Today's entry in the Medical Humanities Lexicon is "theodicy."
I believe in the sun even when it is not shining.
I believe in love even when feeling it not.
I believe in God even when he was silent.
This refrain was inscribed on the wall of a cellar in Cologne, Germany where Jews hid from the Nazis. It was found by Allied troops in 1945. Aside from its stark beauty, it neatly encapsulates the problem of theodicy, which is roughly defined as the question of how God can be perceived as good, right, or just, given the existence of suffering and evil in the world.
The problem arises as a dilemma in the technical sense. Given the phenomena of evil, there are apparently two possibilities: either God is incapable of preventing the evil in question, or God is capable of preventing that evil but chooses not to do so. The first option seems unsatisfying because it denies omnipotence to God, which is deeply problematic at least for many who ascribe Judeo-Christian beliefs. The second option is arguably worse because it problematizes the notion of a just, benevolent God; how could such a God choose to permit such evil to occur? How could God be silent in the face of such suffering?
The problem of theodicy, which is sometimes referred to as the ontological problem of evil, is at least as old in Judeo-Christian traditions as the Book of Job itself, which is a marvelous albeit deeply troubling work. To provide a basic narrative, Job is a righteous person who has generally enjoyed good health and prosperity. Suddenly, and for no apparent reason, a number of horrific calamities befall him. He loses all of his money, his children die one by one, he becomes afflicted with a number of gruesome illnesses, etc. He naturally begins to wonder why his life has taken such a sharp turn, especially given that he has generally lived a life of piety. This last point is important, for it is no answer to Job's problems to assert that his current misfortunes are his just desert, for there is no suggestion anywhere in the text that Job has perpetrated any works that would merit such punishment.
Job's problem, of course, is the problem of theodicy: the innocent suffer. How can God justify it? How can God be both all-powerful and benevolent if the innocent suffer? The remainder of the text consists generally of a dialogue between Job and his peers, who assert the point I have already suggested is unpersuasive: Job's misfortunes must be linked to his own sins. The idea that suffering is linked to personal sin is pervasive, especially in Judeo-Christian morality, and, in On the Geneology of Morals, Nietzsche provides the most eloquent explanation for why this idea maintains such currency: “[t]he meaninglessness of suffering, not suffering itself, was the curse that lay over mankind so far . . . .” (162) The sin-suffering narrative is so powerful precisely because it engenders meaning in the face of suffering, which may be more tolerable than the idea that suffering is entirely arbitrary:
suffering was interpreted; the tremendous void seemed to have been filled; the door was closed to any kind of suicidal nihilism . . . it placed all suffering in the perspective of guilt. But all this notwithstanding -- man was saved thereby, he possessed a meaning; he was henceforth no longer like a leaf in the wind.
Ibid.
Job, however, rejects this narrative. He insists that he is blameless, though his peers repeatedly return to the sin-suffering link both to explain Job's misfortunes and to preserve the notions of an omnipotent benevolent God. In chapter 21 of the Book, Job moves to preseve the notion of a just God at the expense of the notion of an omnipotent God. He argues not that God rules the world unjustly, but that he does not "rule" it all. In a conception that presages the Deist ethos, the world just runs on without divine control.
God eventually appears, but one of the most fascinating puzzles of the entire Book is that God never answers the problem of theodicy. Rather, God points out the immense chasm separating human and divine knowledge, and implies that he is uniquely concerned with the plight of humanity. But he never provides a resolution to the dilemma. Interestingly, Job is utterly satisfied with this response. Some exegetes have interpreted this climax as signfying Job's relief at the presence of God. God is no longer silent, to return to our original quotation. His presence alone soothes Job, even if he supplies no answer to the problem that has been causing Job such anguish.
The paradox here is rather profound. While Job may be soothed by being close to God, he could not be farther from divine understanding, as God himself reminds Job. Many Jewish thinkers have attempted to resolve this paradox in one of two principal ways: (1) tracking Job's reaction, some commentators, most notably Maimonides have accepted the epistemic gap between human and divine comprehension, but have argued that suffering may be transcended through closer relation to the divine presence itself; or (2) some commentators, especially 20th century thinkers, have adopted Job's earlier tack, and begun to reject the notion of an omnipotent deity.
