Biomedical Ethics In The Christian Narrative Essay.
Biomedical Ethics In The Christian Narrative Essay.
Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to:Biomedical Ethics In The Christian Narrative Essay.
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- Encourage collaborations across communities and sectors.
- Empower individuals toward making informed health decisions.
- Measure the impact of prevention activities.
Introducing Healthy People 2020
Healthy People 2020 continues in this tradition with the launch on December 2, 2010 of its ambitious, yet achievable, 10-year agenda for improving the Nation’s health. Healthy People 2020 is the result of a multiyear process that reflects input from a diverse group of individuals and organizations. Read the press release for the Healthy People 2020 launch. [PDF – 149 KB]Biomedical Ethics In The Christian Narrative Essay.
Vision
A society in which all people live long, healthy lives.
Mission
Healthy People 2020 strives to:
- Identify nationwide health improvement priorities.
- Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress.
- Provide measurable objectives and goals that are applicable at the national, State, and local levels.
- Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge.
- Identify critical research, evaluation, and data collection needs.Biomedical Ethics In The Christian Narrative Essay.
Overarching Goals
- Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
- Achieve health equity, eliminate disparities, and improve the health of all groups.
- Create social and physical environments that promote good health for all.
- Promote quality of life, healthy development, and healthy behaviors across all life stages.
- Write a 1,200-1,500 word analysis of “Case Study: Healing and Autonomy.” In light of the readings, be sure to address the following questions:Biomedical Ethics In The Christian Narrative Essay.
- Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study?
- Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?
- According to the Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation in the topic readings, how might one analyze this case?
- According to the topic readings and lecture, how ought the Christian think about sickness and health? What should Mike as a Christian do? How should he reason about trusting God and treating James?
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.Biomedical Ethics In The Christian Narrative Essay.
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Scripture is somehow normative for any bioethic that would be Christian. There are problems, however, both with Scripture and with those who read Scripture. Methodological reflection is necessary. Scripture must be read humbly and in Christian community. It must be read not as a timeless code but as the story of God and of our lives. That story moves from creation to a new creation. At the center of the Christian story are the stories of Jesus of Nazareth as healer, preacher of good news to the poor, and sufferer. The story shapes character and conduct and enables communal discernment.Biomedical Ethics In The Christian Narrative Essay.
Keywords: scripture, Bible and bioethics, healing ministry, poor, sufferingI. Introduction
All scripture is inspired by God and is useful for teaching, for reproof, for correction, and for training in righteousness, so that everyone who belongs to God may be proficient, equipped for every good work. (2 Timothy 3:1–17)
So an early Christian leader commended scripture to his readers. And so I would commend scripture to my readers. Scripture is the measure, the “canon,” for any bioethics that would be Christian. Attention to scripture as somehow normative for bioethics is what makes Christian bioethics Christian. That is the claim of the first part of this essay. But if that claim is true, then a Christian bioethics will need not only to affirm that scripture is “somehow” normative but also to ask how it is normative for bioethics. Somehow—but how? The second part sketches a methodological proposal in reply to that question; and the third part suggests a substantive proposal. A Christian bioethics will not be identical with scripture, but a Christian bioethics may proceed gladly and boldly by way of reminder, by remembering the story scripture tells, the story Christians love to tell and long to live.
II.
Scripture is somehow normative for bioethics, “useful for teaching, for reproof, for correction, and for training in righteousness” in bioethics. That is the claim, but there are problems in such a claim, and it may also be useful to begin by acknowledging them.Biomedical Ethics In The Christian Narrative Essay.
One obvious problem is the silence of scripture about many of the moral issues taken up by bioethics today. No law code of Israel, for example, attempted to write legislation on human cloning. No scribe ever asked Jesus about stem cell research. The Bible simply does not address many of the questions which new medical powers have forced us to ask, and it is folly to search the scriptures looking for veiled references to them. 1 This is not to say, however, that scripture is irrelevant to the questions about which it is silent.Biomedical Ethics In The Christian Narrative Essay.
The silence of scripture is not the only problem. Besides the silence of scripture there is the strangeness of scripture. When scripture does speak of sickness and of healing, its words are, well, sometimes quaint. When the Chronicler chides Asa for doing what any of us would be quick to do, consulting a physician about a gangrenous leg (2 Chronicles 16:12), it’s a strange world of sickness in scripture. And when the psalmist joins confession to lament in his sickness, “There is no soundness in my flesh because of your indignation; there is no health in my bones because of my sin” (Psalm 38:3), there are from our world of sickness many unanswered questions: What’s the diagnosis? What’s the prognosis? Is there a doctor in the house? But here there is evidently no concern with a medical diagnosis and no effort to secure the aid of a physician, only penitence for the sin that presumably wrought the sickness. It’s a strange world of sickness in scripture. We may as well admit it: much of what scripture says about sickness and healing is alien to us, strange. The words of scripture are human words, we are driven to admit, words we may not simply identify as timeless truths dropped from heaven or repeat without qualification as Christian counsel for medicine or for bioethics today. Even when we use the story of the Good Samaritan as a paradigm for medical care, to pour oil and wine into wounds seems strange rather than paradigmatic emergency treatment (Luke 10:30–35).Biomedical Ethics In The Christian Narrative Essay.
