
The Dr. John Patrick Bioethics Column: Imposed Order
“Go and clean your room!” Now, is that likely to get immediate and rueful compliance? Probably not, yet we cannot live without a modicum of order. But order divorced from a richer framework can become a devastating obsession. As is inevitable, if we are made in the image of God, our bristling response to anyone telling us what to do meets an inner reality that we know when the command is justified. We are not mere animals responding to innate instincts. We do not even arrive as an empty slate but as rational beings with moral knowledge, but so often we are unable to respond appropriately and very, very unlikely to be grateful that we are made with moral knowledge. Blessed are the wounds of a friend, but he’s no friend of mine at the moment of conviction. Ah, the human condition is not compatible with Utopian dreams.

John Patrick, MD
“Go and clean your room!”
Now, is that likely to get immediate and rueful compliance? Probably not, yet we cannot live without a modicum of order. But order divorced from a richer framework can become a devastating obsession. As is inevitable, if we are made in the image of God, our bristling response to anyone telling us what to do meets an inner reality that we know when the command is justified. We are not mere animals responding to innate instincts. We do not even arrive as an empty slate but as rational beings with moral knowledge, but so often we are unable to respond appropriately and very, very unlikely to be grateful that we are made with moral knowledge. Blessed are the wounds of a friend, but he’s no friend of mine at the moment of conviction. Ah, the human condition is not compatible with Utopian dreams.
As a morally fractured culture, we are so solipsistic (navel gazing) that we all want it my way and don’t tolerate anyone asking the question, “Why?” Anyway, who is going to adjudicate? The ever-enlarging bureaucracy wants to, but its continuous power grabs are not going unnoticed. Some sort of agreed ethical framework, one that is realistic about who we are, is desperately needed. The courts should go back to interpreting the law not making it. But on what foundation do ethics stand?
If I ask medical students to rank the four moral principles in patient care-beneficence, non-maleficence, autonomy and justice-they most frequently put autonomy at the top. If I state them differently as, “Do not do harm, do good, be just, honor autonomy,” they will be more thoughtful but still lost. These are your future colleagues-brainwashed into reductionism not understood by either their role models or themselves. In The Abolition of Man, C.S. Lewis summarized it with an earthy metaphor: “We castrate and bid the gelding be fruitful.”
Of the many contradictions that the ruling elite face, the meaning of fact is the most ambiguous. If only scientific facts are publicly true and that includes radical Darwinism, then there is no universal good. “What’s in it for me” is the only real Darwinian question, and getting caught is the only restraint. Yet the leaders of our profession waffle on about the need for empathy with patients who are suffering and dying. Science has nothing to offer at this point, so we are providing euthanasia.
How did all this come about? Jews and Greeks and all the great religions believed in transcendence. There must be something beyond us, materialism is not enough. They could see that some lives were well lived, and they were ordered toward honesty, integrity and justice-they had genuine purposes in life, labeled as telos in Greek. Living well meant finding one’s place in the natural created order. The children of Israel believed God gave them the law so they would flourish. He did not give reasons for the laws, but He said, “Keep this law and you will flourish, go against it and you will not.”
There is a real fact/value divide. Clever academics confuse students with trickery by saying I can get a value from a physical fact: “If you want to catch the train you ought to leave now.” However, that is only a prudential ought, not a moral one. Read and re-read C.S. Lewis’ The Abolition of Man until you can make the argument. It is only just over 100 pages.
Before the Scientific Revolution beginning in the late 13th century, moral facts were dominant because they gave us a telos, a purpose for living well. They were qualitative and described good and bad character, but the new science started measuring things and experimenting, hypothesizing and testing again. The power of reductive science was utterly astonishing. Within a couple of centuries, Francis Bacon purloined the word “fact” for things which can be measured. That is how we almost all think today. Of course, all the cultural norms derived from the Greeks and Judeo-Christian theology were assumed to be untouched, but they were not. COVID managers had only the physical facts in their field of vision. They were blind to all our metaphysics, love, loyalty and promise keeping, and they forced us to break our marriage vows (until death do us part) by putting a glass screen between people who had lived together for decades.
English philosopher Thomas Hobbes, he of nasty, brutish and short fame, taught that we needed rulers to provide law and order so we could get on with producing more things. We, as individuals, are free, but we willingly trade in some of our freedom for security and order. This is the consent of the governed. Obey the law and do what you want.
Hobbes followed with the recognition that such individual freedom will spread onto all areas of life not controlled by law. He acknowledged that the origin of parental authority was God’s law delivered to Moses, but he said it was self interest that made it work and individuals should be free, including wives and children, but they would face trade-offs. He did not engage with the idea that when we cease to honor God, we will soon cease to honor His laws. Autonomy was nevertheless king.
Patrick Deneen wrote, “Ironically, the more complete the securing of a sphere of autonomy, the more encompassing and comprehensive the state must become. [Modern views of] liberty require in the first instance liberation from all forms of associations and relationships-from the family, church, and schools to the village neighbourhood and community broadly defined-that exerted strong control over behavior largely through informal and habituated expectations and norms.”[i]
Now we have reached a cancel culture where local loves and norms are dismissed, while unscrupulous traders in victimhood without thought of consequence have effectively destroyed the lives of many whom they claim to represent with the inner-city riots and accompanying vandalism of small businesses.
Freedom must be preserved, but to quote English philosopher Lord Acton, it must be the freedom to do what you ought, not what you wish. Sadly, without a revival of genuine religion, that is unlikely. “Out of the crooked timber of humanity, no straight thing can be made” (which is Isaiah Berlin quoting Kant).
John Patrick, MD, studied medicine at Kings College, London and St. George’s Hospital, London in the United Kingdom. He has held appointments in Britain, the West Indies and Canada. At the University of Ottawa, Dr. Patrick was Associate Professor in Clinical Nutrition in the Department of Biochemistry and Pediatrics for 20 years. Today he is President and Professor at Augustine College and speaks to Christian and secular groups around the world, communicating effectively on medical ethics, culture, public policy and the integration of faith and science. Connect with Dr. Patrick at johnpatrick.ca. You can also learn more about his work with Augustine College at augustinecollege.org.
[i] https://www.firstthings.com/article/2012/08/unsustainable-liberalism