Beginnings: Interrogating Hauerwas (9): Medical Ethics, Disability and the Cross

I’m deliberately posting this on Easter Sunday – the content is profoundly appropriate.

This is a series of short excerpts from each chapter of Beginnings: Interrogating Hauerwas edited by Leixlip lad Kevin Hargaden.

The outline of the book is in this post. This is an excerpt from Chapter Seven, Medical Ethics, Disability and the Cross.

How do we think of modern medicine? What questions do we need to be asking as Christians when facing life and death decisions? In whom or what do we trust and how is this revealed in what we expect or hope medicine to do for us? What should we be saying NO and YES to?

This is a long conversation ranging over a number of topics. The thread tying them together is Hauerwas’ work in critiquing liberal modernist assumptions within the practice of medicine and how ‘the disabled’ are treated.

As Brian Brock puts it at one point .. “the technical apparatus of caregiving, organized by liberal society, gets to define the field” (201). This is the tyranny of the expert; how power is ceded to the medical professionals : how we put our trust in medicine to such a point that –  as Hauerwas likes to say – we begin to believe that it will enable us to get out of life alive.

Books discussed are Suffering Presence and Naming the Silences. This post only touches on one aspect of the discussion – Brian & Stephanie Brock’s encounter of the health care system through the experience of their disabled son Adam, who also has leukemia and a degenerative eye condition. It’s a very honest and moving account.

Naming the Silences (1990) talks about the need to hear and listen to those actually suffering before talking about suffering. It also hones in on the issue of facing childhood leukemia. Brock, the interviewer, is coming at this discussion from first hand experience of both. He comments that

I feel in an especial position to revisit it and probe the whole theology of modern medicine and the role of church and family in offering a better way. (214)

These are my words and they may or may not be accurate to the discussion: the issue here is how the juggernaut of medical professionalism and high-tech treatments swamps our humanity. We treat because we can, but all sorts of ethical and moral questions do not get asked.

For example, in the children’s leukemia ward, progress of how to treat childhood leukemia is mostly made by what is, in effect, experimentation on children. There will be little benefit for the child being experimented on, but over time advances are made … and so goes the process. But this is a process that is largely hidden from parents and children. (215-16)

Brian Brock tells of he and wife fighting to have their son treated free from involvement in medical experimentation – and how incredibly difficult it was. Hauerwas adds:

SH: I was talking to one oncologist who said, “You know, we’re pretty good now at curing hard tumors.” And I said, “How did you get there?” And he said, “Oh we just used the drugs we had. We’ve had them on hand but we just got better at doing it.” I said, “How’d you do that?” And he said, “We experimented on kids.” And I said, “Did they die?” And he said, “Yes.” And I said, “Did you tell the parents it was experimentation?” He said, “No, we told them it was therapy.”

Even if they had told them it was experimentation, many parents of course are so desperate to have their children live they’ll say, “Oh yes, do whatever you think is necessary.” I do think that what’s crucial here is a truthful medicine, in which the parents have some sense that if they want to use these experimental techniques on their kids, that their children may well suffer pain they wouldn’t otherwise have suffered and will also die. (216)

Which leads a bit further on to this exchange ..

BB: We are in an odd kind of Mobius-strip world in which medicine can then only be funded because it is experimental and going to produce more high-tech medicine.

SH: I keep saying that Americans are committed to the idea that if we just get smart enough then with our medical technologies we will be able to get out of life alive! It’s not going to happen.

BB: Taking it back down to the concrete level: even with all the improvements in success rates, leukemia is still a terrible disease to treat because what you are treating is the bone marrow. You can’t get to it without a needle or a drill. And you treat it by injecting poison that is so toxic to the body that you have to put it in an arterial vein. If you put it into a peripheral vein it will burn right through the blood vessels and into the surrounding tissue. This means that when the disease is discovered you need both to get the chemo going and to surgically implant a port, so you don’t burn up too many of the peripheral veins with the chemo. But the kid at the point of diagnosis is pretty sick, so their immune system is not working very well.

