This European synthesis, in his view, was the basis for providing a secular state with a secular moral authority guided by reason through philosophical arguments that could be agreed on by all (Hugo Tristram Engelhardt, 2017). Engelhardt rejected this whole-heartedly and cautioned the readers to be aware of the fact that, “there still remain powerful, but unfounded philosophical expectations regarding the existence of a generally secularly justifiable morality, bioethics, and political authority that persist as remnants from the via antiqua of the Western Christian Middle Ages…Most significant is the severance of morality, bioethics, and state authority from any hint of ultimate meaning. Because the contemporary dominant secular culture is after God, secular moral reflection must approach everything as if it came from nowhere, was going nowhere, and existed for no ultimate purpose. The point is not simply that in a godless universe, there is no necessary retribution for immense, unrepented-for acts of evil. More fundamentally, all, in the end, is simply ultimately meaningless (Hugo Tristram Engelhardt, 2017).”
He seized on the fact that post-modernity and its pluralism had led to a secular fundamentalist state, a term that may concern readers, because of the term’s attachment to Islamic fundamentalism. However, he makes his argument in regard to its intractability in this fashion, “Here it is important to recognize that the contemporary secular state has become a secular fundamentalist state in the sense that a particular ideology, along with its secular morality and bioethics, has been established in a fashion similar to the establishment of a religion, along with its morality and bioethics, in a religious fundamentalist state. Because the differences between the moral and bioethical claims of believers and those of the secular state are so different in content and justification, there is no place for compromise (Hugo Tristram Engelhardt, 2017).”
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From this point, he argues the secular state has lost political and moral authority thereby becoming only a modus vivendi because the central authority only reflects a particular policy “among a plurality of freestanding accounts” none of which is anchored in a morally rational canonical account (Hugo Tristram Engelhardt, 2017). The experiment of reason leading to one secular morality justified by rational thought has failed according to Engelhardt. Therefore, there cannot be a sole, unified, canonical bioethics for all to follow. With a multiplicity of views, bioethics in the 21st century will fail (except for the ethics consultants themselves who have, essentially, become legal representatives of the multiple lifestyle choices or life and death choices) (Hugo Tristram Engelhardt, 2017). Bioethics had been originally put together with a God’s-eye perspective, but now that has vanished. He voiced considerable concern about “how very different reality and morality cum bioethics and health care policy appears without God (Hugo Tristram Engelhardt, 2017).”
The difficulty with the current state of bioethics, according to Engelhardt, was that human dignity was derived from a specific community (multiple communities), and this pluralism was a problem because there is a socio-historically conditioning of secular morals into an intractable moral pluralism (Hugo Tristram Engelhardt, 2017). A particular secular bioethics or morality today can be found in every community. Engelhardt considered this the loss of a transcendent orientation will prove fatal to bioethics as once envisioned and practiced, i.e., the loss of the God’s-eye perspective. As mentioned above, Engelhardt had a concern that bioethicists had become quasi-lawyers (Hugo Tristram Engelhardt, 2017), and “in accord with them and articulate the dominant culture of the age, become an immanent surrogate for God (Hugo Tristram Engelhardt, 2017).” This was of paramount importance to Engelhardt because 21st-century post-theistic culture had intellectually excommunicated traditional Christian theologians; today’s mainstream bioethicists thought the traditionalists to be politically insensitive. Therefore, traditional Christian views required banishment. Even today’s bioethicists of the Roman Catholic church have taken a weak position vis-a-vis theology, and put some distance between themselves and Orthodox Christians (Hugo Tristram Engelhardt, 2017).
Engelhardt was disappointed that bioethics was now forced to reside within the narrative of the dominant culture, which was secular, and all questions in regard to morality and rational thought are settled in the intellectual class represented by philosophers of the dominant culture, a globalized elite culture (Hugo Tristram Engelhardt, 2017). This philosophical elite serves as God when a God’s-eye perspective has vanished. These elites present a view of reality that eventually becomes affirmed by most of the public. Engelhardt claims the necessary conversation between opposing views has disappeared. The intellectual elite of the now dominant secular culture regards traditionalists as “not just wrong, but crazy (Hugo Tristram Engelhardt, 2017).” In so speaking and writing without a God’s-eye perspective, “there is no structure of reality beyond the grammar of our language and thought (Hugo Tristram Engelhardt, 2017).” Without a real philosophical exchange among civilized and civil-tongued individuals, rhetoric poses a moral truth that sustains the established culture, its morality, its view of bioethics, and its account of the state (Hugo Tristram Engelhardt, 2017).”