Scripture is sometimes silent; it is sometimes strange; and sometimes one part of scripture seems to disagree with another part. That diversity of scripture may be counted a third problem: scripture does not speak with one voice about sickness or about healing. If, as we have seen, the sick were sometimes blamed for their condition and expected to assume the posture of a penitent, the book of Job sees things quite differently.Biomedical Ethics In The Christian Narrative Essay. Job suffered not only from the death of his children, not only from his own ulcerous body, but also from the confidence of his friends in the familiar paradigm that suffering is a punishment for sins. Job rejected both the paradigm and the penitence that defined the sick role in ancient Israel because of it. And if, as we have seen, the Chronicler rejected physicians and their medicines, in the deutero-canonical book of Ecclesiasticus the sage Jesus ben Sirach effortlessly integrated physicians and their medicines into Jewish faith in God the healer (Ecclesiasticus 38:1–15). “Honor physicians for their services,” he said, “for the Lord created them … The Lord created medicines from the earth, and the sensible will not despise them” (Ecclesiasticus 38:1, 2, 4). King Asa would probably have loved it. And so, of course, would Luke, “the beloved physician” (Colossians 4:11). It will hardly do, of course, to respond to this diversity by treating scripture as if we were at some literary garage sale, looking for something we like, something that strikes our fancy, something that will not cost us much, while we regard the rest of it as white elephants. 2
There are problems, however, not only with scripture but with us as readers. One problem here is simply that we are unfamiliar with scripture. There are far too many Christians who are biblically illiterate, even when they have grown up within the church, even when they have some vague idea that the Bible ought to be important to them. A colleague at the college where I used to teach tells of a student, for example, who wrote in an essay that Jesus must have been a Roman Catholic because he was, after all, born before the Reformation. Our lack of familiarity with scripture makes understanding any part of it difficult. This problem, thankfully, can be remedied. We can all invest some time in becoming more familiar with scripture.Biomedical Ethics In The Christian Narrative Essay.
The problems with us as readers, however, go deeper than ignorance. As readers we are sometimes arrogant, and in that arrogance we have used scripture in self-serving ways, twisting it into the service of the conclusions we had previously reached on other grounds. Moreover, the abuse of scripture has sometimes led to the abuse of people—with scripture as the instrument. Appeals to scripture, it must simply be admitted, have sometimes done a great deal of harm. When Genesis 3:16, “in pain you shall bring forth children,” was quoted to oppose pain relief for women in labor, a great deal of harm was done.Biomedical Ethics In The Christian Narrative Essay. When some would prohibit transfusions because of a curious reading of a curious set of texts about blood, a great deal of harm is done. When the Bible was pointed to by those who said AIDS was God’s punishment for homosexual behavior, a great deal of harm was done. It may be said, and rightly said, that these uses of scripture are all abuses of scripture, but people have nevertheless been harmed—notably women and children and other patients on the margins, seldom “righteous” adult males. The abuse of scripture, and the abuse of people with scripture as weapon, should give us pause before we attempt to join the Bible to bioethics. Given all the problems, perhaps it would be best simply to ignore scripture.Biomedical Ethics In The Christian Narrative Essay.
On the other hand, there is that famous commendation of scripture by the author of Second Timothy with which we began. There is the commonplace affirmation of the creeds and confessions of the churches that scripture is somehow normative for the churches’ faith and life. And there is, moreover, the practice of Christian communities. They continue to read the biblical materials not simply as an interesting ancient Near Eastern library but as Christian scripture, not only as curious literary artifacts but as canon, not only as scripted, as written, but also as script to be somehow performed.Biomedical Ethics In The Christian Narrative Essay.
That practice is not an optional one in Christian community; it is essential to Christian community. “Scripture” and “church” are correlative concepts. Part of what we mean when we call a community “church” is that this community uses scripture somehow as normative for its identity and its common life. To say “church” is to name a community that gathers around scripture and uses it somehow to form and reform its walk and its talk. And part of what we mean when we call certain writings “scripture” is that these writings ought to be used somehow in the common life of the church to nurture and reform it. To say “scripture” is not simply to name a little collection of ancient Near Eastern religious texts; it is to name the writings that Christian churches take as “canon,” as the rule somehow for its thought and life. 3 Ignoring scripture is not an option for the church, not at least if it is to continue to be the church.Biomedical Ethics In The Christian Narrative Essay.
If we allow the problems we have identified to overwhelm us, if we push scripture to the margins of reflection about bioethics because of them, we put ourselves at risk of forgetfulness. Without the practice of reading scripture, the church suffers amnesia; she forgets who she is and what she is called to be and to do. There is no Christian life that is not shaped somehow by scripture. There is no Christian moral discernment that is not tied somehow to scripture. There is no Christian ethics—and no Christian bioethics—that is not formed and informed somehow by scripture.Biomedical Ethics In The Christian Narrative Essay.
Granted that scripture is sometimes silent about the particular moral questions in bioethics that Christians face today. Granted that the worlds of sickness and healing in scripture are sometimes strange and alien. Granted that scripture is sometimes diverse and sometimes difficult. In spite of the problems Christian communities turn again and again to scripture, and they find in scripture a resource to renew their life, to retrieve their identity and vocation, and to reform their practices. Biomedical Ethics In The Christian Narrative Essay.The fundamental problem is finally not whether to continue to read scripture as [“useful for teaching, for reproof, for correction, and for training”] in bioethics but how, not whether scripture is somehow normative but how it is, how scripture is to be performed in bioethics, how it guides us through the new powers of medicine and through the ancient human events of giving birth, suffering, dying, and caring. Christian bioethics will not simply be identical with scripture, but it must somehow be informed by it. 4 Somehow—but how? That is the problem.Biomedical Ethics In The Christian Narrative Essay.
III.
It is not the sort of problem, however, that with a little time and effort we might figure out and set aside as solved. It is more a mystery than a puzzle. The formation of a community and its moral life by the reading of its scripture is a mystery that transcends our puzzling over it, eludes our efforts at mastery of it, and evokes not just curiosity but wonder. That mystery is admitted and celebrated when Christians point toward the Spirit of God as the One who both inspires scripture and illuminates it.Biomedical Ethics In The Christian Narrative Essay.
The mystery should keep methodological reflection humble, but it does not eliminate the need for it. The Spirit did not simply overrule the human authors of scripture. They spoke and wrote with their own voices. And the Spirit does not simply overrule the human readers of scripture. The community that gathers around scripture needs to think hard and humbly about how scripture is “useful” for the moral life.
Humility requires that any proposal for joining the Bible and bioethics acknowledge that decisions about how to use scripture are reached not so much at the end of an argument as in the context of a religious community and as a result of an experience of the authority of scripture within such a community.Biomedical Ethics In The Christian Narrative Essay. The authority of scripture is recognized in and with what David Kelsey calls an “imaginative construal” of the way God is present among the faithful, of the way God is related to scripture and to the community through scripture. And that “imaginative construal” of scripture and of God’s relationship to us through scripture is enabled (and finally tested) by the common life of the community of faith; it is enabled (and finally tested) by practices like prayer and proclamation, liturgy and service, and—not least—by the practice of moral discourse.Biomedical Ethics In The Christian Narrative Essay.
