Book Review: Health Policymaking in the United States
choosing that are incapable of proper description by reductive material explanations. After an opening chapter about the philosophical lineaments of Thomistic anthropology, he discusses at length the various aspects of human cognition and human volition that cannot, in principle, be explained merely in terms of such biological organs as the brain that satisfy the necessary conditions for these functions. He also critiques various contemporary authors who ignore or misunderstand these aspects of Thomistic anthropology, including Robert Pasnau’s (2002) Aquinas on Human Nature and Jean Porter’s (1999) Natural and Divine Law. These critical reviews of the literature constitute a particularly valuable aspect of Payne’s book, for their presentations have contributed to influential misunderstandings of the Thomistic position, often for the sake of the ethical implications they think to flow from their interpretations of Aquinas’s texts. Chapters 5 and 6 provide a sophisticated discussion of certain trends in contemporary science and contemporary theology. Of special importance here is Payne’s account of the current understanding of evolutionary theory. He is right to note the misguided emphasis that is often placed on the undisputed part of neo-Darwinian theory, namely, natural selection, while minimizing the more complex and more demanding aspect, namely, the processes by which variations are brought about that can then be subjected to natural selection. Common explanations of this second element in terms of “chance” often takes the epistemological meaning of the term (our inability to predict an outcome) as if chance named some causal force by which variations are produced. The Thomistic conviction that everything that takes place must have a sufficient reason (an adequate explanation) for its occurrence thus provides a philosophically rigorous framework for the scientific quest for the intelligibility of natural processes that is far more suitable than any philosophical outlook that depends on misconstruing the epistemological notion of chance as it were a causal factor. In the sixth chapter, Payne treats various theological currents associated with twentieth-century writers (e.g., Karl Barth) and writers from the early modern period (John Calvin and Guido de Bres), particularly with reference to the effects of original sin upon human cognition and volition. In the final three chapters, Payne provides answers to various perennial questions that have remained prominent in the twenty-first century, such as efforts to use a noncorporeal criterion for humanness, efforts to assert progressive humanization in the course of human development, and the confusions associated with tendencies to describe genuinely developmental processes as if they were processes of construction. As in the fine work done by Valparaiso law professor Richard Stith (see, for instance, his many articles in the Proceedings of the University Faculty for Life), this third issue is a question of the proper model when describing human origins: should we envision it in terms of a process in which the powers already present in a nature unfold and mature in the course of time, or should we envision it on the model of building and manufacturing, such that it is human intent that decides the questions about a thing’s fundamental constitution and type? Payne makes a solid case here that both Aquinas and the best of contemporary science give evidence of a truly developmental model (not a constructive one) and thus provides a solid basis for drawing out the moral implications that require protection of even the earliest stages of human life as well as those with great vulnerabilities. In Payne’s book, we have a fine use of a sound philosophy, with results that help to resolve many interesting problems that are alleged to separate science and religious belief.