What Is a Worldview?
The following definitions are helpful:
“A set of assumptions or beliefs about reality that affect how we think and how we live” (Cosgrove, 2006, p. 19).
“The comprehensive perspective from which we interpret all of reality” (Keller, 2012, p. 157).
Worldview is often described as a set of lenses through which we view the world. As a descriptive lens, our worldview influences our perception of the world. What is true? What is reality? As a prescriptive lens, our worldview influences our evaluation of what is true. What does it mean? How should we live?
One may readily see that if one views the nature of the universe as consisting of only physical matter and energy, then that person’s understanding of the meaning of life and how we should live will likely be far different from one whose perception of the universe includes a spiritual realm where life continues after death and goodness is rewarded.
While it is true that all people have their own private worldviews with values and beliefs that have been shaped by culture, education, experiences, and relationships, it is also valuable to speak of shared worldviews, those foundational assumptions or beliefs that many people hold in common. For the sake of this course, the course content will be reduced from the many-shared worldviews to three basic worldview families.
What Are the Three Basic Worldview Families?
Though there are many different worldviews, for the purpose of this course they have been simplified into three basic worldview families. There are many variations within these families.
Atheism is the worldview of those who believe only in what their senses can detect–only what may be analyzed and understood in a scientific laboratory. This view believes in no God or spiritual realm. The cosmos consists of only the natural or physical realm of matter and energy. Other names often associated with this worldview family are naturalism and secular humanism. Most whose worldview values and behavior are aligned with atheism prefer to be considered agnostics. These are uncertain of the existence of God, skeptical for the most part, yet open to the possibility.
Pantheism is the worldview of spiritualism, the belief that “all is God” as the word implies. Pantheists believe in a spiritual realm, but no relational God who has revealed himself to humanity and is actively involved in the lives of those who believe in him. This worldview family consists of the Eastern religions of Hinduism and Buddhism, as well as the more eclectic Western belief known as New Age. Pantheists typically embrace an impersonal oneness of which all humans may become a part, becoming godlike themselves as they reach higher levels of spirituality.
Theism, or monotheism, is the worldview of the three major religions, Judaism, Christianity, and Islam. Though these three have huge differences rendering them incompatible with each other, they do nonetheless have some similarities. Theists all believe in a single, personal, and relational God who is the creator and sustainer of all that exists. They all likewise believe in absolute truth and morality, and an afterlife. The focus of this course is Christianity, so the course will be comparing these three worldviews: atheism, pantheism, and Christianity.
Another common worldview name, deism, is somewhat of an enigma–having a basic belief in God, but a God who is not relational or involved in human life. So although falling under the broad category of theism, deists may effectively live as atheists. Many people have complex worldviews that are a mix of various beliefs from the major worldview families.
How Do We Determine Our Worldview?
There are six components that help to determine worldview. The following questions correspond to each component. Answering each of the following questions for yourself will help you begin thinking about your own worldview:
1. What Is Ultimate Reality?
Does reality consist basically of physical matter and energy, as the atheists believe? Is reality an impersonal spiritual entity that dominates the universe and to which all humans must endeavor to attain unity with, as the pantheists assert, or is there a personal and relational, all-powerful, and sovereign God who exists everywhere, but is separate from the physical world he created, as believed by Christians and other theists?
2. What Is the Nature of the Universe?
This is similar to the question above but focuses strictly on what one believes about the natural world. Is the universe strictly physical and yet eternal in one form or another? Is it merely an illusion intended as a battleground for us to work toward enlightenment, or was the universe created by God and far more complex than can be detected by scientists, consisting of both a physical and a spiritual realm?
3. What Is a Human Being?
Is a human basically a biological machine, just a higher level of animal? Is a human a type of god with powers to reach perfection, or is a human an off-the-charts creature designed in the image of God with an eternal spirit like his and similar abilities to reason, seek moral purity, communicate on a high level, create for beauty, and love even those who cannot love in return? Is death the end of existence, or is there a soul that lives on? Does that soul return in another life, or does it return to God and await judgment?
4. What Is Knowledge?
Is there such a thing as absolute truth, or is truth relative? Is true knowledge only that which may be acquired and understood through scientific means, or is there also knowledge that only may be acquired by revelation from God? Should you only trust your senses, or should you explore the spiritual realm and seek knowledge from God?