I say all that because I vividly remember sitting on the edge of the hospital bed with Adam on my lap and holding the wound on his chest from where they’d put the port in. My despair was complete as I saw the incision slowly splitting open because his skin and his blood were unable to muster the strength to bind the wound. I tell this story because leukemia is a disease that leaves no marks at all, but the treatment leaves incredible wounds. I know people would find your comment about the barbarism of those treatments offensive, and yet any truthful account would say that it’s the treatment that is so scarring. You cut and stick and poison the kid because the only alternative is their dying. (218-9)

And Brock adds this from the perspective of a parent of son who is mentally delayed and largely non-verbal.

Adam hurts but he can’t verbalize where it hurts. He thus seems incapable of being incorporated within this medical narrative. In this, he seems to be more than a canary in a coalmine— another way that you often talk about disabled people— because he reveals modern medicine for what it is. Because he is impermeable to the mutual pretenses that govern our lives, for him there seems to be no other reality than trust and communion, or its lack. Without a horizon of future or past, he demands presence. (219)

And it is this demand for presence that meant that the Brocks decided that they would not subject him to the cruelty of a bone marrow transplant and 6 weeks in a bubble to avoid infection. To be separated from physical presence would be beyond bearing.

It did not come to this –  but these are the sorts of questions that Hauerwas and Brock are probing and encouraging Christians to think hard about rather than unthinkingly go with the modernist flow of whatever the medical experts say.

It would be wrong to end here without some more theological comment. At the end of the chapter Brock raises the idea that disability is a hermeneutical key to reading Hauerwas. By this he means that as Christians we are to live by and under the cross.

The Christian faith is not a success story. It is God’s glory revealed and victory won at the cross. The church and all theology can never move past the cross. We live in a world that Hauerwas has spent his life trying to engage Christianly – a world of war, pain, mental illness, physical illness and death, slavery, patriarchy and so on. (237)

He is, I think, an ‘anti-success theologian’. He takes seriously that the foolishness of God is wiser than the bankrupt wells of human wisdom.  And that is profoundly counterintuitive in a North American culture dedicated to success, happiness and positive thinking.

Comments, as ever, welcome.

 

 

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An Easter Reflection: 1 John 4, love, life, wrath and the cross

In 1 John 4: 7-10, the apostle writes this:

7 Dear friends, let us love one another, for love comes from God. Everyone who loves has been born of God and knows God. 8 Whoever does not love does not know God, because God is love. 9. This is how God showed his love among us: he sent his one and only Son into the world that we might live through him. 10 This is love: not that we loved God, but that he loved us and sent his Son as an atoning sacrifice for our sins.

That is 9 occurences of the noun or verb for love of [agapē (love) and agapaō (to love)] in 4 verses. I John is easily the most ‘love saturated’ book in the Bible and these verses represent the most ‘love saturated’ section of the epistle.

Famously – and uniquely in Scripture – John states that ‘God is love’. Love ‘comes from God’ because God, in himself, in his essential being, is love. This means everything that he does is loving – whether creating, sustaining, redeeming or judging.

For John, love is never abstract; it is always concrete and practical. God’s love takes the visible and tangible form of sending his one and only Son into the world – in John a realm of sin, death, rebellion and hate. If love is the motive, the result is that we might have life through him.

John thinks in big picture theology rather than systematic details. The ‘sending’ of the Son is shorthand for the whole story of Jesus – his incarnation, life, ministry, death and resurrection. His focus here is on the cross as verse 10 makes clear.

The Son is sent in love to give us life. But how does this work?

1. Somehow the death of the beloved Son is an ‘atoning sacrifice’ (hilasmos) for our sins – yours and mine. Despite some attempts to evade this, hilasmos has the sense of propitiation – turning away divine wrath against sin and sinners via an acceptable sacrifice. The love of God sits right alongside his anger and judgement against sin. It is at the cross that the love and judgement of God meet. To see Easter and the cross only as a supreme example of divine love and to airbrush atonement for sin out of the picture is to depart from the apostolic gospel.

