OPINION PIECE
John Patricka
a MBBS, BS, MRCP, MD, President and Professor of the History of Science and Medicine, Augustine College, Canada
We were asked to look into what accounted for the… pre-eminence of the West all over the world… At first, we thought it was because you had more powerful guns than we had. Then we thought it was because you had the best political system. Next, we focused on your economic system. But in the twenty last years, we have realized that the heart of your culture is your religion: Christianity. This is why the west has been so powerful. The Christian moral foundation of social and cultural life was what made possible the emergence of capitalism and then to democratic politics. We don’t have any doubt about this.
Only by accepting [Christian] understanding of transcendence as our criterion can we understand the real meaning of… freedom, human rights, tolerance, equality, justice, the rule of law, universality and environmental protection.1
- Chinese scholars quoted by Niall Ferguson
Universal global health, human rights, and justice are all problematic ideas. They are not an inevitable development of civilization, but a consequence of previous religious and philosophical influences. Definitions, distinctions, and limitations are, therefore, a necessary preliminary. Human rights and justice are very different in different cultures. In a tribal society, loyalty to family, clan, and tribe are far more important than any universal concepts, such as the practice of truth-telling. Both loyalty and truth are virtues, but which one trumps makes a lot of difference. Where loyalty dominates, everything depends on “who you know.” Where truth dominates, “what you know” prevails. Only Jews and Christians, and then only at their best, have managed to put truth first, and it has played a large part in the development of science and medicine in particular.
The more fatalistic a society is, the less the sense that things can really change. The idea of fate and reincarnation makes it very easy to rationalize doing nothing for those whom our world calls the under-privileged. Indeed, Hinduism can legitimately say that no one should interfere with karma; let reincarnation work everything out. Three and a half millennia ago, the people of Israel were given the Torah and were told obedience would lead to flourishing. It included codified rights for the foreigner but they were not the same as those for the native born. Christianity soon promulgated the idea of equality in Christ — neither Jew nor Greek, neither male nor female in Christ (Gal 3:28). Although still working out what this means, the West has led the world in implementing equality.
We have our problems with utopian dreams. Even when we acknowledge rights politically, we still have a parochial hierarchy of who gets what. The elite in their gated communities have a very different view of rights from those who are pushed out of their traditional communities by militant immigrants forming their own ghettos. Universal human rights do not come naturally; neither is the problem merely one of ignorance. Without the will and cultural norms supportive of the concept of rights and the capacity to enforce them, mere declarations will only raise expectations that will be frustrated and produce envy and resentment. A good start is to distinguish real rights with obvious and undeniable reciprocal duties from pseudo-rights with no such undeniable obligations.
The more Christian concept would be to talk about human responsibilities, which were set out in the Torah as being founded in loving God with all our hearts, souls, and minds and in loving our neighbours as ourselves. Unfortunately, we do not live like that. Our wills are too weak (think about how long New Year’s resolutions last). Note however, we do not have a deficit of knowledge. We have all been taught a lie: that we can do whatever we set our minds to do, that the only barrier is ignorance. The university is almost necessarily committed to this view but sadly the barrier is the will, not ignorance. A simple example in the Western world is how in the last 50 years the cause of most disease has changed. It used to be that God or Nature was thought to be the cause for all except diseases like sexually transmitted infections, or stupid accidents and alcoholism. But now, at least in part, human behavior is the cause: not ignorance, but simply diminished character and will. No great scientific advances are needed; we just need to do what we already know. Everyone knows that if you don’t eat excessively you won’t gain weight, but we have a global epidemic of obesity that is tragically destroying many lives. Education programs do not work well. Even if weight is lost, it returns in a few years. What is even more astonishing is the utter incapacity, or more precisely, unwillingness, of the medical profession and the political and public health elite to connect the dots and acknowledge the spiritual factor in global health.
