Byrnes, W. Malcolm

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TTmNATIoNAL Clrsoltc Btoerrucs Quanrrnrvot 'AuruM{ 2002assistedsuicide. The readerwill find this bookto be extensively referenced, and a good ad-dition to the reading list of medical ethicscourses.Whatever else we arg we axe creatures thatexist in relationship with each other. After rea&ing various examples of PAS from the Neth-erlands to Dr. Kevorkian and Oregon, one canmake no mgumentthatthese acts were basedon the love of another human being. Larsonand Amundsen bring us to the fork in theroad. Willwe ultimately legislate ourworthtobe equivalent to that of an oyster, or will weembrace imago Def?Anne Daunt, Phamt. D'St. Elizabeth's Medical CenterBoston, MassachusettsRuse, MichaeLCan aDarwinimt Be aChris-lian?: The Relationship betloeen Scienceand Religion. Cambridge: Cambridge Uni-versity Press, 2OBl. 242 PP. Index.In his epilogue, Michael Ruse writes: "Ourlimitations [as humans, in trying to under-stand the ultimate mysteries of the universe]do not make Christianity mandatory or evenplausible, but necessitate a tolerance andappreciation of those who would go beyondscience, even ifwe ourselves cannot follow"(219). This excerpt fairly well sums up Ruse'sanswer to the question he poses in the titleofthe book-"Can a Darwinian Be a Chris-tian?" His answer is: Yes, a Darwinian can bea Christian ifhe wishes and, ifhe cannotper-sonally accept Christianity, should at leastrespect those who can.Ruse, professor ofphilosophy at FloridaState University, is the author of a number ofbooks on the philosophy of biolory, particu-larly Darwinian evolutionary biolory' He is apublic defender par aecellence ofthe teach-ing of evolution versus creationism in publicschools. In 1981, he testified alongsideStephen Jay Gould as an expert wiflress for564the American Civil Liberties Union in their(successfirl) efforts to overtum an Arkansaslaw thatwouldhave allowedthe teaching of"creation science" inpublic schools. He cer-tainly is qualified to write this book'The book is divided into fwelve chapters,together with a prologue and an epilogue. Inthe firsttwo chapters, Ruse outlinesthe fun-darnental tenets and the historical development of Darwinian evolutionary theory (ch.1) and Christianity (ch. 2). In chapters 3-7,he moves into a discussion of topics rang-ing from human origins (ch. 3), the natureand evolution of humans (ch. 4), naturalismand miracles (ch. 5), the question of the in-telligent design ofnature (ch. 6), and the re-alities of human pain and suffering (ch' 7).After a brief detour in which he considersthe likelihood of extraterrestrial beings (ch.8), Ruse goes on to discuss Christian ethics(ch. 9), social Dmwinism (ch. l0), sociobiol-ogy (ch. l1), and the issues of freedom anddeterminism (ch. 12).In his tour through Darwinism and Chris-tianity near the beginning of the book, Rusedemonstrates an impressive depth ofknowl-edge of both topics. He describes Darwin'soriginal thinking, discusses developmentssince Darwin, and gives us a flavor of therange of contemporary evolutionarythough! from Dawkins to Gould. In the chapter on Christianity, he takes us through thehistorical development of Christianity, fromthe time of Jesus to the ear$ Christians tothe Reformation and the Enlightenment. Thediscussion includes historical figures suchas St. Augustine, St. ThomasAquinas, Mar-tin Luther, David Hume, and Immanuel Kant.Ruse compares and contrasts the beliefs ofCatholics and Protestants, and discusses the*Christian liberalism" of today.In chapter five, Ruse delves into the issueofmiracles. Heaskshow miracles, which areostensibly outside the law, can be compat-ible with Darwinian science, which is law-bound. He notes that many of today's liberalChristian theologians would take the"miracle-compatible-with-laf' stance. Heconjectures that miracles ranglng from themultiplication of the loaves and the fishes tothe raising oflazarus can be explained byBoorRcvmws"the enthusiasm of the moment," and by"people's hearts being filled with love." Henotes that, according to this thinking,"Lazarus and the ruler's [Jairus's] daughterwere more than likely brought back fromtrances" (96). Indeed, for