The Ethics of Leadership for Health Care Professionals in a Post-Modern Context

The Ethics of Leadership

For Health Care Professionals

In a Post-modern Context

James C. Denison

Religious trends in the Western world are not encouraging. According to the latest American Religious Identification Survey (ARIS), the number of Americans who describe themselves as “Christian” has dropped from 86% to 76% since 1990. At the same time, the number who say they have “no religion” has nearly doubled to more than 15%. The number who call themselves “atheist” or “agnostic” has quadrupled, and is now almost twice the number of Episcopalians in our country.

The Pew Forum on Religion and Public Life recently released their “U.S. Religious Landscape Survey.” The survey reports that more than one-quarter of American adults (28%) have left the faith in which they were raised in favor of another religion, or no religion at all. Among Americans ages 18-29, one in four say they are not affiliated with any religion.

Spiritual trends in Europe are even more troubling. Harris Interactive conducted a large survey of religious beliefs on the Continent. Its results: in Italy, 62% say they believe in “any form of God or any type of supreme being”; in Spain, 48% of the population agrees; in Germany, 41% affirm the existence of “God”; 35% in England and 27% in France concur.

Why is Western spirituality in this condition? How are we to understand the ethics of leadership in our “postmodern context”? What is a “postmodern context”? What does any of this say to the issue of leadership for health care professionals?

Why do we think the way we do? Explaining the “postmodern” context

The first Christians held a clear and positive view of biblical authority, so that Paul could say that “All scripture is inspired by God” (2 Timothy 3:16).

The medieval world

However, the authority structures of the Christian movement soon shifted from the Bible itself to the Scriptures as they are interpreted by the Church. Ignatius, bishop of Antioch argued for the authority of the bishop over the church and a “college” of bishops as the ruling authority of the universal Church. Irenaeus further identified the Roman Church as the “preeminent authority” in Christendom, with her leaders emanating from Peter and Paul through the bishops who have succeeded them.

Soon (ca. 250) Cyprian of Carthage had separated the “clergy” from the “laity” and made his famous claim, “He can no longer have God for his Father, who has not the Church for his mother.” When Constantine made his conversion to Christianity in 312 and subsequently legalized the church, the institutional authority of the Christian movement was clearly defined as the Roman Church and her leadership.

Of course, this concept of ecclesiastical authority molded greatly the patristic and medieval concepts of Scriptural authority. As God gave the Scriptures through the Church, so (it was argued) he guided the Church through her leaders to the proper interpretation and application of his word. Creeds, councils, and papal rulings became the means by which the biblical materials were understood and transmitted.

And so the foundation blocks of the modern world were set in place: objective truth and absolute authority structures, centered in the teachings of the Church.

The Reformation project

In shorthand, the Protestant reformers sought to relocate authority with the Scriptures as they are interpreted by the individual believer. Martin Luther made the famous claim, “Only the Holy Scripture possesses canonical authority.” He discounted in turn the claims of magistrates, church councils, church fathers, bishops, and even the pope to authority over the Scriptures. John Calvin agreed: “God bestows the actual knowledge of himself upon us only in the Scriptures”; “Scripture has its authority from God, not from the church.”

With the reformers’ achievement the Protestant foundation blocks of the modern world were laid: a Bible which possesses objective meaning, theological positions which are certain and true, and Scriptural authority which is final and absolute.

The “modern” mind

While the religious world was experiencing this monumental conflict between ecclesiastical and Scriptural authority structures, the philosophical world was undergoing a struggle equally foundational and far-reaching.

Rene Descartes, a Catholic mathematician with an intense personal need to find foundational truth, sought that truth which he could not doubt. He determined that the existence of the thinking self was the first truth which doubt could not deny. As a result, he defined the human condition as one centered in the autonomous rational process. The “rationalist” worldview followed Descartes’ location of authority within human reason.

The empiricist reaction focused upon personal experience as the true authority for knowledge. John Locke asserted that the mind is born not with innate ideas (the Cartesian system) but as a blank slate, a tabula rasa. David Hume claimed that this empirical method cannot lead to true and certain knowledge. Every belief is derived from an object; our minds connect these objects into patterns on the basis of the appearance of unprovable causal relations. We cannot defend our reason by reason.

Immanuel Kant forged that merger between the rational and the empirical worldviews which organized the foundational building blocks of modernity into their final form. In short, his truce between mind and senses combined both into a larger whole: the senses furnish “raw data” which the mind organizes according to categories within itself, and the result is “knowledge.” However, according to this system we can have certain knowledge only of the “phenomena” (those objects which are present to the senses of the knower), not of the “noumena” (objects lying beyond sense experience). This distinction would prove to be crucial for the later shift from the “modern” to the “postmodern” world.

With the Kantian synthesis the philosophical foundation stones of the modern world were laid beside the Catholic and the Protestant. In all three, truth is certain and available, and epistemic authority is clear and absolute. Whether authority resides in the Church, the Scriptures, or empirical knowledge interpreted rationally, there is no question in the modern mind about its objective character.

The philosophical problem was this: there exists within the Kantian synthesis a subjective element undetected by most of its contemporary followers. In short, if knowledge is the result of our individual interpretation of our personal sense experience, then in what sense can this knowledge be objective? My sense impressions may be different from yours. My interpretation of this data is personal and subjective as well. Not only can I not know the “noumena” (the “thing-in-itself” which lies beyond my senses), I cannot claim objective authority for my interpretation of the “phenomena,” either.