The Implications of Being Both Physician and Saint

The Implications of Being Both Physician and Saint

Ed and Hilton,

Here is my initial email again, I have included 4 questions at the end that get to the core of some of my musings. I could have elaborated/qualified these, but for the sake of simplicity, I'll leave them as is. Hilton, Ed suggested that I also ask for your perspective on some of these things. I appreciate any sage thoughts you might have on this.

Your Brother in Christ

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I have been mulling over some things over the past few weeks, trying to think through some of the implications of being both physician and saint. Bear with me on this one, and perhaps you can offer some insights . . .

Many of us in medicine have been, by the sovereign will and mercies of God, elected unto salvation and faith in Christ. We have been transformed, and are being transformed, by the renewing of our minds. We have, or should have, seen the myth of religious neutrality and understood that life--all of life--is profoundly religious. The way we live, eat, drink, work, play, theorize, think, practice medicine--all of it--to one degree or another, will reflect our opinion of God, our true allegiances, the commitment of our hearts, indeed, of our entire beings.

But what does this mean for those of us in the medical profession? Let us ignore, for the sake of focused cogitation, the saddening and easily dismissible fallacies -- the notion that science and Christianity are irreconcilable; the idea that the weight of God should rest heavily in church and during Bible study, but lightly during work or in noon conference; the mistake that value-free ethics is humanly possible or even desirable, etc. etc. Forget the unbiblical smorgasbord that we so easily nibble at, even if only selectively.

What about those times that we, by the grace of God, desire to please Him through and through; those times we are driven by a theology that is (or tries to be) impeccable, whose praxis flows naturally from the springs of clean doctrine; those times when we love God--granted with staggering imperfection--with all our heart, mind, soul, and strength? What then does it mean to be faithful and upright before God, to cast our lot with Job and Jeremiah? Or more to the point, what does it mean *practically* to glorify God in our professional life? I think thoughtful evangelicals have provided careful, godly answers to some of these questions. I think of J.P. Moreland's "Love your God with all your Mind, Sire's "Habits of the Mind," Steven Garber's "The Fabric of Faithfulness," Noll's "The Scandal of the Evangelical Mind" etc. Granted, some of these volumes are more helpful than others, and none, probably are without blemish. More pertinent to my vocational context, the Journal of Biblical Ethics in Medicine, works by yourself, Nigel Cameron, Lloyd-Jones, Meilander, Kilner, and others have been very helpful in this regard.

Having said all this, I am struggling with a few questions that bear on some of these threads of thought.

For instance, I have been paying increasing attention to some of our brethren who are engaged in courageous battle. You know them all, Cameron, Ben Mitchell, Frank Young etc. and the stem cell research debate (www.stemcellresearch.org), Trinity's Center for Bioethics and Human Dignity and many other similar groups, Christopher Hook (Chair of the Ethics committee at Mayo; I haven't had a chance to get to know him yet) and other visible Christian ethicists. Now, granted God knows man as he really is, but I would venture to say that many of these men are theologically astute, deep lovers of God. That they have a profound grasp of life, of God, of who we are, of how to make biblical sense of our world (medicine specifically). To be sure, they have had different measures of success in articulating or communicating a biblical vision of medical ethics or the like. To be sure, some have failed dismally, and should probably desist from the articulate waste of paper. But still, others have been more faithful, and at the very least, have edified the Body. And perhaps even challenged some of the reigning secular hubris. Nigel Cameron's "The New Medicine: Life and Death After Hippocrates," is surely an excellent exhibit for this kind of godly thinking (to be honest, I haven't read it yet -- I have ordered it though. I have a good idea what it's about having researched its theme. Plus, I have read JBEM's largely complimentary review of it).

Why then, did you often criticize, sometimes quite scathingly, these men? You rarely complimented them, or encouraged them, in their efforts. Then again, the converse was probably true as well. Not that criticism is a problem at all. But surely, to borrow Qoheleth's perspective, there is a time to criticize and a time to encourage [even then, I agree that some things, sadly, warrant consistent criticism]. And to be fair, I think you often tried to be even-handed, as in your review of "Do the Ends Justify the Genes?" Even then, one can't help feeling that your general posture was overly critical.

