Review

Books

Culture

Epistimology

Psychology

24 January 2025

8 min read

The provocateur philosopher who wants to wean us off the junk food of popular science

David Bentley Hart serves up meat on mind and matter.

Isaac Frisby

Isaac is a PhD candidate in Theology at Durham University and preparing for priesthood in the Church of England.

Cupid and Psyche by François Pascal.

Simon Gérard via Wikimedia Commons.

It will be immediately obvious to the reader of David Bentley Hart’s new book that the structure is quite different to most other titles on the philosophy of mind.

Hart admits that in its original form it was in fact far longer than its substantial 500 plus pages, but, in a perhaps inspired move, it has undertaken a metamorphosis from the ponderous-tome genre of philosophical discourse to one much older: the dialogue.

Instead of other such works which draw on an enormous and panoramic amount of literature presented in regular academic style with copious footnotes, Hart has opted for intelligibility in the mode of a dialogue between characters, historically most notably deployed by Plato. For this reason, it works well as an audiobook, as well as printed text. The downside to this format is that Hart has opted for a somewhat unfortunate weighting of three-on-one. Whilst this format makes the twist and turn of the at times obstruse argumentation more accessible, the impression can feel somewhat unbalanced. Hephaistos, one of those in dialogue, sometimes cuts a lonely and sympathetic figure, and his opponents sometimes are slightly too self-satisfied. This is not overwhelmingly so, but it is worth remembering that all voices are Hart’s.

His choice of dialogicians is telling - four Greek divinities. Psyche (soul), the mortal woman made divine by love. Eros (love), the divine lover of Psyche, Hermes, Psychopomp (that is, the guide of souls in the afterlife). And the stolid Hephaistos, god of craft and manufacture, the main antagonist as the advocate of all things materialist and physicalist. Three characters signal Hart’s intent to guide the reader into a new realm beyond the mundane; the fourth is the mouthpiece of this mundanity. Together in a garden, prompted by a plucked rose, they discuss some the deepest questions of mind, matter, and life.

The title, All Things Are Full of Gods, is a quotation attributed to the pre-Socratic philosopher Thales. Like Thales, Hart wants to argue that not only is the divine a reality but is in fact the ground of all things. The six days of dialogue cover the full gauntlet of metaphysical debate over the nature of reality.

On day one, ‘Mind, Life, and Pictures of Reality’ the gods set up the groundwork of the reductionist materialist physicalism (RMP) perspective and the older pictures of classical philosophies.

Day two, ‘Mind and Matter’, draws the battlelines between the qualitative difference between mind and matter.

Day three, ‘Brain and Mind’, engages with arguments concerning how mind and matter relate.

On day four, ‘Machine and Soul’, the place of mind in the body is deepened in the debates on computationalism and functionalism and a useful unpacking of the limitations of panpsychism, which is currently seeing a revival in philosophical circles.

Day five, ‘Soul and Nature’, sees the dialogue broadened to nature itself, reconsidering the mechanical paradigm which presently dominates.

Concluding, day six, ‘Nature and Supernature’, is where Hart delivers his final case, having thoroughly prepared the ground, arguing that mind characterises all of reality and that this is ultimately the only truly rational account of being.

In an important ‘Coda: The Age of the Machine’ Hart addresses the problem of evil, something largely absent from the rest of the work. Hart has a good track record on this topic: The Doors of the Sea, written in light of the Boxing Day Tsunami, is essential reading for Christians and others who see the paradox between an all-loving, all-powerful God and the presence of suffering and evil. Readers will have to decide for themselves; it is not a topic on which one may enforce an opinion either way. The discussion concludes on the sixth day, “. . . and on the seventh day they rest.” (483)

Whilst All Things is dialogic, it also appears to be something else: catechesis. Hart is a catechist. Theologian and philosopher also; linguist certainly; provocateur undoubtedly. But the intention of this book is to catechise the reader, to induct them into the mystery of mind and reality. This might be a somewhat dusty word to some, implying the rote learning of religious dogma. Others will be barely aware of such a word. In Christianity, catechesis is the process of instruction, usually conducted through question and answer.

Hart is an Eastern Orthodox Christian, though in many ways an unorthodox one. His commitment to a form of perennialism, his belief that many of the major religious philosophies of the world (Vedic, Greek, Jewish, Christian, Islamic) share important and compatible insights into the nature of reality and God as the primordial ground of all things, is evident through the pages of All Things. This is unsurprising as he states that of all his writings All Things is the natural successor to The Experience of God: Being, Consciousness, Bliss (a deliberate allusion to the Vedic concepts of sit, chat, ananda) in which he sought to argue the rational coherence of a theism shared by a number of the great religions over and against the irrationality of modern physicalist materialism. It is worth reading and would certainly give the reader of All Things a primer for the extended discussion.

