Monday, October 20, 2014
This is the final of three Ethical Musings' posts on death and assisted suicide. The first post discussed the issue of life expectancy; the second post explored the morality of assisted suicide. This post delineates proposed criteria that laws regulating assisted suicide should incorporate (the presumption, of course, is that readers and legislators have found the case for assisted suicide persuasive).
First, a person requesting assistance with suicide should be terminally ill and have a life expectancy of less than six months. Assisted suicide is not an ethical option for the depressed, the disappointed, or the despairing. Assisted suicide offers a positive option for the person whose suffering—in the individual's own estimate—exceeds whatever value s/he may find from living longer.
Second, the law should require a physician approve a person's request for assisted suicide after discussing the mechanics of assisted suicide and the person's illness together. Only a physician is competent to assess whether a person is terminally ill and to offer an expert estimate of life expectancy.
Third, the person should make the request on more than one occasion. The law in all four states that have legalized assisted suicide stipulates that the terminally ill person must make the request twice orally and once in writing. This seems reasonable. On the one hand, it avoids whimsical, spur of the moment decisions. On the other hand, the requirement is not excessively onerous.
Fourth, a person making the request must be a mentally competent adult, i.e., over eighteen years of age. Establishing an age is somewhat arbitrary, but not allowing a four year old to decide whether to commit assisted suicide is clearly reasonable. Although one might argue for setting the age of consent at sixteen or twenty-one, eighteen seems a reasonable compromise. I invariably think that the age at which a nation is willing to send someone into harm's way as a member of its armed forces represents a reasonable age for other significant choices, such as voting, consuming alcohol, entering into marriage, etc. Mental competence (sanity) is also a reasonable requirement. The mentally ill and incompetent require our assistance rather than our complicity in making difficult choices.
Fifth, assisted suicide laws should specify that suicide occur through a lethal dose of legally prescribed drugs, in as painless a manner as possible, and, if possible, the terminally ill person should take a decisive role in administering the drug(s), even if that consists simply in pushing a button or flipping a switch. Legalizing assisted suicide without making it legal for physicians to prescribe the requisite drugs and pharmacists to fill those prescriptions is wrong. Having the person take an active part in her/his own death both helps to ensure that the person wants to die and that the death is truly assisted suicide, not murder.
Individuals should have the right to die with dignity. Choosing to die rather than to endure suffering that has no value is inherently part of dying with dignity. When a terminally ill person has had an opportunity to say goodbye or otherwise end important relationships, when that person is at peace with her or himself, and when that person is at peace with God, then choosing to die may represent taking a step forward toward the goal of abundant living.
I have never understood Christianity's condemnation of suicide. In my experience working with suicidal individuals (sadly, I have worked with more than a hundred of them, several times intervening decisively to prevent an unnecessary death), people turn to suicide out of desperation, believing that their only hope—no matter how slight—for a better life consists of trusting in God's mercy. For the terminally ill who are in great and sometimes unmanageable, death may in fact be their only real hope of a more abundant life.
Thursday, October 16, 2014
An Ethical Musings' reader sent me a link to Ross Douthat's recent Op-Ed piece in the New York Times, "The Last Right" (October 11, 2014), soliciting my thoughts on assisted suicide.
What is right? How do we know?
First, life is good. For the religious person, life is not only good but also a gift from God, directly (e.g., for a creationist) or indirectly (e.g., for someone who accepts the theory of evolution). For the non-religious person, the good of life is manifest in the desire to live and, in many people, the desire to perpetuate life by procreating.
Second, life is transient. In the large scheme of the cosmos, an individual human life is ephemeral. In the small scheme of a human existence, the span of a human life can seem short (an infant who dies within a month of birth) or lengthy (the life of a centenarian). In either case, a human life is like a lily, beautiful in the moment and then gone.
Third, for people who believe in life after death (regardless of whether one imagines the next life as a blissful eternal existence or a form of reincarnation), death is not an end but a moment of transition. The common euphemism for death, "passing," connotes death as a transition, passing from one life to another. If death is a transition, then lingering too long in a stage may retard development, growth, arrival in a more blessed state, etc.
Fourth, for people who do not believe in life after death (and for many who do believe in life after death), the quantity of life may not be the only value. Quality of life may be at least important as longevity. The tradeoff between quantity and quality is observable in the lives of individuals who sacrifice self for the well-being of others, such as the warrior who dies in defense of country, the healthcare worker who becomes infected with a terminal disease while aiding others, etc.
