Divinity Dialogues: Medicine, Metaphysics, and Moral Pluralism

June 17, 2021
Omar Sultan Haque, MTS ’04, MD ’08
Omar Sultan Haque, MTS ’04, MD ’08, physician, teacher, philosopher, and 2021 Gomes Honoree.

Continuing Divinity Dialogues—a special edition podcast series from Harvard Divinity School that puts conversations on faith, purpose, and bearing witness at the center of today’s most pressing issues.

Today, we hear from HDS alum Omar Sultan Haque, MTS ’04, MD ’08. Dr. Haque is a physician, social scientist, teacher, and philosopher who studies questions ranging across social medicine, religion, and bioethics. He is also one of this year's Gomes Distinguished Alumni Honorees.

In the interview below, Haque shares how he began his spiritual journey as an atheist, what psychiatry misses with its materialistic bias, and how to navigate moral pluralism within the medical field.


"The future is bright with promise because you’re in it. And my word to you is don’t give up, don’t give out, don’t give in! It is yours to make, and those who come after you will be very grateful for your witness.”

AMIE MONTEMURRO: The voice you just heard belongs to the late Reverend Peter J. Gomes speaking to Harvard University in a 2010 Keynote Address on “Harvard’s Transition to a More Diverse Community.”

 

Distinguished faculty member for four decades. Senior minister at Memorial Church in Harvard Yard. Rev. Peter J. Gomes is remembered fondly for his spirited take on the world and serving as a moral compass for the community.
 

I am Amie Montemurro with Harvard Divinity School, and this is Divinity Dialogues—conversations on faith, purpose, and bearing witness. Today, we continue our series of special edition interviews with this year’s Gomes Distinguished Alumni Honorees.

 

Each year, the Alumni/Alumnae Council honors the legacy of Reverend Gomes by recognizing graduates whose excellence in life, work, and service pays homage to the mission and values of the Harvard Divinity School.

 

From investigative journalism to intersectional poetry and Buddhist ministry to bioethics in medicine, this year’s honorees bring the Divinity School’s vision—working in service of a just world at peace across religious and cultural divides—to fruition. Each week in June, we’ll hear the stories of our honorees.


This week, we’ll hear from Dr. Omar Sultan Haque, who earned two degrees from Harvard (among others)—a Master of Theological Studies degree from the Divinity School in 2004 and an MD from the Medical School in 2008. Dr. Haque is a physician, social scientist, teacher, and philosopher who studies big questions ranging across medicine, religion, and bioethics.


A production note: This interview took place in April 2021, in the midst of the Covid-19 pandemic. Dr. Haque and I met over Zoom to avoid travel and practice good public health measures.

 

AMIE MONTEMURRO: To get us started, can you say a little bit about your relationship with religion and/or spirituality and particularly the role it may or may not have played before you joined the Divinity School community?

 

OMAR SULTAN HAQUE: Sure. Well, I guess I'm a person who—most of my life, I was an atheist or naturalist in terms of my ontology and metaphysics, meaning I thought that science was the royal road to truth, and nature was all there is. And I was pretty into my studies—I studied neuroscience in college and also philosophy of religion, and then went to medical school here at Harvard and started studying more experimental social sciences.

 

Looking back, I thought scientism was true in some sense. That natural science was the way to have reliable knowledge, and that maybe even the social sciences and humanities would be subsumed as branches of this, as in the vision of E.O. Wilson, or my advisor Steven Pinker at the time. I was somewhat of a reductionist, I guess.

 

But I started thinking over time. I went and did a doctorate in philosophy and religion and started seeing—studied, specifically—the philosophy of naturalism and started thinking that there's some cracks in the ice there. That there had to be some non-naturalistic premises that were snuck into humanism and, for example, the belief that we're fundamentally persons—that all of our mental and moral and aesthetic properties, could it be reduced to the description given in physics?