Maimonides, roughly contemporary of Aquinas, was arguably just as enamored with the concept of right reason as was the latter. He suggested that through our intellect we could transcend our material existence and the suffering that accompanied it and move closer to God. Though I admit to finding the transcendentalist response deeply unsatisfying, one arguably redeeming feature of the Maimonidean version is that it places the onus on humans to work out the problem of theodicy. According to Maimonides, we cannot expect God to solve this problem for us. It is humans who must grapple with it. This response to me sounds remarkably familiar to one of my favorite essays ever, one which holds great personal significance for me, Camus' Myth of Sisyphus. It is Sisyphus who choose his own fate by pushing the boulder up the hill. Il faut imaginer Sisyphe heureux.
While transcendentalism maintained a powerful hold in Judeo-Christian thought for centuries following Maimonides, it became increasingly difficult to stomach after the Shoah. Richard Rubenstein argues that "[t]he fact of Auschwitz rules out such ideas forever" (Leaman 187). Moreover, the notion of a God who is utterly detached from the suffering of his children is deeply problematic for a tradition built upon the negation of that notion. Harold Kushner, in his well-known account of his attempts to make meaning of the death of his son, escapes the theodic dilemma by rejecting God's omnipotence. He observes that he can worship a benevolent but not all-powerful God, but that he cannot worship an omnipotent being who allows the innocent to suffer so. Elie Wiesel adopts an entirely pragmatic approach: to abandon God would be to grant success to the hopes of the Nazis in seeking to exterminate a Jewish way of living and thinking. Thus, belief in God is a pragmatic course, though he does not offer any resolution to the problem of theodicy itself.
Finally, Leibniz proposed that this world, even with its significant evils, is the best of all possible worlds. Under this analysis, all actual evils are essential ingredients in the divine plan in which this world remains the best of all possible worlds. To omit these evils would wreck the entire design itself. Numerous commentators have criticized this proposal on many different grounds, the most obvious of which is that it seems to rely on a brazenly consequentialist ethic.
It should take no great exercise of moral imagination to see the connection of the problem of theodicy to the medical humanities. The question of how an omnipotent, benevolent God can permit the innocent to suffer remains a profound problem for many, both for providers and health care professionals, and for patients and caregivers (each of whom may well take on both kinds of roles in their lives on multiple occasions). Of course, the problem of theodicy is no problem at all for atheists, and there are certainly non-Western belief systems which are untroubled by the problem because the relevant deity or deities is not deemed omnipotent to begin with.
Nevertheless, I submit it is safe to suggest that there are many participants in medical practice for whom the problem of theodicy is profound and agonizing. Even outside of a Western religious paradigm, Eric Cassell, one of the chief authorities on suffering, states that "[t]ranscendence is probably the most powerful way in which one is restored to wholeness after an injury to personhood" (45).
And even for those untroubled by the problem of theodicy, the sin-suffering narrative has demonstable clinical effects. Some patients, for example, do not request adequate pain management because they feel that the pain is their just desert for the sins they have committed. Through their suffering, they hope to expiate their sins. Susan Sontag's Illness as Metaphor highlights some of the ways in which the suffering of cancer patients is linked to sin. Saul Brody's seminal work on the history of leprosy shows an even closer link between illness, suffering, and sin. Arguably, part of the impetus for such a narrative is that it resolves the problem of theodicy. If suffering is linked to merit, or lack thereof, the notion of an omnipotent, benevolent God is left untroubled.
Thoughts?
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Bibliography
Mitchell, Stephen, trans. The Book of Job. New York: HarperPerennial Press, 1987.
The Cambridge Dictionary of Philosophy, 2d ed., s.v., "Theodicy."
Leaman, Oliver. Evil and Suffering in Jewish Philosophy. Cambridge: Cambridge University Press, 1997.
Freeman, David L., Abrams, Judith Z., eds. Illness and Health in the Jewish Tradition. Philadelphia: The Jewish Publication Society, 1999.
Kinzbrunner, Barry. "Jewish Medical Ethics and End-of-Life Care." Journal of Palliative Medicine 7, no. 4 (2004): 567.
Barilan, Y. Michael. "Revisiting the Problem of Jewish Bioethics: The Case of Terminal Care." Journal of the Kennedy Institute of Ethics 13, no. 2 (2003): 147.
Cassell, Eric J. The Nature of Suffering and the Goals of Medicine. Oxford: Oxford University Press, 1991.
Kushner, Harold. When Bad Things Happen to Good People. New York: Avon Press, 1981.
Nietzsche, Friedrich. On the Geneology of Morals. Translated by Walter Kauffman & RJ Hollingdale. New York: Random House, 1989.
Kapeli, Silvia. "Between Suffering and Redemption: Religious Motives in Jewish and Christian Cancer Patients' Coping." Scandinavian Journal of Caring Sciences 14, no. 2 (2000): 85.
