold reason discloses. This leaves us asking how to mediate between accounts of what reason discloses.

Reason will not resolve the culture wars because the appropriate role for reason or of what is admissible evidence in support of a claim is disputed. We are left with asking how to mediate between accounts of what reason discloses, and there is no definitive way to resolve these disputes.

Some scholars, such as Kevin Wm Wildes, S.J., have assessed the gaps and found some tenuous footpaths between them (2000). These would allow us to distinguish between true moral strangers and moral acquaintances. The latter are able to find some areas of shared understanding or at least are willing to attempt to find shared understanding despite other differences. Acquaintanceship should not be confused with moral friendship, and thus the plausibility of acquaintanceship does not mean that deep rifts are insignificant.

Others have asserted bolder claims dismissing the significant of pluralism. They have argued that despite foundational disagreements, there is in fact a common morality that exists in mid-level principles. “[E]veryone,” they say, “grows up with a basic understanding of the institution of morality, its norms are readily understood. All persons who are serious about living a moral life already grasp the core dimensions of morality. They know not to lie, not to steal property, to keep promises, to respect the rights of others, not to kill or cause harm to innocent persons and the like … They know that to violate these norms without having a morally good and sufficient reason is immoral” (2001, 3). In later work they refer to these norms as “so widely shared that they form a stable (although incomplete) social agreement” (2009, 2) and they maintain that “[a]ll persons committed to morality do not doubt the relevance and importance of these rules … [and] know that violating these norms is unethical and will likely generate feelings of remorse and provoke the moral censure of others” (2009, 3). This is the common morality. Although some communities and individuals may hold additional moral values and norms, what Beauchamp and Childress refer to as particular moralities, and some will disagree about exactly how to fulfill the obligations of particular principles of the common morality, they share the basic norms of morality—the common morality. Beauchamp and Childress identify four norms of the common morality that are expressed as the well-known four principles of biomedical ethics: respect for autonomy, nonmaleficence, beneficence, and justice (2009, 12). The claim is that all morally serious persons recognize these principles as “general guidelines for the formulation of more specific rules” concerning ethical issues in medicine and health care (2009, 12) Differences on specific interpretations and applications of the midlevel principles do not reflect a deep chasm that divides us such that describing disagreements in terms of warfare would be highly inappropriate. This view is deeply problematic. Either it is a very bold claim that presumes that all who do not share the midlevel principles as Beauchamp and Childress articulate and interpret them are not morally serious or it is very weak claim because the substance of any alleged agreement is so thin as to make one wonder whether it is relevant or meaningful or useful (see Alora and Lumitao, 2001; Takala, 2001).

Deep disagreement alone is not likely to result in interactions that merit reference to war. If those who disagree stood in complete isolation of each other, the deep gulfs between them would be mere observations about the world. When persons or groups attempt to use the coercive power of the state to privilege or impose a particular morality, these deep differences become public and battles in the public square ensue. It is then that we experience culture wars as Hunter describes. There may be politically plausible mechanisms to avoid warfare, as discussed further below. Political compromises aimed at peaceful coexistence should not be confused with agreement.

III. CONDITION 2: THE ROLE OF THE STATE

A second reason the culture wars emerge and persist turns on different views about the role and authority of the state and attempts to use the coercive power of the state to enforce or at the very least privilege one understanding of morality over others. Hunter observes that “cultural conflict is ultimately about the struggle for domination” and “the power to define reality” (52). Culture wars are not about what private citizens think and say in the confines of their homes regarding controversial topics. They are, instead, about “public culture” (Hunter, 53).

