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PHI-413V Topic 1 Overview
Discussion: Foundational Issues in Christian Spirituality and Ethics
Discussion: Foundational Issues in Christian Spirituality and Ethics
Welcome to Grand Canyon University’s course on Ethical and Spiritual Decision-Making
in health care. Some students may be apprehensive and object to taking this course
because they feel such a course is not necessary for their major. Yet Grand Canyon
University has a long-standing Christian heritage, meaning that our Christian faith is
fundamental to all that we do. We want all students to feel welcome here, regardless of
their religion or beliefs, but we also want all students to at least understand the
Christian worldview and be challenged to think carefully about the deeper questions of
In addition, this course serves several key purposes for training in health care. First, it is
important to understand that many of the foundational beliefs that the fields of
medicine and health care take for granted (such as the intrinsic dignity and value of all
human beings, regardless of race, gender, religion, socioeconomic status, etc.) are
deeply held Christian values that come from the Christian worldview and have shaped
the practice of medicine for almost 2,000 years. Second, all human beings hold beliefs,
live, and act in the context of their worldview. All decisions, including health care
decisions, that human beings make are informed by their most deeply held values and
beliefs which comprise a person’s worldview. Thus, it is important to understand how a
patient’s worldview will shape their decision-making and values in health care.
Third, decision-making in health care often times involves ethical decisions about right
or wrong, and it is crucial for health care practitioners to have an understanding of the
nature of ethical decision-making, as well as some practical training. Fundamentally, this
course is about how the Christian worldview approaches various issues and questions in
health care. In understanding the Christian worldview, one will also come to learn how
different worldviews might approach the same questions.
Some students may be unsure what their worldview is or have a worldview that is very
different from Christianity and wonder how they will fit into such a class. Everyone has a
mixture of beliefs that make him or her unique. Please be assured that the goal is to
help each student feel comfortable interacting with other students and to have a
positive experience. The College of Theology and instructors hope to encourage critical
thinking about one’s worldview and purpose in life. This is an opportunity to think about
what you believe, challenge your assumptions, learn from others, and move forward on
your unique life journey.
Throughout this course, you will be seeking wisdom. And from the Christian worldview,
all wisdom comes from God. This is why James, the brother of Jesus, wrote in his letter,
“If any of you lacks wisdom, let him ask God, who gives generously to all without
reproach, and it will be given him” (James 1:5 NIV). Understanding what a worldview is, and in particular the elements of Christian worldview, will help one understand the foundations of Christian spirituality and ethics.
What Is a Worldview?
The following definitions are helpful:
• “A set of assumptions or beliefs about reality that affect how we think and how we
live” (Cosgrove, 2006, p. 19).
• “The comprehensive perspective from which we interpret all of reality” (Keller,
2012, p. 157).
Worldview is often described as a set of lenses through which we view the world. As a
descriptive lens, our worldview influences our perception of the world. What is true?
What is reality? As a prescriptive lens, our worldview influences our evaluation of what
is true. What does it mean? How should we live?
One may readily see that if one views the nature of the universe as consisting of only
physical matter and energy, then that person’s understanding of the meaning of life and
how we should live will likely be far different from one whose perception of the
universe includes a spiritual realm where life continues after death and goodness is
While it is true that all people have their own private worldviews with values and beliefs
that have been shaped by culture, education, experiences, and relationships, it is also
valuable to speak of shared worldviews, those foundational assumptions or beliefs that
many people hold in common. For the sake of this course, the course content will be
reduced from the many-shared worldviews to three basic worldview families.
What Are the Three Basic Worldview Families?
Though there are many different worldviews, for the purpose of this course they have
been simplified into three basic worldview families. There are many variations within
Atheism is the worldview of those who believe only in what their senses can detect—
only what may be analyzed and understood in a scientific laboratory. This view believes
in no God or spiritual realm. The cosmos consists of only the natural or physical realm of
matter and energy. Other names often associated with this worldview family are
naturalism and secular humanism. Most whose worldview values and behavior are
aligned with atheism prefer to be considered agnostics. These are uncertain of the
existence of God, skeptical for the most part, yet open to the possibility.
