Medicine & The Decalogue-- Medicine & The Second Commandment:
Dr. Pomerantz is a 1986 graduate of the School of Osteopathic Medicine and Dentistry of New Jersey. He is currently a resident in Family Practice and lives in Glassport, Pa.
Most Reformed folk are familiar with the Second Commandment by what is called the "Regulative Principle", whereby that which is not commanded by God in worship is forbidden; in context, the immediate concern is the worshipping of God through physical objects. Some explanations of this issue can be found in the Heidelberg Catechism Question 981, Belgic Confession Article 32, 1 Calvin's Institutes II. VIII.172, and in the Westminster Larger Catechism Questions 107-110.3
The Reformed divines saw neither Deut. 12:32 nor the regulative principle as bound by the walls of the church building, but rather sought to apply the general equity of God;s law to all facets of life. The Westminster Assembly, in this spirit, saw as one of the sins forbidden by the Second Commandment that of "tolerating a false religion" (Deut. 8:6-12;Zech.13:2,3;Rev.2:2,14,15,20; 18:12,16,17) expressed in Larger Catechism Question 109.3
As Christian physicians we must choose between theonomy -- God's law -- or autonomy -- self-law -- in developing an ethic to regulate our lives and practices. If we are to properly "kiss the Son" (Ps.2:12) and bear Him witness, we then must purge our minds and practices of the false religion of humanism. Here, then, are four humanistic myths prevalent in our culture with which we must deal in a Scriptural manner.
The first such myth is the doctor-as-priest concept. Most of us undoubtedly have endured formal encomia regarding the assumption of the mantle and charisma of medicine, or at least read such in books or journals. Dr. Felix Marti-lbanez put it succinctly: To be a doctor, then, means much more than to dispense pills or to patch up or repair torn flesh and shattered minds. To be a doctor is to be a mediator between man and God.4
This theme was also recently taken up by physician-rabbi E.R. Braverman in the pages of the Southern Medical Journal. HE has proposed a "spiritual behavior inventory" to assess a patient's "spirituality" in a manner analogous to the mental status exam. In discussing the implications of such a tool Beverman tells us that: "Religion is incomplete without medicine and science, for there is no way of life without medicine and science. Indeed, more people are immunized than are circumcised or baptized...The increasing role of physicians in social concerns...speaks for the pervading function of medicine as surrogate priesthood in America..."5
According to Scripture, medicine is a salvific activity, for healing is implicit in the meanings of the words God used for salvation (Heb. Yeshuah, Gk. Soteria). Health is also a blessing of covenant fidelity (Deut. 30:15ff; 32:39), enabling us to better be about God;s work.6 Nevertheless doctors are not priests, save for the general priesthood of believers. The only physician to have had a mediatorial role in a covenant -- which is, after all, what a priest does -- was the Great Physician; He shares this distinction with no man (I Tim. 2:5).
So what, then, do physicians do? Since true healing requires spiritual healing, such healing cannot occur without the Church.6 All a physician can do -- and only with patient compliance -- is to forestall imperfectly the inevitable. Patent coronary arteries and normal biochemical profiles are not tickets to heaven, and these define the limits of medicine per se. So where did these physicians get the idea that they were priests? Obviously, from the same source from whence Cain offered God a bloodless sacrifice, Nadab and Abihu offered foreign fire on the alter, Uzzah presumed to steady the ark, Uzziah presumed to burn incense, etc. -- from a rebellious and sinful nature. Let us have covenant mediation to the High Priest after the order of Melchizedek, and be about the work which He has given us to do.
Our next myth to consider is the Regulative Principle of Sodom and Gomorrah: "whatever I do is okay as long as I don;t hurt anyone else." Such is the dark side of American individualism, though the unctious babbling of this phrase would undoubtedly gain one a free drink and a toast in a gay bar. Since humanistic ethics boils down to personal preference anyway, how could our society say anything but this?! In medicine this is known as the ethic of autonomy, where the individual reigns supreme and is sole arbiter of right and wrong. Hr. Heimburger7 called this view the "egoist ethic", and gave illustrations of it in the abortion and "living will" movements; the thought herein is the same -- "I'm autonomous and thus am free to do whatever I want to do".
Needless to say, God expressed stern disapproval of this ethic in Scripture. The judging of nations (Ps. 2, etc); the destruction of Sodom and Gomorrah; the plagues brought upon Egypt prior to the first Passover; the punishments for violating the Second Commandment; the command for Christs to baptize nations (ethnos), and countless other examples from the Bible make it clear that we as humans share a connectedness with each other which is sinfully disdained in American thought. In short, when consenting adults break God's law together, others are hurt. Indeed, what hemophiliac child stricken with AIDs from contaminated blood products "asked for it"? What the above mentioned blood-donating sodomites did in the privacy of their own rooms has killed others! In similar fashion, will God not answer the innocent blood so cavalierly shed by abortionists? Hint: read Ex. 20:13,21:22, and Num. 35:33ff. "There is a way which seemeth right unto a man, but the end thereof are the ways of death" (Pro. 16:25); to reject God's law is to court death (Deut. 30:19). Theonomy leads to the blessings of Gerizim; autonomy -- doing "that which was right in (our) own eyes" (Jdg. 17:6) -- leads to the curses of Ebal. Physicians are not exempt from the command to kiss the Son.