To say that proposals for the use of scripture depend upon some “imaginative construal” of scripture is not to say that there are no controls, no limits, on the moral imagination of those who would join scripture to bioethics. It is not to say that there is nothing to prevent someone with an imaginative brainstorm from twisting scripture to their own and their community’s destruction. These are old and legitimate concerns, of course.Biomedical Ethics In The Christian Narrative Essay. The author of 2 Peter expressed them early on, “There are some things in them [i.e., in the letters of Paul] hard to understand, which the ignorant and unstable twist to their own destruction, as they do the other scriptures” (3:16). We point toward the controls and limits when we return to the point made just a moment ago. Imaginative construals of scripture—and proposals for the use of scripture which have their beginning in such construals—are not only enabled by participation in the common life of the churches but also finally tested by the common life of the community of faith. They are not only enabled but also finally tested by practices like prayer and proclamation, liturgy and service, and—not least—by the churches’ practice of moral discourse. A humble proposal submits itself to the community and to its practices. It makes itself publicly accountable; that requires, of course, that an account be given. Proposals for the use of scripture must be able to bear examination in the discourse of the community, must be “patient of reasoned elaboration” and “consistent formulation” (Kelsey, 1975, p. 171).Biomedical Ethics In The Christian Narrative Essay.
I have made such a proposal elsewhere (Verhey, 2002, pp. 55–75; 2003, pp. 41–67). Here I simply summarize that account. Christians must read and use scripture humbly. Without humility we will be guilty of that interpretative arrogance that, as we said, abuses both scripture and persons. Biomedical Ethics In The Christian Narrative Essay.Without humility we will use scripture like a weapon against a neighbor. Humility is the first and great rule for reading and using scripture. And a second is like it: We must read and use scripture in Christian community. It is like it because humility, like love, “does not insist on its own way” (1 Cor. 13:5), even when reading scripture. Humility does not insist on some “right of private interpretation,” which always leaves us in charge instead of scripture, but turns to the community whose book it is and whose common life is constantly formed and reformed by its practice of reading scripture. On these two rules hang all the rest. The rest are simply correlatives.Biomedical Ethics In The Christian Narrative Essay.
If we read scripture in Christian community, we will read it not simply as an ancient collection of ancient Near Eastern religious literature but as canon, as (somehow) the rule of our faith and practice. The history of the canon is a complicated history, of course, but the heretic Marcion surely played no small part in that history. Biomedical Ethics In The Christian Narrative Essay.The Church rejected Marcion’s rejection of the Hebrew scriptures along with his rejection of the Creator God and his dismissal of the body as a gift of the Creator. The Church insisted against Marcion not only that the Hebrew scriptures be accepted as the Old Testament but also that the Father God who sent Jesus into the world to redeem the world be acknowledged as “God the Father almighty, maker of heaven and earth” and that the body be celebrated as a good gift of the creator and as the object of the redeemer’s love and resurrection power. To read scripture as canon, therefore, is to read it without Marcion’s dualism.Biomedical Ethics In The Christian Narrative Essay.
To read scripture as canon is to read it as script to be somehow performed. But because the canon is quite candid about the fact that it has a history, that it did not fall entire from heaven, at least some among the community of performers must read it as scripted, as written over time by authors on particular occasions addressing specific audiences dealing with different historical crises and using words and traditions available to them. To perform scripture well as script we will have to read it well as scripted, that is to say, with exegetical care and skill. If we would read scripture in the community of those who acknowledge that they are formed by these writings and who stand ready always to be re-formed by them, then we must be ready continually to assess existing traditions of interpretation and performance.Biomedical Ethics In The Christian Narrative Essay.
If we would read scripture in Christian community, we must read it in ways that serve the practices of that community and are informed by those practices. Consider, for example, the practice of prayer. We must read scripture prayerfully and in the service of that practice of simple attention to God. As prayer calls upon God, so we read scripture to remember the story of the God we invoke. As prayer makes confession, so we read scripture over-against ourselves, not in self-serving defense of our own righteousness. As prayer gives thanks to God, so in the reading of scripture we share the gifts of God (including the scholarly gifts of some readers). And as prayer makes petition, so we govern our petitions and our readings and our deeds by the vision of God’s good future born of remembrance—and by the aching acknowledgment that that future is not yet.Biomedical Ethics In The Christian Narrative Essay.
But there is another practice we may not neglect. It is the Christian community’s practice of reading scripture itself. We must read scripture in accord with the churches’ practice of reading scripture. In that practice, the good is remembrance. We read in order to remember. By reading scripture in Christian community we remember the story that gives us our identity and makes us a community. It is the story we love to tell and long to live. It is the story that is constitutive of identity and determinative for discernment. Little wonder that some insist that we read scripture according to the creed, according to the “Rule of Faith,” for the creed is simply the abridged version of the story scripture tells, the “short story” of the canon. Moreover, in that communal practice of reading scripture, there are standards of excellence for reading: holiness and sanctification, fidelity and creativity, discipline and discernment.Biomedical Ethics In The Christian Narrative Essay. We must set these writings aside as “holy” and set aside a time and a place to read them. We must set all the stories of our life alongside the story of scripture that they may be made new. We must read scripture and perform it both faithfully and creatively; fidelity requires creativity; and both may be tested against the story. We must read it with a readiness to be disciplined by it, to be disciples of the remembered Jesus. We must read it with (and for) discernment, reading any part in the light of the whole story and testing our conduct and character by whether they are worthy of the story, “fitting” to the remembered narrative. Scripture is not to be read as a timeless moral code but as the story of God and as the story of our lives. 5
IV.
Reading scripture and remembering the story, a Christian bioethics proceeds by way of reminder. The story is gospel, so it may proceed gladly by way of reminder. But the gospel makes claims on our lives, and so it must proceed boldly by way of reminder.Biomedical Ethics In The Christian Narrative Essay.
