For Certain?

This morning I'm thinking about how we can know anything with certainty. In the Middle Ages philosophy reigned as the integrator of knowledge. I suppose it was an easier time or maybe a simpler one. From the perspective of the 21st century there was less to know or less that was known, and so philosophy could be relied on to put it all together.

The 20th century Roman Catholic theologian, Karl Rahner, argued the expansion of knowledge rendered us susceptible to what he called "gnosiological concupiscience," a tongue-tyer that essentially means none of us can know everything. I guess we always knew that but it's a convenient phrase to have on the tip of the tongue the next time cocktail party conversation lags and we're looking for a quick exit.

Seriously, though, Rahner was referring not only to the expansion of knowable things but the proliferation of pluralism that exists within specific fields of knowledge. We are no longer able to speak in terms of discrete disciplines like philosophy or science without specifying which one we mean. And this creates problems because none of us is sufficient to know enough about all of them to be able to integrate them in a unified field. Nevertheless, this is what we try to do.

Maybe it comes from discomfort with ambiguity. Maybe thinkers like Elton Trueblood are right after all, and humans have an inherent drive to establish or connect with a center of certitude. But like Archimedes, who said (more or less), "Give me a lever, fulcrum, and a firm place to stand, and I can move the earth," we want a reliable point from which we can begin.

We're all concerned about healthcare these days. Well, for years, or so the argument goes, doctors relied on their own clinical experience in decision-making rather than on the accumulation of scientific data. And the reason for this was, the absence of empirically-gathered data supporting one decision over another. We are now encouraged to rely on evidence that has been gathered experimentally to inform medical decisions. Based on the evidence, algorithms are developed to guide treatment. If A, do B, and follow B with C. If not B, do D. That kind of thing. It simplifies a lot.

The problem comes about when we're faced with situations that don't fit the algorithm and this is precisely what thinkers like Harvard's Jerome Groopman have pointed out. If you haven't read his marvelous book, What Doctors Think, I encourage you to do so before your next physical exam. It will open your eyes. Groopman points out how simple conditions like the common cold are very amenable to algorithms, but serious conditions tend to be far more complicated and frequently fail to fit within the neat confines of evidence-based medicine. When faced with this kind of situation, a person has to be able to think creatively and that means managing ambiguity.

There it is again, that pesky ambiguity. Seems like we can't escape it, can we? At every turn there's something that can't quite be reduced to A+B = C. So, where does our certainty come from, if not the absolute reliability of the scientific method? Maybe in the end we're forced to return to the core of individuality, that place where we encounter the depth dimension of life. And, of course, once there, we find philosophy and theology waiting for us. Pluralistic though they may be as well, at least they remind us that we can't escape being human after all.

It's something to think about.