the liberal Chris-tian, Ruse observes, "even the suprememiracle of the resurrection requires no law-breaking return from the dead." Instead, themiracle could be explained by the disciplesbeing "filledwith greatjoy andhope" on andafter the third day (96). Ruse writes that "thisis not a position of desperation" and that thevalue of the position is that it "meshes withscience." But he also acknowledges that, forsome people, "the whole point is that Jesuswas well and truly dead, and then rose mi-raculously back to life" (97). The difficultywith Ruse's style of presentation here-andthis is seen throughout the book-is that itis hard to determine where an explication ofothers'ideas ends and a statement of Ruse'sopinion begins. One is left with the question:"Exact$ where does he stand on this issue?'Chapter five is also marked by sfenuousarguments against the philosopher and au-thor Alvin Plantinga who, in a recent publi-cation on methodological naturalism, arguesthat Christianity and Darwinism are incom-patible because Darwinian science excludesthe possibility of God and of miracles. Hedescribes miracles as "science-stoppers."Part of Ruse's argument against Plantingainvolves making a distinction between cos-mic history (made ofrepeatable events) andsalvation history (unique events). Ye! Rusedoes not follow through on this line ofargu-ment. Left hanging is the intriguing issue ofcosmic versus salvation history and thequestion of whether the two can be sepa-rated from each other or, rather, are mysteri-ously two aspects of one reality.In attempting to find compxibility betweenDarwinism andChristianity, Ruse focuses onthe "survival of the fittesf' or the "strugglefor existence" aspects of Darwinism. Yet,sometimes associated wift this model ofnatu-ral selection is the notion of biological'!rogress." And, sometimes @ut not always)tied with biological progress is the notion ofhuman social progress. It is this associationbetween strict Darwinism and social progressthat is disturbing to some people, especiallysince it carries with it the assumption thatsome individuals or groups are less "fit" thanothers. In his chapter on "Social Darwinism,"Ruse writes that*far from Christianity's pos-ing problems for the social Darwinian, it plugssome significant gaps...." Christianity"meshes nicely" with social Darwinism ( 185).Ruse describes the natural-selection-drivenworld proposed by Ronald Fisheq "the great-est evolutionist of [the twentieth] century"(12l): "Selection pushes populationsto everhigher points of fitness. . . . The human task isto keep humans up and beyond their naturalpeak. Here the key is eugenical interventionin human breeding patterns" (185). Disappointingly, instead of vehemently denounc-ing Fisher's eugenical intentions, Rusewrites: "You may not much care for theseparticular details, but as was so often thecase, Fisher gotthe main picture right." Thereader may disagree with this assessment.The task Ruse gives himself is, in a nut-shell, to *convince" aparticularbrand ofevG.lutionist, the sociobiologist Darwinian, thatit is okay to be a Christian. To accomplishthis, Ruse presents the Drwinian with a smor-gasbord ofdifferent Christian b€lief systemsfrom which he can select one that he likesbest. Like a waiter at a French restaurant, Ruseexplains the flavor and taste ofeach Chris-tian dish, presents the different varieties, andmakes recommendations about which com-bination the Darwinian patron might findmost pleasing (the progressionist liberalChristian one?). There are two difficultieswith this approach. First, one is left with thequestion of why his efforts are so narrowlyfocused on the sociobiologist Darwinian. Abroader, more inclusive, embrace of evolu-tionary theory would have made his taskmuch easier. Second, one must ask: is a smor-gasbord approach really the best way to con-vince a person to be a Christian? Is not thedecision to convert to Christianity invariablybased on a personal call from Jesus? Does itnot always involve a leap of faith?Despite these difficulties, one must admireRuse forthe sheervolume ofeffort expendedin accomplishing his task. One must marvel565TriENeuoNar Canrolrc Brormcs