5. What Is Your Basis of Ethics?
How do you know right from wrong? Is morality learned, or is it designed into our conscience? Is there a set of absolute moral standards given by God, or is morality relative, a matter of culture, and what is acceptable to a society?
6. What the Purpose of Your Existence?
Is human life as you know it merely the result of some amazing cosmic accident, or is there an underlying meaning to history, a purpose toward which time will culminate? Does life have meaning and purpose for individuals, or is it simply whatever one makes it? Did the Creator design his children with a purpose? If so, what might that be?
How Do We Test Our Worldview?
Everyone (not only religious people) forms his or her worldview on the basis of faith (assumptions and presuppositions) and reason. So we must ask ourselves “how reasonable or consistent is our worldview?” Are there any contradictions that are apparent? Testing a worldview is critical because at the end of the day, most people want to make sure that they have truebeliefs about the world. The following tests are just some ways of determining whether or not a particular worldview is true. Consider only three basic tests summarized here:
1. The Coherence Test checks the internal consistency of a worldview to see if one’s specific values and beliefs contradict any other beliefs within the worldview.
2. The Correspondence Test examines how well a worldview corresponds to reality. It evaluates evidences and experiences to see if the worldview matches with what one perceives in the real world.
3. The Practical Test evaluates a worldview’s livability. Does the worldview bring satisfaction as one faces life’s challenges, or is it found to be lacking?
Foundations of Christian Spirituality and Ethics
The foundational beliefs of Christianity inform the Christian understanding of the nature of spirituality and the nature of ethics. Thus, the way in which the Christian worldview answers the six questions above shapes a distinctly Christian spirituality and Christian ethic. The term spirituality has many different definitions in popular culture and in different contexts. One influential definition claims, “spirituality is an aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred” (Puchalski et al., 2009). This definition is broad enough to give a general idea of what spirituality involves, but it does not give a full picture of a person’s spiritual life or spiritual needs. Those details will be filled in by examining a persons specific worldview.
Spirituality in the Christian worldview has its foundations in the reality of a triune God who eternally exists as Father, Son, and Holy Spirit. God is one being in three persons and is the creator and sustainer of all that exists. He is all-knowing, all-powerful, and loving to his core, “And so we know and rely on the love God has for us. God is love. Whoever lives in love lives in God, and God in them” (1 John 4:16). This God has revealed himself in different ways to human beings, including through the natural world. However, he has revealed himself and his will for human beings most authoritatively through the Bible and in the person of Jesus Christ. In this view, whatever it means to be spiritual will in some sense be related directly or indirectly to God, and will come to be known primarily through the teachings of the Bible. Furthermore, Christian spirituality will refer to the beliefs and practices that are meant to reflect the proper functioning of God’s creation, and which promote right relationship to God and deeper knowledge of him. Many times spirituality is taken to be synonymous with the feeling of deep emotion or of oneness with a transcendent reality, but Christian spirituality is not limited to the experience of mere emotions or feelings. Feelings and emotions are an important part of being human, and they are even an important part of one’s relationship to God. Yet, spirituality in the Christian worldview is not dictated by the feelings or emotions one might be experiencing in the moment, but by trust in the goodness of God and obedience to him.
In the same way that Christian spirituality finds its foundations in the reality of the triune God of the Bible, ethics also has its foundations in God. Ethics, broadly speaking, is the study of good and bad, right and wrong. Every worldview has to explain the foundations of ethics (in line with worldview question #5 above) such that it explains the basis of what counts as good and bad, right or wrong. In the Christian worldview, there is a God who exists and has created the world with a moral structure and purpose such that what is truly right and good is a reflection of God’s character. God’s own holy, loving and perfect character is the standard of right and wrong. Badness or what is wrong is then defined as anything that is contrary to God’s character, his will, or to his design and purpose for his creation.
The Bible reveals what God’s character is like. Exodus 34:6-7 says,
The LORD, the LORD, the compassionate and gracious God, slow to anger and abounding in love and faithfulness, maintaining love to thousands, and forgiving wickedness, rebellion and sin. Yet he does not leave the guilty unpunished; he punishes the children and their children for the sin of the parents to the third and fourth generation.
