Identifying Religious Modes of Discourse in Healthcare Policy Debates

Ira Bedzow

Black Beach in Iceland by Job Savelsberg on Unsplash.

Religious discourse in multicultural environments has enormous potential to enrich our larger society, especially in matters related to healthcare. It can allow religious communities to ensure that their values are both heard and considered. The introduction of different religious views also provides context and counterpoints in public debate over issues in healthcare. Context within the debate is provided when different religious groups make their grounding premises and values explicit and easily understood by others. Counterpoints occur when different positions are discussed and new understandings revealed. 

Yet in order for religious discourse to be beneficial – rather than simply add to the cacophony of voices in the public square – it is imperative to recognize that religious leaders living in a multicultural community do not engage in public theology or ethics from an “objective” standpoint, i.e. one that is independent of the norms and values of their respective traditions. Rather, they are motivated to live faithfully among others. They therefore provide different arguments, use different rhetorical strategies, and advance different positions, depending on their audience. These different strategies and positions are not due to duplicity on anyone’s part; rather, they result from different goals when speaking to internal or external audiences. (In truth, something similar could be said of any thinker or leader engaging in public debate.)

Three major modes of discourse that religious leaders and thinkers use are the pragmatic, the paternalistic, and the personal. The strategy that leaders use depends on the goal of discourse, the audience to whom they are speaking, and the people affected by the proposed position. 

By understanding each of these modes of discourse and their motivations, religious and non-religious individuals can account for differences of position as well as find areas for accommodation when negotiating norms and values as part of a multicultural compromise. At the very least, we might be able to find certain ways to avoid or at least ameliorate social conflict or tension between people and groups in a multicultural environment.

Pragmatic Strategy

Religious leaders or thinkers use a pragmatic strategy in religious discourse when they seek to advance the goal of religious freedom.  Pragmatic discourse relies on explanations of religious rites, rituals or practices that can be understood within the social parameters of the majority culture or within a multicultural society’s realm of acceptability. Explanations will oftentimes not cohere with an overall religio-philosophical system or framework. In other words, pragmatic expositors will give reasons for a religious observance from a perspective that is outside their tradition and would not be acceptable to an internal audience; they use the values of the greater society to justify why the position is persuasive to others.

From the sources of the Jewish tradition, one can easily recognize when the rabbis use a pragmatic strategy, since it is most often used when conversing with or accounting for non-Jews over a topic of Jewish observance. The following anecdote provides a Talmudic example of pragmatic discourse within the Jewish tradition:

A certain heathen asked Rabbi Yohanan ben Zakkai, “These rituals [of the red heifer] that you perform appear like witchcraft. You take a cow, burn it, pound it, and take its ashes. If one of you becomes impure from a dead body, you sprinkle upon him two or three drops, and say to him, “You are pure!” Rabbi Yohanan answered him, “Have you ever . . . seen a person possessed by the demon of madness?” Said the heathen, “Yes.” “What do you do for him?” “We bring roots, and make them smoke under him, and sprinkle water upon the demon to exorcize it.” Said Rabbi Yohanan, “Let your ears hear what you utter with your mouth! The spirit of impurity is exactly like this demon…Water of purification is sprinkled upon the person made impure by contact with a corpse, and the spirit flees.” When the heathen had left, Rabbi Yohanan’s disciples asked him, “Our master! Him you dismissed with a flimsy excuse, but what explanation do you offer us?” He said to them, “By your lives! It is not the corpse that makes one impure, nor the water that makes one pure. Rather, the Holy One, Blessed be He, declared, ‘A chukka [law] I have enacted, a decree I have issued; you may not violate my decree,’ as it is written, ‘This is the law [Heb. chukka] of the Torah’ (Num. 19:2).”

The heathen did not seek to truly understand why the ritual of the red heifer was established. He started from the premise that it was irrational (i.e. witchcraft). Therefore, Rabbi Yohanan could not justify the practice to him within a Jewish theological-philosophical framework. The purpose of this discourse was not understanding but avoiding ridicule. The response, therefore, had to accord with the heathen’s practices and ethos so that it could be accepted as familiar and valued as legitimate. Of course, when his students asked about the reason he gave to the heathen, Rabbi Yohanan dismissed it. Even if it is a way to appreciate the ritual, it is not the reason for them to observe it.

A contemporary example related to healthcare can be seen when Jewish ethicists defend circumcision against anti-circumcision groups by justifying the ritual because of its health benefits. The “reason” that circumcision should be acceptable in this view, even though it can be seen as cruel to infants or as violating a child’s (future) autonomy, is that healthcare oftentimes accepts instrumental harm for the sake of ultimate health benefit. Of course, the religious reason for circumcision is that God commanded it. Nevertheless, like Rabbi Yohanan’s response to the heathen, the defense of circumcision on the basis that it provides preventative health measures uses the critic’s starting premises and already-accepted norms so that circumcision can be accepted as familiar and valued as legitimate.