I hope I have been fair in the above assessment. In any case, my main concern is that I myself have been very critical, and often dismissive of some of these men's efforts. Recently, I have been questioning my reasons, and wondering if they stand up to biblical scrutiny. For instance, I have been attending IM Ethics lectures at Mayo (preparation for the Boards) that are headed by Dr. Christopher Hook (there are many separate lecturers but he designed the "syllabus." In fact, he is co-author of the Ethics section of the "Mayo Board Review Book.") Aside from the fact that this is directed education, preparing for the Boards; aside from the fact that this is Ethics for a pluralistic physician body; aside from many other pertinent "facts," my initial reaction was profound disappointment. I thought, "Who cares about virtue ethics, about moral theory, etc." and besides, the whole thing--ultimately--collapses under the weight of its own theological impotence. Viagra would be useless, and illogical besides. Now, I think there is an important sense in which I am correct in my judgment. But have I rather quickly passed over some other pressing considerations? Have I been too hasty, perhaps even foolish? After all, what would I have done if asked to design an IM ethics syllabus for Boards preparation? Would I--should I--have drafted a theological manifesto? Surely Wisdom, with her feminine voice, would have something to whisper in my ear, if not proclaim past the nurse's stations (Prov 1:19-21). And I doubt her sister Tact is far away. Surely, my biblical heroes Daniel, Hananiah, Mishael and Azariah have something to say here. And was it not God who gave "To these four young men . . . knowledge and understanding of all kinds of literature and learning"? I don't have space to develop some important ideas, but just a superficial reading of this part of Scripture yields profound applications, don't you think? And you know better than I do that there are intelligent ways to speak a culture's language, and yet, speak *beyond* it to God and His language. Granted, it is difficult, but it can be done. Someone might say, "well you should just never get into that position, reject all similar opportunities to lecture, teach etc. since you can never proclaim Truth in its fullness." I understand the sentiment, and to a large degree, I share it. Yet, I wonder that this posture does not--in some cases at least--commit the fallacy of cultural isolationism, as if that is a biblical option. We need to hold to unequivocal theological particularism (or exclusivism) as opposed to some kind of misguided neo-monasticism. We need to find the right sand, and draw the proper lines.

So then, what bearing does all this have on my struggles? I'm not sure. I realize that the questions are tough, and the answers are tougher. I realize that there is a profound sense in which the art of medicine touches so close to "religion," that any less-than-theological voice might perforate already fragile ethical tympanic sensibilities. But we need to be careful, is the challenge any less for *any* profession? At the risk of oversimplification, our posture toward all facets of life presupposes an understanding of God, or god. Life is religious. Again, the implications of all this can be teased out further, but emails have their limitations.

In any case, I think I may have to be more careful when appraising what my brothers are doing. What are their motives? Because they legitimately "compromised" a message, does that imply failure (assuming there was no error of theological commission, even if there was one of omission. I realize even this distinction may be problematic.)? What does Scripture ( e.g., the Book of Daniel) have to say on this? If we did not "compromise" *on some level,* would we even be heard in the public square [note, I think the word "compromise" does not do justice to what is often actually taking place]? I could multiply the questions.

As a final thought, I would say that I remain convinced of one thing. I strongly believe that many professions have truly encountered the prophetic voice of Scriptural truth (perhaps the most obvious example is the field of Philosophy). In other words, some believers in those professions have been able to forego the "legitimate" option of compromise, and boldly proclaim and engage their colleagues with a radical, biblical perspective. I don't think many can do this. I don't know that many should even try to do this (not because it is wrong, but because, while it is noble to want to run a Marathon, I would be a fool to try). But when it does happen, as you once suggested, it can turn an entire world of thinking upside down. My feeling is, that in medicine, prophetic voices have not yet been heard. I think some of the names I mentioned have made inroads, and I praise God for their courage and boldness. But still, I don't think Jeremiah has yet visited JAMA. As Providence sees fit, perhaps our generation will see that bright day.

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Below are some simplistic questions that, at core, touch on the important questions of how we, as physicians and saints, relate to those within, and those outside, the [conservative evangelical] Body. Granted, even the qualification "conservative evangelical" is often meaningless in our postmodern culture.

#1 Why have both of you largely avoided joining the discussions, anthologies, public battles of Meilander, Cameron, Kilner, Young etc.? Are you afraid of committing a similar error as the defunct Moral Majority or Chuck Colson and Nancy Pearcey's flawed "How Now Shall We Then Live" -- what might be called unbiblical ecumenical cobelligerence. [Whether this is identical to Shaeffer's notion of "cobelligerence" need not detain us here.]

#2 Is complete professional separation the only way of proclaiming legitimate theological disagreement between *CONSERVATIVE EVANGELICAL* brethren? Or, does writing a chapter in an anthology imply complete agreement with all views expressed?

#3 How does the above relate with your involvement with the conservative/sometimes-religious/clearly-nonchristian Medical Sentinel [Hilton you are on the editorial board, and Ed has written articles on more than one occasion] and the theological diversity found in many JBEM articles?

#4 When we engage in conversations with *UNBELIEVERS* on medical ethics, etc., is there any difference, in God's eyes, between the conscientious "compromise" of theological commission vs. omission? Will compromises of theological omission not be inescapable if we will be heard in the public square? Where does godly wisdom come in?

Your Brother in Christ