Thomas Jefferson, a fellow Virginian, would have enjoyed our Pigfest. The conversation was fluid and dynamic. The food was excellent. The topics were engaging.
I opened the Pigfest with a Thomas Aquinas quote that "civilization is constituted by conversation." Jefferson, and many others through history, understood the importance of mixing hospitality and conversation in advancing ideas and thought.
Our first proposition was that the evangelical protestant churches teach our youth that love amounts to being meek, mild and gentle. Jesus, however, was clearly not a casper milktoast wimp. We know that he let loose on the money changers who had turned the temple into a mockery. There are times to get angry about what God gets angry about. Love does not always mean capitulation. Love includes taking a stand for justice.
Our second proposition was that the Bush administration in its efforts to be tolerant of Islam has gone too far in accepting Islam's intolerance towards others. The most recent example of this was in its inexplicably slow response to the Talibanish threats of the Karzai government to execute Abdul Rahman, the Christian convert in Afghanistan. Diana argued that Sharia law must be removed from Afghanistan's constitution, because Islam cannot co-exist with the notion of religious freedom. This was a lively discussion. Morgan did an effective job of employing the devils rule by defending the sovereignty of Afghanis to set up their own laws as they see fit. We had a rich discussion of Natural Law theory, and the divine law that supersedes the laws of man. The best example of that is the greatest act of civil disobedience in American history: the underground railroad movement in the early 19th century in America. Christians, by the thousands, defied the fugitive slave laws and provided safe havens for escaping slaves -- all because they were driven by their understanding of Natural Law and human rights.
Our third proposition was the most passionate and engaging topic of the evening. Rebekah presented the proposition, that physician assisted suicide compels physicians to violate the Hippocratic oath, and therefore they should not help patients to kill themselves. Talk about a timely topic. This is THE issue of the day in our culture -- even bigger than gay marriage and ID, in my opinion. We had two physicians at the Pigfest, and both made excellent contributions to this important discussion. I learned much from this conversation. For example, since the legalization of abortion, the Hippocratic oath has been downgraded and largely ignored in some medical schools. One of the physicians present indicated that the oath was not administered at the medical school he attended (a prominent medical school which I shall not name). One of the physicians was a psychiatrist. He told us that psychiatrists from Holland are actually doing conferences here in the U.S on the subject of the medicalization of killing -- ok, they don't call it that, but they use terms like humane end of life treatment. Our Pigfester actually attended one of these conferences. The trend is for psychiatrists to become the gatekeepers who make the final decision as to whether the patient who is asking for help in dying is of sound mind. He said there is a lot of resistance from psychiatrists, not so much on moral grounds, but on practical grounds of not wanting to be in that position of deciding who lives and dies. Emily invoked the devil's rule and raised the "quality of life" argument, and I am glad she did. This is the biggie -- the argument is that if a person's quality of life degrades to a point of no longer being deemed worthy of life, then they should be allowed to end it. That led into a super discussion of exactly what it is that makes life worthy -- is it a utilitarian ethic, or is there truly an intrinsic value in human life? If quality of life becomes the defining ethic, can a severely depressed person seek help in committing suicide? If not, why not? Blockbuster topic.
The fourth topic was raised by Daniel, and it was that an artist can either pursue art wholeheartedly, or pursue God wholeheartedly, but he cannot do both. Daniel argued that an artist who pursues creating the perfect piece of art will ultimately succumb to the temptation of idolatry in creating that piece of art. The artist will be using his or her art to redeem ... instead of Christ being the redeemer. This was a controversial proposition. Sarah, a professional artist and Christian, disagreed from the get-go. She argued that art becomes an expression of beauty that can bring glory to God, not detract from His worship. Scott argued that it is not just artists that can create idols out of what they do -- physicians, software developers, and just about anyone can define themselves in terms of what they do instead of who they are. We agreed that God is a creative artist, and it does not take much to realize that. As image bearers, we have some of that creativity imbued in us. We should each seek ways to unleash creativity and create beauty in this world, but do it in a way to give glory to our Creator instead of ourselves.
