The Prospect of a Christian Post-Liberal Biopolitics
Last Name Karches
Terminal Degree(s) MD
Title/Position Assistant Professor of Medicine and Health Care Ethics
Institution/Organization Saint Louis University
The modern liberal nation-state claims sovereignty over its citizens’ bodies, a claim that rests implicitly on a dualistic separation of soul from body. Thus in liberal states citizens enjoy freedom of worship, purportedly a private good pertaining to the soul, but insofar as religious action affects citizens’ bodies in the public space, the state as sovereign may regulate such acts. This cleavage between private and public space influences physician practice in turn. Smoking, for example, is placed in the public realm and therefore amenable to state regulation and medical intervention intended to eliminate the behavior, but risky sexual behavior, despite its similarly serious potential impacts on patients’ health, is considered a private matter, and thus physicians limit themselves to mitigating its consequences. Although liberalism has come to dominate contemporary bioethics, it has always been in tension with a more traditional ethic in which physician and patient work together to promote health, a good that crosses the boundaries between soul and body, private and public. Liberalism’s agnosticism toward the good life has left bioethics unable to speak of health in this more holistic sense. Liberal bioethicists had assumed that better health would perhaps arise spontaneously from granting wider scope to patient choice, as another instance of liberalism’s faith in the “invisible hand.” Instead, the costs of care have ballooned, necessitating ever more regulation by the sovereign state. Yet recent years have seen challenges to liberal values from both the “left” and the “right,” and this crisis provides an opportunity to imagine a bioethics that reintegrates what liberalism has put asunder. In this paper, I will argue that an integral Christian conception of ethics and politics can preserve what is genuinely good about liberalism while also escaping its limitations and resisting the modern state’s claim to control over the body. I will show that Christianity provides sufficient grounds for the best aspects of liberal bioethics, such as informed consent, while also supporting a more robust conception of health that integrates the good of individual patients with the common good. The future of medicine may yet belong to those who can expose as a fiction and thus overcome the liberal dichotomy between the religious and the secular.