System Admin

Based on your reading of the GCU Introduction and the textbooks below,

what is the main difference between the modern Western worldview and the postmodern worldview?

Which parts, if any, do you identify with? Explain. Cite references from your reading to support your answer.

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Foundations of Christian Spirituality in Health Care

Introduction

There has been an increase of interest in the role of spirituality in health care, as well as in the

workplace and other fields in general. This interest has been met with a variety of responses, including

an uneasiness that has historical roots. There is generally a perceived tension between science and

religion/spirituality. This estrangement between the worlds of science and religion is in some ways is not

truly reflective of some inherent incompatibility between science and religion per se, but rather a

reflection of underlying worldview tensions. The rediscovery of spirituality and its implications for health

care provides recognition that the estrangement between the two worlds has not served patients' best

interests. If this is the case, then part of the task of serving patients well will require some basic

worldview training in order to not only understand patients' own backgrounds more clearly, but to also

promote the fruitful interaction of science and religion in the health care setting more generally.

Spirituality and Worldview

The theoretical and practical foundations of any discipline or field take place within the wider

framework of what is known as a worldview. A worldview is a term that describes a complete way of

viewing the world around you. For example, consider religion and/or culture. For many people their

religion or culture colors the way in which they view their entire reality; nothing is untouched by it and

everything is within its scope. Yet one need not be religious to have a worldview; atheism or agnosticism

are also worldviews. Thus, all of one's fundamental beliefs, practices, and relationships are seen through

the lens of a worldview. The foundations of medicine and health care in general bring with it a myriad of

assumptions about the very sorts of questions answered in a person's worldview. Consider carefully the

seven questions in Called to Care textbook in order to begin grasping more clearly the concept of a

worldview.

A Challenging Ethos

A fundamental thesis of this course is that two sorts of underlying philosophies or beliefs about the

nature of knowledge, namely, scientism and relativism, are at the heart of this perceived tension

between science and religion. Moreover, scientism and relativism help explain to some degree why this

tension has not served the best interests of patients, and is even at odds with the fundamental goals of

medicine and care.

Scientism is the belief that the best or only way to have any knowledge of reality is by means of the

sciences. At first glance this might sound like a noncontroversial or even commonsensical claim.

However, think about this carefully. One way to state this is to say that if something is not known

"scientifically" then it is not known at all. In other words, the only way to hold true beliefs about

anything is to know them "scientifically." Relativism on the other hand is the view that there is no such

thing as "truth" in the commonsensical sense of that concept. Every and any claim about the nature of

reality is simply relative to either an individual or a society/culture. Thus, according to this way of

thinking, it might be true here in the United States equality is a good thing, but in some Middle Eastern

countries it is simply not a concern. Yet there is no ultimate "truth" of the matter, it is simply a matter of

individual or popular opinion. In some way, "truth" is just what an individual or a culture decides that it

is, and therefore not truly discovered, but invented.

The current context of health care and medicine in the West is defined by an ethos (the prevailing

attitudes and beliefs of a culture) of scientism and relativism. This ethos has exacerbated the perceived

philosophical and cultural tension between science and religion. The result has been a general

relativizing and caricaturing of religion, and the elevation of "science" as the default epistemology for all

things "rational" or even true.

While scientism may seem commonsensical or rational at first glance, a closer examination reveals

glaring weaknesses. It should be noted right from the outset that "scientism" is not equivalent to

"science." This is because "scientism" is a philosophy about the nature and limits of science as well as

the extent of human knowledge. Scientism is a philosophical thesis that claims that science is the only

methodology to gain knowledge; every other claim to knowledge is either mere opinion or false.

One of the most pressing dilemmas's for scientism is science's inability to make moral or ethical

judgments. To understand why consider the nature of scientific claims and their distinction from moral

or ethical judgments. We can describe general scientific claims simply as the attempt to make

descriptions of "fact". But when we make moral or ethical judgments, we do not simply make

statements of fact (though that is part of it), but we are evaluating those fact claims. Thus when making

a moral judgment we are evaluating whether some fact is good or bad. Thus consider the distinction

between the following statements:

(1) 90% of Americans believe that racism is wrong

(2) Racism is wrong

Statement (1) is a statement of fact  in the sense that it is meant to describe the way things actually are,

or what is the case. Statement (2) however, makes a judgment; it makes a normative claim in the sense

that it is making a claim about what ought to be the case. Statement (2) is not simply reporting or

describing the facts, it is saying that it is not the way it is supposed to be. In recognizing these

differences a crucial distinction has surfaced between (1) scientific claims and (2) moral and ethical

claims. Scientific claims are limited to statements of description; they are solely claims about what is the

case. Moral and ethical statements are prescriptive and are evaluative claims about what ought to be

the case. This has been described as the "fact-value" distinction to designate the difference between

facts and values, values  being a prescription of the way things ought to be, the moral evaluation of

facts. This distinction has also be described as the "is" (fact) vs. "ought" (value) distinction.

Thus, because science deals with mere facts, it is not in a position to tell us anything about what ought

to be the case. Science is relevant to moral and ethical claims in interesting ways, but prescriptive

statements about what morally ought to be the case are simply beyond the bounds of science. To try to

derive what ought to be the case only from what is the case is a logical fallacy. If one were to look at the

world and the way things are, and then claim that it simply follows that it is the way it ought to be does

not match our experience of morality. There are many events that are the case and describe what is

(genocide, war, hatred, murder), but whether or not they ought to be that way is a further question that

science is not in a position to answer. Thus to try to derive an ought from an is, refers to what is called

the fallacy of deriving of ought from an is.  Much more could be said of the inadequacy of scientism, but

it ought to be noted that moral, ethical and religious claims all involve normative claims about the way

the world ought to be.One practical effect within health care has been the subtle but pervasive view

that religion is a harmless tangent to medicine and health care at best, and a superstitious and

destructive distraction at worst. Recently there has been a resurgence and appreciation of "spirituality"

within medicine in more holistic approaches to health care. For example, the Center for Spirituality,

Theology and Health at Duke University was established in 1998 for the purpose of

conducting research, training others to conduct research, and promoting scholarly field-building

activities related to religion, spirituality, and health. The Center serves as a clearinghouse for

information on this topic, and seeks to support and encourage dialogue between researchers,

clinicians, theologians, clergy, and others interested in the intersection. (Center for Spirituality,

2014, para. 1)

While a welcome corrective, it is easy to inadvertently buy into weaker forms of scientism and fail to

appreciate the particularity of each religion by reducing all religion to a generic "spirituality." For

example, Burkhardt (1999) attempts to defend a generic definition of the term "spirituality" (p. 71), but

Shelly and Miller (2006) point out the inadequacy of such a strategy. It is not fair or respectful to paint

all religions or worldviews with the same brush under the heading of spirituality and ignore the

differences.

Thus, in the interest of philosophical clarity, religious sensitivity, and genuine care, this section will

introduce fundamental concepts and challenge the contemporary ethos to make room for genuine

religious dialogue.

The Foundations of Christian Spirituality in Healthcare

In stark contrast to this ethos is the Christian tradition and the resources it provides for a rich

conception of "care." Contra scientism and relativism, the foundations of Christian spirituality in health

care includes two attitudes/theses: (1) an acknowledgement of science as a subset of "knowledge" in

general, and a deep appreciation for science as a collective human enterprise that reflects the

knowability and order of creation; and (2) the goodness and worth of this creation (in so far as it reflects

God's "creative intention") with human beings bearing special "dignity" and intrinsic worth, reflected in

the well-known bioethical principle of "respect for persons" (National Commission, 1979).

The foundations of Christian spirituality in health care assume genuine knowledge of God and His

purposes. Central to this foundation are the Biblical Christian narrative and the person of Jesus Christ. In

order to appreciate and do justice to this center, the ethos of scientism and postmodernism must be

first challenged and dispelled.

This first topic of this course is devoted to understanding the concept of "worldview" in detail and to

begin to challenge the philosophies of "relativism" and "scientism." It will also begin to lay the

foundations of a broadly holistic understanding of the relationship between spirituality and health care

in general, and a Christian worldview for health care in general.

References

Burkhardt, M. (1989). Spirituality: An analysis of the concept holistic nursing practice.

Center for Spirituality, Theology and Health. (2014). Retrieved from

http://www.spiritualityandhealth.duke.edu/

National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research.

(1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of

research. Retrieved from http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html

Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2nd ed.). Downers

Grove, IL.: IVP Academic.