The story begins “in the beginning,” of course. To remember that God made all things has always had at least two implications for bioethical reflection. First, because God made all things, nothing that God made is god. And second, because God made all things, all that God made is good. Christian bioethics will return again and again to these prohibitions of both idolatry and dualism. When we are tempted to make an idol of technology (or life or health or children or the body), and when we are tempted to disregard the fact that technology (and life and health and children and the body) are good gifts of God, then it is time to read scripture together and to remember the story that begins “in the beginning.” Christian bioethics may proceed with confidence that goodness and righteousness go with the grain of the universe God has made, not against it. But it should proceed with caution about its ability to read God’s cause directly from “nature” (or what is), for both what is and our vision of it have been corrupted by sin. We need the corrective lens of scripture.Biomedical Ethics In The Christian Narrative Essay.
Creation, of course, is not the end of the story. The story continues and the plot thickens with the story of human sin and the curse that followed in its train. But that – by God’s grace – is not the end of the story either. God does not let sin and death have the last word in God’s good creation. God comes again to covenant and to bless. So we read of the ancestors and of Israel, of Sinai and the law, of kings and prophets and sages. We remember births and deaths, laws to protect the poor, wisdom about suffering. There is much here that will inform a Christian bioethic, not as law exactly as given by an ancient lawgiver nor as timeless principle discerned by an ancient sage but as part of the whole, as part of the story. At the center of Christian scripture, however, we read the story of Jesus, the story of the chosen one of God, the one who makes both God and humanity known, the one who comes announcing the good future of God and already made its power felt. And I hasten on to illustrate how the story of Jesus may inform a Christian bioethics.Biomedical Ethics In The Christian Narrative Essay.
A Christian bioethics remembers Jesus as the one who healed the sick and disabled, as the one who preached good news to the poor, as the one who suffered and died under Pontius Pilate, and as the one whom God raised up “as the first fruits of those who have died.”
In his healing ministry Jesus made known God’s good future, and he made its power felt against death and Satan and sin. 6 First of all, and most obviously, in the healing ministry of Jesus the good future of God already made its power felt against the power of death. 7 The dead were raised, and those who were thought in the first century to be “like dead” or under the power of death, the lepers, the blind, the paralyzed, were healed (Luke 7:22–23; Seybold & Mueller, 1981, p. 123). The healing ministry of Jesus disclosed the power and the purpose of God. God’s cause is life, not death; God’s cause is human flourishing, including the flourishing we call health, not sickness. And when God raised this Jesus from the dead, that cause was assured.Biomedical Ethics In The Christian Narrative Essay.
In memory of Jesus and in expectation of God’s final triumph, the Christian community will celebrate and toast life, not death, but also be able to endure even dying with hope. In memory of Jesus and in hope the Christian community will delight in human flourishing, including the human flourishing we call “health,” but also be able to endure even the diminishing of human strength we call “sickness” with confidence in God.Biomedical Ethics In The Christian Narrative Essay.
A Christian bioethics may still praise God for doctors and nurses and for their knowledge and skill. It may still see medicine as a gift of God the creator, still following the lead of that wise and prudent Jewish teacher, Jesus ben Sirach. It may also, remembering Jesus, see medicine as a servant of God the redeemer, as a healing ministry today, as a way God’s future may still be given token. Physicians and nurses within the Christian community may construe their profession as a “calling,” indeed as a “holy” calling and themselves as “disciples of the saving Christ,” as Walter Rauschenbusch prayed they would (1998, p. 5). To condemn medicine because God is the healer would be like condemning governments because God is the ruler or families because God is the father. Of course, if medicine pretends to be messianic, if it arrogates to itself the role of faithful savior, if it presumptuously thinks of itself as the ultimate healer, then its arrogance may be and must be condemned—as the arrogance of governments and families who make pretentious claims to ultimacy may be and must be condemned. Perhaps doctors and nurses—at any rate good and honest doctors and nurses—are less tempted to this sort of extravagant and idolatrous expectation of medicine than many patients are. At any rate, a modest medicine may be granted its modest—and honorable—place under God and alongside other measures that protect and promote life and health, good nutrition, public sanitation, a clean environment, and the like. Medicine need not be condemned in Christian community—but it may not be “idolized.”Biomedical Ethics In The Christian Narrative Essay.
In his healing ministry Jesus made the good future of God present already also by making its power felt against the power of Satan and his hosts,8for that ministry included exorcisms. “If it is by the finger of God that I cast out the demons,” Jesus said (Luke 11:20), “then the kingdom of God has come to you.”Biomedical Ethics In The Christian Narrative Essay.
“Possession” was widespread in the ancient Mediterranean, or, more precisely, the demonological understanding of sickness and psychosis was widespread (Seybold & Mueller, 1981, p. 116). Jesus was hardly the only one with the power to “cast out demons.” Indeed, one defense Jesus makes against the charge that he casts out demons “by Beelzebul” is the inconsistency of attributing the exorcisms done by “your exorcists” to God and those done by Jesus to the power of Satan (Luke 11:18–19). Jesus evidently shared the demonological understanding of some sickness and psychosis. He explained his exorcisms neither as collusion with Satan nor as magic but as the present power of the future sovereignty of God over Satan (Luke 10:17–18). His exorcisms—and all exorcisms—were of one piece with God’s final triumph over the powers of evil and already diminished Satan’s dominance.Biomedical Ethics In The Christian Narrative Essay.
To remember this Jesus and to welcome the future sovereignty of God he promised is to celebrate his exorcisms and somehow to make the stories of exorcism our own. That does not mean that we must account for pathologies and psychoses in the strange and alien terms and categories of the first century, as the power of demons at work. The texts are not addressed to twentieth century scientific and clinical questions and may not be used to prescribe either the way to understand such suffering today or the way to provide therapy. 9 It remains a strange world of sickness in scripture. Do demons exist? Frankly, I don’t know—but I know this in memory of Jesus: that God will triumph over all that hurts and harms and demeans persons and over all that destroys human community. I know this in memory of Jesus: that “If there are any demons, they are shadow players in the drama of God’s action, already doomed to be driven foolishly from the stage with no one to mourn their loss” (Bartlett, 1975, p. 83).Biomedical Ethics In The Christian Narrative Essay.