But how is it exactly catechesis? Hart wants to wean the reader off the junk food of popular science with its tendency to not take questions about its philosophical basis very seriously, especially in how its epistemology, ‘what it knows’, produces its ontology, ‘what exists’. This deficiency, as Hart is keen to point out, means that often ontology secretly precedes epistemology. For instance, most scientist will take central place of mathematics within their discipline for granted, without acknowledging that mathematics is itself is groundless: it is epistemologically irreducible as it is not empirical, but is ontologically essential to the scientific method. Hart argues that it is in it’s very groundlessness and givenness to intelligibility, i.e. that the world can be understood at all, that means the world in fact shows itself to have rational mind-like structure, capable of being known. Many advocates for RMP will simply shrug and say that we’ve simply evolved to see structure which isn’t inherently there; Hart is here to pick a philosophical bone with them. His intention as catechist is that, even if one does not become a Christian at the end of this book, one can no longer remain in the comfortable and familiar philosophical milk of the dominant RMP paradigm but be stirred to hunger for the meat of reality. Although not an explicitly Christian book, there are certain hints. A number of Christian theologians recur, especially towards the end: Karl Rahner, Bernard Lonergan, Meister Eckhart. That the dialogue is set over six days “. . . and on the seventh day they rest” (483) ought not to be lost on the reader.

His position in a nutshell is that all is mind or spirit (this linking of terms that are separate in English derives from their indistinction in the German Geist, used extensively in German Idealism, in which a lot of this debate has its origins in modernity). This is not a denial of matter (as in some forms of idealism), but that matter is a material manifestation or substrate of the principle of mind behind all reality: God. In many ways All Things is the extension of his previous book, The Experience of God: Being, Consciousness, Bliss, which he acknowledges in the ‘Introduction’. His position is argued in response to the currently most dominant intellectual paradigm, RMP: the idea that reality consists only of that which is matter or can be observed as a consistent mechanical attribute of matter (such as gravity).

Hart’s argument rests on a number of fallacies in this paradigm; the most important of these and the one which recurs most frequently throughout the dialogue between the gods is the ‘pleonastic’ fallacy:

No matter how many purely objective quantitative steps the supposedly mechanistic material order may have taken in the direction of mind, none of them seems as if it could have constituted that sudden qualitative transition from pure exteriority into an unprecedented inwardness.

In short, quantitative accumulation cannot produce qualitative transformation. Mind is not another form of exterior reality, like the physical world; thought takes up no space and is of an entirely different, interior order. This is Hart’s principle complaint against both RMP and historical forms of dualism such as that of Descartes. The six ‘days’ of dialogue is essentially an account of the various arguments presented by the RMP paradigm to demonstrate that this fallacy is not in fact true. The most important of these concerns the trend in various sciences to speak of ‘emergence’: the appearing of qualities or realities such as mind which, whilst dependent upon a physical foundation for their existence, cannot be understood or explained by examination of their physical foundation; they cannot be reduced (explained) by the substrate. Hart draws the distinction between water’s property to extinguish fire, despite it being made up of the highly combustible elements hydrogen and oxygen, and the emergence of mind as a different order of reality from physical combination:

Physical properties derived from other physical properties—no great problem there. So long as this is all that’s meant by “emergence,” then the concept is as inoffensive as it is obvious. But there’s a point at which vague talk of emergence is just another way of talking about something that you might otherwise justly call magic.

This is because water’s watery-ness is also a physical phenomenon, the product of the combination of these particular elements in this particular configuration. But this is still and exterior reality; mind on the other hand is not a property like the watery-ness of water because mind is an interior phenomenon, one which is entirely inaccessible except for the mind who is the mind in first-person perspective. To then argue that pure exterior accumulation quantitative of reality can produce this interiority is, to Hart, not only nonsensical but irrational. Part of his argument thus also turns upon the principle of Occam’s Razor: “if you have two competing ideas to explain the same phenomenon, you should prefer the simpler one,” as Chris Simms describes it. With some of the arguments from RMP approaching this almost ‘magical’ solution, Hart is at pains to argue that indeed the simplest explanation for the mind-like structure of reality is that it is indeed Mind.

