On the Cutting Edge.

Reclaiming the Body

Christians and the Faithful Use of Modern Medicine

Joel Shuman and Brian Volck

Brazos Press, $19.99, 173 pp.

The contemporary literature of bioethics, although vast, can often make for unsatisfactory reading. It tends to place too much emphasis on patient autonomy, yet fails to adequately examine the ethical implications of procedures such as genetic testing, abortion, and euthanasia. There is often little scrutiny of the moral ends of medicine and far too much emphasis on the ethics of particular means.

It is refreshing, in this environment, to read Joel Shuman and Brian Volck's Reclaiming the Body. Theirs is not a typical jargon-laden bioethics treatise. Shuman, a moral theologian, and Volck, a pediatrician, have crafted a different kind of book: a readable monograph that takes as its starting point theology and faith, not medicine. They are interested in exploring the meaning of the physical body, not just as it is viewed by the medical establishment, but how it is presented in Scripture and in the Christian tradition. The book is clearly addressed to Christians, who are encouraged to approach medical matters "as if God mattered."

They begin by questioning whether theology "has something to offer" anyone who must deal with the medical community. Their answer is yes, and in chapters that explore the power of the medical establishment, the meaning of the body, and other themes, they examine the many ways in which Christian Scripture and practice can inform our approach to medicine. Medicine itself, they remind us, is "a belief system," one with its own traditions, high priests, and norms, so it poses a particular challenge to Christians who must negotiate it, not least of all because the medical "belief system" pays little or no heed to matters of theology. "In few other places in contemporary North America is God's name so frequently invoked as in the hospital," they observe, "yet there are few places where God makes less of a difference in the way things are done." And yet Shuman and Volck believe that Christians have not done enough to combat this development. The authors have little patience with what passes for spiritual guidance in some medical settings--the generic, "cliche-ridden theobabble" that patients, including Christians, assume is the only guidance available.

The Christian community, the authors argue, poses a distinct challenge to the individualistic, consumer-driven ethos of contemporary medicine because Christians, as members of a "community called the Body of Christ," "never really go to the doctor alone." As part of a "gathered people" who follow a distinct set of communal norms, Christians do not necessarily abide by the medical establishment's definition of success. "The consumer model to which medicine seems to be uncritically adopting presumes that providing what the patient wants--that is, customer satisfaction in matters of health--is the measure of success," they write. But this is not necessarily the case for Christians, who must consider other factors when assessing medical care.

For example, Shuman and Volck argue that for Christians the body is a gift that they share with other members of the community. "There is no 'individual self' in Christian worship," they note, "as all are gathered into one body by the very act of sharing Christ's body and blood." This view of the body as a gift, they argue, counsels a form of acceptance (although not passivity) about the challenges of disease and physical suffering that can at times clash with the medical establishment's willingness to take extreme measures to prolong life.

Viewing the body as a gift also poses challenges to medicine's desire to improve and enhance, not merely cure. Shuman and Volck are most engaging when they discuss children and the new world of genetic diagnosis and improvement. In a chapter that asks the question, "What are children for?" they explore contemporary reproductive technologies and society's increasingly consumerist approach to parenting. Even before they are born, the authors note, "children are subjected to unspoken tests of value, both to the parents and to 'society.'" This is clearly shown by the fact that more than 90 percent of fetuses diagnosed with Down syndrome are aborted. Like the body, Shuman and Volck argue, children, too, are gifts, whether or not they fall within society's definition of what's normal.

Relying on the excellent work of bioethicist Carl Elliott, Shuman and Volck also examine "enhancement" technologies--including those increasingly popular cosmetic procedures that promise eternal youth do an aging population. While the authors do not condemn all enhancement procedures, they warn "the desire for such goods is legitimate only insofar as it is placed in the service of that vision of human flourishing that counts as its greatest good friendship with God." They ask, in other words, for Christians to question their motives when considering getting that nip or tuck. How necessary is it, they wonder, to have a cosmetic eyelift when more than 18 million people worldwide have either impaired sight or blindness from two preventable conditions: river blindness and trachoma? Such juxtapositions, although stark, force readers to weigh different values from the ones the medical establishment (and cosmetic surgeons) would consider.

Throughout the book, Shuman and Volck remind us of just how far society has strayed from the values of the Christian community. They properly lament "our society's unwillingness to abide with contingency and imperfection," not only with regard to our own appearance, but in our children and in others. This concern is especially relevant given the challenges of our aging society. With families scattered geographically and neighborhood networks frayed, a strong Christian community is more acutely needed than ever before, both for its spiritual support as well as for the practical help (such as driving a sick friend to a doctor's appointment) that an increasing number of us will need in the future.

In exploring these many themes, Shuman and Volck offer very few concrete answers to the challenges they pose; this is in fact one of the great strengths of the book. The authors offer a new and more illuminating perspective, not merely prescriptions for behavior. The book is an extended conversation with medicine, not a condemnation, and it is a conversation that yields a wealth of insights into the challenges that our contemporary health technologies pose.

Christine Rosen is a fellow at the Ethics & Public Policy Center in Washington, D.C., and the author of Preaching Eugenics: Religious Leaders and the American Eugenics Movement (Oxford University Press) and My Fundamentalist Education (Public Affairs).