The Obstetrical Implications of Fides et Ratio Stratford Caldecott

The Obstetrical Implications of Fides et Ratio Stratford Caldecott Pope John Paul II s 1998 encyclical, Fides et Ratio (Faith and Reason) opens with the words: Faith and reason are like two wings on which the human spirit rises to the contemplation of truth. My aim in this paper is to discuss how faith and reason might become better integrated within the practice of midwifery and the medical care of mothers. For John Paul II, philosophy must be open to the whole of reality, and attentive to the entire human person, the entire human family. Such a philosophy can be said to serve as a kind of midwife to a civilization of love. This is the root of the connection I want to establish between the encyclical on Faith and Reason and the topic of this conference. The dignity of mothers and obstetricians is at stake in how we relate faith to reason. For if we separate reason from faith, we reduce motherhood as such to a merely biological function. No theological sticking-plaster will suffice to reclothe it in its true dignity. But if we integrate faith with reason, opening our intelligence to the whole of reality and specifically the reality of the person, motherhood emerges in its full glory as the closest possible human collaboration with God of which the Blessed Virgin Mary is the archetype and proof. Faith and Reason In the last year of his earthly life, 2004, John Paul II addressed the Italian Catholic Doctors Association. Medicine, he reminded his audience, cannot do without an attentive reflection on the very nature of man, created by God in his image and likeness. The dignity of man finds its foundation not only in the mystery of creation, but also in the redemption wrought by Jesus Christ. The mission of a Catholic doctor, he went on, is to defend the inviolable dignity of every human person. This dignity is such that there are no lives that are not worthy of being lived, or sufferings that can justify the suppression of a life, or reasons that make acceptable the artificial creation of human beings to be used or destroyed. This speech is full of implications for obstetrics. The twofold foundation of human dignity which is central to medicine, according to this speech, lies on the one hand in creation and in the other in redemption that is to say, in both nature and grace. Often we assume that this dichotomy is absolute. Nature, we think, is best understood by reason and by the natural sciences, whereas grace is understood by faith and by theology. But it was the purpose of the encyclical, Fides et Ratio, to overcome the absolute dichotomy between faith and reason. For though they are distinct, nature and grace are unified in the notion of the universal human calling which is our vocation to holiness. In other words, faith and reason come together in our understanding of the human person. This unity is made possible by the union-in-distinction of God and Man, divinity and humanity, in Jesus Christ, through the Virgin Mary. Thus in F. et R. the Pope quotes the Second Vatican Council in conjunction with the First, to the effect that Christ the Lord in revealing the mystery of the Father and his love fully reveals man to himself and makes clear his supreme calling, which is to share in the divine mystery of the life of the Trinity through self-giving love. 1 He goes on: Revelation has set within history a point of reference which cannot be ignored if the mystery of human life is to be known. Yet this knowledge refers back constantly to the mystery of God which the human mind cannot exhaust but can only receive and embrace in faith. Between these two poles, reason has its own specific field in which it can enquire and understand, restricted only by its finiteness before the infinite mystery of God. (FR, 14) The rest of the encyclical is about how these two faculties must be complementary, how each completes the other, in a sense contains the other, and enables the other to do its work. Faith opens reason to a transcendent horizon, it assures reason that the world as a whole does make sense, it enables reason to aspire to truth. In a word, it liberates reason (FR, 20). Without the 1 Gaudium et Spes 22 and Dei Verbum 2. 1

assurance of faith, reason would stop short on the journey to truth, it would give up, it would lose itself at the foot of the mountain, as the Israelites lost themselves in the worship of the golden calf in the absence of Moses. 