Depending on their view of the state, some who hold traditional Christian commitments will recognize the limited state as the only justifiable state in a pluralistic society and as the only state that will allow them to remain faithful to their commitments. A limited state will not require traditional Christians to pay for or provide abortions, physician-assisted suicide, euthanasia, third-party–assisted reproduction using donor gametes, and other interventions they find objectionable. Similarly, persons who hold that in a pluralistic society only a limited state is justified will not seek to use the state to require individuals to engage in certain practices that some may find acceptable or even obligatory, such as physician-assisted suicide or preimplantation genetic diagnosis. They will not seek to require participation in or payment for these practices. Those who favor an expansive state that uses its coercive force to operationalize or institutionalize their commitments will come to different conclusions. It is here that the culture wars break out, and for this reason they persist. Persons who seek to use the state to prohibit certain practices and require others will find themselves at war with those who seek to either be left alone or to use the state to require and prohibit a different set of practices. The role of the state combined with deep differences in understanding of God and His commands yield divisions among Christians as well as between Christians and secular thinkers. Deep differences in what morality requires, what the ultimate purpose of life is, and so on generate one set of cultural differences. These differences take on the character of a war when persons attempt to use the state to impose a particular understanding of the world. Many secular thinkers appear to believe that as long as what is being universally imposed is not religious it is not problematic. This is not so. To privilege a particular agenda over others or coercively to impose it is fuel for the culture wars fires. As I have argued elsewhere:

To privilege secular moral reasoning as pursued by certain individuals or groups (whose nonneutral premises often are undisclosed or unrecognized) and then to privilege particular products of such reasoning is to evade neutrality and the claim that one aspires to secure shared moral insight. Christian bioethics finds itself already embedded in a field of secular moral controversy before it adds the perspectives it brings (Iltis, 2009, 222).

Absent efforts by anyone to use the state to privilege or enforce a particular morality, it is less likely that the language and reality of a culture war would persist. We still would have vast cultural differences and those could be source of great stress among people seeking to coexist, but these differences might not lead to interactions characterized as wars. Secular thinkers may hold that their efforts to use the state are different from efforts of religious thinkers to use the state to enforce a morality because secular morality is neutral and applicable to all and a religious morality is not. If, they might argue, the public square were left completely secular, the culture wars would not persist. It is, they think, religious zealots trying to impose their religious ideas on others that leads to culture wars. What they fail to recognize is that all moral commitments, including their own, are in the end grounded in nonuniversally accessible and not universally held beliefs. The rejection of God or even the marginalization of God and His commands reflect robust commitments that involve particular metaphysical commitments. They are not neutral, as I have argued elsewhere:

All discourse requires a foundation—a series of assumptions—that generate content. Moral content does not come from nowhere, and to privilege some sources (e.g., secular reason shaped by particular philosophical traditions) over others (e.g., Orthodox Jewish insights) is to ignore the fact that all these positions rely on fundamental assumptions that cannot be definitely defended as the valid starting point for deliberation and none of which can be proven to be the right starting point (Iltis, 2009, 230).

One who knows God exists cannot ignore Him. Any attempt to force persons who know God to act as if God did not exist will lead to warfare.

A limited state is more compatible with the dissolution of the culture wars because, in reducing the significance of the state, much less is of an explicitly public character. Insofar as the culture wars are in part fueled by the desire to dominate the public character of the nation, the less that is controlled by the state, the less that is “up for grabs” as part of the public character. Nevertheless, even with a limited state, we should expect that given deep metaphysical and moral gulfs, some serious conflict will remain. Consider the difference between secular thinkers who advocate allowing Roe v. Wade to stand and essentially think the state should say nothing about abortion and proabortion advocates who seek mandates that health care professionals be trained in abortion, provide abortion, that public funds pay for it, and that insurers be required to cover it. A person who holds that women have a fundamental right to access safe and legal abortions may hold that anything that stands in a woman's path to access, including provider refusal to perform abortions and insufficient funds to pay for an abortion both are unacceptable restrictions on this fundamental right. Such a person will not want the state to remain silent on abortion or merely recognize the procedure as legal but will want to ensure that health care providers are required to provide abortions (e.g., Alexander, 2005) and that the state (through taxpayers) subsidizes abortion. By not only asking others to refrain from imposing restrictions but also by seeking the active assistance of others in facilitating abortion, such a person makes abortion a matter of robust public policy. As a result, abortion opponents, who recognize abortion as a form of unjustified killing, cannot remain silent. Someone who recognizes abortion as murder generally will not want to remain silent and relegate it completely to the private sphere any more than we would say the murder of one adult by another is a matter of private concern. However, the intensity of debate is elevated by efforts to require others to subsidize, facilitate, and provide abortion, making it even a more significantly public matter.