Fifth, the desire to die is sometimes misguided or wrong. Many depressed people contemplate the possibility of suicide; some plan a suicide attempt as a means of calling for help; a relatively few depressives actually want to die. Depression is a mental illness. The symptoms, including the desire to die, are usually treatable; much depression is actually curable. For the depressed, suicide is a permanent solution to a temporary problem and therefore misguided. In other cases in which the person committing suicide is not depressed, suicide is wrong, e.g., a jilted lover wanting to make the former lover feel guilty for having preferred another.
Sixth, God does not control when or how an individual dies. That statement is obvious to persons who do not believe in God. For persons who believe in God, to posit that God controls when and how every individual dies is to make God responsible for great and numerous evils. These evils range from the holocaust to the victims of mass murder. The deaths of innocent infants, famine victims, those who die from natural disasters, cancer deaths, and those killed by drunk drivers are all among the deaths for which God is responsible. Evil deeds are incompatible with the concept of a good God. Attributing control of how and when every individual dies is a form of fatalism that few contemporary theologians find palatable.
Seventh, if God alone is not in control, then humans have some measure of responsibility for how and when people die. Sadly, that control is often apparent in tragic deaths from war, avoidable manslaughter (e.g., the parent who leaves a child unattended in a sweltering vehicle), needless homicide (e.g., crimes of passion), and the spread of infectious disease (e.g., parents who do not have their children vaccinated). Human control is also apparent in the deaths averted from people who feed the hungry, heal the sick, prevent crime, and end fascism.
Eighth, since life is good but finite, and the goodness of life is not measured by longevity alone, and since humans do exercise some unknown measure of control or influence over life's duration, the question is not whether assisted suicide is ethical but under what circumstances or conditions assisted suicide is ethical. To oppose assisted suicide depends upon one of three arguments: that God, not humans, determine the number of a person's days; that longevity is the sole determinant of a good life; or, that a state cannot legalize assisted suicide in a way that effectively avoids abuses, i.e., avoids wrongful suicide, manslaughter, and homicide. I've already rejected the first two of those arguments (points three, four, six, and seven above).
Ninth, the practice of assisted suicide in the four states where it is currently legal has not resulted in allegations of criminal or ethical abuses. In the United States, physician assisted suicide is currently legal in four states (Oregon, Washington, Vermont, and Montana). In Montana, a court must approve the request. In the other three states, the person must be a resident of the state, at least eighteen years of age, within six months of dying from a terminal disease, and have made the request to the physician at least twice orally (minimum of fifteen days apart) and once in writing. In other words, laws and practices in those four states are substantial evidence that legalizing assisted suicide is possible without creating a great potential for abuse or crime.
Tenth, de facto assisted suicide now happens on a widespread basis. Assisted deaths occur with some frequency in all states under unregulated conditions. Most often, well-intentioned healthcare providers administer large doses of narcotics to ease severe pain in the terminally ill. At some point, a dose meant to end the pain has the unintended consequence of permanently ending the person's pain. Unassisted deaths are also widespread: many individuals have signed advance medical directives to prevent healthcare providers from using emergency procedures or invasive interventions to prolong the person's life. In my last Ethical Musings' post, "At What Age Do You Wantto Die?" I discussed Ezekiel Emmanuel's decision to decline medical treatment after age seventy-five, which, in the case of a treatable illness, is a form of passive, unassisted suicide.
Eleventh, anecdotal evidence suggests that a large number, perhaps a majority, of terminally ill people who legally obtain drugs from a doctor with which to commit assisted suicide, opt not to commit suicide. Having the drugs restores a measure of dignity and control to the dying person sufficient to restore hope and meaning to an otherwise bleak, painful existence.
Twelfth, facing death squarely and openly follows Jesus' example. From the gospel records, he recognized that going to Jerusalem for the Passover would lead to his death. He talked about that prospect with his disciples (the gospels record tantalizing snippets of those discussions). In choosing to go to Jerusalem, Jesus recognized that longevity was not the sole measure of the value of life. Indeed, he took a measure of responsibility (or control) over his life and its span. We should do likewise.
My next post will outline some specifics for laws regulating assisted suicide.
