Medical Service

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This morning in our Medical Service, I want us to think about some basics regarding health and healing. And my headings are first, Human Not Animal, secondly, Life Not Death and thirdly, Caring Not Ignoring. But by way of introduction please look at this:

Training Health Workers for South Sudan

Thank you Alice Caisley for filming in the South Sudan and Uganda last month and producing that! So A-I-D (Anglican International Development), with which some of us at JPC are directly involved, is working with ICMDA (the International Christian Medical and Dental Association) in this project. We were to have established the medical training institute in Bor in South Sudan. But three months before it was due to open, civil war broke out in December 2013 and there were terrible killings and destruction in Bor. However, the Mengo Hospital in Kampala, Uganda, generously offered space for the training institute to start with the first annual intake of 50 or so students in 2014. We would value prayer as to where we can go now, as there is only space in Mengo for an extra 18 students this year.

But the important question this morning I want to start with is: "why or how is there a hospital in Kampala that is able to do this and be of such help?" The answer has to be: because of the medical tradition that is now world-wide and has evolved from the Christian faith. Mengo Hospital resulted from an invitation by the King of Buganda. As the Hospital web-site puts it:

"By the 2nd half of the 19th Century, Christianity and Western medical care had not reached Uganda. Ugandans were in "Spiritual darkness". They believed in and practiced witchcraft. Diseases like Sleeping sickness and Syphilis were occurring at epidemic levels. In response to the King's invitation … the Church Missionary Society (CMS) of England sent a team of Missionaries to Uganda. In the team was a Physician, the late Sir Albert Ruskin Cook [then plain Albert Cook] … Consequently on 22nd February 1897, Dr. Cook held his first outpatient clinic under a tree on Namirembe hill in Kampala [the capital of Uganda]."

So started Christian Medical work in Uganda - the seed for the first ever hospital in the whole of East Africa. Certainly African medicine now is from the Christian tradition and has been the result of Christian missionary activity. But the Christian faith leading to modern medical activity is also true of Asia. One Asian has written about this in these terms:

"Many of the finest medical institutions still standing on the Indian sub-continent were founded by Christians on their own initiative, often against the wishes of the European colonial powers. The missionary contribution to medical health in Asia and Africa has been nothing less than extraordinary - from the treatment of leprosy and pioneering discoveries in epidemiology, to the development of national health care systems, the training of primary health care workers, and the setting up of educational institutions for women doctors and nurses."

But Asia has been home to several major world religions, most importantly Hinduism and Buddhism. And they go back thousands of years. Yet devout Hindus and Buddhists never evolved systems of medical and nursing care for the sick and weak, and not least for leprosy sufferers and untouchables. It is a simple fact that modern medicine worldwide has evolved because of certain Christian beliefs and certain Christian ethics. However, if you lose those beliefs and lose those ethics like a flower cut from its roots, expect modern medicine to be fine for a period but then wither and eventually die or revert to more primitive forms. But what is this Christian tradition? Let me be very basic and underline three fundamental convictions in this tradition that are now under attack.

And the first, is that men and women are Human and Not Animal

Of course, Christians have not been the only ones committed to this and the other two convictions. Certainly starting in the fifth century before Christ there was Hippocrates and a Greek Hippocratic tradition which was hugely significant. For it brought about the separation of killing and curing. No longer was the doctor and sorcerer the same person. To quote Margaret Mead, the anthropologist:

"With the[se] Greeks, the distinction was made clear. One profession was to be dedicated completely to life under all circumstances, regardless of rank, age, or intellect – the life of a slave, the life of the Emperor, the life of the immigrant, the life of the defective child …"

And this tradition was taken over and developed more successfully by the Christians as it echoed what Jesus was teaching. And what Jesus was teaching echoed the Jewish creation tradition from the Old Testament, essential to which was the uniqueness and radical difference between the human and animal worlds. You have it in Genesis 1 and 2 and particularly in chapter 1 verse 27:

"So God created man in his own image, in the image of God he created him; male and female he created them."

This was on the last day of creation (on the sixth day) and it means that human beings are superior to every other living creature. This was because every single person is made in God's image. And so their lives are sacred, worthy of great respect and to be protected. Therefore, you must not take human-life. Genesis 9.6 says:

"Whoever sheds the blood of man,
by man shall his blood be shed,
for God made man in his own image."