Quanrenrv.. .Aurur,n$ 2002at Ruse 's lnowledge of diverse topics withinthe different areas of Darwinian science,\l-estern philosophy, and Christian thought.The issues Ruse grapples with in his book-the origins of humanity, whether or not therrniverse reflecS intelligent design, evil in theworld. free will-are mon',mentally difficultones. The particular utility ofthis book is thatit brings up many issues and stimulates thereader to learn more. The scientist reader isstimulated to learn more about Christianity,and the Christian reader is stimulated to learnmore about science.W. Malcohn Byrnes, Ph.D.Assistant ProfessorBiochemistry and Molecular BioloryHowad University College of MedicineWashington, D.C.Ubel, PeterA.,M.D. Pricing Life: Why lfsTittufor Heakh Care Rotioning. Cambridge,MA: MlTPress,ABradford Boolq 2m1. 208pplnderlt Pricing Life, Dr. Peter Ubel covers aconsiderable amount of ground in only 197pages of text in this shod but informativebook which contains three sections andeleven chapters. The three major sections ofthe book are "Cost-Effectiveness and theControversial Necessity of Health Care Ra-tioning," "Cost-Effectiveness and BedsideRationing: Do Two Wrongs Make a Right?",and *The Future ofCost-Effectiveness Analy-sis and Health Care Rationing."Throughout the text, the author relies onhis experience as a practicing physician inintemal medicine at aYA hospital, his ownresearch on clinician, patient, and communityattitudes and values regarding health care,and his background in health economics andbioethics. The coalescence ofthese variedexperiences leads to the following distillation:l) Modern health care is expensive; 2) Thedemand formodem health care is limitless; 3)566Supply of health care cannot keep up withdemand; 4) Therefore, health care must berationed to some extent; 5) Although healthcare rationing currently exists in severalforms, many physicians, patients, and ethi-cists are opposed absolutely to rationing; 6iWe wouldba better offplacing more empha-sis on how to ration health care (for example,through cost-effective analysis) than in con-tinuing the quasi-utopian debate on whetherto ration health care. The arguments and ex-amples put forth in support of the six pointsitemized abovewere compelling and logical.As a clinical research scientist, I foundthe most interesting part of the book to bethe clinical parables that illustrated theauthor's various points. These short storieswere entertaining, informative, and illustra-tive. In contrast, the frequent use of simpli-fied figures and graphs gave the short trea-tise an unnecessary textbook flavor. Also,the clarification ofthe diversity ofmeaningsaround the term "rationing" might have beenimproved ifthe authorhad defined it soonerrather than later, and then left it to the readerto sort out the other opinions. (Dr. Ubell de-fines health care rationing broadly as "any-thing that allows patients to go without ben-eficial medical services" [30].)Although Pricing Life is a thoughtful,well-written discussion oftlis important is-sue, there me three matters that call for com-ment a suggestion related to the role oftech-nology, a discussion regarding communityinput, and a few omissions. First, regardingomissions, the elephant-1n-1fos-liying-roomissue, that is, the disproportionate amountofthe total national health care budget spenton the last ninety days of a patient's life,was not well addressed. Another omissionvis-d-vis rationing was the lack of discus-sion regarding the frugality of mental healthservices not related to substance abuse. (Thebrevrty ofthe text may have been a factor inthis latter omission, as mental health is a co-nundrum in its own right.)Although not explicitly stated, Dr. Ubel'scharadeization of technological advance-ments intimates that innovation necessarilyincreases the cost ofmedical care. There aremany examples of the introduction of new

Ruse, Michael. Can a Darwinian Be a Christian?: The Relationship between Science and Religion

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Ruse, Michael. Can a Darwinian Be a Christian?: The Relationship between Science and Religion

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