Paternalistic Strategy

A paternalistic strategy in religious discourse is used when religious leaders or thinkers believe that religious values are — or should be — shared by the greater public. The leader or thinker, therefore, attempts to persuade the greater public to adopt such a value. To be persuasive however, the discourse must account  for the context and other beliefs and values of the religionist’s audience rather than the internal ethos of the religionist.

In the Jewish tradition, a paternalistic strategy is employed when a person identifies a value or a religious observance that is both particular to the Jewish people and universal, since it is encompassed by the Noahide laws. One difficulty in employing a paternalistic strategy arises in situations when the religionist’s observance may be different than what is seen as the requirement for the general public. In such a case, the paternalist thinker must consider whether to hold a double standard, to promote the universal position, or to promote the one that applies to the religionist’s community. Either of the latter two options may leave people with too high or too low a bar, and the double standard may come off as inconsistent or arbitrary at best or unjust at worst.

In order for religious discourse to be beneficial – rather than simply add to the cacophony of voices in the public square – it is imperative to recognize that religious leaders living in a multicultural community do not engage in public theology or ethics from an “objective” standpoint, i.e. one that is independent of the norms and values of their respective traditions.

To give a contemporary healthcare example, the jurisprudential analysis over the prohibition of abortion with respect to Noahide law is different from the one affirmed within Jewish law. In the Talmud, Rabbi Yishmael is cited as ruling that a Noahide who aborts a fetus has the legal status of a murderer. Maimonides codifies Rabbi Yishmael’s statement as the normative Jewish position for Noahide law. Jewish legal commentators debate whether Rabbi Yishmael’s statement and Maimonides’ ruling imply that a fetus is a person with rights under Noahide law (and for that reason abortion is akin to murder) or whether the offense relates not to the status of the fetus as a person but rather to the manner of punishment for the offense. In practical terms, the former interpretation disallows even therapeutic abortions, while the latter decision may allow for greater leniency. Because of different jurisprudential premises, Jewish law permits therapeutic abortions.

Given this difference, what policy should paternalistic Jewish leaders promote? If they promote the prohibition of even therapeutic abortions, they would be advocating for a position that aligns with Noahide law but is in opposition to Jewish law. If they were to advocate for the permissibility of therapeutic abortions, they would be advocating a position potentially contrary to Noahide law. 

A religious leader using a pragmatic strategy would not be troubled by this, since the goal of their discourse would be different. A pragmatic strategy would be to advocate for choice, so that members of the religious community can make their own decisions about how to act within the four cubits of Jewish law and not be encumbered by the laws of the state. 

Personal Discourse

As the name connotes, personal discourse is personal, i.e., meant for the internal audience of co-religionists. It does not attempt to enter the public conversation to promote religious values to those outside the community. Rather, it tries to reinforce — or explicate — religious beliefs and values to those who already hold them. The purpose is to encourage the internal audience to maintain a strong sense of cultural heritage and understanding of their religious tradition, and for them to develop the confidence needed to promote their values — or at least their ability to exercise those values — in the public sphere. While those who are not members of the faith may be able to appreciate another religion’s personal discourse, they do so as outsiders who bring their own views and understandings with them. 


For religious discourse to be productive in informing healthcare policy, it is imperative to recognize that different cultural systems express beliefs according to the value premises that undergird their respective traditions. Moreover, religious leaders will utilize different rhetorical strategies or modes of discourse depending on the position they are promoting and the audience whom they are addressing. As such, it is important to understand each strategy to know when each is being used and how it may inform practice in the public sphere. If one views all religious discourse as homogenous, contradictory claims or reasons will seem incoherent. If, on the other hand, one knows which strategy is being used, one can determine the argument’s relevance in terms of weighing its normative claims and how the argument may be incorporated into public policy decisions. ♦

Ira Bedzow is a Senior Scholar at the Center for the Study of Law and Religion, Emory University. He is also Senior Scholar of the Aspen Center for Social Values, co-director of the Maimonides Institute for Medicine, Ethics and the Holocaust (MIMEH), a regular contributor in Forbes for their Diversity, Equity and Inclusion section, and an Orthodox rabbi (yoreh yoreh, yadin yadin).

Recommended Citation

Bedzow, Ira. “Identifying Religious Modes of Discourse in Healthcare Policy Debates.” Canopy Forum. November 18, 2022.