Applying the Grammar of Assent to Address Greenblum and Hubbard’s ‘Public Reason’ Argument
Paul Riffon, MA Theology, PhD Student , Saint Louis University
Jake Greenblum and Ryan K. Hubbard in their recent article 'Responding to religious patients: why physicians have no business doing theology' argue that a physician is obligated to refrain from substantive religious dialogue with their patients when helping them reach medical decisions. Greenblum and Hubbard give two reasons for this conclusion: 1) that a physician, as a public official, is duty bound to engage only in public reason, of which religion is outside and 2) that the patient-physician relationship is akin to a fiduciary relationship and a physician who cites religious reasons undermines the trust of that relationship.
This essay will address the assumptions at the foundation of the public reason argument as presented by Greenblum and Hubbard. I will argue against the idea that there is such thing as a neutral public space in which ‘reasonable people’ can engage and is free from metaphysical assumptions. Borrowing from John Henry Newman’s 'Grammar of Assent,' I will argue that by appealing only to the certitude of apodictic proofs, the physician does harm to the patient. To do this I will level two critiques: First, I will perform a brief genealogy of Greenblum and Hubbard’s Public Reason Argument and Fiduciary Argument. Both arguments share a similar history in secular humanism and liberalism whose foundations are critical of and antagonistic to religion. This genealogy will outline the rise of secularism and it’s obsession with apodictic certitude beginning with Descartes’ cogito. I will show that what is characterized as a homogenous, normative public space is in reality the fragmented meeting of moral strangers. Second, contra Greenblum and Hubbard, I will argue that a physician is not asked to ‘do theology’ in the sense of being a theologian, rather the physician is asked to respond to the lives, beliefs, and attitudes of their patients, of which religion is often a central essence. By only accepting apodictic knowledge, Greenblum and Hubbard ignore the fact that persons regularly give assent without syllogistic proof; metrics contribute to decisions, but according to John Henry Newman, so do impressions, intuitions, and experiences. A physician appealing solely to reason refuses to approach the patient on their own terms and respect their beliefs. In so doing, the physician does harm to the patient. I will conclude by arguing that in the adoption of a strict appeal to public reason, the physician foists a secular worldview onto the patient, one that doesn’t respect the nuance of ‘assent’. Using a case example, I will suggest that in the messiness of a medical prognosis, a patient never relies totally on evidence-based medicine and public reason. The patient naturally uses what Newman describes as the illative sense which carries one from formal inference through informal inference to the point of assent (of which religious morality, lessons, and experiences are a vital part). The physician would provide better care if they respected the illative sense of the patient rather than reduce all decision-making to strict syllogism and metrics.
This essay will address the assumptions at the foundation of the public reason argument as presented by Greenblum and Hubbard. I will argue against the idea that there is such thing as a neutral public space in which ‘reasonable people’ can engage and is free from metaphysical assumptions. Borrowing from John Henry Newman’s 'Grammar of Assent,' I will argue that by appealing only to the certitude of apodictic proofs, the physician does harm to the patient. To do this I will level two critiques: First, I will perform a brief genealogy of Greenblum and Hubbard’s Public Reason Argument and Fiduciary Argument. Both arguments share a similar history in secular humanism and liberalism whose foundations are critical of and antagonistic to religion. This genealogy will outline the rise of secularism and it’s obsession with apodictic certitude beginning with Descartes’ cogito. I will show that what is characterized as a homogenous, normative public space is in reality the fragmented meeting of moral strangers. Second, contra Greenblum and Hubbard, I will argue that a physician is not asked to ‘do theology’ in the sense of being a theologian, rather the physician is asked to respond to the lives, beliefs, and attitudes of their patients, of which religion is often a central essence. By only accepting apodictic knowledge, Greenblum and Hubbard ignore the fact that persons regularly give assent without syllogistic proof; metrics contribute to decisions, but according to John Henry Newman, so do impressions, intuitions, and experiences. A physician appealing solely to reason refuses to approach the patient on their own terms and respect their beliefs. In so doing, the physician does harm to the patient. I will conclude by arguing that in the adoption of a strict appeal to public reason, the physician foists a secular worldview onto the patient, one that doesn’t respect the nuance of ‘assent’. Using a case example, I will suggest that in the messiness of a medical prognosis, a patient never relies totally on evidence-based medicine and public reason. The patient naturally uses what Newman describes as the illative sense which carries one from formal inference through informal inference to the point of assent (of which religious morality, lessons, and experiences are a vital part). The physician would provide better care if they respected the illative sense of the patient rather than reduce all decision-making to strict syllogism and metrics.