Here follows a specific practical aspect where Engelhardt’s views of obligation may be of interest. Two recent publications regarding public health emergencies of international concern (PHEIC), and the ethical conduct of the medical profession, governments, and other international and regional institutions during a PHEIC may give cause to think about Engelhardt and his writings (Papadimos et al., 2018a, 2018b), especially as it regards obligations of what is good and right (Hugo Tristram Engelhardt, 2017). In these two position statements from the Society of Critical Care Medicine (SCCM), an attempt is made to bring a bioethical perspective to serious international outbreaks of disease. Thereby addressing therapies, treatment limitations, and obligations of health professionals to treat patients during a PHEIC, as well as a perspective on family-centered care. Engelhardt’s work weighs heavily in regard to the cultural wars regarding his positions vis a vis abortion on demand, stem cell research, etc. (Hugo Tristram Engelhardt, 2017). However, his view, or influence, of the teleological vs. the deontological aspects of medical professionalism in regard to serious epidemics affecting major populations may be of interest to all. While rational Kantian thought and religion are not explicitly addressed in these SCCM position statements, Engelhardt’s arguments regarding the underpinnings of what the healthcare provider response should be during a PHEIC could be instructive to some physicians. A practical example of a PHEIC, Ebola viral disease, follows. While a disease such as Ebola is not directly addressed by Engelhardt, certain questions regarding obligations to treat patients arise around this disease. The duty to treat was raised in these SCCM position statements. What should be a physician’s obligation to treat such patients? Is the good independently viewed from what is right? Should physicians maximize the good (teleological), i.e., perform in a manner that produces the best? In such a case, physicians judge what is good or best actions without judging whether they are right (Hugo Tristram Engelhardt, 2017). In other words, “the righteousness of an action depends on its consequences (Hugo Tristram Engelhardt, 2017).” This contrasts considerably with the deontological view (supported by Engelhardt), in which a physician, “ought not to violate core right-making conditions, no matter the consequences: fiat justitia, pereat mundus (Hugo Tristram Engelhardt, 2017).” Here, according to Engelhardt (and Kant), morality is concerned with imperatives that are categorical, not hypothetical; what is right precedes the good and is not independent of it. “Moral choices and, therefore, bioethical choices are to be made apart from any of their consequences (Hugo Tristram Engelhardt, 2017).” Engelhardt probably would say, “just do what is morally right, no matter what.” While Engelhardt and the dominant culture disagree with one another on various secular and religious moral aspects of life, there is much that all persons from all corners of the political and religious spectrum could learn from his body of work.
Since the mid-1960 the question of whether God is dead has been continually discussed ('Is God Dead?' 1966). This was followed by claiming Jesus never rose from the dead, and thereafter Christianity underwent a softening. This disturbed Engelhardt. The secular West had successfully recast the character of the public space. God has become private, and transcendence is abhorred in many circles. However, without God, Engelhardt believed there is a propensity toward the pursuit of self-realization and self-absorption without consideration of God or the transcendent. He pointed out that Orthodox Christians, Orthodox Jews, and Muslims understand this. Uncivil rhetoric and uncivil behavior in public spaces, in physical, written, and visual insults to each other have left a gulf between the secularists, the traditionalists, and those who actually see value somewhere in the middle where values may be discussed. Engelhardt may have disagreed with the secular community as to what should be and what should not be in regard to sex, abortion on demand, politics, procreation, end-of-life matters, stem cell research, etc. (Hugo Tristram Engelhardt, 2017), but he would have never shut any side out of a discussion. He loved to debate and he was always well armed, spirited, and extremely persuasive, and was ever “the enfant terrible of bioethics: irrepressible, irreverent, unpredictable, but ever insightful and brilliant (Iltis & Cherry, 2014).” His concern about who will be the spokespersons for bioethics at this time in history concerned him greatly. He had feared that the secular community had become, or at least behaved as, a fundamentalist religion in and of itself and that the secular community would not listen to what the current non-dominant traditionalist voices had to contribute. He feared that a loss of the God’s-eye perspective would indelibly harm the practice of bioethics and the formation of healthcare policy. His work After God has exquisitely brought his concerns to light.
Conclusion
H. Tristram Engelhardt’s life’s work cannot be given due justice here because only his last book is discussed (although this text does embody much of his life’s work). Furthermore, it is addressed by an author, who while holding him in high regard, does not have the required depth on the matters discussed, but will always remember his friendship and tireless, rigorous work challenging and confronting Western secular philosophical assumptions that he (Engelhardt) believed were not adequate to provide a successful canonical foundation for a bioethics and political theory that supports healthcare policy in the West, as influenced by his Orthodox Christian faith. We will miss him.
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