If one is ill because of behavior and those you love are suffering with you because of that behavior, it is impossible to avoid an ongoing burden of guilt. If the guilt entailed is not acknowledged and dealt with spiritually, no cure will be achieved. Just scan the index of any textbook of medicine to find a discussion of this guilt, and you will search fruitlessly. The politically correct world does not like to realistically discuss human nature. Nevertheless, as Chesterton put it — surely the only incontestable Judeo-Christian doctrine is the fall.2 Any coherent understanding of “Health, Justice, and Rights” must start from that reality. Starting from a utopian view of human nature, we will get to false and very expensive policies. The fact is that the decline of the Christian ethos in the West has been associated with a dramatic increase in diseases with major behavioural components. We used to be ashamed of these, but this ought not to be a surprise but an expectation. The logical inverse that those who live in traditional believing communities should be much healthier than those who don’t is true. That “truth” has huge implications is now extensively documented.3
One obvious demonstration of the tacit acknowledgement of the cultural crisis we are facing is the introduction of ethics courses into professional training. They do not work for perfectly logical reasons. The current teaching of ethics in medical school illustrates what CS Lewis recognized a long time ago, that most heresy is a good thing in the wrong place. The Georgetown Mantra of autonomy, justice, beneficence, and non-maleficence are almost never taught as ordered goods. The order they are in is drawn from our cultural preferences, but believers should see that the reverse is the biblical sequence. When the Israelites were given the law, the Ten Commandments were things not to do! Non-maleficence is the foundation from which the desirable but often unachieved beneficence can be set as a target. Only then is justice possible and necessary if autonomy is not to degenerate into anarchy. The real problem is the erosion of trust which can only be based on knowledge of character which is what you do even when no-one is watching. Robert Fogel, University of Chicago Nobel laureate in economics, has discussed this in his book The Fourth Great Awakening.4
Justice needs more space than I have been allotted, but fortunately, Arthur Leff gave a magnificent account 40 years ago in the Duke Law Journal. Here is my shortened version of his opening statement of the problem of justice in the modern world:
I want to believe and so do you, in a complete transcendent and comprehensible set of rules directing us how to live our lives righteously. [He understands if the law does not come from God there is no authority to control the judges.] But I also want to believe and so do you in no such authority but rather that we are wholly free to decide for ourselves what we believe and what we will do. What we want, heaven help us, is to be at the same time to be perfectly ruled and perfectly free; that is to simultaneously invent and discover justice.5
He goes on to brilliantly discuss this conundrum. Thus, the Jews gave us justice but we are steadily eroding its transcendent foundations. When Lenin said it will be necessary to legalize terror, he was merely describing what all “utopian” regimes do.
Rights, too, are not so culturally transposable as we would like to think. To have a functional theory of universal human rights, we must be able to trust that a degree of a particular form of altruism exists in all societies. We live in a time where the fear of God is rapidly diminishing, and without it, only utilitarian ethics can be realistically proposed, but that system cannot support altruism. It is much more an ethics of “What can I get away with?” than one of “What ought I to do?” The best discussion of this problem I know is by David Stove.6 Moral relativism is the inevitable result. It is received with mother’s milk. The following quotation makes my point:
If relativism signifies contempt for fixed categories and men who claim to be the bearers of an objective and immortal truth… from the fact that all ideologies are of equal value, that all ideologies are mere fictions, the modern relativist infers that everybody has the right to create for himself his own ideology and attempt to enforce it with all the energy of which he is capable.7
We really must recognize that choices come with logical consequences, whether we recognize them or not. If we deny real transcendent good, we have no valid arguments against the above comment or its fascist manifestation. The law becomes the pursuit of power rather than the pursuit of justice. Respect for law and the practice of democracy are both fragile flowers; they flourish only in particular soils, and they are rare. Every society has some sort of ethical code. Moses reminded the children of Israel in Deuteronomy 4 that their God is greater than those of the surrounding tribes who will recognize that by seeing how wise the Torah is. But he also reminds them that, despite the experience of Mount Sinai, they will not keep their promise to obey. The seduction of other gods, who command the kind of sexuality which man is prone to desire, was as overwhelming as it is in our day where sexual libertarianism turns freedom into addiction. True freedom is not the freedom to do what you wish, but the freedom to do what you ought. In The Abolition of Man, CS Lewis put it like this, ”For the wise men of old the cardinal problem of human life had been to conform the soul to objective reality, and the solution had been knowledge, self-discipline and virtue… [for modern man] the problem is how to subdue reality to the wishes of men and the solution is technique.”8
Why is it necessary to build a discussion of how to achieve global health, justice, and human rights by using history, theology, and philosophy? Because these things do not come easily, and history helps us to understand their origins. Christian conversion and the growth of a recognizably Christian ethos have very different time lines. In the Acts of the Apostles, the church grew quickly, but it was not long before social problems came to the fore. Conversion makes one redeemed, but Paul’s epistles show how he had to labour long and hard for the mind and character of Christ to be formed in the infant church. It was fortunate that by the grace of God the early church was dominated by those formed by the long history of Israel, particularly, honouring and obeying the law, the prophets and the writings.
The amazing missionary work of the 19th century successfully planted the Gospel in places where it had never been heard, but training in righteousness was rather thin. Making disciples takes time. Rwanda is a tragic case study. Mass conversions happened during the early 20th century Rwanda Revival, and one can still find people for whom it is still an event remembered with joy. But the joy of conversion was not followed up by anything approximating Paul’s teaching. After the horrendous carnage of the Tutsi and Hutu conflict, I spent the summer of 1995 teaching in the Hutu refugee camps. Perhaps 80% of Rwandans went to church, but it had not prepared them to deal with the tribal conflict of the Rwandan civil war. The first question I was asked by repentant Hutus was, “how could we, who called ourselves Christians, kill people we knew?” The answer, of course, is “welcome to the club.” All religious groups have been guilty of humanitarian injustice and secularists (also a belief system) have outdone them in the 20th century. Knowing that history was exactly what they needed to hear. Then, it was time to deepen their account of conversion, introduce them to discipleship and the formation of a Christian character from a deep engagement with the sermon in the mount, and most importantly Jewish child rearing practices as in Deuteronomy 4-6.