My next post will outline some specifics for laws regulating assisted suicide.
Monday, October 13, 2014
An Ethical Musings' reader called my attention to an essay at The Atlantic, "Why I Hope to Die at 75" (September 17, 2014), in which Ezekiel J. Emanuel explains just that: why he wants to die at age 75.
On the one hand, I agree with both of his basic premises. First, he emphasizes that quality of life is much more important than longevity. This premise coheres with Christian theology and ethics. The value of life is not determined by its length but by whom one becomes and how one lives.
Emanuel openly acknowledges that death marks the end of life and therefore represents a loss. Prolonging life simply to gain more time many times results in a net loss. That is, those days may come at the price of diminishing quality of life that may include, for example, growing mental incapacity, progressive physical handicaps, or increasingly incapacitating pain. Life expectancy in the United States has increased, but so has the expectation of living with a major incapacity. Furthermore, even for those persons who manage to avoid a major degradation in their quality of life, age inexorably brings with it diminution of one's capacities.
Emmanuel's second premise, implicit throughout his essay, is that it is wrong for an individual to burden the community with the cost of care in the face of both the individual's diminishing quality of life and capacity to contribute to communal well-being. The US devotes a staggeringly disproportionate amount of healthcare to the elderly, particularly to the elderly who with less than a year to live. The elderly comprise 13% of the population but consumed 36% of healthcare expenditures (for more statistics, follow this link).
On the other hand, I find myself unable to state with any conviction an age or even set of criteria for determining when I want my life to end. There are too many possibilities to make assessing all of the hypotheticals feasible; I am now enjoying life too much to enjoy extensively contemplating my own finitude.
Unlike Emanuel, I am not opposed to physician assisted suicide when a person is suffering from a terminal illness and in untreatable pain or is rapidly losing his/her mind to a disease such as senility or Alzheimer's. The idea that God determines when a person dies is incomprehensible to me. If God actually controls the lifespan of every human, why do babies die? Why do people die of easily curable diseases? Why do drunk drivers kill children, teens, and young parents? Why does anyone die a lingering, long-suffering death? These are just a few of the questions for which theological fatalism (i.e., God numbers our days) has no satisfactory answers. Theological fatalism also erodes our motives to relish each day, to live prudentially, and to work diligently to end suffering.
My answer to thinking about the age at which I want to die has three parts. First, I want to cherish and live fully every moment that I do have, for life will too soon end. Second, I want to balance enjoying the present with taking care of myself for tomorrow. Although decline is inevitable (and I have no desire to be younger than I am), I do not want to contribute to, much less expedite, that inevitable decline. Third, I hope that I will have the wisdom and courage to decline unnecessary, wasteful healthcare as I near my end. Care that extends the number of my days without a commensurate increase in my quality of life is wrong. Government funds spent on my healthcare that could achieve greater benefits if spent on another person should be expended on that person and not me. In this, I obey Jesus' command to love my neighbor as myself, living into his statement that a person has no greater love than to lay down her/his life for another.
Thursday, October 9, 2014
The rather lengthy September 2014 report (available here) from the Taskforce for Reimagining The Episcopal Church (TREC) contains an interesting mix of proposals. Unsurprisingly, the report has evoked a great deal of response, both pro and con, including from a recent Churchwide meeting (video available here). Here's my take.
TREC perceptively describes the need for and consequences of a new organizational paradigm in The Episcopal Church (TEC):
We live in an age of networks, yet our churchwide structure has not fully adapted to this organizational paradigm. The evolution from a bureaucratic/regulatory agency paradigm to a network will profoundly change the role, culture, decision making processes, and leadership paradigms of and within The Episcopal Church’s churchwide structures. This would not be unlike other significant evolutions that have occurred historically around our church’s governance and structures.
TREC also helpfully catalogues functions that central TEC structures and resources can provide to dioceses and congregations, i.e., they can be catalysts, connectors, capability builders, and conveners. However, not all of the TREC proposals appear likely to move TEC toward a new organizational paradigm or actualizing those functions.
Positive aspects of TREC's proposals include:
- Clarifying managerial and supervisory relationships. Excluding a CEO (there is no option: the CEO must report to some form of board or other group), groups are an inefficient and ineffective means of managing staff in any organization. When it works effectively, a group directly supervising staff does so because personalities click and not because of it is a sound managerial structure. Under TEC's current structure, responsibility for managing and supervising TEC staff is often unclear, nonexistent, overlapping, or resides with one or more committees, commissions, boards, etc. TREC may not have hit a homerun with respect to this issue but by tackling the problem has helpfully put it on TEC's agenda.
