Christian Bioethics in a Secular World: In Search of Ethical Common Ground

In recent decades, bioethical issues have been a consistent source of tension and conflict in our world; this is true not just in the medical establishment, but also in the personal and political spheres. The past twenty-five years have seen fierce debates over the moral and legal status of abortion, the rapid development and acceptance of artificial reproductive technologies, and the embrace of assisted suicide and euthanasia in many parts of the world. 

It increasingly seems that we are unable to discuss these topics with those who differ from us because we no longer hold enough in common. In 2023, the Pew Research Center reported that six in ten US adults say it is “stressful and frustrating” to have political conversations with someone across the political aisle. Issues relating to bioethical quandaries are almost certainly among the most stressful and frustrating topics to discuss. For the bioethicist, what it means to be human is the issue at stake (as O. Carter Snead has put it). 

As our common ground shrinks, our language becomes impoverished. This impoverishment transforms what might once have been a robust debate over rights and responsibilities into a stack of consent forms. It is part of what drives Mark J. Cherry in his recent book, Bioethics after God: Morality, Culture, and Medicine. In particular, he wonders: in a world that has rejected Christianity, can bioethics still play a meaningful role in moral decision-making? His answer, sadly, is probably not.

The book consists of six weighty chapters: (1) an introduction to Cherry’s project, (2) an account of the philosophical and theological developments that led to our present dilemmas, (3) an argument that contemporary bioethics is ultimately unable to provide moral guidance, (4) a deep dive into some current bioethical issues, (5) a lament over the fact that bioethics today is driven by progressive political aims, and (6) an expression of tentative hope for the future. While the middle chapters offer an astute appraisal of the crisis facing the Christian bioethicist, the biases and oversights in Cherry’s approach to the philosophical and theological background ultimately undercut his vision for the future. 

 It would seem that the ethicist needs to be grounded in something firm and unchanging in order to proclaim moral absolutes. Contemporary bioethics, Cherry argues, is built on a misplaced faith in human reason—which is troubling because “human reason cannot by itself secure a canonical account of reality or morality.” He worries that a society that lacks a robust religious framework cannot possibly be convinced of the immorality of, say, sex robots or head transplants (to pick two issues that he discusses in the book). Cherry himself is a man of Christian faith, and he argues that a commitment to Christianity can help us solve contemporary moral problems. However, he argues that many contemporary theologians have actually contributed to the problem—and, indeed, that theologians as far back as the Middle Ages were some of the architects of our present discontent. 

Although I share many of Cherry’s concerns on specific bioethical issues—and his desire to bring God back into moral theology—I was perturbed by what seemed to amount to his rejection of the unity of faith and reason. Early in the book, he provides an account of how we got here, a genealogical framework to understand the intellectual origins of our current ills. According to Cherry, the “weak theology” of the Middle Ages and the “weak thought” of the Enlightenment join together to yield “weak bioethics.” As I will explain, this is a provocative claim, but it unfortunately fails to pass muster. Ultimately, Cherry’s genealogy paints with an unduly broad brush; even more problematically, it consistently misrepresents the natural law tradition, caricatures the views of key players, makes significant argumentative leaps, and, in sum, fails to fully represent the profound problems we now face. 

This review, then, will consist of three parts: a critique of Cherry’s scholarship in describing “weak” bioethics, a brief preliminary defense of natural law theory and its place in moral theology, and a look at the valuable contributions of Bioethics after God to the field. 

How Did We Get Here? Untangling the Genealogy of Contemporary Bioethics

Cherry’s central argument in Bioethics after God is that contemporary medicine, shaped as it is by secular morality, is becoming ethically unmoored. The widespread acceptance of procedures such as abortion and euthanasia—which would once have been abhorrent to the average doctor—indicates to him that the field of bioethics has been rocked by our decreasing religiosity. Cherry roots this argument in three concepts: “weak thought,” “weak theology,” and “weak bioethics.” 

For Cherry, “weak thought” is the attempt to replace transcendent claims rooted in belief in God with “immanent philosophical speculation set within specific cultures, times, and places, but without God.” “Weak theology” is the result of what Cherry sees as the shift from a theology marked by mysticism and divine commands to one shaped by philosophical analysis and progressive political interests. And “weak bioethics” is a bioethical approach concerned only with the preferences of the individual, stripped of any objective vision for human flourishing. Together, these shifts in thought have created a public square in which secularism reigns supreme. 

