Tuesday, March 15, 2011

“Medicine: In the Biblical Tradition of John Calvin with Modern Applications” by Franklin Payne (Ch. 11)

This review, written by James Rusthoven, is one of our series of reviews of chapters of David W. Hall & Marvin Padgett, Calvin and Culture: Exploring a Worldview (P&R, 2010). We welcome your engagement and responses.

Author Franklin Payne is a retired associate professor of family medicine at the Medical College of Georgia at Augusta, Georgia in the US. He has published several books on medical practice and ethics, including Biblical/Medical Ethics (Milford, MI: Mott Media, 1985) and Biblical Healing for Modern Medicine: Choosing Life and Health or Disease and Death (Augusta, GA: Covenant Enterprises, 1993). In this chapter, Dr. Payne sets out to show that modern science and medicine are direct legacies of John Calvin, that the Calvinist theologians Cotton Mather and Abraham Kuyper made considerable contributions to medicine, and that the Decalogue has considerable application to modern medicine. His attempt to blend theological themes and the lives of these formative Reformed theologians and scholars with aspects of modern medical care is laudable but at times is difficult to follow while important intermediate worldview and philosophical connections are lacking.

As a Christian, he addresses several fundamental concerns about contemporary medical practice in the American context. Two key premises of his critique are 1) a person’s health is greatly dependent on his belief system and 2) health care in the US has become an idolatrous worship of the body. The former is expressed through the belief that health and healing must be prescribed within biblical virtues such as love, patience, and self-control. The latter is demonstrated through factors such as high medical care costs, concrete manifestations of materialism exemplified by abortion and euthanasia, and failure to identify and translate the knowledge of God into a normative understanding of medicine.

I empathize with Dr. Payne’s criticism of prominent Christian scholars who support the revival of a transcendent and covenantal character for medicine grounded in the pagan Hippocratic Oath (though I don’t condone his intimation of blasphemy). I also agree that patients need to be informed fully about their illness and available treatments. However, I disagree on several important points. He fails to reference quotations but, more importantly, major concepts and positions suffer from insufficient depth and clarity of presentation. For example, Dr. Payne alludes to a book by Mather as “mostly a book on medicine” due to its small number of chapters devoted to sin, spiritual healing, and mental illness. This and other examples suggest an inherent conceptual dualism of medicine and spirituality in the author’s analysis. Ironically, in some sections he seems to consciously deny this perspective, claiming that human beings are a psychosomatic entity (which he interestingly distinguishes from a psychosomatic unity associated with pagan philosophical influences!).

Dr. Payne’s overall analysis is more theological than worldview in scope. Focusing on works of Mather and Kuyper, he fails to acknowledge the work of more contemporary Kuyperian successors who further characterize the structures of the created order beyond the five faculties he attributes to Kuyper. This leads to some serious analytical pitfalls such as the implication that all psychologists and psychiatrists are ‘materialist professionals’. He neglects to acknowledge the work of Reformed Christian physicians (including at least one psychiatrist [1]) with distinctly Reformed approaches to medicine. One in particular explores normative structures and directions of medical practice in a systematic effort to avoid reductionistic traps inherent in the materialist culture that Payne tries to critique. [2] Dr. Payne also confounds the normative role of government in health care. From a neo-Calvinist perspective, government need not withdraw from health care (e.g., the high cost of US health care that he largely attributes to government spending can also be attributable to private health care costs) but should rather provide better oversight of just and equitable availability of health care in society.

The author’s frequent appeal to Scripture would be strengthened by applying available intermediate conceptual connections between Scriptural teaching and medical practice such as a biblical covenantal ethic [3] and a multi-aspectual analysis of medicine drawn directly from the Kuyperian tradition. These could give a greater richness to the necessary critique that he has begun and thus lay stronger foundations for a Reformed Christian model for medical practice.

Dr. James Rusthoven earned his MD degree from the University of Illinois and his MHSc degree from the University of Toronto. He is currently Professor of Oncology at McMaster University, Hamilton, Ontario and is completing a PhD in theology and bioethics from Trinity College, University of Bristol, UK. Dr. Rusthoven is an active member of the first Christian Reformed Church of Hamilton, Ontario.

1. G. Glas, “Persons and Their Lives: Reformational Philosophy of Man, Ethics, and Beyond”, Philosophia Reformata v. 71 (2006) pp. 31-57 (online here or here). Dr. Glas is a Christian psychiatrist in the Netherlands and professor of philosophy at the Free University of Amsterdam.
2. J. Jochemsen, “Normative Practices as an Intermediate between Theoretical Ethics and Morality”, Philosophia Reformata v. 71 (2006) pp. 96-112 (online here). Dr. Jochemsen is former director of the Lindeboom Institute, a Christian centre for biomedical ethics in the Reformed tradition in the Netherlands.
3. J. Rusthoven, “Understanding Medical Relationships through a Covenantal Ethical Perspective”, Perspectives on Science and Christian Faith v. 62 (2010) pp. 3-15 (available online).

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