2 At the same time, faith needs reason, theology needs philosophy, in order to penetrate ever more deeply into the mystery that has been revealed, to unfold its implications, and to explore the world in its light. [B]iblical man discovered that he could understand himself only as being in relation with himself, with people, with the world and with God. This opening to the mystery, which came to him through Revelation, was for him, in the end, the source of true knowledge. It was this which allowed his reason to enter the realm of the infinite where an understanding for which until then he had not dared to hope became a possibility. (FR, 21) Thus the Pope writes: Christian Revelation is the true lodestar of men and women as they strive to make their way amid the pressures of an immanentist habit of mind and the constrictions of a technocratic logic. It is the ultimate possibility offered by God for the human being to know in all its fullness the seminal plan of love which began with creation (FR, 15). The Failings of Reason Before we apply the lessons of the encyclical to obstetrics, we should note that the danger of what the Pope calls an immanentist habit of mind and the constrictions of a technocratic logic must apply with particular urgency to that part of the medical profession which concerns itself with human life at its most vulnerable for example in pregnant mothers. For wherever the transcendent cause and destiny of man is denied or ignored, the human person drops out of the frame, and the body tends to be reduced to an impersonal heap of matter, a biological machine subject to technological manipulation for extrinsic ends. 3 But unless the human person as such is valued and treasured, vulnerable human life will be easily dismissed or ignored as simply too expensive or inconvenient to take care of. These dangers are mentioned in chapter 7 of Fides et Ratio, where the Pope looks at the contemporary crisis in philosophy and issues a challenge to philosophers to resist it, with the indispensable help of Christian metaphysics and anthropology. It may be worth listing the philosophical errors he identifies, although I won t make any attempt to refute them in detail. The specific philosophical errors he mentions (in sections 86 to 91) include eclecticism, historicism, modernism, scientism, pragmatism, and nihilism. In fact there is something of a progression in this series. At each stage modern thought descended further into the abyss, and the way out became more and more difficult to find. So, first, what the Pope calls eclecticism betrays a lack of concern for coherent thought. We begin to pick and choose what we want to believe. Implicit within this may be the historicist error of thinking which denies any enduring validity of truth, so that all we have left is what a particular era or social group happens to believe. This error may also take the guise of modernism, where the opinions of our own period are assumed to be necessarily more worthy of attention and respect than any other, simply because they are more up to date. That is a bit like 2 It is as if, moving between the twin poles of God's word and a better understanding of it, reason is offered guidance and is warned against paths which would lead it to stray from revealed Truth and to stray in the end from the truth pure and simple. Instead, reason is stirred to explore paths which of itself it would not even have suspected it could take. This circular relationship with the word of God leaves philosophy enriched, because reason discovers new and unsuspected horizons (FR, 73). 3 Leon R. Kass, in The Permanent Limitations of Biology, Ch. 10 in Life, Liberty and the Defense of Dignity: The Challenge for Bioethics (San Francisco: Encounter Books, 2002), shows this in some detail, contrasting the dehumanizing and homogenizing effects of a science that seeks to know how living things work with those of a more contemplative and less pragmatic science that seeks to know primarily what things are. 2

preferring Tuesday to Monday because it is closer to Wednesday. (The heresy of Modernism was one manifestation of this attitude applied to theology.) Modernism in turn tends to go hand in hand with scientism, by which I mean not a belief in the value of science (which none of us would dispute) but a cult of science which refuses to admit the validity of forms of knowledge other than those of the positive sciences; and relegates religious, theological, ethical and aesthetic knowledge to the realm of mere fantasy (FR, 88). Scientism, in other words, eliminates mystery, miracle, virtue and wonder. 4 We have already sunk pretty low, but it is possible to go lower still. Thus from scientism we descend to an attitude called pragmatism, which replaces the criterion of truth altogether with decisions based on pure utility, even when these concern ethical questions. (The Pope s encyclical on moral theology, Veritatis Splendor, had already responded in detail to the errors of pragmatism and consequentialism.) This erosion of a sense of being and meaning ends in the nihilistic denial of the possibility of any knowledge at all. Thus with nihilism we hit rock bottom. This is the philosophy of nothingness, which abandons all hope of certainty and reduces life to a mere search for sensation (FR, 46), although the Pope adds that a certain positivist cast of mind continues to nurture the illusion that, thanks to scientific and technical progress, man and woman may live as a demiurge, single-handedly and completely taking charge of their destiny (FR, 91). Thus the will to power, exercised above all through the machine, takes the place of the will to truth and goodness. Three important points should not be left out. First, the Pope is careful not to deny, and on the contrary affirms, that modern philosophy has also achieved many precious and seminal insights in its analysis of perception and experience, of the imaginary and the unconscious, of