While reading the opening pages of Bioethics after God, I was struck by the absence of any mention of natural law. After all, those moral precepts that, according to figures like Cicero and Thomas Aquinas, are available to us by reason, must surely be relevant to a discussion of the fate of bioethics in our fractured culture. But when I came to Cherry’s genealogy of weak theology and weak bioethics, I realized that his view of the power of human reason is much narrower than I had initially imagined. 

In providing a historical account of how the West became mired in the present crisis of bioethical discourse, Cherry places a large share of the blame at the feet of Roman Catholic theologians. In his estimation of the medieval period, “a source and unity for morality was sought in reason rather than in an encounter with God as lawgiver or in theologians as mystics.” From this point on, Cherry holds, theology took on a “decidedly philosophical cast.” 

He expresses deep concern at the Roman Catholic emphasis on reason alongside faith. As he puts it, “much of Roman Catholic moral exploration has been articulated in terms of a natural-law philosophy that seeks to determine forbidden, obligatory, and permissible moral action through what it claims is an objective understanding of human nature and human good.” For Cherry, the tradition of natural law ultimately amounts to an attempt to provide an ethical framework without God, and this error plays a crucial role in his account of how the West ended up where it is today.

Cherry argues that “there is no reason to believe that rationality requires one to be moral.” Later, he asks “If philosophical reason is sufficient to grasp the content-full requirements of human ethics, why is there such moral pluralism?” This question is an important one, and one that deserves to be engaged rigorously. Yet I found myself frustrated by how little seriousness he shows when discussing the very natural law tradition that he sees as so crucial to his genealogy of modernity. I found myself wishing that Cherry would engage with the work of thinkers such as J. Budziszewski, Jean Porter, and Russell Hittinger, who address virtually all of the lines of criticism that Cherry puts forth in their various works on natural law. 

Throughout his discussion of weak theology, Cherry consistently incorporates quotations that misrepresent the positions with which he is engaging. For example, he sums up all of natural law philosophy with a block quotation from Joseph Boyle—a prominent proponent of “new natural law” theory, which differs from classical theories of natural law in ways extremely relevant to Cherry’s argument. At another point, he uses a quotation from Alasdair MacIntyre about the philosophy of the Enlightenment (“So, it was hoped, reason would displace tradition.”) in a way that implies that MacIntyre is talking about the theological shifts of the Middle Ages. And during a lengthy series of criticisms of Pope Francis, he uses a quotation from Time magazine to sum up what he sees as the pope’s failure to consistently articulate the tenets of Christian morality—even though secular magazines like Time are not exactly known for their accurate portrayals of Christian issues. 

From here, Cherry goes on to consider how the guiding principles of contemporary bioethics (autonomy, beneficence, nonmaleficence, and justice) ring fairly hollow without the content-full perspective of belief in God. He provides a deep dive into a handful of today’s hot-button issues—assisted reproductive technologies, medical assistance in dying, sex robots, head transplants—and argues that secularism has taken on the flavor of fundamentalism. 

I was drawn to this book because I share Cherry’s concern that contemporary bioethics is easily reduced to a discussion about autonomy and informed consent. I have seen this numerous times when teaching young people who are interested in entering the medical profession. To quote Cherry, “This is one of the reasons secular morality and bioethics focuses so intently, nearly dogmatically on the supposed value of personal autonomy: it is your experience of your life and your own personal values that matter. Without God or some other canonical ground, it is unclear what else could possibly matter.”

What Natural Law Can—and Can’t—Do 

What Cherry fails to understand is that the natural law (at least as conceived by most Thomists) is not an attempt to construct a moral framework without God in it; traditional natural law theory is an acknowledgment of His presence in the innermost workings of the human heart and mind. One has only to look at Aquinas’s definition of the natural law: “the rational creature’s participation in the eternal law.” In other words, natural law can neither exist nor be understood without reference to God. Furthermore, natural law has a descriptive quality to it; it’s not a source of moral norms as much as it is the way human persons live within Divine Providence. 

For readers interested in a corrective for the holes that I believe to be present in Cherry’s account of natural law and its role in the supposed downfall of moral reasoning, an excellent one would be an article published by William Mattison in the Journal of the Society of Christian Ethics, “The Changing Face of Natural Law: The Necessity of Belief for Natural Law Norm Specification.” Drawing on the work of Porter and Hittinger, Mattison emphasizes that natural law is not a set of rules, immediately discoverable by all, nor is it an effort of human reason, completely separable from divine revelation. 

