The prophetic and the priestly.

The Prophetic and the Priestly In recent years there have been several impressive efforts to retrieve and to develop religious and theological perspectives on bioethics. Such efforts often gain support from interpretations of morality that stress virtue, narrative, tradition, community, emotion, etc. Major discussions appear regularly in Second Opinion: Health, Faith and Ethics; important discussions also appeared in the special supplement, "Theology, Religious Traditions, and Bioethics" in the Hastings Center Report (July/August 1990). In an illuminating analysis, James M. Gustafson has identified four major forms of moral discourse (or morally relevant discourse) about science, medicine, and health care: ethical, prophetic, narrative, and policy discourse. Ethical discourse uses concepts and categories from moral philosophy and theology to decide how one ought to act in particular circumstances. By contrast, prophetic discourse tends to offer more general indictments or utopian visions, and narrative discourse invokes the values and visions of communities as shaped by their stories. Policy discourse tends to ask what is possible. Gustafson argues that morally significant issues are neglected if only one form of moral discourse is recognized. (See Gustafson, "Moral Discourse About Medicine: A Variety of Forms," Journal of Medicine and Philosophy 15 [April 1990], 125-42.) Very much in the narrative and prophetic mode of discourse is one of Stanley Hauerwas's most powerful and illuminating books, Naming the Silences: God, Medicine, and the Problem of Suffering (Grand Rapids, Mich.: William B. Eerdmans Publishing Co., 1990, forthcoming). Hauerwas "focuses on why the problem of illness and death--particularly the problem of childhood illness and death--is so troubling for us." While explicating why we seek explanations of suffering and death, he contends that such explanations are "theologically and philosophically wrong-headed." Our modern liberal versions of such explanations often rest on "destructive presuppositions about the nature of our existence." And we can "rightly express our care for one another through the office of medicine" only if "we understand those presuppositions and why they have such a hold on us." Hauerwas's critique of liberal culture is prophetic; its style is largely narrative. Its ethical implications are clearer than its policy implications. Another important theological work is a collective effort by scholars in the Calvinist tradition: Hessel Bouma III, Douglas Diekema, Edward Langerak, Theodore Rottman, and Allen Verhey, Christian Faith, Health, and Medical Practice (Grand Rapids, Mich.: William B. Eerdmans Publishing Co., 1989). In the context of major theological convictions (for example, God as the Creator, the Provider, the Redeemer, human beings as created in the image of God), the authors seek "to suggest what faithfulness to God requires of those who deliver and receive medical care." This work is more clearly theological in prophetic and narrative modes than Paul Ramsey's earlier work on covenant fidelity, but it combines, to some extent, all of Gustafson's forms of moral discourse. However, I would have appreciated a fuller statement of the implications and limits of "respect, tolerance, and cooperation" in a pluralistic society. In the Catholic tradition, Richard McCormick, S.J., has published another important collection of his essays, entitled The Critical Calling: Reflections on Moral Dilemmas Since Vatican II (Washington, D.C.: Georgetown University Press, 1989). While half of the twenty-two chapters are devoted to fundamental moral theology, the others focus on practical and pastoral questions, largely in biomedical ethics. McCormick's important work is subjected to analysis, criticism, and expansion in a festschrift edited by Charles Curran, entitled Moral Theology: Challenges for the Future (New York: Paulist Press, 1990), which is largely devoted to McCormick's approach to fundamental moral theology, with a few essays on biomedical ethics. …