2. In atoning for our sins, the death of the Son gives believers life. This implies a doctrine of regeneration. To be in the world is to be in a realm of death. Through God’s loving initiative, we are given the gift of eternal life. We no longer are to belong to the realm of the world.

3. Easter is solely dependent on God’s love and is God’s initiative alone – we are utterly unable to deal with our sin or be reborn into new life. It is only God who can  atone for sin and give us life. He does so at supreme cost to himself.

4. If the whole point of Easter is to give us life – what does this life look like? Quite simply it is a life of love. John’s focus is our love for each other. If we do not love, it reveals that we do not actually know the God who is love. Love is the ‘proof’ that we have received new life and our sins have been atoned for in the death of the Son. As we enter this Easter weekend, let’s first and foremost remember that both the motive and the ultimate purpose of the cross is love.

Easter is therefore a good time to reflect on our ‘love lives’ – how well are we loving?

Easter is an appropriate time to pray, repent and ask God to help us love – to be the people that the atoning death of Christ is designed to make us be. Perhaps there is someone we need to act to be reconciled with this Easter.

Easter is most of all a time to rejoice and worship the God who is love and who acts in love so that we might have the privilege and joy to know him.

Comments, as ever, welcome.

Resurrection changes everything

 

If you believe in the resurrection of the Messiah, it changes everything. There is no middle ground.

Take some implications for Paul, who came to believe on the Damascus Road that Jesus was indeed God’s promised Messiah who had  been raised from the dead.

1) His view of God is transformed:

The mystery of the gospel (which had NOT been revealed before the resurrection) is that God has chosen to effect salvation in and through the death and resurrection of his Son by the power of the Spirit. The cross is the supreme act of love by the Triune God.   Paul’s Christology is as exalted as can be imagined. The saving purposes of God are centered in and through Jesus. Jesus is revealed to be the reigning Lord who alone is worthy of worship, love, and wholehearted obedience.

2) His view of God’s people is transformed.

Since Jesus the Christ is raised from the dead and is Lord of all, the saving significance of his death is relevant to ALL people. The entire story of Israel has reached its climax and fulfillment in Jesus, but he is not a Messiah only of the Jews but for the whole world. God’s people are now made up of all who believe in and follow Jesus – whether they are Jews who follow the Law or Gentiles who do not.

3) His view of the future is transformed

Since Jesus is raised from the dead, his resurrection proves God’s victory over sin and death. All who are ‘in Christ’ are guaranteed to follow the same path of resurrection to new life. Christian hope is of resurrection life in a new resurrection body within a renewed creation.

4) His view of his own life and identity is transformed

No longer does Paul the Pharisee seek to persecute the fledgling Christian movement but becomes its champion to the Gentiles.  Whatever was dearest to him – his religious identity within Judaism – becomes of relatively zero importance in light of the resurrection. His life is changed forever, shaped around proclaiming, persuading, talking and writing about the glorious good news of the victory of God in Christ – whatever the cost to himself personally. Nothing is more important than sharing the gospel of the life, death and resurrection of the Lord.

5) His view of a life pleasing to God is transformed

Rather than a life under Torah being the goal of a holy life, now, in light of the resurrection, the goal of life is to be conformed to the image of Jesus. The Torah can’t achieve this, only the Spirit of God can bring new resurrection life. It is through faith in Christ that sins are forgiven and new life entered into by the Spirit. It is life in the Spirit that fulfills the Law, pleases God and leads to a transformed life of love and joy, lived out of thankfulness and response to God’s redeeming love.

That’s a lot of transformation. Nothing for Paul was ever the same again. Nothing for any of the first disciples was ever the same again. The world changed on that first Easter Sunday.

It continues to call you and me to deeper worship of God, a transformed community of fellow believers, a transformed hope, a transformed identity and purpose, and  a transformed life in the power of the Spirit ….

Best wishes for a joyful Easter Sunday!

How does the cross trouble you?

The CrossThis Good Friday Christians remember, reflect upon and celebrate the death of Jesus, the Messiah.

