What are the sources of obligation?

In a discussion on Milan's blog, I was asked, "what are the sources of moral obligation to the state and/or parents, aside from consent?" I thought I would post my answer (slightly edited).

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What are the sources of obligation? Many and varied, though I would even want to question the language of “obligation” as a primary way of speaking about morality. I’d prefer to refer to concepts such as our freedom to love within moral community.

Opportunities to nourish the good and redeem what is evil are granted by God as gifts. They are occasions to reflect something of divine generosity and faithfulness and so to express our true humanity and creatureliness. Put in slightly less theological language, moral virtues are excellences in character that belong to what is properly humane and their development constitutes part of the gift and privilege of becoming more human, more ourselves.

A crucial aspect of human existence is our identity being formed in community, being received from those around us (not in a deterministic way, since the reception is not purely passive but can be creative). And so relationships of trust and mutual care are at the heart of ethical deliberation. We are therefore to honour the relationships into which we are born precisely as a reminder that our existence and identity are received, not self-forged.

These relationships may begin with a family circle (“honour your father and mother”) and move out from there. At higher levels of abstraction, such as a nation, then the appropriate honour may be quite limited. For a modern nation-state, as an invention of modernity, the appropriate form of honour may be quite minimal indeed. Established political authorities are part of the network of relationships into which we are born and which we are to receive with thanksgiving, though not without critical and creative receptivity to possibilities of growth and reform. And the necessity of such critical and creative work regarding the contemporary nation-state is evident in all kinds of ways, not least the ways in which most contemporary governments fail miserably in their appointed task of minimising evil in the ecological sphere, and so collude (with corporate power amongst other things) in the undermining of the conditions under which human society can flourish.

Such are some thoughts off the top of my head. Sorry if they are a little shorthand at points. Hopefully, they give you a little bit more of a taste of where I’m coming from. I began by noting the sources of moral obligation to be varied, and moved on to speak of our identity as humans (and as creatures: our moral community extends beyond the boundaries of homo sapiens). I could equally have spoken about becoming more like Jesus, the true human, or of living in light of God’s promised future, or living in line with the realities of the created order, or of the imitation of God’s gracious care, or of responsiveness to God's summons. Each of these require more unpacking. I guess my point is that I see morality as a web of sources and resources for growing in faith, hope and love. Consent takes its place amongst these resources as an aspect of human will expressed in relationships. Consent creates and requires trust (in some measure) and so forms part of faith (which is more or less another word for trust, in my book). Consent therefore has an important place in moral discussion, but not an exhaustive one (as is often assumed or claimed by many political liberals – using the word in the technical, rather than partisan sense, to refer to a worldview based on voluntarism and so placing consent at the core of interpersonal and political morality).

What we do with what we know: a story

A few years ago, I was diagnosed with cancer. It was not an easy cancer to explain to people, because, basically, the doctors hadn’t seen any cases quite like it before and could not identify precisely where it had started or what caused it. Since it was such a rare growth, they could also not give me a meaningful prognosis. The scans indicated that it was of a significant size, in a critical location and there was good reason to think it was probably growing quite rapidly. Their recommendations were that surgery would be almost impossible (one of them told me, “I’m not into killing my patients”), but that chemotherapy and/or radiotherapy might have some effect (one oncologist spoke of “curative doses” and another simply of reducing its size).

Now at this point, I had a variety of possible responses open to me. I could go and get further oncological opinions (I had already gone to three different hospitals and had multiple scans and a variety of tests).

I could have weighed up the probable side effects of treatment (quite a long list!) and decided that it was not worth it and tried to make the most of my remaining time, however long or short that turned out to be.

I could have heeded the many voices telling me that traditional medicine doesn’t know how to deal with cancer and that I needed various alternative treatments: homeopathy, acupuncture, meditation, herbal remedies, hypnosis, miracle diets and many more that were urged upon me by well-meaning contacts, often with powerful testimonials.

I could have listened to the Christian sisters and brothers who told me that I would be healed if I had faith, that God loves miracles and would preserve my life without treatment, that they had seen or been given amazing recoveries after prayer.

I could have embraced the cynical critiques of the medical system by noting that it is in doctors’ interests to keep me thinking that I am sick, that I need them, that I need their expensive and complicated treatments.

I could have gone onto Google and attempted my own re-diagnosis on the basis of extensive reading of the most popular sites, or by consulting the most helpful discussion boards.

Each of these options were being put forward by people who apparently desired good for me. Yet deciding to go ahead with the recommended treatment was a relatively easy conclusion for me. Despite its costs, I do not at all regret the decision and suspect there is a very good chance I would not be here today without the excellent treatment I received at the Royal Prince Alfred Hospital. Indeed, it has been three years today since I had my last radiotherapy dose, a few more days since my final round of chemo.

I’m sharing this story not for the sympathy vote, nor to celebrate an anniversary, and nor yet to ridicule the faith or intentions of those who urged me to avoid treatment. I share this story to raise the issue of the relation of knowledge to ethics. How does our knowledge of the world affect our obligations and opportunities to pursue good?

Many factors contributed to my decision to accept treatment, but significant amongst them was the considered advice of recognised experts in the field based on years of empirical research. I was not morally bound to follow this advice. The research has not been exhaustive. Not all the experts I saw recommended exactly the same treatment. My case involved some degree of novelty. Not all cancer treatment is as effective as mine has been so far. But I do believe I would have been both foolish and seriously at fault if I had simply ignored their advice, or acted as though the diagnosis must be wrong because I’ve heard of some misdiagnoses in the past, or if I had presumed that I would be alright because some tumours undergo spontaneous remission.

It would be no good to say that since the scriptures don’t tell me whether or not to trust doctors, then I have no reason to trust them. It would equally be no good to say that since the scriptures don’t tell me to have cancer treatment, then I was under no moral obligation to take the advice of the oncologists seriously.

Of course, receiving treatment in order to try to stay alive was neither my only nor my highest moral obligation. There are worse things than death. There are ways of staying alive that diminish the point of being alive. But all things considered, I believe there was a compelling moral case for me to accept the recommended treatment. I believe that not only was it possible to pursue this treatment without being distracted from more important things (like loving those around me and praising the wonders of the one who gives all life), but that the treatment was in fact a means to that end, keeping me alive for more service and song, and opening many opportunities to love and praise that I might otherwise not have had.

It may be obvious where I am going with this, but in case it is not let me spell it out. There is a large and diverse body of scientific experts with years in the field who point to widespread and growing empirical evidence of a critical diagnosis, which we cannot in good conscience ignore. They may offer a variety of different (even sometimes conflicting) advice on specific treatment, but it would be irresponsible to dismiss their warnings or to treat the situation as though it were nothing but a distraction from what is truly important.

Our knowledge of the world, though fallible and incomplete, is nonetheless sufficient to contribute to the moral deliberation of Christians. The evidence for alarming anthropogenic climate change is strong enough such that wilfully ignoring or burying the issue at this stage has become irresponsible. This is not a denial of sola scriptura nor to fall into legalism. Nor is it to say that climate change is the only or primary moral challenge of our day, or that all Christians ought to become climate change activists. And neither yet do I claim that Christians owe their allegiance to any particular mitigation strategy. But as one significant pastoral and social issue amongst others, and one linked to fears and guilt, to anger and confusion, to questions of greed and of faith, hope and love, addressing climate change Christianly is neither a luxury nor a distraction from the gospel.