19 August 2010

On the Pathological Reliance on Medicine

I witnessed a convergence of ideas the other day when reading Rob Moll’s The Art of Dying: Living Fully in to the Life to Come. (A book, incidentally, that I think ought to be read, along with Elisabeth K├╝bler-Ross' classic On Death and Dying.)

A few months ago I came across (again) Gilbert Meilaender's brief article
"I Want to Burden My Loved Ones" (first published in 1991 in First Things—back when it was less of a rag). Moll then brought it up in The Art of Dying and unpacks it a bit: 
"Meilander gently argues against the application of living wills or advance directives as the modern fix-all to the tendency of doctors to rely too heavily on medicine. We say we don't want to burden our families with making difficult choices when we cannot make medical decisions on our own, so we turn to legal documents that outline what we would and would not want should we ever be unable to tell a doctor ourselves. . . .
[But] this appeal to a piece of paper overturns what families are supposed to do—carry each other's burdens. When we allow someone else to care for us, make decisions for us, Meilander says, we most often discover that they are willing and eager to pick up our burdens." (p. 90)
Advance directives are, of course, not inherently wrong, but "it is best when a range of people . . . are part of the conversation about what medical care a patient desires." The main benefit of advance directives is getting the conversation started.

Moll also writes early on in the book about what he alludes to in the above quote—relying too heavily on modern medicine. "Our hope in medicine can lead to an unrealistic expection that medicine can cure whatever disease we or our loved ones might have. Such expectations tempt us to believe we need not contemplate and prepare for our death or that of our family members." He goes on: "Aggressive medical care may always be our first option, but by pursuing powerful medicine until there is 'nothing left to do' we likely forgo time with loved ones, final pursuits or perhaps a spiritual deepening in anticipation of life with God" (p. 35). Such is the irony of certain Christians' proclivities toward being "so pro-life [that] we're anti-death" (in the words of one Christian gerontologist, p. 33).

Then along came Hauerwas. In
"America's God Is Dying," he writes (among other things that are actually the piece's focus):

"The fear of death is necessary to insure a level of cooperation between people who otherwise share nothing in common. In other words, they share nothing in common other than the presumption that death is to be avoided at all costs.
That is why in America hospitals have become our cathedrals and physicians are our priests. I'd even argue that America's almost pathological reliance on medicine is but a domestic manifestation of its foreign policy. America is a culture of death because Americans cannot conceive of how life is possible in the face of death. And thus 'freedom' comes to stand for the attempt to live as though we will not die."
The point about foreign policy aside, think how this same culture (of triumphalism and glory) has gripped the American church—the very place where the cross ought to be rooted. Christians here cannot conceive of how life is possible in the face of death. And so American Christians, just as much if not more than non-Christians, die poorly, precisely because they have forgotten how to die well, which means they've forgotten how to live. 

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