A review of "Medicine as Ministry" by M. Mohrmann

First off, it is worthwhile to note that Mohrmann is one of the few people who have the background, experience and training to write a book about theological ethics and medical practice - she is shared between a professorial chair of paediatrics, and an associate professorial chair in religion, at the university of virginia. Thus, unlike many doctors who do not have the breadth of knowledge/reading to comment in an indepth fashion on ethics, or the theologians who largely remain strangers to the world of medicine, Dr Mohrmann is able to unite the best of both worlds, and hence what she says has a very practical, yet deeply reflective element to it.

On to the book - this is not an exaustive treatise on biomedical ethics. As the title "reflections on suffering, ethics and hope" suggests, it is a book exploring what it means to be a doctor in a suffering world, and how we react to it.

Rather than offering a case-by-case discussion of the various areas of controversy, Mohrmann chooses instead to focus on the question of what "ethics" means to christians, and where this "ethics" comes from. The book, in rough order, reflects on the meaning of the trinitarian God for ethics, and necessity of engaging with the rich narratives of our patients' lives in order for medical practice to truly reflect what God intends it to be. Her arguement centers much on the narrative nature of human experience, and the need for broader engagement with the community of a patient for true healing to occur.

This book is more thought provoking than answer giving, as Mohrmann freely challenges our views of health, life and dying, even suggesting that we have idolised life itself. Nonetheless, Mohrmann is able to keep the book thin and make it a light read (I finished it 3-4 hours).

People looking for straightforward analyses of specific moral dilemmas and answers to life questions need not read this book - it is meant to stimulate thought on approaching our ethics differently, and in the process of doing so, enable us to fulfill the commandment to love our neighbours more meaningfully.

On Swine Flus, SARS and perspective

This article from The Age pretty much sums some of the things going through my mind as people squeal in fear from the possibility of a pandemic from the H1N1 flu outbreak that will kill us all:

http://www.theage.com.au/opinion/fears-distorting-reality-20090429-ancz.html

Some extracts:

...why do the deaths of only some people from obscure diseases cause us to panic? And how can we be so unfeeling when we have the power to save the lives of millions by relatively simple, inexpensive precautions and treatments?....

...it seems that only when we perceive that infectious diseases threaten "people like us" do we respond with real urgency. The millions killed by TB, AIDS, malaria and other mass killers are doomed to fit the stereotype of people who live and die like that. We can accept it as the way of the world. Aboriginal Australians are just as much victims of the indifference that flows from such stereotyping.

In all reality, we only have 7 confirmed deaths from the Swine Flu (based on WHO analyses - Mexican databases aren't exactly stellar), in a country that is known for its gross inequities and dodgy standards of health and living. In contrast, the normal flu kills 250-500,000 people a year, of which 2000 are in Australia. Yet, all of the sudden, we have the leaders of the known world speaking up and declaring that they will spare no expense to contain this outbreak.

I admit the need for an effective public health response, and even acknowledge that there is more to gain from stoking people's fears and insecurities, hence keeping them on the alert, as compared to calming them. It's good to take appropriate measures at disease containment, for epidimiological reasons, but probably more so for political ones (this is already turning into opportunities to score political points if you read the news).

However, despite all the fearmongering about it being the "next big pandemic" and how we are "overdue for a massive outbreak"that "threatens the existence of humanity", in all likelihood this H1N1 virus thing is going to become something of the past, just as SARS did. Does anyone remember the HK flu from the 1960s that killed over a million people worldwide-no? In addition, the world of international communications and public health is incredibly different from what it was in the century of the last pandemic. Just google something like "Developments/achievements in the last 50-100 years" and you'll see what I mean (this includes the internet btw).

And so I come back to my original point - lots of fearmongering and scares at "possibilities" that are in reality mere shadows, revealing a distinct lack of perspective on disease and illness. This is in stark contrast to our ignorance at the daily epidemics and massive numbers of deaths in poorer nations around us. I believe these events do something more than threaten the health of us all - they reveal the hypocrisy and lack of perspective in our lives, how we spend with reckless abandon at anything that immediately threatens our welfare, but live in gleeful ignorance what happens beyond our own world (I'm just as much guilty of this). I cannot help but think about God's anger - not expressed through disease as a punishment, but against us, for our indignancy, and our love for evil, not good.

PS: For those who are freaked out by the WHO near declaration of a pandemic - look up the definition first, see see how vague it is. The only thing that separates a "pandemic" from something like the normal flu, is the fact that it's new to populations.

A Review of The Living Word of God: Rethinking the Theology of the Bible, by Ben Witherington III

In this book, Witherington writes in response to 2 unhealthy patterns and attitudes to the bible he sees in today's world - on one hand, we have the fundamental conservatives who insist that everything in the bible is literally true, and understand the "authority" of scripture in a straightforward, literal sense, as demonstrated by Christians who insist the world is flat and square because Revelation speaks of how "angels came from four corners of the earth". On the other hand, we have the liberals, demonstrated by Erhman and his new book "Jesus Interrupted", pointing out that the bible is full of contradictions and cannot be trusted.