Similarly, 1 John 4:7-9 says,
Dear friends, let us love one another, for love comes from God. Everyone who loves has been born of God and knows God. Whoever does not love does not know God, because God is love. This is how God showed his love among us: He sent his one and only Son into the world that we might live through him.
Psalm 18:30 declares, “As for God, his way is perfect: The LORD’s word is flawless; he shields all who take refuge in him.” Many more verses could be surveyed, but the Bible makes clear that God is perfectly good and holy. Knowing right and wrong then will mean knowing that which accords to God’s character.
Right or wrong can be discovered in multiple ways. It can be discovered in God’s creation by examining the natural world or by the use of human reason. In this way, one discovers God’s design for the way things are supposed to be by examining what is built into creation; this is often referred to as “natural law.” For example, one can know by means of reason and observation that murder is wrong or that a broken bone is bad and not the way it is supposed to be. Conversely, one might come to know that feeding the homeless is good, and loving one’s spouse is right. One does not need to be religious or even believe in God to be able to know propositions of “natural law.” Nevertheless, the Christian worldview holds that these truths are built into the world by God. Second, right or wrong can be discovered by reading the Bible or looking at the example of Jesus Christ. The Bible reveals God’s commands and principles such as the Ten Commandments or the teachings of Jesus on the sermon on the mount. In addition, the Bible provides us with examples of virtuous people. The perfect man and moral exemplar (though much more than only a man and an exemplar) in the Christian tradition is Jesus Christ himself. The Christian is to not only obey God’s commands, but to be transformed into the kind of person that reflects the character of God. Jesus Christ is the perfect representation of such a life; Christians, thus, ought to embody the virtues and character of Jesus himself. The attaining of these virtues will not only be a matter of intellectual knowledge of right and wrong, but an active surrender and transformation by means of God’s own Holy Spirit. The wisdom to navigate all the complexities of ethical decision-making will be a consequence of a person’s character and the active guidance of the Holy Spirit.
Knowledge of God, Knowledge of Ethics
A key component of the foundations of Christian spirituality and ethics as described above is the view that people can have genuine knowledge of God and knowledge of right and wrong. A few observations about the word knowledge need to be considered. First, by knowledge we mean the opposite of mere opinion. Knowledge is more than just an educated guess; it is being in touch with the real world as it really is. Thus, knowledge in this sense is not merely subjective, but is rather an objective description of reality. For example, the proposition “the earth is round” is an objectively true description of reality, even if some people happen to subjectively deny that the earth is round. Subjective beliefs may be true or false. What would make subjective beliefs true would be if they matched the real objective world. Fundamentally, knowledge is the possession and awareness of truth.
There are two philosophies, however, that stand in contrast to the Christian belief that one can have knowledge of God and knowledge of right and wrong, namely scientism and postmodernism. These two philosophies are very influential in today’s society, although they are not compatible with the Christian worldview. It is important to understand these philosophies because not only are they not compatible with the Christian worldview, they arguably have negative effects on the practice of medicine and health care.
Although the term scientism has the word science in it, it is crucial to recognize that (1) scientism is not the same thing as (2) science. In the Christian worldview, science is a great and good thing. In fact, the Christian worldview has always encouraged careful investigation of the natural world. In the Christian worldview, medical technology is considered a good gift from God insofar as God has created the kind of world that has a structure that can be discovered and manipulated to bring about the good of human beings (Rae & Cox, 1999). Scientism, however, is not compatible with the Christian worldview. Scientism is the belief that the best or only way to have any knowledge of reality is by means of the sciences (Moreland & Craig, 2003, pp. 346-350). In other words, if something is not known scientifically then it is not known at all, and the only way to hold true beliefs about anything is to know them scientifically.
That may sound reasonable and even commonsense, but there are two problems with scientism: (1) scientism is a self-refuting philosophy, and (2) science has clear limits. First, if the only way to have true beliefs is through science, then the thesis of scientism itself (“the only way to have any knowledge of the world”) could not be true because it cannot be proven scientifically. Thus, the thesis of scientism fails its own truth test. Scientism’s thesis is, in fact, a philosophical statement. Philosophers call such propositions self-refuting because they invalidate themselves by definition, similarly to someone claiming, “I cannot speak a word of English.”