Let me think, what else? The fact that we have human dignity, that we have human rights, those are not things you examine if you dissect a person. Our moral equality, our fundamental moral equality, it's not based on our physical interchangeability; the obligations we have to disadvantaged persons, and so on. Many, many ontological as well as moral premises that I felt were not easily justified as a naturalist. And then I started—I was a physician as well later on, and there was a whole journey there that intersected with my studies, but the Divinity School was a wonderful place where I launched into the philosophical and ethical dimensions of all of this.

AMIE MONTEMURRO: And now, were you a practicing physician before you came to the Divinity School? After? During? What was that timeline?

OMAR SULTAN HAQUE: My philosophical and theological studies were interspersed throughout my scientific training, but I was not yet an independent attending physician at the time.

AMIE MONTEMURRO: All right. Thank you. And we'll be asking you a few more questions about your career as a physician among other things coming up in a bit here. So, one thing I've been wanting to ask you about: people can be surprised when they learn that the Divinity School is a non-sectarian, multi-faith organization. Frankly, you don't even have to be religious to attend. And our student body represents approximately 30 different religious traditions and denominations each year. What is something else that may be surprising about the School? 

OMAR SULTAN HAQUE: Yes, definitely true that it's a very unique place. And I think the biggest thing that it meant to me—along the direction that you describe—it is a place where you can really explore any of the dimensions of values and spiritual traditions, and even outside of those. I mean, there's a whole track for humanists and secularists.

It's a place for serious philosophical and ethical study and I, particularly, just enjoyed the time being able to reflect on those things. And I thought of it as a detour, but it really became a main highway in my life.

AMIE MONTEMURRO: Excellent. Shifting a bit more broadly here—from your perspective, how can we, as individuals, find our way to lead with ethics and with compassion and, particularly, when we're weathering difficulties—and we've had a number of them over the last year, plus year? Just really wanted to get your guidance there.

OMAR SULTAN HAQUE: Mmm. Yeah. I did a talk with the religion and practice of peace program a couple of years ago. It reminds me of this question of how to find peace between different worldviews and things like that. But I think the first thing would be to engage people who we disagree with intellectually and morally.

It's so easy for us to find people who we agree with, and I think that leads to self-censorship and lack of dialogue. And I think the Divinity School aims to open the discussion up—open inquiry and respectful constructive disagreement between people, even if they don't see eye to eye; acknowledging our own fallibility—that we don't know everything, we can learn from others.

Looking for common interests across difference and moving those to the top of our agenda. For example, I saw a project on how people on the left and right focused on childhood poverty as a common cause they both cared about. And I think also looking to our common humanity as a way to motivate moral action to be very productive, as opposed to all of the differences, however interesting they are… And this is what I presented in that talk: If you ask people to look at things from God's point of view, they actually, rather than inflaming differences, this can actually distract people away from their ego and their own environments. And then they're able to imagine other people's perspectives a little bit easier because—it's even shown in couples therapy—that if you ask people to imagine the other person's point of view, and that person to imagine your point of view, it's not as good as asking how would a third party who cares about both of you, who's wise and benevolent, think about what you're saying and think about what your partner is saying?

And what that does is it allows each person to not only think about the other person, but themselves. Because often, the problem is our own egos getting in the way. So that's [the couples therapy intervention] a secular surrogate for thinking about it from God's point of view. And, interestingly enough, that's been studied in the Israeli-Palestinian conflict [with God concepts], and it does increase the attribution of moral worth to outsiders.

There's another interesting psychological mechanism called motive asymmetry bias, which means that when we think of what's happening in a group conflict between two people or even two groups, we often assume that the other side is doing what they're doing because they hate us. And we're doing what we love, we're trying to protect our own values and help our people. But if you get people to think about how the other group, also, is doing what they do for the love of their people or something that is deeply valued for them, and, also, that we might be doing things also out of aggression and hate, that reduces this motive asymmetry bias. That's another one that's really cool. So, you can see that at work in actual conflict.

A third thing that's really interesting, I think, is the idea of sacred values. When you look in negotiations you see the economists always say just offer money, or just give people material goods and incentives—to trade things off, things that they value as sacred. This is where I think the religious studies and theological scholars and anthropologists understand things a little more deeply—that people will be willing to lose money to preserve sacred values, the things that they find sacred.

