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Saturday, November 23rd 2013


Triage and Evil


The pain to which I referred in the last two posts is a whole lot less, now that I've stopped taking the new medication Dr. B had me try. Obviously, that also means that I won't get the benefit of it, which I regret. But one has to take into account the benefits vs. the costs. One web page concerning the medication said something like, "Keep in mind that your doctor woud not have prescribed this medicine for you if he didn't believe that on the whole its benefits outweigh the side effects." Good point. But pain at levels 8 or 9 pushes the equation in the other direction. Fortunately, Dr. B has given me the freedom to decide whether I'm tolerating the medication or not, so I don't have to do any negotiations with him. Not that I think that in this case it would really be up to question. -- What I'm really thankful for is that, even though the PD symptoms are slowly progressing, I'm still at a stage where drastic measures regardless of side effects are not called for. Let me add this thought, leading up eventually to a clever segue: I guess this is kind of a personal "triage" situation.

"What is triage?" you might ask. Back when I used to teach ethics from time to time, I usually found myself at some point or other writing in big letters on the board:


MASH"Triage" refers to the process of sorting out how best to allocate limited resources in order to do whatever is best in a critical emergency. For example, if you run a military medical station like in the good old TV show MASH, and the helicopter shows up with "Incoming Wounded," you have to decide whom to treat first. Let's say that there are three groups of wounded:
Category 1. Those who have serious, but not life-threatening injuries. They definitely need help, but they're not going to die if not treated within the next twenty-four hours or so. We'll say that this is is the largest group.
Category 2. A relatively sizeable group of those who have serious, life-threatening injuries, but their chances of survival, given the proper surgery and medication soon, are fairly good.
Category 3. A few people whose lives hang in the balance. They are in highly critical condition, and it'll take an intervention on a grand scale to save their lives. It will require a massive effort in time and resources to save them, and even then it may be futile.
Whom do you treat first?

This is the part that everyone hates. Unsurprisingly, when I used to teach this course to nursing students at Indiana University Kokomo, the majority usually came up with a realistic answer. In other contexts, the heroic side of college students frequently manifested itself: "You have to save every life, and so you have to start with the most seriously wounded and then work your way down." Alas! Let me remind you that the stipulation is that, as is often the case in reality, your resources are limited. While you may be spending hours treating people in Category 3, who may still not even survive, the men and women in Category 2 may be dying on you. Resources in personnel and equipment may dictate to you that you are best off saving the lives of those in Category 2 first, hoping that as many people as possible in Category 3 will hang on. Then you should go on with the Herculean effort required to save their lives as well. As I said, NOBODY LIKES TRIAGE! It would seem that in the best of all possible worlds one wouldn't have to make such awful, almost dehumanizing, decisions. The issue has nothing to do with "playing God"; I assume that if God would intervene and dictate the decisions to them, the human beings who are saddled with making them at the moment would be delighted. These decisions are a very heavy burden to bear, and it seems to me that they are one of the many reasons that people come back from war psychologically tied in knots. Still, in the meantime, they have to keep trying to make the right decisions , perhaps hoping that God will forgive them if they made wrong ones. Similar consideration apply in huge civic emergencies or natural disasters.

The reason that I carried on with describing the nature of triage above is that there are clear parallels to the problem of evil, namely the idea that what may be an evil in isolation, may bring about a higher good than would be possible without it, and that this higher good is worth the price of tolerating such an evil.

Let's keep our minds clear on two points.
1. The very nature of the problem is based on the stipulation that God exists. One can, of course, immediately say that, since there is evil, the existence of God is not possible and leave it at that. However, in addition to the fact that such a judgment would not take cognizance of the many ways in which theists have shown that the existence of God and the reality of evil are not incompatible, it doesn't help. Declaring that God does not exist is to throw in the towel and concede that evil has won. By assuming atheism, one has not eliminated a single particle of evil. What one has done is to eliminate the only basis on which there is any hope for the abolition of evil. The conceptual problem is caused by the concept of an infinite God whose attributes are unlimited. However, only by holding on to the reality of an infinite God do we have any hope that evil will be eliminated.
2. We also should not minimize the reality of evil. This is where the analogy to a triage decision becomes the strongest. God hates evil, and he has endowed us with the capacity to recognize evil as repugnant. When we encounter evil and suffering, it is not some good in disguise. Perhaps some good may come out of it, but that doesn't mean that the evil has become good. Consequently, again, recognizing God's nature leads us, then, to believe that he will eliminate that which is unacceptable to him.