Pantheism is the worldview of spiritualism, the belief that “all is God” as the word
implies. Pantheists believe in a spiritual realm, but no relational God who has revealed himself to humanity and is actively involved in the lives of those who believe in him. This
worldview family consists of the Eastern religions of Hinduism and Buddhism, as well as
the more eclectic Western belief known as New Age. Pantheists typically embrace an
impersonal oneness of which all humans may become a part, becoming godlike
themselves as they reach higher levels of spirituality.
Theism, or monotheism, is the worldview of the three major religions, Judaism,
Christianity, and Islam. Though these three have huge differences rendering them
incompatible with each other, they do nonetheless have some similarities. Theists all
believe in a single, personal, and relational God who is the creator and sustainer of all
that exists. They all likewise believe in absolute truth and morality, and an afterlife. The
focus of this course is Christianity, so the course will be comparing these three
worldviews: atheism, pantheism, and Christianity.
Another common worldview name, deism, is somewhat of an enigma—having a basic
belief in God, but a God who is not relational or involved in human life. So although
falling under the broad category of theism, deists may effectively live as atheists. Many
people have complex worldviews that are a mix of various beliefs from the major
How Do We Determine Our Worldview?
There are six components that help to determine worldview. The following questions
correspond to each component. Answering each of the following questions for yourself
will help you begin thinking about your own worldview:
1. What Is Ultimate Reality?
Does reality consist basically of physical matter and energy, as the atheists believe? Is
reality an impersonal spiritual entity that dominates the universe and to which all
humans must endeavor to attain unity with, as the pantheists assert, or is there a
personal and relational, all-powerful, and sovereign God who exists everywhere, but is
separate from the physical world he created, as believed by Christians and other
2. What Is the Nature of the Universe?
This is similar to the question above but focuses strictly on what one believes about the
natural world. Is the universe strictly physical and yet eternal in one form or another? Is
it merely an illusion intended as a battleground for us to work toward enlightenment, or
was the universe created by God and far more complex than can be detected by
scientists, consisting of both a physical and a spiritual realm?
3. What Is a Human Being?
Is a human basically a biological machine, just a higher level of animal? Is a human a
type of god with powers to reach perfection, or is a human an off-the-charts creature designed in the image of God with an eternal spirit like his and similar abilities to reason, seek moral purity, communicate on a high level, create for beauty, and love even those who cannot love in return? Is death the end of existence, or is there a soul that lives on? Does that soul return in another life, or does it return to God and await judgment?
4. What Is Knowledge?
Is there such a thing as absolute truth, or is truth relative? Is true knowledge only that
which may be acquired and understood through scientific means, or is there also
knowledge that only may be acquired by revelation from God? Should you only trust
your senses, or should you explore the spiritual realm and seek knowledge from God?
5. What Is Your Basis of Ethics?
How do you know right from wrong? Is morality learned, or is it designed into our
conscience? Is there a set of absolute moral standards given by God, or is morality
relative, a matter of culture, and what is acceptable to a society?
6. What the Purpose of Your Existence?
Is human life as you know it merely the result of some amazing cosmic accident, or is
there an underlying meaning to history, a purpose toward which time will culminate?
Does life have meaning and purpose for individuals, or is it simply whatever one makes
it? Did the Creator design his children with a purpose? If so, what might that be?
How Do We Test Our Worldview?
Everyone (not only religious people) forms his or her worldview on the basis of faith
(assumptions and presuppositions) and reason. So we must ask ourselves “how
reasonable or consistent is our worldview?” Are there any contradictions that are
apparent? Testing a worldview is critical because at the end of the day, most people
want to make sure that they have true beliefs about the world. The following tests are
just some ways of determining whether or not a particular worldview is true. Consider
only three basic tests summarized here:
1. The Coherence Test checks the internal consistency of a worldview to see if one’s specific values and beliefs contradict any other beliefs within the worldview.
2. The Correspondence Test examines how well a worldview corresponds to reality. It evaluates evidences and experiences to see if the worldview matches with what one
perceives in the real world.
3. The Practical Test evaluates a worldview’s livability. Does the worldview bring satisfaction as one faces life’s challenges, or is it found to be lacking?
