Religion, Health, and Medicine: the Dialectic of Embedded Social Systems

The philosopher in me understands that there are universal principles in logic, mathematics, and in basic scientific tenets such as the law of gravity. Be that as it may, the historian in me recognizes that we inherit epistemologies and ways of thinking from those before us, and from our own historical and cultural contexts. Certain ideas dominate the world; and, while some are indeed universal, especially those based on science, the fact remains that a number of other concepts are only seemingly universal. The concepts of personhood, divinity, self, and even society as we tend to understand them today are largely inherited from a Western, Christian worldview. As these ideas have wrestled with philosophical inquiry throughout history, they have either been decoupled from their origins in religious thought, or they have been secularized and rationalized a la Kantian categorical imperatives or the like—and then disseminated in universities, institutions, cultures, and literatures.

On one level, to speak of the Western world as “secular” is, as the philosopher Charles Taylor notes, to say that “belief in God, or in the transcendent in any form, is contested; it is an option among many; it is therefore fragile; for some people in some milieus, it is very difficult, even ‘weird’” (Taylor: 2011, 49). But on another and much deeper level, this very possibility was only ever tenable on account of two major factors: “First, there had to develop a culture that marks a clear division between the ‘natural’ and the ‘supernatural,’ and second, it had to come to seem possible to live entirely within the natural” (Taylor, 50). This was only possible because of a unique philosophical climate that actively sought to dislodge the old form of moral order and social “embeddedness” in an attempt to establish a “purely immanent order.” Taylor’s groundbreaking work, A Secular Age argues that secularism is part of a grand narrative in the West and shows that its historical and cultural foundations are in fact thoroughly Christian and European. He pushes back against Max Weber’s secularization thesis that religion diminishes in the modern world and in the wake of increasing developments in science and technology—and instead gives a different account of what secularism might mean: one that has deep implications for morality, politics, and philosophy.

Charles Taylor demonstrates the ways in which we now inhabit and are embedded in this secular paradigm. By taking stock of this grand narrative, it is clear that the secular narrative as a framework or method of study in academia is largely a product of, and often unique to, European history generally and its experience with Christianity and the state in particular. That secularism and secularization did not take root elsewhere, or did not occur in the same way or with the same force, suggests that different religious traditions had or continue to have a far different relationship to notions of “the secular.”

Insofar as human rights must take stock not only of law but also of politics and ethics then, we ought not to ignore that there is are diverse ways in which different countries and cultures view rights; and we ought to ask what might be done to bridge that gap in order to couch the discussion in truly universal terms—or if indeed that is even a possibility. Alicia Ely Yamin, in her recent health law workshop on “Democracy, Health Systems and the Right to Health: Narratives of Charity, Markets and Citizenship” tackled the concept of health as a human right. In an erudite paper drawing on John Rawls, Amartya Sen, and others, she highlighted the differences of perspective amongst several South American countries in how they view health, centreing her argument around the notion of human dignity. The concepts of human dignity, value, and human rights are no doubt very important, yet in view of the historical arc above, I wonder to what extent they have underlying philosophical foundations in Christianity or in the West more broadly, and whether a cosmopolitan approach to human rights could be a way to broaden the discourse, while remaining true to Yamin’s compelling notion of “social citizenship.”

This is not an appeal to relativism. Nor is it necessarily inherently problematic if it turns out that these concepts are unique to the Western tradition alone (doubtful though that would be). The point of a cosmopolitan approach to human rights is to recognise that when we look at the world we see that society is not usually ordered with consciousness or with intention, but rather simply exists having been constructed unphilosophically and uncritically. Such an approach thus broadens the discourse in hopes of consensus while also accepting that there are real differences. As Harvard psychiatrist and medical anthropologist Professor Arthur Kleinman argues, “The tie between social and personal worlds is mediated by language, symbols, value hierarchies, and aesthetic forms that are the pervasive cultural apparatus which orders social life” (Kleinman: 1988, 3). Medicine, health, law, are not exempt from this dialectic.

When academic scholarship—whether law or anthropology or medicine—assumes, even unwittingly, a position of power from within, or by virtue of, the discourse or narrative of secularism—or approaches ethical value from the perspective of political liberalism—it unfairly excludes other cultural or religious accounts as viable or valid. This is not to say that only religion is able to define morality or the highest human good, nor that it is necessarily sui generis; instead, following Taylor, I call into question the religious-secular divide itself in hopes of drawing out the nuances of both terms and concepts in the context of their historical and socio-cultural roots in the West, as well as the implications for examining ethics, health, and medicine vis-à-vis religious traditions. Secularism as a “neutral” analytical perspective, or even as a so-called “scientific” category of understanding, thus needs to be reassessed in light of the underlying assumptions implicit in much secular-liberal academic scholarship.

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