Freedom of belief

Culture

Freedom

Freedom of Belief

20 September 2023

8 min read

Why religious liberty? Love, actually

Claims for religious freedom can be controversial. Nathan Chapman weighs up approaches to accommodating them, not just legally but in the light of love.

Nathan S. Chapman

Nathan S. Chapman is a scholar of constitutional rights, religious liberty, and Christianity and the law. He is a Professor of Law at the University of Georgia.

A montage of people praying with hands held together.

A detail of Norman Rockwell's 1943 Freedom of Worship illustration.

Norman Rockwell, Public domain, via Wikimedia Commons.

Religious liberty is a cornerstone of liberal democracy. The freedom of religious belief and practice is enshrined in human rights instruments, national constitutions, and legislation. Usually, those rights are uncontroversial. Only when someone claims a right to do something that threatens the rights of others – such as a right to decline to bake a cake for a same-sex wedding – do most observers take notice. Unfortunately, in controversial cases the values underlying both of the competing rights claims tend to get lost in political rhetoric. The arguments against the religious liberty claims may be obvious - concerns about security, or public health, equal treatment of LGBTQIA+ persons - but for many it is harder to see the value of allowing dissenters to peacefully practice their religion.

So, what is the point of religious liberty? Several justifications have deep historical and philosophical roots. Top of the list is reducing conflict: from the view of believers, God demands one thing, society another. Best to let believers have their way so long as they are peaceful about it. Concerns about political conflict were one of the key reasons for the rise of religious tolerance in the 17th, 18th, and 19th centuries.

This reason goes only so far, though—only far enough to prevent actual conflict. It does nothing to justify freedom for groups or individuals who pose no threat to political stability, perhaps because they are small, or because they are politically withdrawn. And focusing exclusively on conflict is intellectually unsatisfying; it considers only the effects of religious difference instead of digging into why people adhere to unpopular religious practices. For that, we need an insider's point of view. We need to see why believers have often supported religious liberty not only as a political expedient, but because they have believed religion required religious liberty for everyone.

Consider two Christian statements of rationale for religious liberty that have become canonical among western democracies. The first comes from John Locke:

“true and saving religion consists in the inward persuasion of the mind, without which nothing can be acceptable to God.”

Such “persuasion” must be free, and it must be sincere. Under this view, compelled religious belief is an oxymoron; it doesn’t work, and even if it did, it would do the believer no good--salvation requires voluntary belief. Therefore, says Locke, the “civil” jurisdiction and the “spiritual” jurisdiction are strictly separate, with the civil magistrate having no say over spiritual matters. This argument went a long way toward justifying the government’s toleration of dissenting assemblies, preaching, and worship. But toleration goes only so far. It does not include freedom from any legal duty that is rightly within the domain of the civil magistrate. For instance, a religious pacifist--Christian, Buddhist, or otherwise--who objects to mandatory military service is out of luck.

James Madison, the architect of the U.S. Bill of Rights, was more sympathetic to dissenters. When Virginia tried to make taxpayers pay tithes to their local churches, Madison pointed to the Virginia Declaration of Rights (1776):

“Religion, or the duty which we owe to our Creator, and the manner of discharging it, can be directed only by reason and conviction, not by force or violence.”

At first glance, this may seem to restate Locke’s position: true religion requires intellectual freedom. But it goes much further than Locke did. Madison defines religion as the duty one owes to God and “the manner of discharging it.” And, crucially, Madison jettisons Locke’s binary view of “civil” and “spiritual” jurisdiction. Only one jurisdiction matters for determining the scope of religious liberty: God’s. When we have a duty to God, the civil government should get out of the way. Under Madison’s view, religious liberty resolves inconsistent commands of rulers with overlapping jurisdictions in favor of those issued by the higher authority, God.

This view does not satisfy everyone (including some believers). In the first place, it relies on premises that many reject: the notions that there is a knowable God, that people owe duties to God, and that others should respect those (perceived) duties. In the second place, in religiously pluralistic societies, it often seems like each person claims different duties to different gods. Religious liberty facilitates religious diversity, which proliferates inconsistent claims of divine “duty," thereby diluting each of them. At the same time, it makes accommodating every claim more costly, because there are more of them, and they seek accommodations from a wider variety of laws.