The Tikkun Olam (application) time focused on ways in which we could as fathers and grandfathers teach our children what love in action looks like. How do we teach them that love does not mean being wimps, but involves standing up for what is right, and resisting what is wrong. Sometimes that takes bold action. We also talked about how to push back the darkness in our daily lives. Emily reminded us of the importance of demonstrating kindness to the people who are despised and left behind by our society. Tracey said, "you don't mean random acts of kindness, do you?" Jim responded with, "no, more like consistent acts of kindness." I like that.
Brendon summarized the evening with some excellent aphorisms.
Love is more than just getting along.
There is a higher law, than the laws of man.
Human life has intrinsic value, beyond it's utilitarian use.
You are not your job. You are called to a higher purpose.
Jeff,
It was a wonderful PigFest. I thoroughly enjoyed it! I am sorry I will miss the April PigFest due to travel for business and personal reasons.
Enjoy the books that are on their way to your house! Thank you for your family's hospitality to me. I feel at home when I come to your house and the love of Jesus is manifested the moment I step in the door.
Posted by: B.A. | March 25, 2006 at 22:18
[P]hysician assisted suicide compels physicians to violate the Hippocratic oath, and therefore they should not help patients to kill themselves. . . . For example, since the legalization of abortion, the Hippocratic oath has been downgraded and largely ignored in some medical schools. One of the physicians present indicated that the oath was not administered at the medical school he attended (a prominent medical school which I shall not name).
This isn't news to anyone in the medical community, but the timeline is somewhat off.
The Hippocratic Oath has never been universal in the medical profession and has never been an authoritative statement of medical ethics (it is only in the last few hundred years that it was widely recognized at all). In fact, it has always been controversial and many different versions of it have been written to address different controversial points.
The Oath and the Prayer of Maimonides (attributed to the great 13th-century rabbi/physician but likely actually from a late 18th century Western source) are inspired by the Hippocratic Oath but are very different in content. They are popular in many medical schools for their emphasis on the humanity of the patient and the humility of the physician.
WWII, and the revelations of the abuses of Nazi physicians, prompted an international conference of the World Medical association, resulting in a general statement of principles for medical research, and later the "Declaration of Geneva", which is a general medical-ethical oath based on, but intended to supplant, the Hippocratic Oath.
Several Christian versions of the Hippocratic Oath have been published, eliminating references to Greek gods changing the explicit precepts in various ways. The earliest was in the 10th century.
In the US, post-war revelations of American abuses such as the Tuskegee Syphilis Study, and increasing public concern in the 1960s and 70s over health-ethics issues such as access to then-scarce kidney dialysis machines and informed consent for medical treatment, gave rise to the formal study of medical ethics (now often called "bioethics"). There were several variant Hippocratic Oaths published. In 1964, the hugely influential and respected American physician Louis Lasagna wrote a Time Magazine stating that the Hippocratic Oath was outdated and inapplicable, and announcing a worldwide competition for a new and better version. He needn't have bothered - the version that he himself wrote has become one of the most widely-used physician oaths in the US today. (Note that this was almost 9 years before abortion was legalized nation-wide.)
Today, almost all US medical schools incorporate some kind of oath-taking into their ceremonies. There is a movement underway to impose an oath at the beginning of medical education rather than at graduation. But each school chooses its own oath, and only a small number use the original Hippocratic Oath. Many use one of the variants mentioned above, and many others have each class of medical students write their own oath to make it more meaningful to them. Some allow students to choose which oath they personally endorse.
So it's certainly true that the Hippocratic Oath has almost no sway in contemporary medicine, but the reason has nothing to do with abortion. It was a dead letter for most of its history, and its recent further decline has to do with the obvious deficiencies in the Oath, not some particular change in medical law. Attempts at revising the Oath have been made throughout its history; the ones cited above almost all come from outside the US and predate our abortion controversy by decades or centuries. Today, few physicians, and virtually no professional medical ethicists, believe the Oath has any moral authority (a prominent exception being Dr. Edmund Pellegrino, recently-appointed Director of the President's Council on Bioethics, and one of the few remaining Hippocratic physicians).