Christianity is nothing without the cross. (And the cross is nothing without the resurrection – but that’s for another day).

Paul would only boast in the cross (Gal.6:14). Christians are baptised into the death of Christ. The share the Lord’s Supper to remember and proclaim Christ’s death. The gospel begins with ‘Christ died for our sins’.

But to boast about or celebrate the cross would have been utterly bizarre for a first century person, especially a Jew. It should strike us as pretty weird too but we are inoculated by over-familiarity.

A positive assessment of a barbaric pagan execution method? Impossible. A crucified Messiah? Grotesque.

If Good Friday reminds us of anything, it is of the shocking ‘otherness’ of God. His ways are not predictable or nice or neat.

The life and mission of Jesus began and ended in violence and bloodshed. His ministry was shaped by increasing conflict that climaxed in a solitary,  brutal and unjust death at the hands of Empire.

And yet the united witness of the NT writers is that this was no accidental or insignificant event,  but God’s dramatic confrontation of sin and death and evil in his Son made flesh.

No-one imagined that this would be the identity and calling of the Messiah until Jesus burst on the scene, healing people, announcing the coming kingdom and uttering dark predictions about his voluntary, sacrificial and substitutionary death (Mk 10:45).

The cross announces to all that our lives and this world are so broken and distorted by sin that absolutely nothing else can begin to set things right except the death of the Son. For if there was any other way to effect forgiveness and avert the wrathful judgement of God, then the cross would indeed become a symbol of an unjust and unloving Father who allows his Son to suffer unnecessarily.

This death is the decisive event in God’s saving purposes for individuals and for all of creation. It is a place where something so deep and mysterious happened that the Bible talks about it in multiple ways. For centuries Christians have wrestled with what happened at the cross – how atonement ‘works’ – and it’s remarkable how no one explanation can ‘capture’ the atonement, it is simply too big and rich and breathtaking to tie down in one image or idea.

But, however understood, it calls each and every person to worship of the self-giving God who in himself and out of love atones for sin, enacts just judgement, defeats sin and death and overcomes evil.

Too often, Christians can think of the cross as only a ‘past event’.

But the cross is never an end in itself – it is only the beginning of a whole new life within the bigger picture of salvation. Consider Titus 2:11-14

11 For the grace of God has appeared that offers salvation to all people. 12 It teaches us to say “No” to ungodliness and worldly passions, and to live self-controlled, upright and godly lives in this present age, 13 while we wait for the blessed hope—the appearing of the glory of our great God and Saviour, Jesus Christ, 14 who gave himself for us to redeem us from all wickedness and to purify for himself a people that are his very own, eager to do what is good.

The self-giving Messiah dies to redeem his people from something to something else: from a life lived for the self in this age, to a life shaped by the age to come.

All of the Christian life is to be lived under the shadow of the cross – the Christian life is nothing if not cruciform. To follow Jesus in living life for the good of others; in putting to death the old and putting on the new; in being willing to face suffering.

As I think about Good Friday I am troubled by how comfortable and untroubled I am by this God.

This cross confronts my self-sufficiency – it announces to you and me that there is no human way of salvation for if righteousness could be gained in any other way then ‘Christ died for nothing’.

The cross confronts my theology of God himself. I fear that in studying the big picture unfolding narrative of the Bible and being able to see something of how it fits together, God can be all too easily boxed away; his present and future actions fitting safely within the boundaries of an already written story that we, as NT Christians, now have a much fuller understanding of than in the OT.

But at the cross, God exploded his people’s understanding of who he was and what he could and would do. I wonder how and where he might do the same for his people today?

Comments, as ever, welcome.

 

 

 

 

Falling over themselves to explain Easter

Sacrifice, justification, redemption, penal substitution, ransom, healing, victory, example, reconciliation …..

The writers of the New Testament are falling over themselves to explain the saving work of God on the cross. All of these pictures or metaphors are ways to explain what happened at the cross.