personhood and intersubjectivity, of freedom and values, of time and history (FR, 48). Second, he does not simply reject modern philosophical positions on the grounds that he does not like where they lead. It is neither the task nor the competence of the Magisterium to intervene in order to make good the lacunas of deficient philosophical discourse (FR, 49). The teaching authority can point out where a philosophy is incompatible with the revealed truth, but the resulting tension must be resolved philosophically. The Church simply challenges philosophers not to abandon prematurely the search for truth, meaning and coherence. And the third point to note is that the Pope assiduously avoids naming the culprits who might be blamed for some of these negative philosophical developments and others I didn t bother you with but which he lists in the encyclical, such as fideism, idealism, and ontologism. He deliberately restricts himself to generalities. He does not mention the masters of suspicion William of Ockham, Descartes, Hume, Kant, or Nietzsche, let alone Darwin, Marx, or Freud. He does not want to be drawn into the game of condemning thinkers who were not all bad, and who may in any case have contributed to necessary philosophical developments. On the other hand, he does refer by name to those philosophers who have offered a way of philosophizing that is compatible with the faith notably St Thomas Aquinas, of course, but also Pascal, Newman, Rosmini, Maritain, Gilson, Edith Stein, and even Orthodox scholars such as Soloviev, Florensky, and Lossky (FR, 74). The Crisis in Maternal Care In order to draw some conclusions from Fides et Ratio for obstetrics, we need to see how practitioners are influenced in their work and in their thought often without realizing it by the philosophical assumptions and theories that draw them into this downward curve towards nihilism. The fact is, we are all philosophers, whether we know it or not. Pope John Paul writes, All men and women are in some sense philosophers and have their own philosophical 4 The contemplation of Christ s miracles as described in Holy Scripture may serve as a healing corrective to scientism. We become aware that, while we may always look out for a natural explanation, the decision to exclude the very possibility of miracles can only rest on an act of faith in the philosophy of materialism. In this way, the balance of faith and reason can be restored. 3

conceptions with which they direct their lives. In one way or other, they shape a comprehensive vision and an answer to the question of life s meaning; and in the light of this they interpret their own life s course and regulate their behaviour (FR, 30). To the extent we are influenced by nihilistic philosophies we will begin to treat human beings increasingly like animals or machines, and to calculate even our care for them in terms of efficiency and cost-effectiveness. Perhaps some examples would help. In the UK alone, approximately 30 embryos are destroyed for every live birth by IVF, accounting for over 2 million deaths since 1991. But even if we ignore the embryos that were killed, we still are unsure of the long-term psychological effects on children of discovering their origin lies not in the love of their parents but in a scientific experiment or commercial transaction. And the treatment of human life as a merely biological or even mechanical process leads in ever more bizarre directions. It was revealed to the British Parliament in July that 155 animal-human hybrid embryos have been created in British laboratories since such research was legalized in 2008 (that is, before the funding ran out). The justification given as in the case of research on embryonic stem-cells in general was of the type that has become all too familiar: that is to say, it might help (eventually) to eliminate all kinds of diseases. The end justifies the means. These examples of technological intervention have to be seen in the context of a legal culture that arbitrarily defines the moment when a right to life kicks in, some weeks after conception, in order to permit millions of routine abortions, often of children who, if wanted by their parents, doctors would have fought to keep alive. With the help of Fides et Ratio, we can identify some of the philosophical positions that distort and disfigure typical ways of thinking and acting in the medical and caring professions. We are reminded that faith needs reason and reason needs faith, because faith in truth and in God are a stimulus to the search for truth and the living of a worthwhile life. But we need to go further, to find a corrective to these philosophies that threaten our humanity. We may all have an unconscious philosophy, but we are not all philosophers in the sense that we can think our way out of the traps into which we have fallen. And here I think Pope Benedict XVI can help us. The final paragraph of Ratzinger s 1999 talk at the Sorbonne, looking forward to his first encyclical, Deus Caritas Est, seems to take us one important step beyond Fides et Ratio when he speaks of a correspondence between love and reason as fundamental pillars of the real: true reason is love, and love is true