And I know this: that the stories of exorcism may remind even the twentieth-century scientific clinician of some features of the cause of God. One decisive characteristic of “possession” was precisely possession. The sick did not have control of themselves; they were possessed, subject to the power of the demons; their speech and action had no genuine connection with who they were. And a second decisive characteristic of possession was isolation. The sick were separated from their community, alienated from the very ones who would care if they could. The strong man of Mark 5, for example, “lived among the tombs; and no one could restrain him any more, even with a chain” (Mark 5:3). But Jesus healed him, restored him to self-control (5:15), and said, “Go home to your friends” (Mark 5:19). The exorcisms freed persons to be themselves and to be with others; they restored persons to their own identity and to their community. The cause of God made known in Jesus’ healing ministry is human flourishing, and the human flourishing made known in the exorcisms includes integrity and community.Biomedical Ethics In The Christian Narrative Essay.
In memory of Jesus physicians may use their best medical skills and knowledge to explain what is happening in and to the sick, but they must use those skills and that knowledge in ways that honor God and serve God’s cause, including not only life and health but also the integrity of the sick and their community with those who are well. Sometimes sickness threatens the ability of people to act in ways that have integrity with their identity and their community, and then medicine can serve God’s cause by using its powers. But sometimes medicine itself can threaten the ability to live (or die) with integrity or within community—and then medicine can only serve God’s cause by not using its powers. When, for example, medicine can only prolong one’s dying, or when by its technological interventions it can only rob the dying of dignity and separate the dying from the human companionship of friends and family, then medicine must acknowledge that the moral limit to its powers comes long before the technological limit of its powers.Biomedical Ethics In The Christian Narrative Essay.
The healing ministry of Jesus disclosed already also God’s great victory over the power of sin. In the ministry of Jesus sins were already forgiven in token of God’s reign on the far side of the last judgment, and in his healing ministry Jesus already broke the power of sin. Jesus broke the conventional correlation of sin and sickness. To be sure, the stories of Jesus point in more than one direction here. On the one hand (John 9), Jesus rejected the assumption that a man’s blindness must be caused by either his sin or the sin of his parents. Instead, he simply pointed to the power of God to heal and made that power felt. To remember Jesus is to disown the putative connection of sin and sickness whenever it is used to distance ourselves from the sick, whenever it is used to renege on our obligations of solidarity with the suffering, whenever it is used self-righteously to justify segregating the “sinful” sick from the “righteous” well. Whenever we refuse to be present with the sick or to use our powers against disease because they deserve their sickness, the memory of Jesus will have none of it. It is the disposition to cure the sick, not a readiness to condemn them, which is worthy of the gospel. It is care, not condemnation, which fits the memory of Jesus. When, for example, a person with AIDS is abandoned or neglected or shunned or condemned, then Jesus is not remembered nor the scripture performed.Biomedical Ethics In The Christian Narrative Essay.
On the other hand (Mark 2:5), we have Jesus’ astonishing reply to a request for healing, “Son, your sins are forgiven.” In this case the connection between sin and sickness was apparently accepted, but it was not used to isolate, segregate, judge, or condemn the sick. On the contrary, God’s acceptance of the sick young man was unqualified, and the whole person was renewed in earnest of God’s good future. To remember this remark by Jesus and to hope for the future sovereignty of God it signals is not to disown a duty to care or a desire to cure; it is to recognize and to deal with the whole person, refusing to reduce a person’s suffering to a pathology. Many persons with AIDS, for example, sometimes hurt in places no medicine can touch; they have needs which are not simply medical but psychological and social and spiritual. Sometimes they need relief from a sense of isolation and abandonment; always they need to restore and maintain not only certain physiological processes but also certain relationships with others. In memory of Jesus we will not reduce patients to their pathologies—“the heart attack in room 515,” for example—nor reduce the practice of medicine to a collection of skills and tools.Biomedical Ethics In The Christian Narrative Essay.
Moreover, if Jesus forgives people in token of God’s good future, then we ought also to forgive one another. Jesus came announcing that the good future of God was near. He called for repentance in response to it (Mark 1:15), and he forgave sinners in token of it. Remembering Jesus still evokes practices of repentance and forgiveness. Confession is good for the soul, of course, but it could also be good for bioethics. It helps us to see the fallibility of both medicine and patients.Biomedical Ethics In The Christian Narrative Essay.
Consider the physician who is angry at the patient who refuses another round of therapy, angry at her own powerlessness to save him, eager to use her authority as a physician to convince him to try again, and eager to avoid him when he refuses to try again or dies before she can. It is no great callousness she must confess; it is the failure to acknowledge the fallibility and limits of medical care. 10 Physicians sometimes need the forgiveness of God—and of their patients.Biomedical Ethics In The Christian Narrative Essay.
Or, consider the patient who is angry at the doctor who cannot deliver a miracle, judging her much too quickly and severely, angrier still that she would try to tell him how to live while he is dying, and eager to render her still more powerless and optionless. It is no great callousness such a patient must confess either; it is the failure to acknowledge the fallibility and limits of his own autonomy. Patients sometimes need the forgiveness of God—and of the doctor.
Confession helps us recognize the evil we sometimes do in resisting evil, the suffering we sometimes inflict in the effort to banish suffering and those who remind us of it (Hauerwas, 1986, p. 35). Both doctors and patients are a little too ready to condemn and to blame. Doctors are sometimes a little too ready to reduce the patient to his body, to manipulable nature, and then to manipulate it (and him), a little too ready to reduce the patient to his disease and then to combat it (and to combat him). And patients are sometimes a little too ready to reduce the doctor to an “animated tool” 11 and then to put it down (and to put her down). Repentance and forgiveness might heal their relation a little, at least enable them to listen to each other a little longer and a little better. The memory of Jesus and his forgiveness would neither render the patient optionless and choiceless by insisting on a physician’s authority nor render the physician optionless and choiceless by insisting simply on patient autonomy.Biomedical Ethics In The Christian Narrative Essay.