And all of them would be meaningless if it were not for the resurrection (1 Cor 15). The resurrection is the seal, the vindication, the visible triumph of God in Christ through the Spirit over sin and death and evil. We celebrate today Resurrection Day.

They are not, however, random pictures. They are creatively and imaginatively chosen in the midst of ‘flesh and blood’ letters and gospels  consistently to interpret the cross of Jesus through the lens of the biblical story. In a very real sense, the entire New Testament is a theological reflection on the life, death and resurrection of Jesus Christ in terms of fulfilment of God’s promises to Israel. And these fulfilled promises now extend wider than Israel. The astonishing good news of Easter and Pentecost to come, is that this is a victory won by no localised Jewish Messiah, but a saviour for the world.

We can’t understand the depth and wonder of the cross without that OT framework. And even then, we will only scratch the surface. Such is the magnificence of saving work of God, there is no one picture that can possibly capture its scale and beauty.

To change the metaphor to a golfing one (from Scot McKnight in A Community Called Atonement – an excellent book ) we need to play with all the clubs in the bag if we are to play well. Each club is designed to do a particular job. If we play with one club all the time, our game will become one-dimensional and much less effective. And there are a lot of clubs in the Bible’s bag …

All of these pictures of the atonement are different ways of explaining HOW the gospel of Jesus the Messiah is good news (forgiveness, peace with God, right relationship with God, adopted as children into the promise, victory over sin and death etc).

God’s work of salvation is comprehensive and complete; it cannot be bettered.

They point to the COST of salvation. Jesus died for a purpose. The cross is necessary.

They show us WHY we need salvation. Enslaved, under judgement, captives who need releasing, facing death …

They point to the immeasurable LOVE of the triune God; Father, Son and Holy Spirit  (1 John 4:9-10)

This is how God showed his love among us: He sent his one and only Son into the world that we might live through him.10 This is love: not that we loved God, but that he loved us and sent his Son as an atoning sacrifice for our sins.

With best wishes to you for a joyful Resurrection Day

The call of the cross

A Good Friday Reflection

Without the croMonasterboice High Crossss, Christians have nothing whatsoever distinctive to say.

The cross is at the heart of all truly Christian theology. The Christian life is a life lived under the shadow of the cross.

The gospels can be described as passion narratives with extended introductions. While you might be uneasy with this (does it not relegate Jesus’ birth, life and preaching of the kingdom to secondary importance?) the fact is that the birth, life and teaching of Jesus are all cross-directed. They lose all sense and coherence without the cross.

Matthew captures the developing conflict with the authorities which leads to his climatic abandonment and death. All happening to fulfil the words of the prophets.

Mark consistently talks of discipleship in terms of suffering and the way of the cross  (8:34-8). Jesus’ own clear self-understanding of his mission is famously summed up in 10:45 where he comes not to be served but to give his life a ‘ransom for many’ – a reference to the servant of Isaiah in 52:13-53:12.

Matthew also links to Isaiah 53, a profoundly important framework for the mission of the Messiah (Matt. 8:17; 12:17-21).

Luke describes Jesus setting his face to Jerusalem, the place of his death and the focus of mission (9:51).

John opens with Jesus ‘the lamb of God who takes away the sin of the world’ (1:29). His whole gospel is focused on the death (and glorification) of the Christ. His link to Passover is echoed by Paul who calls Jesus ‘our Passover lamb’ (1 Cor 5:7). Here is the cross as sacrifice for sin, a theme expanded on at length in the book of Hebrews.

Paul wants to know nothing but know nothing but “Jesus Christ and him crucified” (1 Cor 1:1-2). He talks of Christ crucified being the power and wisdom of God. While Jews look for miraculous signs and Greeks look for wisdom, ‘we preach Christ crucified’ (1 Cor 1:18-25).

The foundational act of fellowship within the early Christian communities is a meal to remember and proclaim Christ’s death (1 Cor 11:26). In terms of the gospel, it is of first importance that Christ ‘died for our sins’ (1 Cor. 15:1-5). To be a Christian at all means to be ‘baptised into his death’ (Roms. 6:3). If Paul is to boast in anything, he will only boast in the cross of Christ (Gal. 6:14).