To make matters worse, the divine duty rationale implies that religious liberty has no limits. The person who believes that God demands human sacrifice has as much a claim to religious liberty as the one who simply doesn’t want to be made to attend a church service. The rationale also rests on a notion that is increasingly difficult for those in secularized societies to view sympathetically: the idea that the Creator of the universe exacts obedience, and that society should honor the individual's perception of that duty, in exchange for... what, exactly?

A more thoroughly Christian view of religious liberty depends on grasping why believers want to obey God. Locke’s answer was straightforward: fear of eternal damnation. What ought to motivate religious tolerance, Locke insists, are differences about what constitutes “true and saving religion.” Here, Locke was understandably a creature of his times, when western Europe and North America were divided by doctrinal disputes about Christian salvation. Although the promise of eternal life through faith in Christ is the core of Christian doctrine, Scripture surely teaches that those who have already acknowledged Christ as their Savior should obey God not out of fear of damnation, but out of love. Jesus said the greatest commandments were these: “Love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength” and “Love your neighbor as yourself.” Whatever duties we owe to God and others, from the most sublime form of corporate worship to the most mundane task of changing a diaper, flow from love. Love is the framework, the backdrop, the engine for Christian duty.

Where does such love come from? For Jews and Christians alike, such love is a proper response to God’s love for all of creation, and especially for humankind. Consider the evocative imagery of the ancient songwriter/poet known as the Psalmist:

“How precious is your steadfast love, O God! The children of mankind take refuge in the shadow of your wings. They feast on the abundance of your house, and you give them drink from the river of your delights. For with you is the fountain of life; in your light do we see light.”

For Christians, God’s love is shown most thoroughly in the teaching, life, death, and resurrection of his son, Jesus Christ. As the Apostle John wrote,

“By this we know love, that he laid down his life for us, and we ought to lay down our lives for the brothers.”

All too often non-believers seem to appreciate the core of Christian ethics better than many self-proclaimed believers: Christian duty ought to be not merely a private act of personal piety, but an active, self-giving, others-oriented love that mirrors the gentleness, kindness, and sacrifice of Christ.

It turns out that love, actually, is the root of the Christian duty that can sometimes generate conflicts with civil law. The freedom to love God and others according to one's best lights is the most thoroughly Christian basis for religious liberty. "According to one's best lights" is an important qualification. Although Christians agree on the requirements of love in many cases, they have from the beginning disputed whether some conduct is consistent with love. For instance, in the first century, they debated whether it was okay to eat food that had been sacrificed to the idols representing Roman deities. Some thought yes, some no. The Apostle Paul taught those who had no qualms with eating such meat to be understanding of those who did. Christians were to tolerate those with different interpretations of the requirement of love--at least as to matters that were inessential to the gospel.

What difference might love make for religious liberty? Most importantly, it might render claims for religious liberty more legible to those of any (or no) religion who disagree with the claim's morality. Not everyone has experienced fears about eternal salvation, but everyone has experienced a moral duty arising from affection, whether for a favorite sporting club, a family member, or country. Believers regard God as the source of all these good things, and many others besides, so God alone deserves our highest adoration. We may not be able to relate to a God who issues (seemingly) severe commands, but we ought to be able to relate to one who asks for, and merits, our love.

If love is the best motivation for observing a higher duty, we ought to think twice before we condemn those who say their religion will not allow them to follow the law. We ought to presume they have the best of motivations. To be sure, not every one who claims a religious exemption is motivated by love—no one is perfect, and some religiously-motivated conduct (whether in the name of Christianity or another religion) is decidedly unloving. Moreover, believers sometimes disagree about what love requires. In my own country (the U.S.), some religious claimants assert a religious duty to avoid funding contraceptive insurance on the ground that it facilitates abortions, while others claim a religious duty to facilitate an abortion. Those claims are morally inconsistent. If we assume that religious claimants in principle might be motivated by affection for what they take to be the divine, we ought to respect the dilemma that claimants find themselves in--even when the law does not, and should not, exempt their conduct.

Religious love is especially deserving of our respect and, when possible, accommodation. We should affirm our neighbors' attempts to follow the demands of divine love, even when we disagree with their understanding of those demands. And we should respect them even when that understanding cannot be squared with the needs of society in any given case. Love should not always be a trump card--no more than divine fear should be a trump card. Some religious freedom claims will not, and should not, win the day. There is no avoiding drawing lines according to law and public conscience. But love for God offers a richer, and perhaps a more attractive, justification for religious liberty in the first place.