The healing ministry of Jesus is remembered in the gospels and still remembered in the churches. It forms a people—and a bioethic among those people—disposed to protect life, not to practice hospitality to death; disposed to sustain health, not to welcome sickness; disposed to respect the embodied integrity of people, not to run roughshod over their freedom and identity; disposed to nurture community, not to isolate and alienate the sick; disposed to cure and, if to cure is impossible, always at least to care, but not to condemn or abandon. The memory of the healing ministry of Jesus still calls Christian doctors and nurses to a humble healing ministry of their own as “disciples of the saving Christ” and still calls the rest of us to gratitude for the presence of such caregivers among us.Biomedical Ethics In The Christian Narrative Essay.
A Christian bioethics will remember Jesus not only as a healer but also as the one who brought good news to the poor (Luke 7:22, Matthew 11:5), as the Christ, “the anointed one,” “anointed,” as he said, “to bring good news to the poor” (Luke 4:18). His words to the poor and his compassion for them were no less a token and a promise of God’s good future than his works of healing (e.g., Luke 6:20). There is no remembering this Jesus, no calling this remembered Jesus “the anointed,” that may be unmoved by his proclamation of “good news to the poor.” There can be no discernment of a way of life—or of the requirements of a common life—worthy of this gospel that is inattentive to the needs of the poor, including their health care needs.Biomedical Ethics In The Christian Narrative Essay.
No evangelist represents this feature of the memory of Jesus more elegantly or emphasizes this requirement of Christian discernment more powerfully than Luke, the physician. 12 That remembering still forms a people—and a bioethics among those people—disposed to insist on justice for the poor and to practice kindness towards them. Poverty can debilitate both soul and cell. There are too many whose spirits are crippled, whose lives are ended, and whose health is destroyed by poverty. The needs of the poor are not all (or even mainly) medical; even their health-related needs are not all (or even mainly) medical. But the poor do have needs for medical care, and they do not all have secure access to medical care. In the United States, while some of the poor are covered by Medicaid, many others are uninsured and have no assured access to medical care. Medicine, meanwhile, is adopting a corporate image. A marketplace medicine will do great things for those who can pay, but the poor and powerless who are sick will be left to their own resources—and sometimes to despair.Biomedical Ethics In The Christian Narrative Essay.
The Christian bioethics in memory of Jesus must struggle to find words and deeds to form public policies and medical practices that “fit” such a story, that are worthy of “good news to the poor.” The memory of Jesus can be honored in political efforts to form a medical care delivery system that expresses and signals a concern for the poor and for the health of the poor. The memory of Jesus can be honored in community efforts to support hospitals that resist the marketplace story of medicine. And the memory of Jesus can be honored in efforts to nurture the professional identities of doctors and nurses so that they have the strength (and the resources) to resist the temptation to become “hirelings who serve only for money,” to use Rauschenbusch’s still apt phrase (1998, p. 5).
A Christian bioethics will remember Jesus not only as the healer, not only as the preacher of good news to the poor, but also as the one who “suffered under Pontius Pilate, was crucified, dead, and buried.” 13 The passion narrative is remembered by all the gospels; indeed, they decisively tie the memories of Jesus as healer and as preacher to the story of the passion. This is the crucial memory. Apart from it the Church is always at risk of distorting the good news into a kind of Pollyanna triumphalism and then of self-deceptively ignoring or denying the sad truth about our world. But with this memory of the suffering of Jesus the Church is able to face the sad truth about our world and to respond even to suffering and to death truthfully.
Doctors confront suffering in the myriad of sad stories people tell with and of their bodies: the burn victim who endures not only pain but disfigurement, the athlete whose accident severed her spine and left her a quadriplegic, the parents who grieve the death of their child of promise, the elderly patient in decline with Alzheimer’s, the AIDS patient. It is a sad world medicine witnesses and serves. The questions of theodicy are hardly theoretical in a hospital. There people cry out in the honesty of grief and pain, “Why, God? Why?” and they beat against the heavens with the one great human complaint, “If you are so good and powerful, God, how can you let this happen?”Biomedical Ethics In The Christian Narrative Essay.
The Christian community will not find that question or that complaint offensive. How can it? For it remembers Jesus, who cried out from the cross, “My God, my God, why have you forsaken me?” (Mark 15:34, Matthew 27:46) and made the human cry of lament his own cry. It will not find that question or that complaint easy to answer, either, however. It does not have any tidy theoretical theodicy to give in reply.
The memory of Jesus does not make liars of us. Much suffering is undeserved; much suffering is pointless. It is a sad world, marked and marred by suffering. Christians do not deny the horrible reality of suffering or their own powerlessness to “justify” God and God’s ways in a theoretical theodicy. In memory of Jesus Christians point to a Roman cross and to an innocent Jewish healer and teacher who suffered there. The cross is no lie. The cross is the truth about our world in its revelation of the reality and power of evil. When Christians remember the cross, they acknowledge the sad truth about our world. In remembering the cross Christians point to the son of God who hung there and made the human cry of lament his own cry (Psalm 22:1; Mark 15:34; Matthew 27:45). Jesus shares our suffering, making it his own. The cross is no lie. The cross is the truth about our world not only in its revelation of the reality and power of evil but also in its revelation of God’s own compassion, of God’s suffering with those who suffer. And when Christians remember the cross, they not only acknowledge the sad truth about our world, but they also celebrate the glad tidings that God cares, that God does not abandon the sufferer, that God “did not despise or abhor the affliction of the afflicted … but heard when I cried to him” (Psalm 22:24). The lament which opens with the great cry of abandonment ends with confidence in God and with a vision of God’s good future (Psalm 22:27–31). To those who suffer, then, the first word of the Christian community is not an effort to justify God for sending evil as punishment or as training; it is to remember Jesus and to practice the presence of God.