Gunderman, Richard B. "Medicine and the Question of Suffering." Second Opinion 14, no. 1 (1990): 16.
Rahula, Walpola. What the Buddha Taught. New York: Grove Press, 1974.
Sontag, Susan. Illness as Metaphor and AIDS and its Metaphors. New York: Picador Press, 1989.
Brody, Saul. The Disease of the Soul: Leprosy in Medieval Literature. Ithaca, NY: Cornell University Press, 1974.
A nice introduction to an important topic.
Of course theodicy as such does not arise in Buddhism (I saw the Rahula title in the bibliography) although Buddhism does focus on the problem of suffering as fundamental to its spiritual worldview, commencing with the Four Noble Truths (and the Buddhists resort to a medical analogy here, as do the Hellenistic schools as discussed in Martha Nussbaum's The Therapy of Desire: Theory and Practice in Hellenistic Ethics (1994)).
Those who feel a link between illness, suffering and sin in their own lives could still be troubled by the theodicy question insofar as there remains the problem of the suffering of innoncents (e.g., how can one speak of sin in the case of the baby who dies shortly after childbirth?). Attempts to resolve the theodicy question within natural theology would seem to assume God's ways are, in the end, rationally comprehensible, an arguable assumption or belief: which of course does not mean we cannot explore the 'limits' of reason or rely on reason as far as it might take us in matters of faith and spirituality.
I would add two more books to the bibliography: John Bowker's Problems of Suffering in Religions of the World (1970), and Peter van Inwagen, ed., Christian Faith and the Problem of Evil (2004). I was delighted to see the inclusion of Leaman's book, which I have found quite helpful.
It is rather unfortunate that it is often a serious illness of some kind (or the death of a loved one, etc.) that prompts individuals to begin reflecting on such issues.
Again, thanks for a most useful post.
Posted by: Patrick S. O'Donnell | February 02, 2007 at 12:57 PM
Hey Patrick,
Of course you're right about Buddhism. I know something about Buddhism, and the significance of duhkha, or suffering in Buddhist thought, so I included the Rahula reference more as a sign that I am aware that questions of innocence and suffering are certainly not peculiar to Western religions. But you're right that there are many religious systems for which the problem of theodicy would not be a problem at all (though obviously theodicy and suffering are not entirely coextensive).
The notion that God's ways are not rationally comprehensible is, I tend to think, a central tenet in many transcendentalist approaches to the problem of theodicy. After all, that is, at least in part, a core aspect of God's answer to Job, viz., that divine understanding is not comprehensible to humans.
Thanks for the additions to the bibliography. I also loved Leaman's book.
Posted by: Daniel Goldberg | February 02, 2007 at 02:55 PM
Thanks for the quote from Nietzsche (“[t]he meaninglessness of suffering, not suffering itself, was the curse that lay over mankind so far . . . .” (162)).
Wasn't the first sin eating the Tree of Knowledge? How appropriate that the curse should include not knowing why.
Posted by: lifeethics | April 01, 2007 at 07:43 PM
The Biblical Book of Job is a provocative theodicy, an attempt to justify the ways of God to humankind, framed as a lawsuit drama. The moral issues of theodicy are easily transferred into a legal framework of rights and duties. It is a most provocative theodicy for it is the story of the most righteous man on earth putting God on trial for crimes against humanity and refusing to acquit him.
1. The story opens with the judgment that Job is “blameless, one who fears God and turns away from evil.” (Job 1:1) It is a judgment God himself will twice endorse. (Job 1:8; 2:3)
Job is the very best he can be, the very best all of us can be. His blamelessness verges on sinlessness. The book itself may be a parable on the human condition.
From the start, the author structures his theodicy to exclude the traditional explanations of punishment for sin (Augustine) and character development for immaturity (Irenaeus) as reasons for the evil that will befall Job. There is “no reason” in Job that merits the quantity and quality of the evil that befalls him. (Job 2:3)
2. Satan challenges the truth of God’s judgment on Job. (Job 1:11) By implication, Satan is saying God has erred, lost his authority to judge and should set down from the throne of heaven. Further, God has erred in creating humankind in the first place. Human beings are incapable of a completely selfless love of men and women for God. They love God only for what they can get from him. The entire human project should be destroyed. Satan has put God on trial.