- Shortening General Convention (GC) and allowing legislation to die in committee. Few deputies (based on my interviews with dozens of them at three different GCs) have sufficient knowledge of most resolutions before GC to cast votes informed by reason, tradition, and scripture. As one might expect GC deputies tend to be more knowledgeable about issues before a committee of which the deputy is a member than the average deputy is. Allowing issues to die in committee will shorten GC agendas and eliminate numerous well-intentioned if uninformed votes. The twenty-first century TEC needs to develop an energized, engaged mission focus and face the reality that few of our remaining 1.9 million members care about the niceties of legislative process and administrative trivia.
- GC evolving in the direction of a General Missionary Convocation. Implementation of this recommendation would move TEC in the right direction. Implementation needs to be enthusiastic, expeditious, and expansive.
Worrying aspects of TREC's proposals include:
- Diminishing the size of both the Executive Council and especially that of GC. Diminishing the size of these groups will have the unintended effect of distancing both from Episcopalians in the pews. Sadly, most Episcopalians care little and know almost nothing about TEC and its structures (if in doubt, hazard a guess about the total readership of internet sites that concentrate on TEC related issues; if still in doubt, ask five people chosen at random the next time you worship with a TEC congregation). If TEC is to survive as a viable embodiment of one branch of Christ's Church, TEC must broaden participation and deepen feelings of ownership among its members, especially younger members, a move in the opposite direction of what TREC recommends. I'm guessing that fewer than 20,000 Episcopalians participate in diocesan, provincial, and national TEC affairs, i.e., less than one percent of TEC membership. Substantially increasing the level of participation and sense of ownership from among the 1.88 million non-involved Episcopalians requires enlisting them in meaningful and rewarding opportunities for worship and service. Current legislative and administrative agendas provide few such opportunities that most of the 1.88 million find attractive. I've not seen any report of the number of the people who participated in TREC's Churchwide meeting, but infer from the silence (always a dangerous way to draw a conclusion, no matter how tentative) that many fewer than 20,000 persons participated, either in person or via the internet.
- Outsourcing staff responsibilities. Poorly managed outsourcing can quickly become more costly than performing the work in-house. Outsourcing offers limited opportunities for ensuring that a contractor's employees earn living wages, enjoy decent benefits, can make individual choices about women's health, etc. That is, TEC may find itself in the awkward position of indirectly supporting labor practices that, from a Christian perspective, are unfair or antithetical to resolutions adopted by GC. TEC can hire staff for short periods, carefully and explicitly explaining both orally and in writing to prospective employees the position's limited duration. Other non-profits successfully use this model. Setting high expectations that require high levels of employee commitment often attracts extremely well qualified applicants who believe they are responding to God's call.
- Entrusting the Presiding Bishop (PB) and President of the House of Deputies (PHOD) to appoint TEC taskforces. I like and respect both the PB and PHOD. However, making the incumbents of those two positions responsible for these appointments presumes that future PBs and PHODs will always have a decent working relationship, have the time to sort through thousands (at least hundreds, hopefully) of applications, and will resist temptation to appoint only individuals that they (or a handful of trusted advisors) know personally. A nominating committee is not ideal, but like democracy as a form of government, may be preferable to all other options.
- Expanding the role of the PB as CEO responsible primarily to a smaller GC. This proposal evokes images of evangelical missionary organizations (e.g., the Billy Graham organization) in which a central figure has great latitude, is accountable to a small board, and receives funding from a broad base. A key obstacle to TEC adopting this model is that the base has no loyalty to the PB; the base's loyalty, albeit a diminishing loyalty, is to TEC itself. In other words, the proposed change moves TEC in the wrong direction; future TEC viability depends upon increasing the loyalty to TEC of the base, the 1.88 million Episcopalians who occasionally fill our pews but who have little demonstrable commitment to the denomination. Evangelical organizations whose funding is contingent upon popular loyalty to a charismatic founder generally experience greatly diminished income when the founder dies; the organization becomes a mere shadow of its former self, if it even manages to survive.