To those who suffer the story of Jesus is a glad story, indeed. To be sure, this glad story does not deny the sad truth about our world or about our sickness; it does not announce here and now the end to our pain or an avoidance of our death. Nevertheless, it does provide an unshakable assurance that we do not suffer alone, that we are not and will not be abandoned, that Jesus suffers with us, that God cares. And that is a glad story, indeed. So the suffering may cry out ‘My God, my God, why?’ and still know that Christ has made their cry his own. The glad story of Jesus is indeed a hard reminder that in a world like this one, no matter how righteous or repentant we are, we cannot expect to be spared pain and sorrow. Certainly life and the human flourishing we call “health” are goods which belong to the cause of God and which one may and should seek, but “a disciple is not above the teacher” (Matthew 10:24). In our sad stories we keep good company. That’s a part of the good news—and this: that beyond the cross, beyond the sad story of suffering, is the resurrection, the triumph of God over all these diseases.Biomedical Ethics In The Christian Narrative Essay.
The story of Jesus is good news to the suffering, and it provides caregivers a vocation. It is a call to those who would remember him to minister to the suffering, to care for the sick, to have compassion for the dying. Such a calling can nurture and sustain the vocation of medicine to heal and to care, to intervene if possible against the evils of suffering and premature dying, and to be present to the one who suffers even if and when the medical interventions do not provide a happy ending.Biomedical Ethics In The Christian Narrative Essay. The good news must be expressed not only in fitting words but in worthy deeds as well. A medicine formed and informed by the memory of Jesus will be able to care even when it cannot cure, to wipe the tears of the dying away tenderly even when it cannot save his life, to resist the temptation to abandon (or eliminate) the patient when it cannot eliminate her suffering. In those who suffer the eyes of faith are trained to see the very image of the Lord, and the ears of faith are open to that always surprising word, “just as you did it to one of the least of these …, you did it to me’ (Matthew 25:40).” 14
A Christian bioethics will remember the story of Jesus and celebrate it. God raised this Jesus from the dead in our world and in our history, and our world and our history have, happily, no escape. This healer, this preacher of good news to the poor, this one who suffered under Pontius Pilate, was raised up as the “first fruits of those who have died” (1 Corinthians 15:20, 23). The resurrection of Jesus was the promise of God’s good future, the guarantee of God’s unchallenged cosmic sovereignty, the first fruits of a day on which God “will wipe every tear from their eyes. Death will be no more; mourning and crying and pain will be no more, for the first things have passed away” (Revelation 21:4).Biomedical Ethics In The Christian Narrative Essay.
But that good future is not yet, still not yet. God’s cause has been made known and its triumph assured, but the powers of death and sin and suffering still assert their doomed reign. It is not yet the promised future of God’s unchallenged sovereignty. And it is not within our power—not even within our new medical powers—to establish it. Our powers—including our new medical powers—are not messianic. In memory of Jesus we may and we should delight in any and every token of God’s good future in the interim, and medicine can be such a token. But we may not and must not entertain extravagant and idolatrous expectations of any human power, including our new medical powers.Biomedical Ethics In The Christian Narrative Essay. It is God in Christ who suffers with us and for us and can sustain us in our suffering and dying, not medical science. It is God in Christ who will bring the good future of God’s unchallenged sovereignty, when pain and death shall be no more, not medical technology. The memory of Jesus and the hope that memory evokes sustain and nurture patience, courage, and care—not only in the face of the sad stories of pain and suffering and death, but also in the face of the sad stories of the failure of medical interventions to relieve the pain or to remedy the suffering or to rescue from death. The memory of Jesus and the hope that memory evokes sustain and nurture both the sick and those who care for the sick in their respective roles.Biomedical Ethics In The Christian Narrative Essay.
In living and in dying, in suffering and in caring for the suffering, Christians remember the resurrection of this Jesus and hope for God’s good future. So they need not fear death. They need not use all their resources or all human powers against it. They may risk their lives for the sake of other goods that belong to God’s good future, trusting in that future. They may permit death its apparent victory, confident of God’s final triumph. They need not fear suffering either. In memory of Jesus and in the hope it evokes, Christians have the courage not only to risk and to endure their own suffering for the sake of God’s cause in the world but also to share the sufferings of others, to be present in care and in prayer for those medicine cannot cure.Biomedical Ethics In The Christian Narrative Essay.
There is another mark of the “not yet” character of our life and medicine: moral ambiguity. It is not yet God’s future of shalom; there is not yet peace even among the goods which all belong to God’s cause. Here and now, even as the people of God welcome God’s cause and serve it, they face conflicting goods and confront gathering evils. Here and now, even as they seek to consent to God’s future rule, part of what they know to be God’s cause comes into conflict with another part of what they know to be God’s cause. In allocating finite funds, for example, the memory of Jesus as preacher of “good news to the poor” disposes the Christian community to use finite funds to meet basic human needs before they allocate money for expensive medical care, to provide a decent minimum of health care for all before using finite funds to provide the very best medical care for any, but the memory of Jesus the healer disposes people to seek the very best medical care possible for those who need it. In deciding about the care of one patient, to give another example, the disposition to preserve life can come into conflict with the disposition to relieve suffering.Biomedical Ethics In The Christian Narrative Essay.
The conflicts are still more commonplace and routine than that. Tradeoffs are sometimes necessary between listening to a patient’s sighs and listening to a patient’s chest, between taking time to be present with the patient and taking time to research new studies of the patient’s condition. The medical technology which enables medical professionals to care more effectively than before (though not more profoundly) may also so distance the practitioner from the patient that it is more difficult either to nurture or to signal care.Biomedical Ethics In The Christian Narrative Essay.
The memory of Jesus will dispose us to care—and so to heal, if possible. The memory of Jesus will also dispose us to preserve, honor, and respect the embodied integrity of those who are patients, even if and when that embodied integrity requires that a medical procedure not be used—and still to care even when we may not cure.
Here and now, in these times between the times, the dispositions to heal, to respect integrity, to do justice and to love kindness for the poor, to preserve life, all belong to the memory of Jesus and all can conflict. The memory of Jesus does not provide any neat and easy resolution to such conflict. It does not usher in a new heaven and new earth, either. Here and now there is ambiguity.Biomedical Ethics In The Christian Narrative Essay.