It is that serious. Taking human life demands the most serious of punishments. You see, other living creatures are not made in God's image. Nor did the divine Son of God, Jesus, take on animal flesh when he entered this world 2000 years ago, but he became a man – he took on human flesh. All this means that there is something special about the human condition, although we know it is marred by sin. But it is redeemable both spiritually and physically. So Christ came to save souls from sin; and he healed bodies from disease (disease being a consequence directly or indirectly of sin). However, this belief that men and women are special, is not automatic. In Old Testament times Baalism and other nature religions with their strong fertility beliefs, ritual sex and child sacrifice treated the human as subordinate to nature.

Today, secular scientific extremism, where the ultimate is this world, is a sophisticated version of the same thing. Not surprisingly, today there are a growing number of people like, for example, Peter Singer, a Professor of Ethics at Princeton University. He says that to privilege the human over the animal is pure speciesism. So kill, but call it euthanizing, young and old if necessary. He writes:

"If we compare a severely defective human infant with a non-human animal, a dog or a pig, we will often find the non-human to have superior capacities, both actual and potential, for rationality, self-consciousness, communication, and anything else that might be morally significant."

That brings us to our second fundamental belief that Christian medicine is about promoting Life Not Death

And that is why opposing abortion in history has been a defining mark of the Christian tradition. The Greek Hippocratic tradition remarkably included a prohibition on abortion in the Hippocratic oath. Doctors were required to swear,

"I will not give a pessary to a woman to cause an abortion".

This was needed because in ancient Greece abortion was so common. But it was still so common in the Roman world. The Hippocratic tradition had not changed much. However, things changed with the coming of Christ. The sacredness of, and respect for, human life was again understood from men and women being made in the image of God. So the Christian faith brought a new challenge to abortion.

In the period immediately following that of the Apostles – the period of the Church Fathers – one of the distinctive, therefore, that marked the Church off from the pagan world was its opposition to abortion. This also followed from the belief that the gospel related to every human being – rich and poor, young and old, Jew and Gentile, absolutely all - including the young in the womb. And it was, and is, influenced by Christians reading Psalm 139 where verses 13-16 say:

"For you formed my inward parts;
you knitted me together in my mother's womb.
I praise you, for I am fearfully and wonderfully made.
Wonderful are your works;
my soul knows it very well.
My frame was not hidden from you,
when I was being made in secret,
intricately woven in the depths of the earth.
Your eyes saw my unformed substance;
in your book were written, every one of them,
the days that were formed for me,
when as yet there was none of them."

Of course this is poetry, but the gist is clear. That is, that what is going on inside the womb are three things. First, God's creative activity. Secondly, God's covenantal activity – God himself is establishing a relationship with the one in the womb - God knew the Psalmist when he was at that stage of his life, although he did not know God. And, thirdly, there is a continuity in the history of the Psalmist from the moment of conception to the day he is writing this Psalm. It was his "inward parts" that were being "knitted together" not someone else's. It was he that was "being made in secret", not someone else. It was his "unformed substance" that God saw. But this is not only true for the Psalmist. The intra-uterine reality of the human person is elsewhere in the Bible. For example, the Servant of the Lord says (Isaiah 49.1 and 5):

"The Lord called me from the womb … he … formed me from the womb to be his servant."

And, of course, the incarnation of Jesus began with his conception, not Christmas Day. So the pregnant Elizabeth says to the pregnant Mary:

"blessed is the fruit of your womb" (Luke 1.43).

So we rightly say in the Creed, "he was conceived." That and other factors have led Christians to claim that the individual in the womb from conception is human and to be respected. It is not a canine embryo, or an equine embryo but a human embryo or foetus, to be respected and covered by the sixth commandment's prohibition against killing. True, it is not developed like a 20-30s human individual, or failing like a senile human individual. It is a developing human individual – human with potential, not a potential human. There is much more to be said. But the mainstream of the Christian tradition has believed that Christ came to bring life, not death, as evidenced by his resurrection from the dead. And early canon law and subsequent pronouncements, therefore, have defended the embryo and foetus as "human" or "human on the way". So it is worthy of Christian cherishing and protection.

