The Practice of Medicine & The First Commandment: General Considerations
Dr. Pomerantz is a 1986 graduate of the School of Osteopathic Medicine of the University of Medicine and Dentistry of New Jersey. He is currently a resident in Family Practice and lives in Glassport, Pa.
Medicine is a profession like no other: who else has such access to the secrets of distressed souls, or may do the otherwise unthinkable in both examining the naked bodies of patients and asking the most personal questions routinely? The patient/doctor relationship can play upon every emotion and sentiment we possess, and again is unique to our calling. The vast pool of knowledge, logical beauty in diagnosis and therapeusis, dazzling array of technological accoutrements, and well-nigh mystical jargon give medicine an almost sacerdotal image. Indeed, in the eyes of the public, such is the case - we are viewed as oracles of diagnosis and prognosis as if the lab coat were an ephod and our instruments urim and thummim. Television and health care policy both show that this priestly image is ubiquitous in our culture. However awesome, such an image is most certainly a "big lie"; i.e., something patently false but believed, owing to a relentless propaganda campaign. It is also, I fear, idolatrous.
As Christians, we ought not to swallow such nonsense but, contra Wesley, a) we shall not achieve entire sanctification in this life (I John 1:8,9), and b) like Solomon, we may sin despite our wisdom and instruction (I Kg. 11), given our fallen estate. Of course, if an adoring and idolatrous public has put us on a pedestal, we were not dragged there kicking and screaming. Paul charges us to "Prove all things; hold fast that which is good" (I Thess. 5:21), and so we ought to acquire a Biblical perspective on our vocation. This is the purpose of this series; viz., to view the practice of medicine in the light of the Decalogue as understood in the Reformed Faith. Let us commence with a few casual observations regarding medicine and the First Commandment.
1. Thou shalt have no other gods before me.
First of all I offer the trite observation that medicine is but one of many vocations, albeit a respected, sought after, and lucrative one. As a vocation, medicine is approved of God so long as it remains within the pale of His Law. Although medicine is a much honored vocation from the human perspective, a perusal of Scripture fails to demonstrate a similar respect in God's sight. In fact, God reserved special approbation for only two vocations, both of which are governmental: the magisterium and the ministerium.
Of the former, Calvin pointed out in Institutes IV:201 that the magisterium is accorded, amongst many worshipful titles, that of "god."2 We are also to be in subjection to their lawful authority (Ps. 2:10,12; I Pet. 2:17) and to pray for them (I Tim. 2:2); such is also echoed in the Westminster Confession of Faith XXII.7 With regards to the ministerium, the Confession XXV, Institutes IV:3, and The Form of Presbyterial Church Government? prove from Scripture that, as in worldly government, ecclesiastical government commands similar honor. Such officers as elaborated upon in I Cor. 12:28 and Eph. 4:11-13 are worthy of double honor (I Tim. 5:17,18) and are to be submitted to Heb. 13:7); see also the Fifth Commandment and Larger Catechism questions 122-133.7
The medical profession, on the other hand, cannot prove any distinction by Scripture of being a higher calling than any other. Our enterprise is therefore, in this sense, no different from any other. However, like Nehushtan, it is an institution which may become an object of worship (Num. 21:18,19; 2 Kg. 18:4) in violation of the First Commandment; see Larger Catechism question 105.
With regards to the medical profession, "what saith the Scriptures?" In the Old Testament one sees the priesthood functioning as public health inspectors, isolating those unclean due to diverse dermopathies (Lev. 13). This is not medicine, per se, for the "leprosy" (Heb. tzawra'ath) is a generic term not restricted to infection with M. leprae. Furthermore, no treatment is described save for isolation and ablution. Likewise, the unction by New Testament clergy (Jas. 5:13-15) cannot be construed as medical treatment.5 In Institutes IV: 18 Calvin demonstrated that either the unction was a symbol which derived force from the accompanying prayer, or it may have been a charisma no longer operative in the post-Apostolic Church. Both of these practices were thus ritual rather than medicinal.
Rev. Rushdoony is of a different mind. He states:
For Christians, healing, i.e., medical practice, is a religious practice and salvific activity. This means that medicine is a priestly vocation and calling. For this reason, historically the church has fought for the sanctity of the confessional. What is confessed to a pastor. . .(holds true) of all communications between a patient and a doctor; it is a form of confession for the purpose of healing. The doctor is God's agent in process, and the communication is privileged.6
This, however, is unacceptable. Rev. Dawson has pointed out that to swear to secrecy before hearing the secret is a violation of the Third Commandment via promising the unknown;' see also the Confession XXII:6. Furthermore Calvin in Institutes III:4 showed that showed that confession was not a levitical function.
Physicians In Scripture
Physicians are mentioned in Scripture, though. Dr. Payne demonstrated four Old Testament references: chastisement of Asa for seeking medical aid in lieu of God's (2 Chr. 16:12), Jacob's embalming by Egyptian physicians (Gen. 50:2), job's description of his friends as "worthless physicians" (Job 13:4), and Jeremiah's allegorical call for physicians to spiritually heal Israel (Jer. 8:22).5 Furthermore, along the line of Jeremiah, Jesus in the New Testament stated that those who were well did not need a physician (Mt. 9:2; Mk. 2:17; Lk. 5:31); one notices a trace of sarcasm here. Other New Testament references include the woman with a flow of blood refractory to treatment (Mk. 5:25; Lk. 8:43), our Lord's statement "Physician heal thyself' (Lk. 4:23), and Paul's reference to Luke as "beloved physician" (Col. 4:4). All in all, none of these references provides either moral guidance or a favorable view of physicians.