Myth #3, sin-as-sickness, is fallen man's way of trying to evade God's judgment by pleading extenuating circumstances. IN this mode of thought, the sinner cops a plea of illness and is transformed by an extraordinary act of Providence into a victim worthy of compensation. Such autonomous scatology is seen most clearly in regards to alcoholism and violent crimes such as murder. According to Alanon, "Alcoholism is a legitimate disease like diabetes, epilepsy, cancer or heart disease ...is a chronic disease process...Alcoholism develops only in people with the 'X-FACTOR' (capacity to develop the addiction to alcohol). It does not develop in people who do not have the X-FACTOR regardless of how much and how often they drink."8
We are all-too-familiar with cases of murderers and rapists and other such evading the just sentence of death thanks to the pseudoscience of forensic psychiatry; though I, at least, draw a blank when trying to think of an example from Scripture when some physician, monthly prognosticator, Chaldean, necromancer, or witch of Endor ever got a client's death sentence commuted.
Physicians treat illness, not sin; although, of course, much illness is the direct result of sin and all illness is the result of the Fall. We can, again in our office of believer-priest, hold out the Divine offer of forgiveness and grace, but in no wise has God authorized physicians to take the sword out of the hand of the civil magistrate. The issues of substance abuse and psychiatry will be discussed more fully in later articles, but suffice it to say that the treatment of sin is the prerogative of God alone, who normally works through the channels of His Church. In our roles as physicians it appertaineth not unto us to equivocate by calling sin sickness; ask King Asia.
Finally, in a similar vein, there is the myth of sin-as-legitimate-option. Homosexuals are not perverts, but rather practice an "alternative lifestyle;" profligate fornicators are but the "significant others" in the "New American Family"; "choice' and "rights" are words used in conjunction with women who murder the fruit of their wombs; tax-subsidized day-care centers, referred to tongue-in-cheek as public schools, teach sex education from a position of "moral neutrality". Should we demand anything else from a society whose god is its belly? Can we as Christians break the First Commandment of secular humanism: "Thou shalt ram neither thy religion nor thy values down the throat of thy neighbor"?
If what I am about to say offends the principled pluralist, so be it; but I answer the first question with a "yes" and the second with "it's my religion or yours, and mine is the true one -- so open wide"! Enough of this drivel and alleged neutrality; either "The earth is the LORD'S, and the fullness thereof; the world, and they that dwell therein" (Ps.24:1) or it is not. Either we kiss the Son, or receive the head wound (Gen.3:14).
Neutrality towards God's law is hostility towards it, and makes about as much sense for a Christian as a man of the ante-bellum South saying, "I don't believe in slavery, but if my child wants a slave I'll pay for one and make sure that we use a reputable dealer." In medical practice this is analogous to the ordering of serum alpha-fetoprotein levels or amniocentesis for a reason other than the determination of fetal lung maturity -- i.e., that which precedes elective abortion. Likewise, it may be likened to routinely dispensing oral contraceptive pills to single women for reasons other than hormonal disorders, i.e., that which promotes promiscuity. It behooves the Christian physician to review his practice, and to reform it so as not to "call good evil and evil good" (Isa. 5:20).
A Biblical world view is one of the most important weapons
we have for the reformation of medicine; what is in our heads will guide our
affections and thereby direct our hands. If we are to "bring into captivity
every thought to the obedience of Christ" (2 Cor.10:5), our foundation
for ethics and practice must be laid upon Scripture alone, and our heads ruled
by the Logos.
1. Book of Praise: Anglo-Genevan Psalter (Revised Edition), Hamilton, Ontario, Canage: Standing Committee for the Publication of the Book of Praise of the Canadian Reformed Churches, 1984.
2. Calvin, J. Institutes of the Christian Religion (tr. Henry Beveridge), Grand Rapids, MI: Wm. B. Eerdmans Publishing Company, 1983.
3. Westminster Confession of Faith. Glasgow, UK: Free Presbyterian Publications, 1985.
4. Marti-Ibanez, F. To be a Doctor/The Young Princes/The Race and the Runner. New York: MD Publications, Inc., 1968, p.7.
5. Braverman, E.R> The Religious Medical Model: Holy Medicine and the Spiritual Behavior Inventory Southern Medical Journal. 80(4), April 1987, pp. 415-425.
6. Jordan, J. in "The Work of God's People: Worship and Service." Easton, PA: New Life Orthodox Presbyterian Church, 17-18 October 1986. Summarized and transcribed by J. Pomerantz.
7. Heimburger, D.C. A Biblical Model for Medical Ethics: 2. Three Ethical Perspectives --a Biblical Integration. Journal of Biblical Ethics in Medicine. 1(2), April 1987, pp. 22-26.
8. Cannava, R.E. Alanon: Questions often asked by Newcomers to Alanon. Mount Holly, NJ: Memorial Hospital of Burlington County Alcoholism Services, 1979.
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