Other controversial matters in biomedicine similarly take center stage in the public sphere because there is no middle ground. For example, one either allows or disallows euthanasia, a society either allows or disallows teens from accessing birth control and abortion without parental involvement, a society either requires or does not require all health insurance providers to pay for assisted reproduction involving gamete donors, commercial surrogacy is legal or illegal, and so on. The commitments that ground these positions do not allow a “live and let live” attitude. If one thinks persons should have unfettered access to abortion, one will seek to disallow conscientious objection and will seek to require public funding of abortion. If one compares abortion to murder, one will want to see abortion restricted significantly.

Many of the commitments that underlie these kinds of debates are not amenable to compromises. Yet limiting the reach of the state may help diffuse wars. If one accepts a limited state, one will be committed not only to the view that the state should allow women to procure abortions and health care professionals to provide them but also that people can refuse to provide abortion or pay for them. It should be clear that although the former state of affairs will not be pleasing to the traditional Christian, life in a state that actively supports abortion by, for example, requiring qualified health care professionals to participate in abortion will be infinitely less acceptable. Similarly, life in such a state will not be pleasing to an abortion advocate but will be far more acceptable than a state that prohibits abortion. Although ours may be a society that permits abortion, and the traditional Christian may hope to use love and prayer to eliminate abortion, the traditional Christian will seek to constrain abortion by not allowing ours to become a society that promotes or facilitates it or requires anyone to participate in it or even appears to recommend or condone it. The abortion advocate on the other hand may use resources available to him to facilitate access by, for example, raising funds and organizing health care professionals to provide abortion and organizing volunteers to provide transportation etc.

This kind of modus vivendi reflects a resignation to the reality of intractable moral pluralism. It also recognizes that no one seeks to be coerced.

IV. CONCLUSIONS

The deep moral differences that underlie the culture wars will persist. These differences emerge because of radically different metaphysical and epistemological assumptions. We see these differences among religious thinkers, among secular thinkers, and between secular and religious thinkers. There is no universally accessible standpoint that will allow us to close these gaps. None of the positions espoused, including those purportedly grounded in reason, is neutral in the sense of not being grounded in or aiming to promote any particular morality over others. It also is not neutral in the sense of being universally recognizable as a legitimate and justified common ground. If in the face of such intractable pluralism, when any group attempts to use the state to privilege or enforce a particular morality, we should expect to see culture wars. Claims to have characterized a neutral state grounded in various secular commitments are false. The secular state that imposes particular secular commitments on others is not neutral. It privileges one among many sets of commitments. Such privileging may result in culture wars rather than mere dissatisfaction, just as it would if, in the face of intractable moral pluralism, the state were to impose or privilege Roman Catholic, Orthodox Christian, Orthodox Jewish, Confucian, or any other particular moral perspective. The state that is limited has very few opportunities to privilege or impose particular moralities and as such is less likely to generate culture wars. Insofar as Hunter is correct that the culture wars are a struggle to dominate the public culture, then to the extent that there can be no robust public culture, there is less to attempt to dominate and hence less to react against. The existence of a limited state does not resolve the very deep differences between those who hold fundamentally different metaphysical, epistemological, and moral commitments, but it may dampen the effects of such differences at the level of the state. To be clear, such a state is not one person with strong positions will celebrate. Such a state leaves in place practices each finds objectionable. For a proeuthanasia advocate, for example, finding that euthanasia is not publicly funded and the health care professionals may refuse to provide it will be problematic. For Christians, it means that they must accept living in a society in which doctors or other health care professionals are legally allowed to kill their patients. Moreover, persons with robust commitments will resist any efforts to allow others’ commitments to leak into the public domain and infringe upon them and their children. They will not accept the legitimacy of a contrary morality as a public morality or as a basis for public activity. They will insist that there is no shared public morality and resist any effort to expand the state in ways that encroach on their morality. In fiercely defending a limited state, they seek to protect their own integrity.

References