I believe this to be a crucial book in the ongoing dialogue between philosophers and theologians on the one hand and the sciences on the other. The project of pointing out the philosophical problems with the dominant paradigm is a difficult when the other side rarely wishes to listen; Hart, however, is a voice that cannot be ignored.

All Things Are Full of Gods: The Mysteries of Mind and Life, By David Bentley Hart, Yale University Press.

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Article

Assisted dying

Care

Culture

Death & life

13 November 2024

8 min read

The deceptive appeal of assisted dying changes medical practice

In Canada the moral ethos of medicine has shifted dramatically.

Ewan Goligher

Ewan is a physician practising in Toronto, Canada.

A tired-looking doctor sits at a desk dealing with paperwork.

Francisco Venâncio on Unsplash.

Once again, the UK parliament is set to debate the question of legalizing euthanasia (a traditional term for physician-assisted death). Political conditions appear to be conducive to the legalization of this technological approach to managing death. The case for assisted death appears deceptively simple—it’s about compassion, respect, empowerment, freedom from suffering. Who can oppose such positive goals? Yet, writing from Canada, I can only warn of the ways in which the embrace of physician-assisted death will fundamentally change the practice of medicine. Reflecting on the last 10 years of our experience, two themes stick out to me—pressure, and self-deception.

I still remember quite distinctly the day that it dawned on me that the moral ethos of medicine in Canada was shifting dramatically. Traditionally, respect for the sacredness of the patient’s life and a corresponding absolute prohibition on deliberately causing the death of a patient were widely seen as essential hallmarks of a virtuous physician. Suddenly, in a 180 degree ethical turn, a willingness to intentionally cause the death of a patient was now seen as the hallmark of patient-centered doctor. A willingness to cause the patient’s death was a sign of compassion and even purported self-sacrifice in that one would put the patient’s desires and values ahead of their own. Those of us who continued to insist on the wrongness of deliberately causing death would now be seen as moral outliers, barriers to the well-being and dignity of our patients. We were tolerated to some extent, and mainly out of a sense of collegiality. But we were also a source of slight embarrassment. Nobody really wanted to debate the question with us; the question was settled without debate.

Yet there was no denying the way that pressure was brought to bear, in ways subtle and overt, to participate in the new assisted death regime. We humans are unavoidably moral creatures, and when we come to believe that something is good, we see ourselves and others as having an obligation to support it. We have a hard time accepting those who refuse to join us. Such was the case with assisted death. With the loudest and most strident voices in the Canadian medical profession embracing assisted death as a high and unquestioned moral good, refusal to participate in assisted death could not be fully tolerated.

We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

Regulators in Ontario and Nova Scotia (two Canadian provinces) stipulated that physicians who were unwilling to perform the death procedure must make an effective referral to a willing “provider”. Although the Supreme Court decision made it clear in their decision to strike down the criminal prohibition against physician-assisted death that no particular physician was under any obligation to provide the procedure, the regulators chose to enforce participation by way of this effective referral requirement. After all, this was the only way to normalize this new practice. Doctors don't ordinarily refuse to refer their patients for medically necessary procedures; if assisted death was understood to be a medically necessary good, then an unwillingness to make such referral could not be tolerated.

And this form of pressure brings us to the pattern of deception. First, it is deceptive to suggest that an effective referral to a willing provider confers no moral culpability on the referring physician for the death of the patient. Those of us who objected to referring the patient were told that like Pilate, we could wash our hands of the patient’s death by passing them along to someone else who had the courage to do the deed. Yet the same regulators clearly prohibited referral for female genital mutilation. They therefore seemed to understand the moral responsibility attached to an effective referral. Such glaring inconsistencies about the moral significance of a referral suggests that when they claimed that a referral avoided culpability for death by euthanasia, they were deceiving themselves and us.

The very need for a referral system signifies another self-deception. Doctors normally make referrals only when an assessment or procedure lies outside their technical expertise. In the case of assisted death, every physician has the requisite technical expertise to cause death. There is nothing at all complicated or difficult or specialized about assessing euthanasia eligibility criteria or the sequential administration of toxic doses of midazolam, propofol, rocuronium, and lidocaine. The fact that the vast majority of physicians are unwilling to perform this procedure entails that moral objection to participation in assisted death remains widespread in the medical profession. The referral mechanism is for physicians who are “uncomfortable” in performing the procedure; they can send the patient to someone else more comfortable. But to be comfortable in this case is to be “morally comfortable”, not “technically comfortable”. We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

There is also self-deception with respect to the cause of death. In Canada, when a patient dies by doctor-assisted death, the person completing the death certificate is required to record the cause of death as the reason that the patient requested euthanasia, not the act of euthanasia per se. This must lead to all sorts of moments of absurdity for physicians completing death certificates—do patients really die from advanced osteoarthritis? (one of the many reasons patients have sought and obtained euthanasia). I suspect that this practice is intended to shield those who perform euthanasia from any long-term legal liability should the law be reversed. But if medicine, medical progress, and medical safety are predicated on an honest acknowledgment about causes of death, then this form of self-deception should not be countenanced. We need to be honest with ourselves about why our patients die.