TREC has intentionally solicited and welcomed feedback. TREC also acknowledges that their proposals are works in progress and represent initial steps rather than a completed plan of action. TEC is not a nimble organization. Indeed, one of our strengths is that we value tradition, which in many respects is the opposite of being nimble. As TREC's letter notes, TEC is already in the process of change. TREC's diligent efforts and commendable proposals, widening conversation about those proposals within TEC, and a pervasive invitation to the Holy Spirit to continue breathing new life into the Church, to magnify TEC's ministry, and to enhance its unity are encouraging signs that God is not yet done with The Episcopal Church as a vehicle for ministry and mission.
Labels: Episcopal Church
Monday, October 6, 2014
I recently read Breaking the Spell: Religion as a Natural Phenomenon by Daniel C. Dennett (New York: Viking, 2006). Dennett, along with Richard Dawkins, Sam Harris, and Christopher Hichens, is a leading exponent of the new atheism.
Breaking the Spell is not worth reading, unless you cling to an antiquated notion of a supernatural deity, an idea that Dennett takes almost 400 pages to debunk. Dennett is explicit. He considers anyone who does not believe in a supernatural deity an atheist: "If what you hold sacred is not any kind of Person you could pray to, or consider to be an appropriate recipient of gratitude (or anger, when a loved one is senselessly killed), you're an atheist in my book." (p. 245)
Amazingly, Dennett thus implicitly describes existentialist theologians (e.g., Paul Tillich) and process theologians (e.g., John Hick and John Cobb) as atheists. A few pages after his definition of atheism, he cavalierly dismisses Tillich's concept of God as the Ground of Being with an aside, "whatever that [the Ground of Being] is," having already noted his indifference to the idea. Dennett's definition of atheism sweeps up a great many religious leaders and prominent theologians, underscoring the weakness of Dennett's analysis.
In short, as a theologian reading Dennett's book, I wondered, analogously, what a contemporary physicist might think of a twenty-first century book that evaluated physics based on Newtonian rather than quantum principles.
What reading Dennett's book did prompt was an effort to summarize succinctly my basic approach to religion, which I prefer to label post-theism or progressive Christianity:
- The cosmos exists and favors complexity, suggesting the existence of a prime mover (otherwise, why would anything exist?). A methodological problem with scientific reductionism is that it does not recognize the existence of emergent entities, e.g., the characteristics of a molecule differ from those of its constituent components, as do the characteristics of human consciousness from those of the brain that makes consciousness possible.
- This prime mover, God, is not omnipotent but omnipresent (panentheism – cf. David Ray Griffin's book, Panentheism and Scientific Naturalism). God is not supernatural, but natural; God, consequently, always act through natural rather than supernatural means. The presumption of science that all aspects of the natural world are susceptible to study using the scientific method is incorrect, i.e., there are observable aspects of nature that are not predictable (e.g., which sperm will actually fertilize an egg) and probably aspects of nature that are not directly observable by humans (e.g., the cosmos as a whole).
- God seeks to lure creation in a direction of God's choosing, but does not exercise total control (this avoids the problem of evil). The way in which God lures creation (all entities, from a quark to humans to the cosmos as a whole) is neither observable nor quantifiable.
- God's will for humans (the basis of morality, part of God luring the cosmos) is evident in reciprocal altruism. Reciprocal altruism begins as kin altruism (impossible for a newborn to exist without care) but is developing into reciprocal altruism toward all life forms. All religions promote loving one's neighbor as one's self.
- Participating in religion builds community, reinforces moral behavior, and (as even Dennett concedes) has proven to have health benefits for its adherents.
- The basis for religious activity is experiencing God's presence luring one to act or move in a particular direction (what Griffin calls prehension and panexperientialism). The God who exists is the God whom we can know but of whom we cannot speak.
- As mystics have long recognized, the particulars of religious narratives found in Scripture are less important than the common experience of God that lies behind and beyond those stories. Religious pluralism, not religious particularism, points the way; major religions represent different paths, culturally determined, to the one God.
- Scientific reductionism ignores the emergence of the human spirit, e.g., the ability to transcend self, our linguistic capacity, our aesthetic sense, and our capacity to love and be loved. All of these aspects of the spirit have a naturalistic explanation but reductionism offers no hypothesis why humans (or any life form) should develop a spirit or what might be next.