3. God accepts Satan’s challenge to create a world of undeserved and unremitted suffering in order to settle this question of righteousness and reward. (Job 1:12; 2:6 ) God chooses Job as his personal champion in this trial by ordeal and authorizes his destruction. (Job 1:13-19; 2:7-8)
From this point on, the author is presenting God as being causally responsible for the evil that befalls humankind. God accepts that causal responsibility for evil (Job 2:3); Job attributes that evil to God (Job 1:21; 2:10 cf 12:9; 19:21) and the narrator attributes that evil to God. (Job 42:11) While Satan may be his agent, God is the principal and the actions of an agent are attributable to the principal when they are either authorized, intended or foreseen as is the case here. The author structures a non-traditional theodicy: undeserved evil is morally necessary (Hegel) in order to create the possibility for a completely selfless love. Certain first order evils are morally necessary to create certain second order goods. The real issue is the importance of that second order good- selfless love.
4. Why, why, why, why, why? (Job 3:11-23) With this five-fold cry, Job turns to God for answers for the evil in the world. He knows God must have a hidden purpose that he has not revealed. (Job 10:13) But God is silent. It seems the implicit restriction Satan placed on God is that God cannot reveal to Job or to anyone else the reason for evil in the world, lest it give Job a selfish motive to continue his love for God and ultimately to manipulate God. God is on trial for his plan in creation and his hands are tied.
Through five key speeches, Job turns his cry into a demand through an Oath of Innocence. This was a self-contained lawsuit involving a summary trial in absentia and two default judgments. No formal court was required since the oath made God himself the court. No summons was required since the oath dispensed with it. No witnesses were required since the testimony of the deponent was all that was needed.
(a) Job’s statement of claim is a simple one. God is the author of underserved evil in the world and must explain himself. He has deprived Job and humankind of the reason why. (Job 27:2)
(b) Job’s proof of his claim is a lengthy positive (Job 29:2-25) and negative confession (Job 31:1-40)
(c) Job’s enforcement of his claim is through a summary default mechanism. If God does not appear or appearing does not give a morally sufficient answer for evil in the world, then two judgments issue. The first is called “vindication”, a finding of causal responsibility that Job and humankind are not responsible for much of the evil that befalls them but God is. The second is called “condemnation”, a finding of moral blameworthiness attaches to that causal responsibility. The first is automatic; the second is something Job must pronounce by way of a curse. And God guaranteed he would execute that curse. (1 Kings 8:31-32; 2 Chronicles 6:22-23)
This is high drama: an appeal to God, through God and against God for crimes against humanity. Job has set in motion the legal machinery to condemn God if no sufficient answer is forthcoming.
At this point, the author is fleshing out a theodicy of necessity through the Oath of Innocence. The moral necessity of doing evil is expressed through the finding of causal responsibility for evil, “vindication”. The justification of a higher good, a selfless love of men and women for God, is expressed through the possibility of “condemnation” if that reason is either not forthcoming or not morally sufficient. This distinction in the summary default judgments is what makes the defense of necessity possible.
5. To the astonishment of all God appears, but cannot give a reason for his actions based on the restrictions created in his trial with Satan. He enters into a strategy of indirection.
(a) In his first speech to Job, God suggests the existence of purpose and providence through the language of constancy and control. (Job 38:4-39:30)
(b) In his second speech to Job, God suggest the existence of purpose in evil through the image of Leviathan. Leviathan is Isaiah’s name for a cross-cultural symbol of the moral evil that strikes at the heart of creation. It is deeply poetic image with extensive ties to the Babylonian and Canaanite literatures that preceded it. God admits to creating that evil. (Job 40:15,19) But the image carries much more with it. Isaiah used Leviathan as a moral metaphor for an apocalyptic end of the world when God would destroy and explain all evil including Leviathan. (Isaiah 25:6-9; 27:1; 28:9-13; 29:18-21; 30:18-21) God wants Job to pick up on that hint and his description of Leviathan (Job 41:1-7) draws heavily on Isaiah’s messianic banquet when Leviathan is served as the main course.
God rests his case, having hinted at the existence of a defense but having never presented it. In doing so, God opens himself to the condemnation that is the second part of the enforcement mechanism of Job’s Oath of Innocence. But God also puts Job and us to the ultimate test: will we condemn God (a finding of moral blameworthiness) so that we ourselves might be justified (a finding of causal non-responsibility)? (Job 40:8)
Job elects not to condemn God but to continue to worship him.
(a) He intuits the existence of a hidden purpose in evil based on God’s presentation of the image of Leviathan. (Job 42:2)
(b) He despises the premature judgment of condemning God before God has had a chance to present his case more fully. He melts to his knees in worship. (Job 42:6a) The Hebrew here “em’as” means both “despise” and “melt”.