The reasons are obvious: it is virtually impossible to take the Oath seriously. (That is why there have been so many attempts to upgrade it - though they, too, are doomed for many of the same reasons.) If you read the classical version of the Oath, it becomes immediately apparent that parts of it simply cannot be correct, much of it is irrelevant, and other parts are completely out of keeping with modern medical practice - and that's ignoring anything that could actually be controversial!
In brief: the Oath opens with an invocation of the Greek gods, whom nobody today (not even Greeks) believes even exist, and closes with a vow to the same gods. So the entire moral force of the oath is one that literally nobody in the entire world thinks is valid. That by itself would take it out of consideration. But there's more: it is clearly aimed at the practice of medicine in ancient times (with explicit directions as to "free persons and slaves"; prohibitions on all, or a specific type of, surgery, which at that time was not part of a physician's skills; detailed instructions on how to treat one's teacher, one's teacher's children, and other medical students which are completely inapplicable to modern medical education; a requirement to keep medical knowledge secret from non-physicians; and a strong implication that women could not become doctors). These teachings are either irrelevant or actually counterproductive today (we do want doctors to perform surgery, and we do not insist that medical students share their income with their teachers).
So it is obvious that any attempt to take the Oath seriously would require disbelieving its moral invocation and ignoring or deliberately violating extensive parts of its content. But that means that the moral basis of medicine is something that we believe is grossly wrong in many parts. That doesn't sound like a good basis for a moral code. And, again, this doesn't even get to the controversial parts, such as the probibition on giving a "deadly drug . . . when asked to do so", or on abortion. (Note also that the actual text, accurately translated, refers to "a pessary to procure abortion", which was a particular type of treatment - it is only assumed by some interpreters that this was a blanket prohibition on all abortions, which is not what the text says.) Presumably, if the Oath is morally binding we must accept its prohibitions on those practices. But it is not a very strong argument to claim that they are prohbited just because an ancient oath says they are, and it is even weaker to make that claim if you have already agreed that much of the non-controversial content of the oath is wrong anyway.
If the Oath were to be taken seriously at all, it is obvious that much of it would have to be changed - which, again, is why so many people have tried to do so. But if we are to write a new oath, that new one would have even less authority than the discredited original one! The original Oath can at least claim to have been regarded as important by some generations of physicians (not all of them, but many of them at least). It has the weight of tradition behind it, even though it makes no sense. A new oath would just be "a good idea" - perhaps with some valuable things in it, but with no inherent moral authority and no weight of tradition. And if it attempts to impose binding obligations by a vow to the gods, then again there is the question whose gods are being appealed to. Is it the case that medical students who do not believe in those gods cannot become doctors - or that they are doctors who are not bound by the oath? Once more we revert to chaos, since there is no way to impose binding moral obligations on every possible candidate with words that many of them do not believe in.
Perhaps the Oath merely has symbolic force - it does not bind doctors to specific moral rules, but to a general notion of morality in medicine, as they join the long line of physicians who have seen the Oath as morally significant. That seems possible, but it would mean that the actual content of the Oath is not binding. You would need some completely separate set of rules to tell you what the actual moral truth was about abortion, euthanasia, confidentiality, or the other things that the Oath was originally intended to address in a non-symbolic way.
In the end, then, the Hippocratic Oath in its original language obviously has no moral basis that anyone living today would regard as authoritative; much of its content refers to practices or situations that are no longer relevant; some of its passages directly prohibit things that today are central parts of normal medical practice (such as female physicians, or the practice of surgery); and it is predicated upon expectations for medical education and practice that are completely irrelevant to the way the modern profession is organized. Its controversial passages, as well the parts that today are still considered morally relevant, are impossible to regard as binding because the rest of the Oath is either wrong or irrelevant, and it is all non-binding anyway. And there is no way to revise it that does not either introduce even greater controversies over its moral authority, or render it contentless.
For all these reasons, the Oath has not been taken as an authoritative statement of medical ethics for many decades. Ethicists today try to work out moral controversies in medicine rationally, on philosophical and ethical principles, not by simply citing the (falsely-attributed) words of some ancient Greek from the Bronze Age. But that's not a scandal. It's progress.