In both cases, Witherington argues, there is ironically the same problem - a straightforward, simplistic approach to scripture that neglects fundamental issues that arise in the study of any piece of literature (religious including). In both cases, there is a neglect of the complexity of scripture, with both groups forgetting that texts can and should primarily be understood as they were meant to be understood - eg: we should not be reading a comic strip as if the statements within where academic literature.

For example, liberal theologians often have an issue with the chronological differences between the four gospels - forgetting that biographies written 2000 years ago were not seeking to establish historical chronicity or accuracy, but rather sought to demonstrate and describe a persons life in particular themes. In essense - biography is different from history (especially ancient biogrpahy and ancient history).

Witherington spends much of the book look at specific issues and case studies - for example household regulations found within colossians and whether Paul is inadvertently promoting slavery and patriarchal systems, and discussing how a surface interpretation of the text will not suffice to do justice to it and the theology drawn from it. He also devotes 1/4 of the entire book to a QnA section, where he answers some of the most common questions he receives from the general public about the bible.

This book probably underachieves - it is entitled "rethinking the theology of the bible", but in reality Witherington does little more than to put forth a solid, well thought out argument for the proper and careful exegesis of scripture and its application to Christian life. His arguments are nothing groundbreaking, and would be what you expect from any reasonable book on hermeneutics.

Where it does shine, however, is the (rather slim) chapter on postmodernism - and a brief commentary on self proclaimed postmodern christians, such as Brian Mclaren, Rob Bell and Dan Miller. In this, he effectively argues that they aren't true postmodernists, demonstrating that Christians, both professional and lay, often have a misconception of what true postmodernism is, and how it impacts the way we read scripture. Alas, this chapter is rather short.

In summary, "The Living Word of God" puts forth a good case for the need to properly and carefully handle the Christian scriptures, and warns against the fallacies committed by both liberal and fundamentalist camps. It is a book that is perhaps written more for the student who is beginning his/her journey in the study of the scriptures, than for the seasoned and experienced exegete. Nonetheless, the QnA sections, the Case Study sections and a few others do provide some gems and food for thought for someone more experienced.

Here it is from koorong.com.au

Camps, Love and Couples

Our mid-year church camp's theme is "true love awaits", and as the name suggests, it's about "how to love". As one can guess, the promotion so far seems to suggest that while it is not exclusive to couples, it is significantly focused on these relationships.

Apart from the obvious theological issues of asking an anthropocentric question of "how do WE love", I have been wondering whether this is an insensitive and inappropriate theme for a combined church camp.

Within any church, including ours, there is a mixture of singles and couples, and I do wonder whether having a COMBINED camp that focuses on couple relationships does little more than to rub in the fact that the singles are single. Yes they have said that the camp is not just for couples, but the promotional material seems to suggest that singles are more of a "not uninvited" group.

Perhaps it's just been the way it's been promoted, and the actual camp isn't about about couple relationships. But looking at the way it's been going, it seems like it's going to be more segregating than unifying.

The Great Divorce

OK, so maybe it isn't as great a divorce as I make it out to be, but it's still there. Anyway, on to my point:

People in our church have recently been talking alot about change. I'm not sure if it's just some pseudo-Obama fever, or just plain frustration with what's been essential stagnation over the last few years, but the sentiment is there nonetheless.

We have a new pastor, who goes on about how she's going to bring big change. We have a chairperson talking about how change is going to happen in the church this year, and the small group coordinator talks about how change is good. Our sister service, the chinese congregation, is also now shifting their service time to the arvo. (the list goes on)

Whilst I'm not against change, what I do get concerned with is blind change. Yes there may be a need for a move out of a particular situation, and sometimes the move brings some fresh air. However, more often than not, this move is done on the basis of a "good idea" (or something gathered from an experience/book somewhere). There is a prevailing experimental attitude that goes: "this isn't working, so let's try something else and see if it works".

I find it fascinating that the underlying assumptions driving this attitude is rooted in a pseudo-scientific/modernist concept: That there is something that works/is true, and our duty is to explore and experiment until we find out what it is (in contrast to perhaps pre-modern approaches where pure tradition, rather than pragmatism, was the aim of the game).

At the same time, however, Church ministries ignore the other elements of this underlying methodology: namely the concept that it is the combined progress of a body of people that counts. In other words - Churches/ministers tend to want to do 'research' on their own, without the necessary engagement with what others have done elsewhere/before them.

A classic example is the relationships between adolescent behavior and knowledge. Research into adolescent behavior over the last few decades has demonstrated a very weak link between knowledge and practice - ie: for the adolescent, knowledge is not power. In a health setting, it means that providing education on safe sexual practices, safe eating, safe driving, etc, will NOT produce significant behavioral change.