This credo is a work in progress. Comments are most welcome.
Thursday, October 2, 2014
Americans may throw out, uneaten, as much as 25% of the food they buy. Recent data from the US Department of Agriculture (USDA) is even more appalling: about a third of the food available to consumers—this includes both what stores discard unsold and what consumers have bought but do not eat—goes uneaten. This wasted food is worth about $162 billion, an amount that exceeds General Motors' sales for all of 2013.
USDA estimates that of the 133 billion pounds of wasted food, 33% is seafood, 30% roots and tubers, 28% fruits and other vegetables, 27% grain products, 15% milk, and 11% meat.
In Raleigh, the Interfaith Food Shuttle collects food that stores would have otherwise discarded because the items are past their recommended sell by date, have less than a picture perfect appearance, or for another, non-health related reason. The Interfaith Food Shuttle then distributes the food it has collected to food banks, non-profits that feed the hungry, and other organizations working to alleviate hunger.
Those are great efforts. Obeying both Jesus' injunction to feed the hungry and to be good stewards requires that we do more, much more.
First, eat all of the food you buy; don't buy food that you won't eat. Most food that consumers purchase and then waste cannot be donated to anyone else because the food has gone bad while sitting uneaten in a refrigerator or pantry. Not buying that food would have saved the consumer money and, over time, diminish pollution from farming and processing uneaten food. Advance menu planning, minimizing spontaneous buying, and eating in restaurants only as planned in the menu are all ways to avoid food you have bought going uneaten. Agricultural pollution, which includes pesticides, soil erosion, carbon emissions from farm equipment, etc., is a major source of pollution.
Second, support the ministry of groups like the Interfaith Food Shuttle. If your area does not have such an organization, consider founding one. Preventing massive amounts of food from being wasted both feeds the hungry and helps to reduce agricultural pollution.
Third, become a foodie. Good food, well-prepared, and eaten slowly in moderate amounts with friends is one element of living abundantly. Locally sourced food is often fresher, tastier, and may have required less pollution to reach you, e.g., not having been trucked across the country or flown in from another continent.
What opportunity have you missed today to feed the hungry and care for the earth while saving yourself money?
What opportunity have you missed today to feed the hungry and care for the earth while saving yourself money?
Monday, September 29, 2014
Johnathan Haidt in his book, The Righteous Mind: Why Good People Are Divided by Politics and Religion (New York: Pantheon, 2012), argues for expanding moral paradigms. Ethics consists of three broad approaches: deontology, utilitarianism, and virtue. He focuses on the first two. Deontological ethics emphasize duty or rules. The best known philosophical approach to deontology is Immanuel Kant's categorical imperative, which enjoins one to do only that which everyone should do in that same situation. Theological ethics are another form of deontology: it is the believer's duty to act in accordance with God's instructions. Utilitarianism, in its several forms, emphasizes doing that which will result in the greatest good for the greatest number of people. Haidt contends that deontology and utilitarianism are both incomplete and that neither accords with how the human mind actually functions. Citing multiple studies, Haidt insists that humans form reasons post hoc (i.e., after acting) to justify what they have already done.
Instead, Haidt identifies six pairs of constructs that he believes shape human morality:
- Fairness (has two components, equality and proportionality)/Cheating;
Haidt then explores how people who weight these values (another term for virtue) differently hold divergent political views. Liberals emphasize Care/Harm and to a substantially lesser degree Fairness (understood in terms of equality)/Cheating and Loyalty/Betrayal. Intriguingly, Conservatives generally place an approximately equal emphasis on all six pairs (they understand Fairness more in terms of proportionality than equality).
The six pairs of virtues/harms Haidt identified represent an interesting candidate for a catalogue of the virtues, a catalogue with a strong neurological, sociological, and psychological basis. Is the catalogue comprehensive?
The six pairs of virtues/harms Haidt identified also provide a useful paradigm for conversing with people who hold different political, religious, or ethical views, a framework that invites conversation about common ground, disagreements, and why one weights the virtues/harms in a particular manner.
Most importantly, when used as a checklist to shape thinking and comments about ethics, the six pairs of virtues/harms Haidt identified can helpfully and intentionally expand one's thinking about morality. Moral issues often have a complexity lost in the oversimplification that characterizes much contemporary discourse (this unfortunately includes much preaching and biblical exegesis!).