So, that's an often-important part of negotiation and peacemaking. Giving symbolic gestures across difference really helps people understand or softens people's hearts. And so many other things like this. I think there's a huge source of knowledge in the social sciences that could be applied to these kinds of questions.

AMIE MONTEMURRO: So, this brings us to a couple of questions about your education and what your education has brought to fruition for you in your day-to-day experience. You have a number of different roles that you play in the community, but the first one I wanted to ask you about is—as a physician with a master's in theology, how do you foster respect for pluralism in your everyday life?

AMIE MONTEMURRO: I'm going to pause for a moment to answer a listener question: "What is pluralism?" My word-nerd caveat is that "pluralism" is a small word that encompasses a big idea. That said, one definition of "pluralism" is the "quality of or state of being plural" and the key concept here is "the existence of different types of people, beliefs, and ideas within the same society."

OMAR SULTAN HAQUE: I’m a doctor. I have post-doctoral training in psychology and I'm board-certified in the American Board of psychiatry and neurology but also obesity medicine. Outside of the University I run two clinics, both of which I got interested in because of the—my social science work is on stigma and dehumanization, and these two clinics focus on two stigmatized groups. One is a depression clinic; the other one is an obesity clinic.

Pluralism can arise, for my patients at least and people—I’ve also worked in state hospitals in Rhode Island and Massachusetts for many years. But the fact that there are different forms of life that just exist in human community that are different equivalent goods and blessings and gifts that people have been given, and helping people see those things will help them flourish and help us flourish as a community.

There's also different forms of privileges and burdens in life, both with health and illness, disability status, access to care, socioeconomic benefits, and that having this healthy pluralism, or healthy space, for seeing all these good things in life and also difficulties in life that are not distributed randomly or equally, is not a form of relativism or nihilism. We can still bring a normative filtering of what's good and bad, even if we still see that there are different ways of living in the world and being in the world, for whatever reason.

AMIE MONTEMURRO: I think you were just starting to get to my next question, which is, can you tell us a bit more about the barriers to fostering pluralism? Or frankly, if you wanted to take it into this idea of human flourishing—if you wanted to take it into that space? And how do you use what you learned at the Divinity School to overcome these barriers?

OMAR SULTAN HAQUE: Yeah. I think that I primarily, even though I'm a physician and a teacher and a researcher, and other things, in my heart really I’m a philosopher type of person. So, I think of these questions philosophically. And I think of the COVID pandemic recently, I think that's a good lens to look at a lot of these questions. So, for example, I was working on a project on how to preserve the Americans with Disabilities Act and disability rights for patients’ access to care who have disabilities, even though, on a strictly rational accounting of things, one could make an argument for why somebody who has some disability should be not prioritized in medical caregiving.

So that's coming at it from a utilitarian philosophy, and I think a lot of the things I started learning at Divinity School were looking at more deontological approaches to morality. My clinics are—they start with the word "dignity," because I really think that the idea of the dignity of the human person should be at the center of a good society. And in the case of coronavirus with a person's disability, this is a good example because reason doesn't tell you which way to go.

There's a pluralism of moral and ethical theories about how to solve this problem. But if you start with a lens of dignity and equality and human rights, you get a totally different answer to how should you interact with somebody who is going to need more time on the respirator, who is going to take up more resources, as opposed to an alternative rationalistic or utilitarian framing that sees the person as a burden or as—almost in its extreme, can go towards the way the Nazis did medicine.

I did another piece on why doctors joined the Nazi party, analyzing some of these threads as well. But I think that's some of the things I picked up in the Divinity School. How to see this real difficulty of pluralistic moral theory, and deciding between them in a way that's fair and equitable.

AMIE MONTEMURRO: In addition to a medical career you're—as you mentioned earlier—you're a social scientist, you're a philosopher, a teacher, and a writer, and can you just tell us a bit more about how you've woven together these many areas of expertise, which include global health, anthropology, religion, social psychology, bioethics, and law? And tell us a bit more about how your degree from HDS comes to light in this intellectual constellation?

