Does Thomism Really Avoid the Lockean Epistemological Gap between Idea and Thing?

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Portrait of John Locke, by Sir Godfrey Kneller...

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John Locke thought of himself as a realist (not in the Medieval sense of accepting the reality of universals, but in the modern sense of believing in a mind-independent world). Yet it seems that his philosophy leaves no room for any knowledge of that alleged world, as Berkeley and Hume pointed out. Locke believed that all knowledge comes by means of sense experience (thus he is an empiricist, as opposed to being a rationalist such as Descartes–it is ironic that in his hierarchical classification of knowledge Locke lists intuitive knowledge as first, demonstrative knowledge as second, and sensory knowledge as the lowest form of knowledge, barely to be called knowledge). Locke believes that knowledge arises by means of ideas in the mind. Whether these ideas are images or something else remains a subject of debate among Lockean scholars. In any case, Locke believes that that a quality is the power to produce an idea in the mind. Primary qualities are actually in the thing-in-itself, and our ideas of primary qualities are isomorphic with the actual structure of the physical substance we perceive. Primary qualities are measurable, and include size, shape, and mass. Secondary qualities are not in the thing itself; our ideas of secondary qualities are not isomorphic with the actual structure of the material substance. However, the primary qualities interact with human sensory organs and with the human brain to produce ideas of particular colors, odors, sounds, and tastes. Thus, secondary qualities have a partial basis in the thing-in-itself despite the lack of isomorphism between idea and thing.

The classic problem with this view is that Locke claims that we are only aware of our own ideas. We do not have any direct access to the material substance, to the thing-in-itself. In fact, substance is just that which underlies the qualities, a “something-I-know-not-what.” But if we lack access to the thing-in-itself, there is no way to compare our ideas to the actual object allegedly causing those ideas to determine which qualities are primary and which ones are secondary. Access to knowledge of extramental reality seems impossible, and a trip down the phenomenalist brick road of Berkeley, Hume, and the sense data theorists of the early twentieth century. Such an idealistic journey is not what Locke wanted to make. Idealism has serious difficulties; the source of the ideas (our own minds? the mind of God) remains a mystery, and the orderly nature of the phenomena we experience is left unexplained unless a person takes the Berkeleian route of positing God to explain natural laws. Direct realism is another option; the label of “naive realism” is a pejorative and is a blatant attempt to beg the question regarding the truth or falsity of direct realism. As for the straw men critics of direct realism try to knock down, no direct realist has denied the possibility of illusion. It is Berkeley and Hume’s phenomenalism that cannot distinguish between illusion and reality except by taking Hume’s route of more vivid ideas (which he calls impressions) being the most “real.”

Aristotle and St. Thomas Aquinas were both direct realists. Aquinas accepted the idea that knowledge comes through the “phantasm,” or sensory image, from which the mind extracts the intelligible content from a material substance. Thomists today often say that the difference from Locke’s view is that Locke believed we have access to ideas, not the thing in itself–it is the ideas that we know. In contrast, Aquinas believes that it is through the phantasm that a person gains some knowledge, albeit limited, of the thing-in-itself. But does this really avoid Locke’s problem or does it evade it by a kind of word game?

After reading more of how contemporary Thomists deal with the epistemological gap, I must back away from my earlier position that Thomism does not avoid an epistemological gap between mind and thing. Contemporary Thomists believe that humans have evolved as part of their environment, not as creatures separate from their environment. Even thought knowledge is of “external” things, there is a communication of intelligible content from object to subject–agent causation is not limited to human agents. The phantasm contains the information that human beings extract to help them to live in the environment in which they are embedded, to the point that the person becomes “intentionally one” with the thing-in-itself. While Duns Scotus posited intuitive knowledge of an object as existing in addition to a rather traditional Aristotelian account of knowledge, I am not sure that such an intuitive knowledge is necessary for human beings to get by in the world. If such intuitive knowledge exists (perhaps in the form of psi), such knowledge could speed up our apprehension of a thing and determine whether or not it is dangerous. But if the mind is not considered a container, but as one way of an organism’s acting in the world, that seems to eliminate the Lockean gap between idea and thing. The phantasm becomes that “by which” a person apprehends some aspects of the being of a thing.

 

Dr. Jack Kevorkian: Sincerity Does not Negate Moral Evil

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Dr. Jack Kevorkian's cropped image

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My student often with identify sincerity with truth, especially on matters of morality and/or religion. I remind them that Lenin was no doubt sincere in murdering hundreds of thousands of his political opponents. And he was sincere–unlike his successor Josef Stalin, Lenin really did believe in Communism and that killing people may be best for a greater good. Surely his sincerity does not make his actions morally right.