We do not know how to do development. So, we have largely useless courses in social sciences pretending that they know. If we knew, we would do it. Most cultures flourish for a while and then fade away. Toynbee proposed that it is possible to identify cultures about to decline and by inference identify some key factors in building a functional, materially successful culture. He placed moral consensus at the heart of the matter; once lost, the decline had begun.9 Robert Fogel said much the same in The Fourth Great Awakening.4 Moral consensus builds trust, and trust is essential to effective development work. The Western moral consensus cannot be derived from a Darwinian account of humanity, as atheist David Stove has brilliantly demonstrated in Darwinian Fairytales.5 Quite indubitably, we are in a phase of diminishing trust as the explosion of locks, keys, gratings, and surveillance cameras demonstrate. Law is a codification of moral consensus, especially the miracle of common law. We used to be proud of our justice system; now we see far too often there is one law for the rich and another for the poor. The Torah implies that we all know a lot of moral truth. Cain was warned by God that he was about to do evil (Gen 4:6-7). Moral truth and justice are written on our hearts. Children know it; how else does one account for “not fair” being very close to the first words they speak. In the Bible there is no discussion of how justice develops but simply the injunction, “be just as I am just” (Mat 5:48). God has written on our hearts the starting premises. Our job is to think them out. At the American founding they knew this. Harvard, Yale, Princeton, Dartmouth, and the University of Chicago all had Protestant Christian foundations, but we gave them away by dereliction of our intellectual duties as detailed by Marsden.10
The central intellectual miracle of Judaism is Torah, and its central theses are presented as words spoken by God and, therefore, undeniable. Because of it, they were thinking about morality and justice when Europeans were constantly engaged in tribal carnage. This history is vitally important because, without the fear of God as transcendent law-giver, we sink into a swamp of values language. Simply put, we cannot exist without authority. My values versus your values is a recipe for conflict in which power replaces justice. Remember Lenin’s comment. In the Soviet Union, the KGB were feared and ubiquitous, thus in the sixties, it was possible to walk the streets of Moscow without fear of being mugged. Fear controls, but it does not encourage or inspire. Russia destroyed its proud tradition of independent enquiry. Solzhenitsyn catalogued the debacle of the Soviet revolution in the Gulag Archipelago, a must-read book for those interested in how government can get it wrong.11
So why do the Jews survive and flourish? They win a disproportionate percentage of the Nobel prizes every year. Muslims win very few indeed. Science, as we know it, started at the end of the 13th century, long before the so-called Renaissance. Culture matters. This is where our thinking about global health, human rights, and justice must start.
If you question thoughtful believing Jews about their intellectual success, without any development programs (also a much undiscussed feature of the history of the USA), they will take you back to Deuteronomy – the world’s greatest commencement address. Moses is telling the children of Israel what will be necessary if this rabble of ex-slaves are to become a nation. Obeying God’s grace-filled laws is where it starts, but that is not all. It must continue with the teaching of the stories of the Bible to the children at the dining room table. Children before the age of seven have incredible memories. If those early years are used to imprint all the stories of the Bible in their minds, they will have a moral reference code for life. There is no need of any discussion of the meaning of the stories when they are young; that comes later. Why are the Jews so successful? Because, unlike all other national histories, they tell the truth that we are all sinners, but God works with those who keep short accounts with Him. Everything in Jewish history has consequences; no one gets away with anything! For a child to grow up knowing this truth in the depth of their being is an incredible asset in our lying world and a key to human flourishing. This is further developed in a talk entitled Why are there no Hittites on the Streets of New York?12
So how are we doing? A test of biblical literacy is available at https://www.johnpatrick.ca/meaning-metaphor-and-allusion/. Westerners are increasingly post-Christian people living in a softly nihilistic world. Be afraid, be very afraid of hard nihilism. What comes next is brutal.
Development is dependent upon culture. We need to be culture builders starting with the Old Testament which will change family structure at the earliest stages of the life cycle. America had no development programs, but it did accept Judeo-Christian accounts of human nature and law. That was enough. Most Americans have not read DeTocqueville’s Democracy in America.13 He came from the French revolution to try and understand why America’s revolution succeeded and commented that it was only when he went into the churches of America did he understand. This success is fragile. Biblically-informed teachers who know and love the story of how Jesus changed the world are needed to give the world a love of God and neighbor and provide sustainable learning which will lead to progress in development, global health, justice, and human rights for all.