Please note that in the last sentence of the two previous paragraphs I have switched to the future tense. After all, isn't that the better conclusion to draw from the standard delimma concerning evil? Let's look at the traditional dilemma again and revise it somewhat so that it fits in with what we actually believe:

1. The God of theism must be all-good and omnipotent. 
2. If God is all-good, he will want to abolish evil.  
3. If God is omnipotent, he is able to abolish evil.  
4. If God is omniscient he knows how to abolish evil.
4. There is evil. 
5. Therefore, the God of theism wants to abolish this evil, is able to abolish this evil, and knows how to abolish this evil. Furthermore, given his attributes, he will do so in the best possible manner with the best possible timing.
Of course we're now looking at another huge question. And again, I have to say that this question stares with equal intensity at both those who believe in a free will and those who believe in a compatibilist significant will. Why doesn't God eliminate all evil right now rather than letting things carry on for millennia after millennia of people and other sentient beings suffering from evil?

Perhaps if I were truly wise, I should just say, "I don't know." But at least I'll try not to rush in. From the perspective of a biblically-based theology, the answer has to be that God is demonstrating his sovereignty, both in judgment and grace. As I see biblical history, it is a record of how God gave human beings the opportunity in various different settings to demonstrate that they could be righteous on their own: e.g., with no formal rules, with the Noaic covenant, under a patriarchal system, under judges, with and without a detailed formal set of laws, with and without a temple, with different political arrangements, with and without a priesthood, etc. In each case, the result for human beings was failure, and it led up to God himself reconciling us to him through Jesus Christ. Furthermore, the final end is the ultimate demonstration by God of his glory. Maybe we can expand this picture to the extrabiblial world in the context of general revelation and natural theology, thought I think the point can hold its own without having to cram every detail into the scheme.

A Christian view of time is different from any other. Eastern thought tends to see time as cyclic. Western secular thought sees time as linear without a significant beginning or end (interesting tangential question: For a non-theistic person, did time begin with the Big Bang along with the physical universe or just the universe?) Western religions (e.g., Islam, Zoroastrianism) see time as linear with a beginning and an end. For Christianity, time is also linear with a beginning and and end, but the end is already determining the present. We live in the anticipation of future reality ("proleptically," as Pannenberg says).

Philosophically, that mans that, even though this this may not be the best of all possible worlds, surely this must be the best possible way of taking us to the best possible world. If Leibniz made a mistake, it is not the "lapse" that Plantinga attributes to him, but the fact that he took a slice of time and said that this world right now at this moment is the best of all possible worlds. [See the discussion of Leibniz's theodicy by Jill Graper Hernandez, "Leibniz and the Best al All Possible Worlds" in Meister and Dew, God and Evil (Downers Grove, IL: IVP, 2013), 94-105.)] His argument is sound, but there are concerns with the plausibility of his observation (see JGH, 105, the "feminist critique"), which may be more solvable if we add that this is the best of all possible ways to attain the best of all possible worlds.  

Now, why would there even be the need for a process? If there is a goal toward which God wants to take the world, why couldn't he have done so immediately? Couldn't he have taken that awful tree out of the garden so that Adam and Eve would have remained free creatures, but did not have to do anything contrary to God's will? Or could God not have forgiven them immediately afterwards, as Islam teaches, rather than taking us through this long scenario of history? For that matter, if in heaven we will be free creatures but never sin, coudn't God have brought about that state of affairs a long time ago?

There would be such a need if the goal that God wants to take us to logically requires a process.

So am I questioning God's omnipotence? Am I saying that God is limited in what he can do because I'm saying that God's goal may logially be tied to a process?

Not at all. Let me bring up a verbal distinction between "limiting" and "delimiting." "Limiting" means that something could have a greater range of options in the properties it may have or the actions it may perform, were it not for some kind of an external restraint. I'm "delimiting" something when I describe its properties so as to distinguish it from some other thing. When I say that a square has four sides, I'm not really limiting it; I'm delimiting a part of its definition. Furthermore, surely we are not placing a limitation on an infinite being by saying that it cannot be finite!

Similarly, when I say that God acts within the "bounds" of logical necessity I am not limiting God; I am delimiting what is a part of his nature. Since God is rational in his very nature, it would be contrary to his essence to do something patently illogical. God can neither cease being God nor exist and not-exist simultaneously.  Nor, for that matter, can he make a stone so heavy that he cannot lift it. In the same way, if there are some things that God wants to do that logically require a process, he will use that process. (I suppose I could say that he "has to" use that process, but, given what I just said, that would be a redundancy.)

Well, as always when I begin a particular topic on this blog, it tends to wind up taking a whole lot longer than I had planned on. Let me quickly give you a super-brief preview of where I'm heading, so that I can then develop these thoughts in the next post(s) by taking my time without stringing you out longer than necessary: If the best of all possible ways to achieve the best of all possible worlds logically requires that there is evil in the world, then the fundamental problem is solved, but then this world must also be the (metaphysically) worst of all possible worlds. Explanation to follow.

Though I'm obviously not finished yet, feel free to make comments and ask questions now so that, if possible, I can integrate them into the discussion.

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