As for medical intervention in Scripture, one is again bereft of a flattering portrait. Jer. 8:22 mentions a balm, and Jesus sarcastically prescribed eye salve for the Laodicean Church (Rev. 3:17,18); both texts are allegorical. Wine was prescribed by Paul for Timothy in I Tim. 5:23, and was used by the Good Samaritan (Lk. 10:34). Oil, too, was used by him but, as Dr. Payne pointed out, " . . . in this instance medical knowledge is not useful", for such treatment could conceivably increase the risk of infection.' Dr. Payne further stated - as ought to be obvious to those upholding covenant theology - that God would never give a harmful prescription. Again, the woman in Mk. 5:25 and Lk. 8:43 is hardly a good testimony for the state of the art of the current gynecology.
Both Testaments abound with healing' and resurrections; Dr. Payne noted that none were ascribed to physicians or medicine, but rather all were acts of God -tlwough His appointed agents.' One should also note the overall tenor of Scripture in subordinating the physical aspects of life to the spiritual (e.g., Mt. 5:29,30; I Tim. 4:8). Thus Scripture provides us with no warrant to glorify medicine; this does not stop us from doing so.
Our pagan culture is infused and suffused with materialism, a tenet of which is a belief called "scientism." Herein is science apotheosized with humanism its creed, scientists its priesthood, the educational establishment its rites and orders; and, of course, grant money its sacrifices. The medical denomination uses its armamentarium as its sacraments, and is confessionally secularly ethical. Dr. Erde, ethicist at my alma mater, wrote of how his brand of Bible-free ethics would help us with "clarification of ideas," such as, by "proposing a distinction between being human (a biological, genetic category) and being a person (a moral category)"; how such can "thus facilitate understanding of brain death and harvesting organs, and even contribute to better understanding of some abortion issues," and enable us to become more adept at "people improving" by "telling stories" - myths to live by? "with only implicit 'morals.' "14 Read Prov. 9:10 and 16:25, Dr. Erde. Such an antichrist ethic makes us but Humanistic Pharisees who, like the Pharisees, sit in Moses' seat without Divine behest. We assume the "therapeutic privilege" in the face of the Ninth Commandment; bestow personhood by human criteria opposed to Gen. 1:27, and revoke it similar by means of abortion; "medicalize" sins like drunkenness (Prov. 20:1), murder (Ex. 20:13), infanticide (Lev. 20:2-5; Ex. 21:22,23), and homosexuality (Lev. 20:13) by labeling them respectively as alcoholism, "temporary insanity" (why not "murderism?"), "therapeutic" abortion, and "alternative lifestyle" and compound the sin by offering medical therapies as the means of paying off the "wages of sin" (Rom. 6:23).
The general public, despite its wholehearted devotion to the medicine cult, seems to understand Rom. 2:14,15 well. The Law tells them of God's attributes, with an emphasis upon His infallibility; we who play God, then, are expected to play by the rules. This may have some bearing on the current malpractice free-for-all. Yet the public continues its worship at Apollo's altar, praying to escape the consequences of years of trampling asunder the Sixth Commandment in their own bodies and, since "God is love," they assume an inherent right to complete medical care without any personal responsibility for preventive maintenance. While medicine cannot be held entirely accountable for the cult's growth, attempts by physicians to stem the tide have been conspicuous by their absence. As opposed to the ministerium, the cult's priests are handsomely paid.
How should we, as not only physicians but as Christians of the Reformed Faith, view our vocation? To summarize, then: medicine is indeed a worthy calling, but without any legitimate pretention to greater Divine approval than any other lawful vocation; physicians, being without ordination or any Divinely-bestowed honors of charismata, cannot view medicine as a holy office. God has, as demonstrated in the Confession V, established second causes, so the practice of medicine is certainly within His established cosmic order and within His command to subdue nature (Gen. 1:28). We must eschew the cult of medicine as idolatry, cease from overly glorying in our own attributes - which are but His gifts to us - but rather glory in our election (2 Cor. 10:17), supplant the false religion of medicine with the true faith (2 Cor. 10:10) in our practices and, God willing, in our society.
1. Calvin, J., Institutes of the Christian Religion (trans. Henry Beveridge). Grand Rapids, MI: Wm. B. Eerdmans Publishing Co., 1983.
2. See Ex. 22:8,9; Ps. 82:1,6; John 10:34; Deut. 1:16,17; 2 Chr. 19:6,7; Prov. 8:15
3. Dawson, M.L., Sr., "Exodus 20 / Deuteronomy 6:1-5: The Third Commandment." (Sermon preached at Stratford Orthodox Presbyterian Church, Stratford, NJ., Feb. 23, 1986).
4. Erde, E.L., "What Can an Ethics Professor do at a Medical School?" NJAOPs Journal, June 1984, 8-10.
5. Payne, F.E., Jr., Biblical /Medical Ethics. Milford, MI: Mott Media, 1985.
6. Rushdoony, R.J., Chalcedon Medical Report No. 11: 11: 11: 11: 11: The Church and Medical Ethics. Vallecita, CA: Chalcedon, 1985.
7. Westminster Confession of Faith. Glasgow, UK: Free Presbyterian Publications, 1985.
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