Foundations of Christian Spirituality and Ethics
The foundational beliefs of Christianity inform the Christian understanding of the nature
of spirituality and the nature of ethics. Thus, the way in which the Christian worldview
answers the six questions above shapes a distinctly Christian spirituality and Christian
ethic. The term spirituality has many different definitions in popular culture and in
different contexts. One influential definition claims, “spirituality is an aspect of humanity
that refers to the way individuals seek and express meaning and purpose, and the way
they experience their connectedness to the moment, to self, to others, to nature, and to
the significant or sacred” (Puchalski et al., 2009). This definition is broad enough to give
a general idea of what spirituality involves, but it does not give a full picture of a
person’s spiritual life or spiritual needs. Those details will be filled in by examining a
persons specific worldview.
Spirituality in the Christian worldview has its foundations in the reality of a triune God
who eternally exists as Father, Son, and Holy Spirit. God is one being in three persons
and is the creator and sustainer of all that exists. He is all-knowing, all-powerful, and
loving to his core, “And so we know and rely on the love God has for us. God is love.
Whoever lives in love lives in God, and God in them” (1 John 4:16). This God has
revealed himself in different ways to human beings, including through the natural
world. However, he has revealed himself and his will for human beings most
authoritatively through the Bible and in the person of Jesus Christ. In this view,
whatever it means to be spiritual will in some sense be related directly or indirectly to
God, and will come to be known primarily through the teachings of the Bible.
Furthermore, Christian spirituality will refer to the beliefs and practices that are meant
to reflect the proper functioning of God’s creation, and which promote right relationship
to God and deeper knowledge of him. Many times spirituality is taken to be
synonymous with the feeling of deep emotion or of oneness with a transcendent reality,
but Christian spirituality is not limited to the experience of mere emotions or feelings.
Feelings and emotions are an important part of being human, and they are even an
important part of one’s relationship to God. Yet, spirituality in the Christian worldview is
not dictated by the feelings or emotions one might be experiencing in the moment, but
by trust in the goodness of God and obedience to him.
In the same way that Christian spirituality finds its foundations in the reality of the
triune God of the Bible, ethics also has its foundations in God. Ethics, broadly speaking,
is the study of good and bad, right and wrong. Every worldview has to explain the
foundations of ethics (in line with worldview question #5 above) such that it explains the
basis of what counts as good and bad, right or wrong. In the Christian worldview, there
is a God who exists and has created the world with a moral structure and purpose such
that what is truly right and good is a reflection of God’s character. God’s own holy,
loving and perfect character is the standard of right and wrong. Badness or what is
wrong is then defined as anything that is contrary to God’s character, his will, or to his
design and purpose for his creation.
The Bible reveals what God’s character is like. Exodus 34:6-7 says,
The LORD, the LORD, the compassionate and gracious God, slow to anger and
abounding in love and faithfulness, maintaining love to thousands, and forgiving
wickedness, rebellion and sin. Yet he does not leave the guilty unpunished; he punishes the children and their children for the sin of the parents to the third and fourth generation.
Discussion: Foundational Issues in Christian Spirituality and Ethics
Similarly, 1 John 4:7-9 says,
Dear friends, let us love one another, for love comes from God. Everyone who
loves has been born of God and knows God. Whoever does not love does not
know God, because God is love. This is how God showed his love among us: He
sent his one and only Son into the world that we might live through him.
Psalm 18:30 declares, “As for God, his way is perfect: The LORD’s word is flawless; he
shields all who take refuge in him.” Many more verses could be surveyed, but the Bible
makes clear that God is perfectly good and holy. Knowing right and wrong then will
mean knowing that which accords to God’s character.
Right or wrong can be discovered in multiple ways. It can be discovered in God’s
creation by examining the natural world or by the use of human reason. In this way, one
discovers God’s design for the way things are supposed to be by examining what is built
into creation; this is often referred to as “natural law.” For example, one can know by
means of reason and observation that murder is wrong or that a broken bone is bad and
not the way it is supposed to be. Conversely, one might come to know that feeding the
homeless is good, and loving one’s spouse is right. One does not need to be religious or
even believe in God to be able to know propositions of “natural law.” Nevertheless, the
Christian worldview holds that these truths are built into the world by God. Second,
right or wrong can be discovered by reading the Bible or looking at the example of Jesus
Christ. The Bible reveals God’s commands and principles such as the Ten
Commandments or the teachings of Jesus on the sermon on the mount. In addition, the
Bible provides us with examples of virtuous people. The perfect man and moral
exemplar (though much more than only a man and an exemplar) in the Christian
tradition is Jesus Christ himself. The Christian is to not only obey God’s commands, but
to be transformed into the kind of person that reflects the character of God. Jesus Christ
is the perfect representation of such a life; Christians, thus, ought to embody the virtues
and character of Jesus himself. The attaining of these virtues will not only be a matter of
intellectual knowledge of right and wrong, but an active surrender and transformation
by means of God’s own Holy Spirit. The wisdom to navigate all the complexities of
ethical decision-making will be a consequence of a person’s character and the active
guidance of the Holy Spirit.