Second, while science is a powerful way of gaining knowledge of the natural world, science is limited and is not the only way of gaining knowledge. Consider the following two limitations of science (though there are many others); science cannot tell us anything about (1) ethics or (2) how one ought to use the results of science (University of California Museum of Paleontology, n.d.). Science is wonderful and describes the way things are, but it has no authority to tell us what we ought to do morally. Science cannot tell me whether or not I ought to love my spouse, keep my promises, or give to the poor. Even when it comes to ethical issues that involve science, science cannot determine what the right thing to do would be. For example, science might be able to describe the nasty effects of a terminal disease on a person or explain the state of a person’s brain if that person is in a vegetative state. However, science cannot determine whether euthanasia or physician-assisted suicide is good, bad, right, or wrong. Science also cannot determine how scientific data and results ought to be used. Science might enable the discovery of chemical processes or structures, but should the results be used for creating biotechnology to engineer human DNA? Should the results of scientific research be used to create bioweapons for military purposes? Such questions are beyond the bounds of what science can answer. Remember scientism is NOT science; it is a philosophical thesis that claims that science is the only methodology to gain knowledge and that every other claim to knowledge is either mere opinion or false. However, as Nicholas Rescher remarks, “to take this stance [of scientism] is not to celebrate science but to distort it” (as cited in Moreland & Craig, 2003).
Postmodernism is a broad philosophical position that claims that there is no such thing as truth or an objective reality that can be known. A common way in which postmodernism is expressed is through a view called relativism. Relativism is the view that there is no such thing as truth in the common sense of that concept. Every claim about the nature of reality is simply relative to either an individual or a society/culture. Another way to put this is to say that truth is invented by people (whether it is individuals or entire societies) instead of being discovered. According to this way of thinking, there is not genuine truth to be had or known, only subjective opinions or beliefs. While certain questions are no doubt matters of subjective opinion, such as “what is the best flavor of ice cream?” or “what is the proper way to shake hands?” not all questions are. This is most clearly seen when we consider moral or ethical propositions about right or wrong. It would be a serious mistake to claim that the propositions “murder is wrong” or “racism is evil” are mere subjective matters of opinion. However, that is what relativism implies. If all truth including morality is simply a human invention, then there is no standard for genuine truth, and it follows that there is no genuine right or wrong. However, this is certainly false. Whether or not the Nazi party, made up of thousands of individuals, believed that killing 6 million Jews was a good thing, we have to say without any hesitation that they were genuinely wrong. But it is not possible to be wrong unless there is genuine objective truth to be known.
Both scientism and postmodern relativism are incompatible with the foundations of Christian spirituality and ethics. The Christian worldview holds science in high regard and accepts it as one of the most powerful communal ways of obtaining knowledge about the world. However, contrary to scientism,the Christian worldview does not accept science as the only way of knowing things about the world. Secondly, contrary to postmodern relativism, the Christian worldview holds that genuine objective knowledge of God and of right and wrong is possible. It follows then that who God is and what is right and wrong are not merely matters of subjective opinion, but genuine truths to be discovered.
The foundations discussed above provide the framework for Christian ways of ethical and spiritual decision-making in health care. It is important to understand therefore that the Christian way of ethical and spiritual decision-making is distinct from other worldviews and is not the same as Buddhist, Muslim, or even atheist ways of ethical and spiritual decision-making. 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.
Topic 2 will discuss a foundational principle to the practice of medicine and health care, as well as bioethics namely, the principle of respect for persons. The Christian worldview goes even further and states all human beings are made in the image of God and therefore have intrinsic value and are worthy of dignity and respect.
Topic 3 will discuss the field of bioethics and introduce some of the main methodologies of ethical decision-making in health care. The focus in this section will be on the methodology called principlism which stresses the application of four moral principles to all ethical decisions in health care. Prinipalism will be used and interpreted in light of the Christian worldview and the overarching narrative presented in the Bible.
Topic 4 will briefly introduce issues of death, dying, and grief. The focus will be on ethical issues at the end of life and the Christian worldview regarding death in light of the biblical narrative and the hope of resurrection inaugurated by the person and work of Jesus Christ.
Topic 5 will conclude with discussion about the facilitating of ethical and spiritual decision-making for patients, and the practical application of the principles and tools introduced in this course.