OMAR SULTAN HAQUE: Yeah, thank you. That's a big question. I need to trace those threads a little bit. I think of, for example, the question of why did physicians who took the Hippocratic Oath, why would they join the Nazi party even though they seem to have an obligation to care for people? I think that's a good example of how a society can go in one direction, unmoored from any dedication to the sacredness of an individual person. So, I think that's an example of something that I think I picked up.

I think I got interested in the question of dehumanization, also, in medical settings because I also thought that going through residency and becoming a physician is dehumanizing in many ways. So out of that dissatisfaction, I tried to turn that into a scholarly question.

And the way we objectify and animalize or infantilize our patients, as well as each other, and ourselves, I tried to schematize that into a theory and try to expand on that, and apply it to different populations to understand how the interventions could be designed to improve things. But, fundamentally, behind that is the belief that we, fundamentally, are persons to begin with. And that there is something sacred about our humanity, because you wouldn't really be upset about dehumanization if you didn't think that there was something good about being human. And that there was not only something good, but something sacred.

So that's a theological premise that snuck into a lot of our humanism, and I got interested in that question and tried to analyze it. So, that's the social science side of it. The philosophy side of it is—if you really think that there's nothing unique about humanity, then we really have a hard time arguing for why we should allocate resources to us and not all the insects who are being killed in genocides in the forests right now.

If there's not something different between me and the chair I'm sitting on, not just in degree—not that a really, really complicated chair or a really, really complicated alarm clock would eventually be me and would be conscious and would have moral properties—that's also a form of dehumanization—to objectify a person. Thinking about that, I think there's something really deep about that, and that also inspired my interest in the question of dehumanization.

And it applies directly to disability rights and why would you prioritize the value of a person in a society in a hospital if they didn't have intellectual capabilities in the same way that a neurotypical person would? How do we really justify our care for people who are not flourishing in the way that would be valuable to a society? And I think there's many theological accounts of why we have those obligations, but there's only one worldview that I found didn't have an account of that, and that was the naturalistic worldview.

And that's how I got interested in these questions. Because there was a disconnect between my moral experience as a clinician, and my worldview as a naturalist or an atheist. Every day I was caring for people and just having this intuitive experience of doing good and doing the right thing, regardless of what they looked like; regardless of what they smelled like; [regardless of] how much it cost to care for them; across many differences; and I felt this disconnect between my moral experience of the world, my belief in our fundamental equality, and so on, and the world view I was living in. So, I think that might be a way to tie up some of my intellectual and personal beliefs.

AMIE MONTEMURRO: Thank you. If we can go one more question on that topic, if you don't mind? Not every physician has the same training, the same philosophical grounding. So, I have to ask, how is it being out in the world doing the very hard work that you're doing, especially in the midst of a global pandemic, and having that awareness with you that folks are sacred and there is, as you said, this added layer of your understanding of your medical career?

OMAR SULTAN HAQUE: Yeah. You might ask yourself this question: Say you go to a hospital because you have an emergency, or you go to your outpatient clinician—what are they doing? Not in the sense of the mechanistic sense of how are they initiating pharmacology into your body or how they are operating on something, but what are they—what's the point of what they're doing? What are they actually aiming to do with you? Not just with your body but with your whole life and all of your relationships?

That's kind of a question we don't ask in medicine, but if you come at it from this philosophical or moral or spiritual tradition, you have to ask it. And, so, I do think about that a lot and it's really the question of what is human flourishing? What does it mean to flourish as a human being? And, oftentimes, our definitions are mechanistic, they are dehumanizing, and they just try to bring a person to species-typical functioning, or something like that. And it ignores all the existential and moral and spiritual dimensions of the person.

And without that teleological account—teleology means: telos is the purpose and end for the human person­—without that teleological account of what the point of medicine is, and what the point of a human life is, we really can't figure out what is the right intervention, for the right person, at the right time, and the right context. And, so, I think about that all the time, in all the work I do. What's missing in someone's life, but also what is something that we can help bring to them in caregiving, beyond just the protocol of what medication might be indicated?