Article

Assisted dying

Care

Culture

Death & life

13 November 2024

8 min read

The deceptive appeal of assisted dying changes medical practice

In Canada the moral ethos of medicine has shifted dramatically.

Ewan Goligher

Ewan is a physician practising in Toronto, Canada.

a doctor consults a tablet against the backdrop of a Canadian flag.

Once again, the UK parliament is set to debate the question of legalizing euthanasia (a traditional term for physician-assisted death). Political conditions appear to be conducive to the legalization of this technological approach to managing death. The case for assisted death appears deceptively simple—it’s about compassion, respect, empowerment, freedom from suffering. Who can oppose such positive goals? Yet, writing from Canada, I can only warn of the ways in which the embrace of physician-assisted death will fundamentally change the practice of medicine. Reflecting on the last 10 years of our experience, two themes stick out to me—pressure, and self-deception.

I still remember quite distinctly the day that it dawned on me that the moral ethos of medicine in Canada was shifting dramatically. Traditionally, respect for the sacredness of the patient’s life and a corresponding absolute prohibition on deliberately causing the death of a patient were widely seen as essential hallmarks of a virtuous physician. Suddenly, in a 180 degree ethical turn, a willingness to intentionally cause the death of a patient was now seen as the hallmark of patient-centered doctor. A willingness to cause the patient’s death was a sign of compassion and even purported self-sacrifice in that one would put the patient’s desires and values ahead of their own. Those of us who continued to insist on the wrongness of deliberately causing death would now be seen as moral outliers, barriers to the well-being and dignity of our patients. We were tolerated to some extent, and mainly out of a sense of collegiality. But we were also a source of slight embarrassment. Nobody really wanted to debate the question with us; the question was settled without debate.

Yet there was no denying the way that pressure was brought to bear, in ways subtle and overt, to participate in the new assisted death regime. We humans are unavoidably moral creatures, and when we come to believe that something is good, we see ourselves and others as having an obligation to support it. We have a hard time accepting those who refuse to join us. Such was the case with assisted death. With the loudest and most strident voices in the Canadian medical profession embracing assisted death as a high and unquestioned moral good, refusal to participate in assisted death could not be fully tolerated.

We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

Regulators in Ontario and Nova Scotia (two Canadian provinces) stipulated that physicians who were unwilling to perform the death procedure must make an effective referral to a willing “provider”. Although the Supreme Court decision made it clear in their decision to strike down the criminal prohibition against physician-assisted death that no particular physician was under any obligation to provide the procedure, the regulators chose to enforce participation by way of this effective referral requirement. After all, this was the only way to normalize this new practice. Doctors don't ordinarily refuse to refer their patients for medically necessary procedures; if assisted death was understood to be a medically necessary good, then an unwillingness to make such referral could not be tolerated.

And this form of pressure brings us to the pattern of deception. First, it is deceptive to suggest that an effective referral to a willing provider confers no moral culpability on the referring physician for the death of the patient. Those of us who objected to referring the patient were told that like Pilate, we could wash our hands of the patient’s death by passing them along to someone else who had the courage to do the deed. Yet the same regulators clearly prohibited referral for female genital mutilation. They therefore seemed to understand the moral responsibility attached to an effective referral. Such glaring inconsistencies about the moral significance of a referral suggests that when they claimed that a referral avoided culpability for death by euthanasia, they were deceiving themselves and us.

The very need for a referral system signifies another self-deception. Doctors normally make referrals only when an assessment or procedure lies outside their technical expertise. In the case of assisted death, every physician has the requisite technical expertise to cause death. There is nothing at all complicated or difficult or specialized about assessing euthanasia eligibility criteria or the sequential administration of toxic doses of midazolam, propofol, rocuronium, and lidocaine. The fact that the vast majority of physicians are unwilling to perform this procedure entails that moral objection to participation in assisted death remains widespread in the medical profession. The referral mechanism is for physicians who are “uncomfortable” in performing the procedure; they can send the patient to someone else more comfortable. But to be comfortable in this case is to be “morally comfortable”, not “technically comfortable”. We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

There is also self-deception with respect to the cause of death. In Canada, when a patient dies by doctor-assisted death, the person completing the death certificate is required to record the cause of death as the reason that the patient requested euthanasia, not the act of euthanasia per se. This must lead to all sorts of moments of absurdity for physicians completing death certificates—do patients really die from advanced osteoarthritis? (one of the many reasons patients have sought and obtained euthanasia). I suspect that this practice is intended to shield those who perform euthanasia from any long-term legal liability should the law be reversed. But if medicine, medical progress, and medical safety are predicated on an honest acknowledgment about causes of death, then this form of self-deception should not be countenanced. We need to be honest with ourselves about why our patients die.