There has also been self-deception about whether physician-assisted death is a form of suicide. Some proponents of assisted death contend that assisted death is not an act of deliberate self-killing, but rather merely a choice over the manner and timing of one's death. It's not clear why one would try to distort language this way and deny that “physician-assisted suicide” is suicide, except perhaps to assuage conscience and minimize stigma. Perhaps we all know that suicide is never really a form of self-respect. To sustain our moral and social affirmation of physician-assisted death, we have to deny what this practice actually represents.

There has been self-deception about the possibility of putting limits around the practice of assisted death. Early on, advocates insisted that euthanasia would be available only to those for whom death was reasonably foreseeable (to use the Canadian legal parlance). But once death comes to be viewed as a therapeutic option, the therapeutic possibilities become nearly limitless. Death was soon viewed as a therapy for severe disability or for health-related consequences of poverty and loneliness (though often poverty and loneliness are the consequence of the health issues). Soon we were talking about death as a therapy for mental illness. If beauty is in the eye of the beholder, then so is grievous and irremediable suffering. Death inevitably becomes therapeutic option for any form of suffering. Efforts to limit the practice to certain populations (e.g. those with disabilities) are inevitably seen as paternalistic and discriminatory.

There has been self-deception about the reasons justifying legalization of assisted death. Before legalization, advocates decry the uncontrolled physical suffering associated with the dying process and claim that prohibiting assisted death dehumanizes patients and leaves them in agony. Once legalized, it rapidly becomes clear that this therapy is not for physical suffering but rather for existential suffering: the loss of autonomy, the sense of being a burden, the despair of seeing any point in going on with life. The desire for death reflects a crisis of meaning. We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

We have also deceived ourselves by claiming to know whether some patients are better off dead, when in fact we have no idea what it's like to be dead. The utilitarian calculus underpinning the logic of assisted death relies on the presumption that we know what it is like before we die in comparison to what it is like after we die. In general, the unstated assumption is that there is nothing after death. This is perhaps why the practice is generally promoted by atheists and opposed by theists. But in my experience, it is very rare for people to address this question explicitly. They prefer to let the question of existence beyond death lie dormant, untouched. To think that physicians qua physicians have any expertise on or authority on the question of what it’s like to be dead, or that such medicine can at all comport with a scientific evidence-based approach to medical decision-making, is a profound self-deception.

Finally, we deceive ourselves when we pretend that ending people’s lives at their voluntary request is all about respecting personal autonomy. People seek death when they can see no other way forward with life—they are subject to the constraints of their circumstances, finances, support networks, and even internal spiritual resources. We are not nearly so autonomous as we wish to think. And in the end, the patient does not choose whether to die; the doctor chooses whether the patient should die. The patient requests, the doctor decides. Recent new stories have made clear the challenges for practitioners of euthanasia to pick and choose who should die among their patients. In Canada, you can have death, but only if your doctor agrees that your life is not worth living. However much these doctors might purport to act from compassion, one cannot help see a connection to Nazi physicians labelling the unwanted as “Lebensunwortes leben”—life unworthy of life. In adopting assisted death, we cannot avoid dehumanizing ourselves. Death with dignity is a deception.

These many acts of self-deception in relation to physician-assisted death should not surprise us, for the practice is intrinsically self-deceptive. It claims to be motivated by the value of the patient; it claims to promote the dignity of the patient; it claims to respect the autonomy of the patient. In fact, it directly contravenes all three of those goods.

It degrades the value of the patient by accepting that it doesn't matter whether or not the patient exists.

It denies the dignity of the patient by treating the patient as a mere means to an end—the sufferer is ended in order to end the suffering.

It destroys the autonomy of the patient because it takes away autonomy. The patient might autonomously express a desire for death, but the act of rendering someone dead does not enhance their autonomy; it obliterates it.

Yet the need for self-deception represents the fatal weakness of this practice. In time, truth will win over falsehood, light over darkness, wisdom over folly. So let us ever cling to the truth, and faithfully continue to speak the truth in love to the dying and the living. Truth overcomes pressure. The truth will set us free.