For patients with depression, for example, a lot of the psychotherapy is very pessimistic. It comes out of the Freudian antipathy towards the spiritual. And one analogy I like is that it describes us as two-dimensional stick figures, meaning… if you've ever seen one of those animations where there's a two-dimensional account of people interacting, and then all of a sudden it becomes three-dimensional? Because a lot of our psychotherapy and social science and medicine is two-dimensional, meaning it mistakes us for stick figures, even though we have a vertical dimension.

It ignores the vertical dimensions of life entirely. But, nonetheless, our patients are vertical creatures. They live in three dimensions, but we, as clinicians, talk in two dimensions. And so that disconnect manifests all the time. Someone's depression could be entirely because they can't find forgiveness in their life in some way. And that touchy-feely thing, now in studies, we know it changes gene expression; it changes blood flow to the brain in different ways; it changes all kinds of stuff in your neurochemistry.

But someone starting off as a Freudian would never think of that kind of stuff, they would think of it as some kind of unconscious defense mechanism or some kind of epiphenomenon to something more basic, which is just pleasure-seeking. The goal of life for a lot of the Enlightenment thinkers was just… we're just animals and we're just here to find pleasure and avoid pain and then die. And as Freud says, the goal is to go from hysterical misery to everyday unhappiness.

There's nothing beyond that, really. There's no concept of joy and flourishing and purpose and meaning and value. For the Marxist, value is epiphenomenon of dialectical materialism…the superstructure of material forces. Those are abstract-sounding ideas, but they manifest in people's lives in very concrete ways. [For example] when somebody dies and their spouse dies and they're trying to understand how to move past that event.

If we only play our piano with a couple of keys, we're not going to make that symphony in life. And that's what—our patients are living in a symphony that they lost and we're giving them only a couple of keys to play with. I don't know how many more metaphors I have under my belt; there's so many ways to say it.

AMIE MONTEMURRO: I'm hearing Freud could have taken a class in epigenetics and, maybe, human flourishing and would have learned a thing or two?

OMAR SULTAN HAQUE: Right on, yeah. Yeah.

AMIE MONTEMURRO: Yeah. So, I would be remiss if I didn't point out you didn't learn all of this from Harvard. Or, at least, what you learned from Harvard may have been validated by another university. Is that right?

OMAR SULTAN HAQUE: Right. Yes, I also went to Yale Divinity School, and I did a master's degree there. I focused on metaethics and God and morality, and I was really interested in the question of what difference it makes to have God in, or outside of morality. Does it add anything; does it take anything away? And so, I just spent a whole year thinking about that and I guess I can say, yeah, it made me more interested in the idea of human dignity—the basis of our moral equality, which is something that John Locke, for example, wrestled with as well.

And he thought that we needed some kind of spiritual dimension to explain our moral equality because it cannot be based on some cognitive capacity, because people vary in that. People get head injuries, or they are born with more, or less, of whatever capacity we think is the grounds of our political equality.

And then, I think, moral endurance is another feature that I studied. How do we make our moral commitments realizable in the long term? How do we endure it through hardship? I think there's something else that I got into at that time—which is something that Immanuel Kant discussed and struggled with as well. How do we make doing good coincide with our own flourishing? How do we make, I think as the Psalmist says, virtue and happiness meet? How do we flourish and also be virtuous? Because many times, people flourish by being bad...Bad people flourish and good people do not flourish, sometimes often.

And sometimes, doing the right thing means you don't flourish in the short term. So, how do we solve that problem? Kant thought that we had to postulate some God or supernatural realm to help account for the assistance we believe we will find. And whether that's a self-fulfilling prophecy, or itself a metaphysical type of help, I thought that was really interesting, because it's a problem. If you know that virtue and happiness do not align, I think it makes you less likely to be virtuous.

And so, there is a unique contribution you get from theology or the spiritual realm. So anyway, I got really deep into some of those questions…I'm still on the Harvard team, I think.