Since the early modern period, many of us have lost sight of these characteristics of natural law. Natural law reasoning is often conceived as a political cudgel—as a way to arrive at an agreed-upon vision of human flourishing, despite the reality of moral and religious pluralism. But, as Mattison argues, “natural law decision making is not some neutral zone for people of varying belief commitments to debate moral norms without reference to any such belief commitments.” Rather, it is always shaped in each person by a tradition. 

Turning back to St. Thomas, we see that practical reason (thought aimed at action)—unlike speculative reason (though aimed merely at knowing the truth)—is concerned with “contingent matters,” since these are the matters “about which human actions are concerned.” And so, while the first principle of practical reason (good is to be done and evil is to be avoided) applies necessarily in all times and in all places to all men and women, “the more we descend to matters of detail, the more frequently we encounter defects.” Even when the secondary and tertiary precepts of the natural law are applicable to all people in all times and places, they are not known equally to all. This is because reason is “perverted” in some, either by “passion, or evil habit, or an evil disposition of nature.” St. Thomas gives an example: in The Gallic Wars, Julius Caesar relates that theft was accepted among the Goths. It is, then, not a death knell for natural law theory that we live in morally confused times. 

So, acknowledging its limits, is a natural law (as understood by Thomists) of practical use to the bioethicist, the moral theologian, or even just the Christian engaging with a secularized world? Mattison, for one, would say yes. He observes that natural law is often invoked “as a weapon to end dialogue rather than foster it.” Instead of attempting to suppress our ideological divisions, we can practice natural law thinking as we acknowledge and debate the belief commitments that shape our moral reasoning. What are the principles that we derive from the natural law regarding sexuality, birth, death, and illness? How do these differ from the accepted stances of the medical establishment or society at large? What breakdown brought us to this disagreement? A more nuanced approach to natural law is an opportunity, not for defeat, but for richer and more productive dialogue—and one, I think, that would offer a way through the content-poor, secularized bioethical debates to which Cherry draws our attention. 

Truly Theological Bioethics 

Despite my disagreements with his approach to natural law, I was particularly interested in and sympathetic to Cherry’s desire to differentiate moral theology from philosophical ethics. Insofar as I worry about the influence of “weak theology,” I place the blame not on the theologians of the Middle Ages but on the contemporary academy. Cherry pulls no punches in his critique of present-day theological study. “Traditional Christianity recognizes that the term ‘theologian’ refers neither to a university position nor to an honorific title but, in sensu stricto, to one who knows God,” he writes. 

It can be easy to reduce bioethics to a detached, clinical discipline. But when studied by a theologian, it ought to be rooted in prayer and obedience to God’s commands. Still, academic success so often hinges on innovative, cutting-edge scholarship. For the theologian, as Cherry observes, “a bias toward novel and creative academic arguments effectively guarantees religious change, spiritual disorientation, defense of nontraditional moralities, and innovative forms of heresy.” Of course, there are theology departments that work to resist this bias (I speak with personal experience of three of them). But I do think that much of contemporary theology—and moral theology in particular, concerning human behavior as it does—has become unmoored from its object. 

Cherry closes Bioethics after God with an exhortation that we tether bioethics once more to religious faith—and I wish that he had expounded on this further. In Christianity, he writes, “there is an invitation to enter an ancient lifeworld and ongoing set of ritual practices: traditional forms of prayer, fasting, and asceticism. Human flourishing is found in a life oriented toward God in which medical care, while important, does not replace Christian therapy for the soul.” 

Bioethical issues often expose the depths of human suffering: the fear of awaiting the birth of a disabled child, the powerlessness of infertility, the pain and loneliness of growing old. Secularism has nothing meaningful to say in the face of this suffering; it only seeks to put a stop to it. Beyond a mere set of rules and regulations, a bioethics shaped by Christianity does have something to say to those who suffer—and a person to say it to, One who has suffered alongside us. It is my hope—as it is Cherry’s, I imagine—to see bioethics transformed by the love and mercy made possible by a personal knowledge of Christ. 

Image by Renáta Sedmáková and licensed via Adobe Stock.