There has also been self-deception about whether physician-assisted death is a form of suicide. Some proponents of assisted death contend that assisted death is not an act of deliberate self-killing, but rather merely a choice over the manner and timing of one's death. It's not clear why one would try to distort language this way and deny that “physician-assisted suicide” is suicide, except perhaps to assuage conscience and minimize stigma. Perhaps we all know that suicide is never really a form of self-respect. To sustain our moral and social affirmation of physician-assisted death, we have to deny what this practice actually represents.

There has been self-deception about the possibility of putting limits around the practice of assisted death. Early on, advocates insisted that euthanasia would be available only to those for whom death was reasonably foreseeable (to use the Canadian legal parlance). But once death comes to be viewed as a therapeutic option, the therapeutic possibilities become nearly limitless. Death was soon viewed as a therapy for severe disability or for health-related consequences of poverty and loneliness (though often poverty and loneliness are the consequence of the health issues). Soon we were talking about death as a therapy for mental illness. If beauty is in the eye of the beholder, then so is grievous and irremediable suffering. Death inevitably becomes therapeutic option for any form of suffering. Efforts to limit the practice to certain populations (e.g. those with disabilities) are inevitably seen as paternalistic and discriminatory.

There has been self-deception about the reasons justifying legalization of assisted death. Before legalization, advocates decry the uncontrolled physical suffering associated with the dying process and claim that prohibiting assisted death dehumanizes patients and leaves them in agony. Once legalized, it rapidly becomes clear that this therapy is not for physical suffering but rather for existential suffering: the loss of autonomy, the sense of being a burden, the despair of seeing any point in going on with life. The desire for death reflects a crisis of meaning. We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

We have also deceived ourselves by claiming to know whether some patients are better off dead, when in fact we have no idea what it's like to be dead. The utilitarian calculus underpinning the logic of assisted death relies on the presumption that we know what it is like before we die in comparison to what it is like after we die. In general, the unstated assumption is that there is nothing after death. This is perhaps why the practice is generally promoted by atheists and opposed by theists. But in my experience, it is very rare for people to address this question explicitly. They prefer to let the question of existence beyond death lie dormant, untouched. To think that physicians qua physicians have any expertise on or authority on the question of what it’s like to be dead, or that such medicine can at all comport with a scientific evidence-based approach to medical decision-making, is a profound self-deception.

Finally, we deceive ourselves when we pretend that ending people’s lives at their voluntary request is all about respecting personal autonomy. People seek death when they can see no other way forward with life—they are subject to the constraints of their circumstances, finances, support networks, and even internal spiritual resources. We are not nearly so autonomous as we wish to think. And in the end, the patient does not choose whether to die; the doctor chooses whether the patient should die. The patient requests, the doctor decides. Recent new stories have made clear the challenges for practitioners of euthanasia to pick and choose who should die among their patients. In Canada, you can have death, but only if your doctor agrees that your life is not worth living. However much these doctors might purport to act from compassion, one cannot help see a connection to Nazi physicians labelling the unwanted as “Lebensunwortes leben”—life unworthy of life. In adopting assisted death, we cannot avoid dehumanizing ourselves. Death with dignity is a deception.

These many acts of self-deception in relation to physician-assisted death should not surprise us, for the practice is intrinsically self-deceptive. It claims to be motivated by the value of the patient; it claims to promote the dignity of the patient; it claims to respect the autonomy of the patient. In fact, it directly contravenes all three of those goods.

It degrades the value of the patient by accepting that it doesn't matter whether or not the patient exists.

It denies the dignity of the patient by treating the patient as a mere means to an end—the sufferer is ended in order to end the suffering.

It destroys the autonomy of the patient because it takes away autonomy. The patient might autonomously express a desire for death, but the act of rendering someone dead does not enhance their autonomy; it obliterates it.

Yet the need for self-deception represents the fatal weakness of this practice. In time, truth will win over falsehood, light over darkness, wisdom over folly. So let us ever cling to the truth, and faithfully continue to speak the truth in love to the dying and the living. Truth overcomes pressure. The truth will set us free.