Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church (review)

176 BOOK REVIEWS health-related matters. David Feldman has done a fine job of presenting the rich Judaic tradition. —Neal Turk Congregation Ahavath Achim Fair Lawn, New Jersey Stanley Hauerwas, Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church. Notre Dame, Ind.: University of Notre Dame Press, 1986. 221 pp. $19.95, cloth; $9.95, paperback. This volume is focused on the core quandary of modern ethics. How can one justify a particular content for ethics when reason appears to provide so little? On the one hand, Hauerwas acknowledges many of the inevitable and pessimistic conclusions of Alasdair Maclntyre concerning the limits of the Enlightenment hope to establish by reason the concrete fabric of morality. On the other hand, Hauerwas acknowledges that the taken-for-granted concrete moral presumptions that hold communities together and give direction to professions such as medicine are under assault. Reason does not appear able to provide what a loss of faith has taken away. And if some do regain or preserve their faith, there is the problem of reaching across to other communities of belief or to communities of disbelief. Hauerwas wishes to take exception to my endeavor to rescue at least something from the collapse of the Enlightenment hope. He sees my argument that one can at least understand peaceable negotiation as a way of bridging diverse moral communities, as leading to a vacuous commitment to freedom and a loss of the meaning to be found through the moral commitments of a community. If it is true that reason cannot successfully reach across communities with convincing arguments to disclose and justify a canonical, normative, concrete view of the good life, then when we meet as strangers, insofar as we do not want to resolve issues simply by an appeal to force, we will need to acknowledge each other as equals in negotiating common areas of action. Freedom then functions as a side constraint, not because we value it, but because it allows us to have a coherent way of talking about moral authority when reason cannot discover authority and grace does not speak univocally to all. Moreover, a commitment to a process of negotiation makes it possible to understand those who use force to achieve Book Reviews 177 a particular view of the good life as outlaws from any attempt at peaceable negotiation, an attempt that all can understand despite their divergent commitments to the good life. This process of negotiation, the cement of a general secular pluralist morality, gives no content. It affirms toleration and the possibility of a plurality of views, but it is itself not a concrete view. In this book Hauerwas seeks content and moral commitment within a community possessing a concrete understanding of the good life. There is no question that Hauerwas is right, that it is only in actual communities that we truly understand the purpose of life and the meaning of death. In Suffering Presence he succeeds well in portraying a particular genre of Christian approach to the frailties of the human condition. He does this by examining suffering, death, and the status of the medical profession, taking as special foci the case of children and the mentally retarded. He is correct: how we understand the purposes of parenting and the significance of children discloses the kind of people we are and the meanings of the communities in which we live. Our attitudes toward the mentally retarded and the extent to which their birth should be avoided and their suffering relieved disclose a broad and concrete set of moral understandings. To be present with others in suffering, other than superficially , requires being present for a purpose with a sense of the meaning of suffering and the character of human limitation. Concrete understandings of the meaning of suffering and of the commitment to be present for the sufferers have been part of religion generally, and of Christianity in particular. The book can be understood as a special exegesis of a set of Christian assumptions and their implications for medical practice. Hauerwas develops within a narrative tradition what it means to play out certain visions of the good life and of the good death. He often...