Still, already, the memory of Jesus sheds some light on our sicknesses and on our care for the sick and enables the communal discernment and mutual instruction of Christian churches. 15 Reading scripture and remembering the story can, should, and sometimes does illumine both the enduring problems and the novel quandaries of medicine, even it if does not tell us precisely what to do. The Christian community, reading scripture together, can engage in another practice that belongs to it, the practice of moral discourse and discernment. It is empowered by the Spirit, who gives remembrance, for the task of mutual admonition and encouragement. So we struggle together to live the story we love to tell, to perform the scripture we faithfully read, and to form dispositions and deeds worthy of the gospel. Jesus is still the healer, still brings good news to the poor, still suffers with those who suffer, still promises the good future of God for which we watch and pray and work, and still calls us to discipleship.Biomedical Ethics In The Christian Narrative Essay.
Notes
1. This silence of scripture is taken by some secularists to discredit scripture. Carl Sagan, for example, has said, “The fact that so little of the findings of modern science is prefigured in scripture to my mind casts further doubt on its divine inspiration” (1995, p. 35). One might, however, equally well suppose that to expect scripture to provide a text, or even a pre-text, for “modern science” is to entertain unreasonable expectations of scripture. Whatever inspiration means, it does not mean that the Bible may be read (or judged) as if it were a science text or as a medical handbook. Some questions are inappropriate to scripture. If we ask the wrong question of scripture, of course we will get a wrong answer, but the fault in not in scripture but in our question.Biomedical Ethics In The Christian Narrative Essay.2. The “white elephant” image is from Furnish (1985, p. 18).
3. Kelsey (1975, pp. 89–119). “Part of what it means to call a community of persons “church” … is that use of “scriptures” is essential to the preservation and shaping of their self-identity [and] part of what it means to call certain writings “scripture” is that … they ought to be used in the common life of the church to nourish and reform it” (1975, p. 98). Of course, as Kelsey also made plain, to say that scripture ought to be used “somehow” does not say precisely how scripture should be used to shape the church’s faith and life. The agreement that scripture has authority does not entail agreement about how scripture should function as authoritative.Biomedical Ethics In The Christian Narrative Essay.
4. See also the “important two part consensus” identified by Birch and Rasmussen that “Christian ethics is not synonymous with biblical ethics” and that “for Christian ethics the Bible is somehow normative” (1976, pp. 45–46).
5. Every sentence here fairly begs for elucidation, but I simply refer the interested reader to the account given in Verhey (2002, pp. 55–75), and in Verhey (2003, pp. 41–67). It should be observed that there is a Christian consensus that scripture is somehow authoritative for Christian ethics. But it should also be observed that there is less of a consensus concerning how it is authoritative. Those interested in the genealogy of my proposal should be informed that I am a Reformed theologian and churchman and that I identify myself as an evangelical (although some evangelicals shudder a little when I do). They should also be informed, however, that I participate in the practices of the church and regard those practices, including the ecumenical practices of prayer and reading scripture, as more formative of my proposal than the second-order theological reflection in Reformed doctrines of inspiration or in Evangelical quarrels about “inerrancy.”Biomedical Ethics In The Christian Narrative Essay.
6. On the healing ministry of Jesus see especially Seybold and Mueller (1981, pp. 114–117), Oepke (1965, pp. 204–213), Carroll (1995, pp. 130–142), Kee (1983), and Bartlett (1975). The question whether Jesus actually did miracles has been much debated. The tradition of Jesus as miracle-worker is attested by every identifiable source for the gospels and in a variety of forms besides the miracle stories themselves. Moreover, the question at issue initially seems not to have been whether Jesus actually did miracles but how to explain the miracles of Jesus – whether as demonstrations of the future power of God or as collusion with Satan (e.g., Mark 3:22, 23; Matt. 12:27). Leaving aside the question of whether particular stories and their details are historically authentic, the tradition is well-attested, and it can be discounted as the product of an overly active imagination in the church and the credulity of early Christians only if the reader begins with a priori assumptions about a closed universe operating according to fixed laws of cause and effect.Biomedical Ethics In The Christian Narrative Essay.
7. See Bailey (1979), Keck (1969), and Kaiser and Lohse (1977).
8. The figure of “Satan” is, of course, hardly mentioned in the Old Testament (1 Chronicles 21:1; cf. 2 Samuel 24:1). “Satan” – a.k.a. Azazel, Beelzebul, Belial, the devil, “god of this world,” “the evil one,” etc. – becomes an important figure in the apocalyptic literature as the chief of the demons and as the explanation of a variety of evils. See Gaster (1962, pp. 224–228).Biomedical Ethics In The Christian Narrative Essay.
9. Seybold and Mueller (1981, p. 118); see Bartlett (1975, pp. 65–83) for one thoughtful account of ways to celebrate these stories and to own them as our own. This is not to say that our scientific and clinical questions always provide access—or the only access—to what is “really” happening in and to patients. There are Christian communities where the power of demons—as quaint and strange as the notion sounds to “rational” and “developed” Westerners—is still experienced as “real,” and sometimes in the West attention to “realities” like the “id” and “superego” can hide a “spiritual” struggle in and for the patient. I have never seen a demon, but I have never seen an “id” either. In some cultures and in some contexts, “id” is a useful construct to explain what is happening and to help people cope with it; and in other cultures and in other contexts “demons” may be a useful construct.Biomedical Ethics In The Christian Narrative Essay.
10. See Anderson, who focuses on confession, the freedom it gives from being “blinded by the utopian images arising from uncritical overestimations of technology’s power” (1990, pp. 121–122), and the freedom it gives for presence to those who hurt or grieve.
11. “Animated tool” is Aristotle’s definition of a slave (Ramsey, 1978, pp. 45, 158).
12. Colossians 4:14 mentions “Luke the beloved physician.” The traditional identification of the author of the Gospel of Luke with this Luke who was a physician and a companion of Paul has been vigorously challenged, but it remains in my view quite plausible. For a defense of the tradition see Fitzmeyer (1981). From the very beginning Luke emphasizes Jesus’ solidarity with the poor; see Verhey (2002, pp. 278–287).Biomedical Ethics In The Christian Narrative Essay.