reason. In their unity, they are the true foundation and the end of all reality. Pope John Paul II spoke in his philosophical encyclical about faith and reason. Pope Benedict speaks here of love and reason. But the two popes are in perfect harmony. The point Benedict is making is one that was implicit in the writings of John Paul II. Faith and reason, grace and nature, religion and science, are complementary. Each needs the other, like two wings that help us ascend towards the truth. But reason here is not just a matter of dry, mechanical logic, or the grinding of empirical facts one after another. That kind of reason is dehumanizing and leads us away from the fullness of truth. It leads us towards nihilism. True reason, or true intelligence, is actually a matter of love. Now this is a language that potentially makes sense to everybody, because everyone knows that love is what makes life worth living. We might guess that a revival of love would lead to a renaissance of the caring professions and motivate us to work tirelessly for the protection and support of mothers around the world. But in what sense is love the same as reason? In what way does it give us access to truth? If we can t answer that we are left with a kind of sentimental picture of love that will hardly resist the forces ranged against it. It is the contention of Christianity that love is not simply a matter of the will, or of feeling, but of knowledge and in fact that love is in a certain sense the same as being. That is why the Pope can call it the foundation and end of reality. All the forces of politics and science should therefore be subservient to it. Even freedom exists not for its own sake but for the sake of love so that love can be a free gift. God is love, and the world made by him in his image is a world built on love and made of love, so that we only understand the world fully only when we 4

understand love. This love is not a matter of sentiment, of a pretty picture, for Christ on the Cross reveals the spiritual beauty of love even in the midst of ugliness, suffering, and mutilation. 5 But how do we revive love that has grown cold? Not by talking about it, that s for sure. Only by loving. It is the example of love that communicates love, as Christ showed and as the saints have continued to demonstrate through the centuries. And yet talking as we are doing at this conference is not totally pointless. Far from it. By talking we can defeat the intellectual enemies of love, and we can give one another the courage to do what we know we must, if our words are to mean what they say. When people talk about the crisis in obstetrics they tend to be referring either to issues around malpractice insurance, or (certainly in the UK) about a shortage of trained midwives and other problems within the health service. We are also aware of a crisis of much greater proportions in developing countries, in Africa and Asia especially, which tragically affects many millions of mothers and infants. Of the technical, economic, and social solutions proposed for all this, some will no doubt be more effective than others. But though the problems are extremely varied, the root is not a technical problem, but a spiritual one it is a crisis in the sense of vocation, as I mentioned at the very beginning. The professionalization of medicine and care has largely replaced the sense of these things as a vocation, a calling to self-gift, to disinterested service of others. What is more, this is part of a wider problem that afflicts our sense of humanity. Individualism, materialism, and consumerism have undermined the idea of service along with the idea of obedience as a virtue. We no longer regard ourselves as necessarily dependent on others or on God. We have been taught that there is nothing superior to the self which deserves our submission and respect. The Masters of Suspicion have done their work, aided and abetted by the many authorities, religious or not, who have notoriously abused their positions. The adequate response can only be the recovery of the spirit of vocation, of service, and respect for the immeasurable value of every human life. Stratford Caldecott is the Editor of Second Spring, and of Humanum, the online review of the Center for Cultural and Pastoral Research of the Pontifical John Paul II Institute for Studies in Marriage and Family in Washington, DC. He is the author of Secret Fire, The Seven Sacraments and Beauty for Truth s Sake, and of two forthcoming books, All Things Made New, and Beauty in the Word. See www.secondspring.co.uk. 5 In this rediscovery of ontology through love, especially in a fallen world, the phenomenon of suffering occupies an especially important position. This is brought out by John Paul II s Apostolic Letter Salvifici Doloris (1984), in which he writes that suffering is as deep as man himself, precisely because it manifests in its own way that depth which is proper to man, and in its own way surpasses it. Suffering seems to belong to man s transcendence: it is one of those points in which man is in a certain sense destined to go beyond himself, and he is called to this in a mysterious way (SD, 2). See also Benedict XVI, Spe Salvi (2007), section 38. 5