It's not difficult to see how this can easily apply to the church setting as well - we enjoy going on from the pulpit and sunday school classes that youths should read the scriptures and the bibles for their spiritual growth, etc etc - and we all know how that turns out (anecdotally, it would seem that the average youth has immense problem sticking to a disciplined, regimented schedule of daily scripture readings). Recognising that the provision of information does not necessarily lead to behavioral change within this population would lead one to conclude that many of our current methodologies do not work too well.

Whilst we recognise that God is the one who "makes the seeds grow", we also have to recognise that in our ministries, we essentially stand on the shoulders of giants. Where would we be if we did not recognise the contributions of Calvin and Luther to our understandings of salvation, or Tertullian and Augustine to the language of the faith? It is perhaps time to recognise that God has not left us to grasp at straws in the dark, but has made available to us a wealth of resources and tools that enable us to be more effective at discipling the people of the nations. It is perhaps time to heal the great divorce between ministry and research.

(Maybe it's time for Pastors to get UpToDate subscriptions :P jkjk)

Oh please

Some are familiar with the fact that I'm becoming a bit uneasy with movies like SlumDog Millionaire - as to whether they are exploiting the extreme poverty of people for our first world entertainment. I was watching another of these movies last night (Blood Diamond) and the reporter in it sums up my thoughts exactly: We write and take all these pictures of suffering people, we draw a tear or two, maybe even get a cheque written. But in the end - no one really cares. No ones really going to stand up and do something about it.

As a disclaimer, I believe movies like slumdog millionnaire and blood diamond can be useful if they are used in the context of a holistic education on events or realities in the world, reminding watchers that for 99.999% of the people involved, there isn't a happy ending. Together with these movies, audiences need to be made aware of the need to do something about these issues - be it through pressuring the government, to raising awareness, to actually getting out there and doing something. Unfortunately, the "unhappy" message doesn't get transmitted to most of the people watching these movies (after all, people are going to the movies to be entertained, not challenged).

So what we end up with is the "pornography of poverty", where the events of another world are turned into our entertainment. Where what is a serious matter is turned into an object to be devoured by audiences for their pleasure.

The title of this age article couldn't have said it better..."Do the SlumDog!" So now the concept of slum dwellers living and dying poverty is a colloqual term for a hip and fashionable dance. Please.

(PS i have written to the Age about it)

Confessions

I confess - I'm not itching and raving to drop everything and go work in a developing world.

I know how much of a need there is - I've spent 3 months living with the people (mud huts and all) in the poorest regions of India (it isn't much, but it's something). I've read article after article quoting international statistic after statistic, with plenty of case commentaries to demonstrate the difficulty of the situation. Mentors and friends have shared stories about the challenges and trials of working in these areas. I have been moved to tears by sights of poverty and hopelessness.

Unyet, I don't feel like dropping everything I have and heading over there ASAP.

Don't get me wrong, I have immense respect for people who sacrifice much to work overseas, and believe there is a genuine need for all Christians (including myself) to be involved in global missions, in whatever capacity. However, at the same time I can't help but feel that we have "glamorised" the overseas experience, and fixated our eyes on it, while Rome burns.

You don't need to be a genius to realise that our society is cracking at the seams - our health systems are breaking, families are being destroyed, street violence is on the rise, and so on. In many ways, the developed world is a ticking time bomb; we have archaic systems and mentalities in place that are woefully inadequate to meet the changing needs and demands of society, yet this is a society that is integral to the global village (the recent economic crash is a typical example of the central role developed nations play in the world).

An example has grown out of my experience in community pediatrics over the last one month. It has been decades since the concept of the "new morbidity" has been put forth, when pediatricians began to notice the replacement of "developing world" diseases such as meningitis, with developmental problems - learning disabilities, behavioral problems and so on.

"Bah" you may say, "having difficulty learning is nothing when compared to starving to death". In some ways that is true, but consider this - in todays highly educated, competitive and academically oriented culture, a learning disability is going to have massive social repercussions, much more than in a more traditional culture. The label of "dumb" rapidly progresses to bullying, school dropouts, and eventually substance and drug abuse, unemployment and involvement in street violence. Child Safety Commissioner Bernie Geary is quite certain where many of these kids end up: prison. It doesn't take long to see what a social disaster this could become, with up to 20% of Australian kids now having a functionally significant learning impairment. Can we seriously make a value distinction between the impact of starvation and the impact of violence/substance abuse/imprisonment?

In many ways, I can't help but feel that this is going the way of Christian evangelism: for years it was "the West to the Rest", but now, for a variety of reasons, it's very much "the Rest to the West". Unless we keep vigilant on what's happening at home, we could easily end up on a downhill slope in society. Already Keating and Hertzman (1999) have noticed this "paradox of modernity" - that Marmot's social ladder of health is beginning to falter in our modern world.

And so the next time you are tempted to think that the third world is only place needing prayer and transformation effected through the work of the body of Christ, remember events such as this merely scratch the surface of a deeper disease beginning to eat away at the roots of our society.