Dr. Jack Kevorkian was a sincere man. I do not believe, despite his rather expressive paintings of gruesome death scenes, that he was a psychopath or sociopath. He was well read in ancient Greek and Roman classics and was well aware that until Christianity came along, the vast majority of Greeks and Romans supported euthanasia–the Hippocratic Oath, based on the Pythagoreans’ high view of life, was the exception rather than the rule. Kevorkian used their arguments about a person dying with honor and dignity, arguments that were later revived by David Hume (1711-1776), to defend physician assisted suicide. Unlike the current Oregon and Washington State laws, which allow a physician to dispense a prescription of a deadly dose of drugs to terminally ill people who gave prior permission, Kevorkian went further. He built his infamous “suicide machine” which the patient could start himself, but Dr. Kevorkian had the set up in terms of inserting IV lines and arranging the correct drugs in each IV bag. The first bag released normal saline; the second a sedative to relax the patient; the third a dose of a deadly drug. Technically a patient could stop the process at any time; whether this always was the case in practice is a disputed point.

Dr. Kevorkian was not insane, but he was really, truly, sincerely wrong. He believed that he was easing the pain of terminally ill patients (although one woman he “assisted” had fibromyalgia, which is not a terminal illness). Error often contains partial truth, and the partial truth in Dr. Kevorkian’s stance is that a doctor’s sole duty involves more than preserving life. Sometimes it is best for a physician to allow the disease process take its course and withhold or withdraw burdensome treatment such as a ventilator or artificial nutrition and hydration. But to go beyond that and allow physicians to actively help a patient kill himself by a deadly drug that is in no sense a treatment for illness violates the fundamental end of medicine to “first, do no harm.” Kevorkian and his defenders might say, “But we euthanize animals who are hurting.” That is true, but animals do not have the level of understanding of the pain they feel compared to human beings. Human beings can understand what is going on and realize why they are in pain–and they can take steps to get medical treatment to stop the pain. Many physicians are not aware that most pain can be controlled with the proper drugs.

My best friend, during the final month of her life, was in hospice, where she received drugs to control pain and nausea. While the drugs were not by any means perfect, she did feel better, and I and her other friends were able to spend precious time with her and say goodbye before she peacefully passed away. If all terminally ill patients in pain received better palliative care, most of the clamor for physician assisted suicide would most likely go away.

Dr. Kevorkian represents the contemporary view that severe pain is the ultimate evil that can happen to a human being. Don’t get me wrong–I hate pain and have a very low pain threshold. I could not imagine the agony of being in constant, severe pain. I would want the best treatment for pain available if I were in severe intractable pain. In an earlier world that began to dissolve in the fourteenth century, pain was not considered to be the worst evil. Dying without salvation was. Today society is secular, and even many Christians are Christians in name only–they never accepted the world view and view of human nature that comes with Christianity. So they go back to the old Stoic view that suicide can be acceptable in some circumstances. Yet even the Stoics believed it was normally best to suffer misfortune and pain; suicide was a last resort to protect one’s honor and dignity. The modern world does not understand fortitude through pain, using illness to draw closer to the transcendent, or using a long, drawn out dying process to adequately prepare for death, both in secular and in spiritual matters. Today people want a quick death–in their sleep, of a sudden stroke or heart attack. There are times I feel that way, too, but when I use my reason, I realize that knowing one is dying, even if it involves great pain, gives one time to prepare, to say goodbye, and to draw closer to God. None of that would have made sense to the atheist Dr. Kevorkian. Yet a secular case can be made against PAS as well.

Not only does PAS violate the fundamental end of medicine, which is to help a person in need, doing no harm, but wide scale legalization would take away the psychological barrier to including more classes of people as candidates for PAS. Professor Margaret Battin once said at a talk I attended that she believed that someone with intractable chronic depression that could not be treated with drugs is a legitimate candidate for PAS. Most of the audience of physicians and philosophers seemed to agree. What about the person with chronic back pain that is not helped by drugs? What about the woman with fibromyalgia? To how many groups of people will PAS be extended.

In the Netherlands, where PAS is legal, thousands of patients have been actively killed by their doctors–without giving prior permission and without a family or friend as proxy giving prior permission. The doctor makes a judgment about the patient’s quality of life–and if the patient’s quality of life does not measure up to the physician’s standards, the physician kills the patient. A recent attempt to formalize a quality of life standard, below which a physician could kill a patient, was defeated in the Netherlands. But with some physicians already crossing that barrier, it may be just a matter of time before the law reflects practice.

Doctors already have a great deal of power over the patient. The patient comes to the doctor for help, and the doctor has the knowledge and the power to diagnose and treat the patient. Given that amount of power, would someone really want to agree with Dr. Kevorkian to give the physician the authority to help a patient kill himself? Once power crosses one barrier, historically it has tended to cross others.

Dr. Kevorkian meant well. But history shows that some of the worst tyrants in history “meant well.” Pol Pot really believed that by killing the educated classes and moving the rest of the urbanized population of Cambodia he could create a classless society. Instead he murdered over a million people. Dr. Kevorkian only was involved in helping a few hundred people kill themselves. But multiply that by hundreds of other Dr. Kevorkian’s along with a racially individualistic society that affirms that a person “has the right to determine the time and manner of one’s death.” Such hubris feeds Dr. Kevorkians and feeds physician power over life and death–and this in turn feeds Death itself. God help us.