Knowledge of God, Knowledge of Ethics
A key component of the foundations of Christian spirituality and ethics as described
above is the view that people can have genuine knowledge of God and knowledge of
right and wrong. A few observations about the word knowledge need to be considered.
First, by knowledge we mean the opposite of mere opinion. Knowledge is more than just
an educated guess; it is being in touch with the real world as it really is. Thus, knowledge
in this sense is not merely subjective, but is rather an objective description of reality. For example, the proposition “the earth is round” is an objectively true description of reality,
even if some people happen to subjectively deny that the earth is round. Subjective
beliefs may be true or false. What would make subjective beliefs true would be if they
matched the real objective world. Fundamentally, knowledge is the possession and
awareness of truth.
There are two philosophies, however, that stand in contrast to the Christian belief that
one can have knowledge of God and knowledge of right and wrong, namely scientism
and postmodernism. These two philosophies are very influential in today’s society,
although they are not compatible with the Christian worldview. It is important to
understand these philosophies because not only are they not compatible with the
Christian worldview, they arguably have negative effects on the practice of medicine
and health care.
Although the term scientism has the word science in it, it is crucial to recognize that (1)
scientism is not the same thing as (2) science. In the Christian worldview, science is a
great and good thing. In fact, the Christian worldview has always encouraged careful
investigation of the natural world. In the Christian worldview, medical technology is
considered a good gift from God insofar as God has created the kind of world that has a
structure that can be discovered and manipulated to bring about the good of human
beings (Rae & Cox, 1999). Scientism, however, is not compatible with the Christian
worldview. Scientism is the belief that the best or only way to have any knowledge of
reality is by means of the sciences (Moreland & Craig, 2003, pp. 346-350). In other
words, if something is not known scientifically then it is not known at all, and the only
way to hold true beliefs about anything is to know them scientifically.
That may sound reasonable and even commonsense, but there are two problems with
scientism: (1) scientism is a self-refuting philosophy, and (2) science has clear limits.
First, if the only way to have true beliefs is through science, then the thesis of scientism
itself (“the only way to have any knowledge of the world”) could not be true because it
cannot be proven scientifically. Thus, the thesis of scientism fails its own truth test.
Scientism’s thesis is, in fact, a philosophical statement. Philosophers call such
propositions self-refuting because they invalidate themselves by definition, similarly to
someone claiming, “I cannot speak a word of English.”
Second, while science is a powerful way of gaining knowledge of the natural world,
science is limited and is not the only way of gaining knowledge. Consider the following
two limitations of science (though there are many others); science cannot tell us
anything about (1) ethics or (2) how one ought to use the results of science (University
of California Museum of Paleontology, n.d.). Science is wonderful and describes the way
things are, but it has no authority to tell us what we ought to do morally. Science cannot
tell me whether or not I ought to love my spouse, keep my promises, or give to the
poor. Even when it comes to ethical issues that involve science, science cannot
determine what the right thing to do would be. For example, science might be able to
describe the nasty effects of a terminal disease on a person or explain the state of a person’s brain if that person is in a vegetative state. However, science cannot determine whether euthanasia or physician-assisted suicide is good, bad, right, or wrong. Science also cannot determine how scientific data and results ought to be used. Science might enable the discovery of chemical processes or structures, but should the results be used for creating biotechnology to engineer human DNA? Should the results of scientific research be used to create bioweapons for military purposes? Such questions are beyond the bounds of what science can answer. Remember scientism is NOT science; it is a philosophical thesis that claims that science is the only methodology to gain
knowledge and that every other claim to knowledge is either mere opinion or false.