Take Colossians 2: 13-15. It is at the cross that sin is atoned for and forgiveness achieved. It is at the cross that condemnation and judgement are dealt with through Christ our substitute taking the penalty for sin. It is at the cross that a decisive victory is won over the powers and authorities opposed to the reconciling work of God.

“When you were dead in your sins and in the uncircumcision of your flesh, God made you alive with Christ. He forgave us all our sins, having canceled the charge of our legal indebtedness, which stood against us and condemned us; he has taken it away, nailing it to the cross. And having disarmed the powers and authorities, he made a public spectacle of them, triumphing over them by the cross.”

Or back to Corinthians: It is at the cross that the rulers of this age are ‘outsmarted’ – they did not comprehend the wisdom of God seen in the mystery of the cross, “the hidden wisdom which God predestined before the ages to our glory; the wisdom which none of the rulers of this age has understood; for if they had understood it they would not have crucified the Lord of glory” (1 Cor 2:7-8?)

Take Romans 5:1-11: It is the cross which supremely reveals the depth of the love of God “But God demonstrates his own love for us in this: While we were still sinners, Christ died for us.” It is the cross which speaks of the immeasurable grace of God since we are powerless to save ourselves. It is the cross which leads to justification (being declared righteous) and reconciliation (peace with God). It is the death of Christ which saves us from God’s wrath.

Yes, yes, the cross must never be separated from the resurrection – otherwise it remains a brutal form of execution; a place of death and despair. Yes, the cross lead to Pentecost where the victory won at Golgotha leads to the outpouring of the promised Spirit.

But the Scriptures are insistent that something unique happened at the cross. The texts are packed full of images and stories and metaphors of what went on there – and quite rightly we should unpack and explore each one. But the very diversity of images should tell us something. No-one image or picture or theme can neatly capture the cross. We need so many of them because what happened at the cross is something that is profoundly mysterious and beyond easy explanation.

So let’s never get so wrapped up in debates about how the cross works, or what it achieves, that we miss what the cross of Christ calls us to.

It calls us to worship, to adoration, to thanksgiving, to humility, to self-giving lives lived to honour God. It calls us to die to ourselves and live for him. It calls us to be willing to suffer for our faith. It calls us to give up power and control and manipulation as routes to ‘success in ministry’. It certainly calls us to reject violence as followers of a crucified Messiah. It calls us to daily repentance and fresh seeking of the generous grace of God. It calls to wholehearted love of the one who first loved us.

Tenebrae, lament and tears

tenebraeThis evening our wee church will be having what has become an annual Tenebrae Service (‘Service of Shadows’)

I’ve found it a very moving and powerful way of reflecting on the passion of Christ and am grateful to those who got us started some years ago. It’s structured around a liturgy of music, Scripture, silence and a gradual extinguishing of lighted candles after each reading. It ends in darkness when the lit Christ candle is carried out of the room and people leave in silence.

The scripture readings focus on the betrayal, arrest, suffering and death of Jesus, and on the cross as the climatic fulfilment of God’s redemptive purposes.

There are few places within low-church Protestant and evangelical spirituality for silent reflection together on the suffering love of the Messiah. Perhaps this is one reason why Tenebrae makes such an impact each year.

There are perhaps even fewer places for lament, and perhaps even tears, in the songs we sing, in the busy Sunday services we have, and in the activist lives we lead.

What place does lament, and perhaps tears, have for you at Easter?

Tears perhaps of gratitude & wonder at the self-giving character of God?

Or perhaps tears of repentance?

Or perhaps tears for the sacrificial suffering of the innocent One?  “For you know the grace of our Lord Jesus Christ, that though he was rich, yet for your sake he became poor, so that you through his poverty might become rich.” (2 Cor 8:9)

Or perhaps tears at the brutal apparent finality of the enemy that is death?

Or tears at the brokenness, violence and systemic injustice of the world we live in?

But when that Christ candle leaves the room in darkness, it is not extinguished ….