(c) He changes course. He chooses not to condemn God. He is comforted in his own vindication and delays any condemnation of God. (Job 42:6b) The Hebrew here “naham” does not mean confession of sin, but rather “change in action” and “comfort”.
(d) He adjourns the matter to the Day of the Final Judgment to hear from his Redeemer a third time. (Job 42:6b) This was the original trial date set for an answer. (Job 19:25-29) And Job is content to postpone any consideration of a final condemnation of God to that date. He continues the lawsuit. The image of “dust and ashes” builds on Abraham’s ongoing challenge with God. (Genesis 18:20-23) Job will neither prematurely condemn God nor acquit God. Job will neither deny his moral need to know nor his legal right to know. He grants God an adjournment of his defense. He will not “condemn” God prematurely, so that he himself might be “justified” or “vindicated”. (Job 40:8) In the meantime, he will continue to selflessly love, trusting that answers will be forthcoming. This is the moral integrity and selfless love for which the world was created.
Through the Oath of Innocence and Job’s nuanced submission, the author is making a profound point in his theodicy.
(a) God has a duty to give the answer. That duty is rooted in the goodness of God. God has created human beings with certain natural needs, including the need for truth. God has to provide a reasonable possibility that those needs can be fulfilled for it is self-evidently true that “ought implies can”. Otherwise, God is contradicting himself. God does not have any obligations to human beings prior to their creation. But once God creates humankind with certain needs, God acquires certain duties of care. They are duties he owes to himself and to men and women.
(b) But God does not have the duty to give the answer right now. That is because the right to know is not an inalienable and indefeasible right. A right is inalienable or indefeasible if it cannot be “given up”, “taken away”, “deferred” or “overridden”, without a moral wrong being committed. Very few rights are inalienable and indefeasible in that sense. There are perhaps only three such rights: the rights to “life, liberty and the pursuit of happiness.” Those three rights can never be given up, taken away, deferred or overridden, without human nature itself being destroyed. The right to know the truth can be overridden or deferred in certain circumstances. Such circumstances exist where the disclosure of the truth would interfere with the pursuit or possession of a more important good. Selfless love is posited as such a real good. Time is required for the development of that good. Any premature disclosure of that truth is overridden by that higher good. The ultimate disclosure of that truth is deferred to the time at which that good is complete. Truth is never denied as being a real good. If truth were not regarded as a good, then that denial would constitute a moral wrong. It is just that the timing of the disclosure of the truth has some flexibility to it. Since selfless love is posited as a real good justifying the deferral of the truth behind evil in the world for an entire human life, the appropriate time for that disclosure is the moment of death, or a short time thereafter in a resurrection and a Final Judgment on the life one has lived.
This understanding of the nature of the right to know the truth is what underlies God’s failure to answer Job’s complaint and what underlies Job’s adjournment of the lawsuit. It is what allows both God and Job to be right.
7. Job is declared by God to be the only one who has spoken “rightly” about God. (Job 42:7-8) The Hebrew here “kuwn” means “to establish as right or true”. “The root meaning is to bring something into being with the consequence that its existence is a certainty.” It does not carry with it any nuance of “sincerity” such that God might be understood to be excusing Job for speaking “sincerely”, but “incorrectly”. God is saying Job spoke “correctly”. Through his Oath of Innocence, Job has established with certainty two points.
(a) First, God is the author of evil in the world and that evil is undeserved.
(b) Second, human beings have a right and need to know what why God has sent evil into the world.
That is the judgment of God. It is a stumbling block for many a reader.
By this point, the author has had God effectively eliminate the traditional explanations of evil as punishment (Augustine) and as character development (Irenaeus) and proffer a new explanation of evil as a necessary means to the higher good of selfless love. (Hegel) The details of that justification will be revealed on the Day of Judgment.
8. In the end, God richly blesses and restores Job. But this ending is richly ambiguous. If the first test was having less reward than one’s righteousness merits, then this second test is having more reward than one’s righteousness merits. The moral test that is life is merely transposed into a different key. The test is never ending. Will Job continue to demand answers for evil in the world even when he is well off? Will we?
The Book of Job is a masterpiece in world literature, one that has stood the test of millennia. It demands judgment. It provokes judgment. It even tempts to false judgment. Yet it condemns with the harshest judgment those who judge deceitfully or prematurely, showing bias either towards human beings or to God. In many ways, the Book of Job is an abyss of eternal peril for as you look into it, it looks into you. More than any other biblical book, the Book of Job will tell you who you are by the choices it forces you to make.
Posted by: Robert Sutherland | April 22, 2007 at 12:57 AM