Posted by: Kevin T. Keith | March 28, 2006 at 14:17
A few comments:
Jesus, however, was clearly not a [Casper Milquetoast] wimp. We know that he let loose on the money changers who had turned the temple into a mockery. There are times to get angry about what God gets angry about. Love does not always mean capitulation. Love includes taking a stand for justice.Mostly I agree with this, but there are a couple of points I'd add. First, if Jesus is God, then we don't really get to play by the same rules of judgment that He does. Second, I agree with this in principle, but I think that Christians too often focus too much on the wrong things, and when they do focus on the right things, they often go about it wrongly.
One example of this would be same-sex marriage. Set aside for the moment whether or not you feel Christians ought to have a strong position on this issue. This issue gets a huge amount of attention, yet it seems to me that there are much more important issues (such as poverty, injustice, war, etc.) that are also much more pervasive, and that these should get the kind of high-profile attention that gay marriage gets.
Or abortion is another good one. I think that most of us can agree that reducing or eliminating abortion would be a Very Good Thing (provided that we didn't in so doing relegate women to a purely subservient role; that would be a point of some dispute). I just don't think the way most prominent Christians approach it -- through calls for criminalization, and through vilification -- are very Christian at all (not to mention the fact that they've proven woefully ineffective).
Sure, Christ was known to rant now and again, but I think the far larger lesson to take away from his life and his teachings is that we should first and foremost lead by example. And when something is worth taking a stand for, you should condemn the action, not the actor (condemning the actor is for God and God alone). Finally, you'll have the best effect not through condemnation, but through offering a better way.
Diana argued that Sharia law must be removed from Afghanistan's constitution, because Islam cannot co-exist with the notion of religious freedom.
I see where she's going, but I disagree with this statement on a couple of levels. First, state-enforced religious law of any kind cannot co-exist with the notion of religious freedom. Second, virtually every religion, in its most fundamentalist form, is hostile to religious freedom. Truth to tell, the whole notion of religious freedom in America is born of people who at one time in their lives were religious minorities. Many of them (witness, for example, the Puritans) were guilty of the exact same types of abuses when they became the majority in their area.
Religious liberty is a compromise based on the knowledge that we don't all share the same beliefs. But most believers (and even many non-believers) would promptly impose their way if given the power and opportunity.
Finally, I reject the notion that Islam is inherently hostile to religious freedom, at least any more so than any other religion. The Qu'ran contains verses that are more forgiving of nonbelievers than even the Bible (although today's Islamic fundamentalists conveniently ignore these). It's important to distinguish the religion as a whole from certain flavors of that religion.
Christians, by the thousands, defied the fugitive slave laws and provided safe havens for escaping slaves -- all because they were driven by their understanding of Natural Law and human rights.
The problem with this is that at least as many Christians defended the institution of slavery with at least as much zeal, also citing their understanding of Natural Law as the basis for their actions. Unfortunately, the stain of slavery crosses all such divides; no one group is free of its taint.
Regarding the Hippocratic Oath, here's some interesting stuff. The Oath has changed dramatically over the years, in ways that some will not like and in others that few will dislike. For example, the original Hippocratic Oath prohibited doctors from performing surgery of any kind! Bottom line is, the Oath is not some unchanging entity, and its merits have long been the subject of a great deal of debate.
Finally, next time you have a Pigfest, no cheating! Get someone else to hold the camera at least once, so that the host is pictured. :)
Posted by: tgirsch | March 28, 2006 at 14:32
And I see Kevin T. Keith answered my call. :) For those of you who don't know him, he's a co-blogger of mine over at Lean Left, and he's working toward his Ph.D. in medical ethics (although I'm sure he has a much fancier name for it than that).
Clicking on his name at the end of his comment will take you to his bioethics blog, Sufficient Scruples.
Posted by: tgirsch | March 28, 2006 at 14:45
Sorry for the wait, I'll get that emerging church paper to you soon (and maybe a response that I wrote to a McLaren article too). It's paper season and I just want to read over the paper before I send it. I'll try to get it to you this weekend.
Posted by: | March 30, 2006 at 17:43