But there was a sea-change in 1967 with the British Abortion Act. This heralded world-wide the beginning of the erosion of the Christian Medical tradition and ethics. Soon, in 1970, the World Medical Association adopted the Declaration of Oslo to accelerate this erosion. So according to the World Health Organization there are globally now 43 million abortions a year with only 57 million deaths from all other causes! Thankfully a fight back has begun with groups in America and Europe like the Christian Medical Fellowship and the Christian Institute leading the way. Time does not allow me to say more on this and similar issues, except that all should read John Wyatt's masterly book Matters of Life and Death – Human Dilemmas in the light of the Christian faith.

So that brings us to our final and third heading, Caring Not Ignoring which is the third leg, if you like, of the three legged stool that is the Christian medical tradition. This challenge to all Christians is there in the parable of the sheep and the goats (Matt 25.34-40):

"Then the King will say to those on his right, 'Come, you who are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world. For I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you welcomed me, I was naked and you clothed me, I was sick and you visited me, I was in prison and you came to me.' Then the righteous will answer him, saying, 'Lord, when did we see you hungry and feed you, or thirsty and give you drink? And when did we see you a stranger and welcome you, or naked and clothe you? And when did we see you sick or in prison and visit you?' And the King will answer them, 'Truly, I say to you, as you did it to one of the least of these my brothers, you did it to me'"

And then damning words are uttered about those who ignored the needs of those believers who were suffering (Matt 25.46):

"these will go away into eternal punishment, but the righteous into eternal life."

And because Christ has sacrificially offered his own life to save his followers from that eternal punishment, down the centuries there has been an amazing responsiveness on the part of Christians at least in trying to be sacrificially responsive to the needs of others in line with that parable. For example, from the earliest times the pagan and persecuting Emperor Julian could write of Christians (I quote):

"it's their benevolence to strangers, their care of the graves of the dead and the pretended holiness of their lives that has done most to increase their atheism [i.e. not accepting him as divine]… the impious Galileans support not only their own but ours as well."

Then, one early period of persecution was followed by a great plague. It saw wealthy pagans fleeing the city of Carthage, in North Africa. But Bishop Cyprian of Carthage preached to his congregation about loving your enemies from the Sermon on the Mount (Mat 5.43-48), (I quote the ancient historian Eusebius). He was …

"… urging them not to save their own lives, not even to seek the survival of their Christian community, but to love their enemies who had recently been persecuting them. This was an opportunity to show the love of Jesus by staying in the city and nursing pagan and Christian alike."

Since then millions of Christians have followed those examples and Jesus' teaching about caring for, and not ignoring, the sick and vulnerable. Tomorrow, 12 October 2015, some may know is the centenary of the execution of Edith Cavell, an amazing Christian nurse who cared for both allied and German injured in Belgium in the First World War, and is now celebrated as a Christian martyr.

Conclusion

I must conclude. A fight is on for the soul of modern medicine. To lose the Christian tradition will have, yes, disastrous consequences for succeeding generations.

So those of you who are not medics need to pray for those who are. And those of you who are, cannot bury your heads in the sand over these issues of belief and ethics. That is why reading Matters of Life and Death by John Wyatt is so essential for every medic. On "Abortion" my Coloured Supplement for April 2005 on our Website (www.church.org.uk) may be of help. Also after we have gone Multisite next February, I and my wife (a retired paediatrician) hope to be hosting the CMF course, The Human Journey – thinking Biblically about Health. It is run like Christianity Explored but on health and life issues. It has 8 sessions on:

1) Humanity: What does it mean to be human?
2) Start of Life: When does life begin?
3) Marriage and Sexuality: What is marriage for?
4) Physical Health: How should I live?
5) Mental Health: Am I supposed to feel like this?
6) End of life; how should life end?
7) New Technologies: Are we playing God?
8) Global Health: Who is my neighbour?

To finish, may I say this - all of us will have made some mistakes in today's confusion on these issues, through sins of omission if not commission. Let my last words, therefore, be from the book of that course:

"It may be that we find ourselves looking back at decisions we have made in the past and having deep regrets and feelings of guilt. It is a comfort that we do not face these situations alone. This is where the Christian community can offer prayer, support and understanding. Each of us, however we have lived our lives, is a sinner needing God's forgiveness daily and needing to be reconciled with him. We can take comfort knowing that Jesus himself, who entered life as a vulnerable embryo, now walks with us in all our decisions, granting us courage, grace and the opportunity for forgiveness and assuring us that he understands and has already walked the human journey before us. … he fully paid the price for all our sins. By laying down his life, he gave us new life and called us to love one another as he loved us (John 13.34-35). It is only by grace that any of us stand."

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