AMIE MONTEMURRO: We won't make you choose here. And then coming back to your time at Harvard. Before we wrap up, I know that you had the honor of knowing Peter Gomes when you were here. If there's anything you'd like to share, a story or a memory, we wanted to give you some space to talk about Peter Gomes for a moment.

OMAR SULTAN HAQUE: Absolutely. I mean, what an amazing man. I first got interested in taking his class because everyone said he's an amazing lecturer. And he's just a profound speaker. And then I wandered into the class. And I just shopped it for a while. It was the big class he taught on interpretation of the Bible, and I just thought, well, even if I don't believe in any of the stuff, I got to at least listen to this maestro.

And then, I kind of got enraptured by it and I got engaged by what he was saying, and I really got interested in the questions—hermeneutical questions and the philosophical and theological questions. So, I learned a ton, and then I even went back after I stopped being an atheist or naturalist, and I became a Christian, I went back and I reread his book and I got more out of it than I ever did before, because when I was initially going through it, I was more skeptical. But I was interested in him. He really knew how to connect abstract ideas to people's lives…I guess as a pastor, as a preacher. I think he had such a compassionate heart, too. And he was intimidating at first when I met him. And he would invite us to his house for tea, and he opened his doors to everyone. And I always remember that class fondly, because he also had the best sense of humor and I still… I just remember laughing a lot in the class, which I didn't expect to. Very, very wonderful. Thank you for the chance to remember him.

AMIE MONTEMURRO: Thank you for sharing. And that leads us to our final question: The Divinity School's focus can often be characterized as "making a world of difference," What are one or two tangible ways that everyday folks can help bring this HDS focus to fruition?

OMAR SULTAN HAQUE: I think what the Divinity School does to inspire people, as well as to do something different than the University, is that it doesn't come out of this tradition that says that the University is only searching for, essentially, objective person-independent knowledge that would exist even if everyone in the world didn't exist… like died… natural science knowledge, for example.

So, that tradition comes out of scientism and positivism and, I think, what we can do to help people make a world of difference is see the University as having an essentially moral purpose—not an abstract, intellectual, or positivistic purpose. So, if the University exists to pursue moral ends and you, as a student, as an alumnus, you also exist to do good in the world. You're not just a modem or a computer that's here to download information as efficiently as possible and submit it to your neighbor.

And I think one of the most important ends is truth seeking. This is in itself like a normative aim of life, but it's only one aim among many. We must also see goodness and beauty and the transcendent dimension of life. But even if we limit ourselves to truth seeking as our mission, then the truth that we would seek would include more than the truth of the natural sciences. It would include many other types of truth that are non-scientific knowledge. There is such a thing as non-scientific knowledge—moral, aesthetic, and religious knowledge.

But, then again, there's a danger as well. If we think of the University as existing only to pursue moral ends, we then cannot be too comfortable with the ends we decide to pursue. We can't close off inquiry into what our ends are and what the process of finding out how to achieve those ends is. So, there's a danger of a monoculture or an echo chamber, too. So, I think there's dangers on both sides. But I think that's a great way to make a world of difference.

AMIE MONTEMURRO: Many thanks to Dr. Haque for his time, for his insights on the many intersections of health and intellectual exploration, and his care for human flourishing.

And thanks to you for tuning in to this special episode of Divinity Dialogues. This podcast came together with the help of some remarkable colleagues, including Caroline Cataldo with her editing and producing expertise, Kristin Ponte with her exceptional work with the Gomes awards event, and folks across the Communications and Development teams at the School.

 

We’ll have a new episode coming out next week featuring an illuminating interview with Robin Coste Lewis— poet laureate and National Book Award winner for her debut collection, Voyage of the Sable Venus.

 

You can find us on the HDS SoundCloud channel or subscribe to Harvard Divinity School on your favorite podcast platform to make sure you never miss a new episode. You can also find us on Facebook, Instagram, Twitter, and YouTube to learn more about HDS and our amazing community.

 

Until next time…