However, as Nicholas Rescher remarks, “to take this stance [of scientism] is not to
celebrate science but to distort it” (as cited in Moreland & Craig, 2003).
Postmodernism is a broad philosophical position that claims that there is no such thing
as truth or an objective reality that can be known. A common way in which
postmodernism is expressed is through a view called relativism. Relativism is the view
that there is no such thing as truth in the common sense of that concept. Every claim
about the nature of reality is simply relative to either an individual or a society/culture.
Another way to put this is to say that truth is invented by people (whether it is
individuals or entire societies) instead of being discovered. According to this way of
thinking, there is not genuine truth to be had or known, only subjective opinions or
beliefs. While certain questions are no doubt matters of subjective opinion, such as
“what is the best flavor of ice cream?” or “what is the proper way to shake hands?” not
all questions are. This is most clearly seen when we consider moral or ethical
propositions about right or wrong. It would be a serious mistake to claim that the
propositions “murder is wrong” or “racism is evil” are mere subjective matters of
opinion. However, that is what relativism implies. If all truth including morality is simply
a human invention, then there is no standard for genuine truth, and it follows that there
is no genuine right or wrong. However, this is certainly false. Whether or not the Nazi
party, made up of thousands of individuals, believed that killing 6 million Jews was a
good thing, we have to say without any hesitation that they were genuinely wrong. But
it is not possible to be wrong unless there is genuine objective truth to be known.
Both scientism and postmodern relativism are incompatible with the foundations of
Christian spirituality and ethics. The Christian worldview holds science in high regard and
accepts it as one of the most powerful communal ways of obtaining knowledge about
the world. However, contrary to scientism, the Christian worldview does not accept
science as the only way of knowing things about the world. Secondly, contrary to
postmodern relativism, the Christian worldview holds that genuine objective knowledge
of God and of right and wrong is possible. It follows then that who God is and what is
right and wrong are not merely matters of subjective opinion, but genuine truths to be
The foundations discussed above provide the framework for Christian ways of ethical
and spiritual decision-making in health care. It is important to understand therefore that
the Christian way of ethical and spiritual decision-making is distinct from other
worldviews and is not the same as Buddhist, Muslim, or even atheist ways of ethical and
spiritual decision-making. It is not fair or respectful to paint all religions or worldviews
with the same brush under the heading of “spirituality” and ignore the differences.
Topic 2 will discuss a foundational principle to the practice of medicine and health care,
as well as bioethics namely, the principle of respect for persons. The Christian worldview
goes even further and states all human beings are made in the image of God and
therefore have intrinsic value and are worthy of dignity and respect.
Topic 3 will discuss the field of bioethics and introduce some of the main methodologies
of ethical decision-making in health care. The focus in this section will be on the
methodology called principlism which stresses the application of four moral principles to
all ethical decisions in health care. Prinipalism will be used and interpreted in light of the
Christian worldview and the overarching narrative presented in the Bible.
Topic 4 will briefly introduce issues of death, dying, and grief. The focus will be on
ethical issues at the end of life and the Christian worldview regarding death in light of
the biblical narrative and the hope of resurrection inaugurated by the person and work
of Jesus Christ.
Topic 5 will conclude with discussion about the facilitating of ethical and spiritual
decision-making for patients, and the practical application of the principles and tools
introduced in this course.
Cosgrove, M. P. (2006). Foundations of Christian thought: Faith, learning, and the
Christian worldview. Grand Rapids, MI: Kregel.
Keller, T. (2012). Every good endeavor: Connecting your work to God’s work. New York,
Moreland, J. P., & Craig, W. L. (2003). Philosophical foundations for a Christian
worldview. Downers Grove, IL: IVP Academic.
Puchalski, C., Ferrell, B., Virani, R., Otis-Green, S., Baird, P., Bull, J., … Sulmasy D. (2009).
Improving the quality of spiritual care as a dimension of palliative care: The report of
the consensus conference. Journal of Palliative Medicine, 12(10), 885-904.
Rae, Scott B., & Cox, P. M. (1999). Bioethics: A Christian approach in a pluralistic age.
Grand Rapids, MI: Wm. B. Eerdmans Publishing Co.
University of California Museum of Paleontology. (n.d.). Science has limits: A few things
that science does not do. Retrieved from
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