Christian Physicians Research Articles

Two Pioneers of Euthanasia around 1800

In his autobiographical Apologie, the famous French surgeon Ambroise Pare recalled how in 1536, he witnessed remarkable case of mercy killing. On entering conquered city, he encountered three fatally wounded soldiers. They were leaning their backs against the wall of horse stable, next to four others who were already dead. An old soldier approached Pare and asked him whether there was any hope for the three who were still alive. When Pare indicated there was none, the old soldier, to the surgeon's great dismay, calmly proceeded to cut their throats knife. (1) Pare's story is just an anecdote, but it has important implications. It shows that active euthanasia was clearly not beyond imagination in the early modern period. This conclusion is confirmed not only by the famous fictional account of active euthanasia in Thomas More's Utopia, published in 1516, but also by reports of popular customs like pulling the legs of hanged but still living criminals or suffocating dying patients cushions to end their suffering. (2) Western, Christian physicians, however, are generally thought to have unanimously rejected active euthanasia until the late nineteenth century. It was only then, historians of medical ethics have found, that individual physicians joined the ranks of those who, from the 1870s onwards, publicly advocated active euthanasia. (3) As W.B. Fye has argued, various developments in late nineteenth-century medicine and society made it feasible to propose a concept as radical as 'active euthanasia.' These developments were spectacular growth of sophistication in medical diagnosis and prognosis that made it possible to judge patient's condition as incurable with reasonable accuracy; the development of anesthesia and other new, powerful means for the relief of pain and suffering; and the decline of religiously motivated resistance. (4) This standard account of the rise of the modern medical debate on active euthanasia needs to be revised in one important respect, however. It is undoubtedly true that active euthanasia moved into the center of lively controversial debate only in the late nineteenth and early twentieth centuries. But at least two well-known German physicians already publicly endorsed active euthanasia around 1800. Their stance must be understood within the rather special context of German medicine and society at that time. A Radical Break In the year 1800, Carl Georg Theodor Kortum (1765-1824), physician in the town of Stolberg near Aachen, published series of short essays in the leading German medical periodical, Hufelands Journal der practischen Arzneykunde. In one of these essays, Kortum reported various cases of advanced consumption. The patients, he explained, sometimes went through the most horrendous agony, the mere sight of which was difficult for witnesses to bear. As they approached the end, for period of some days they could hardly expectorate or even swallow, until they gradually lost their senses. Yet patient would sometimes live on for another forty-eight hours beyond that, an incessant death-rattle emanating from his or her chest. In such cases, according to Kortum, the only thing one could desire was that gentle death end the patient's suffering. His counsel was clear and explicit: a moderate dose of poppy juice, e.g., 20 drops of Laudanum liq., shortens such agony, by extinguishing the weak vital flame entirely, and it is, in my opinion, morally permitted in such cases. (5) For all we know, Kortum may well have been the first physician in the Christian West who publicly justified and indeed advised active euthanasia on terminally ill patients. And although Kortum did not explicitly state that he himself had acted in this manner, his comment about what dose of laudanum was infallibly successful implies concrete practical if not personal experience. A year later, Christian Ludwig Mursinna (1744-1823), professor of surgery and head surgeon at the Charite hospital in Berlin, was even more explicit in this respect. …

A Practical Church Unity within Secular Hospitals

AbstractEcclesial unity among Christian physicians is jeopardized by the culture of secular medicine. The medical context, rather than being a neutral sphere, has increasingly become a context that cuts loose and reshapes church members into a secular ecclesia. This thesis is demonstrated through focus groups composed of Christian physician-residents within Harvard Medical School residency programs. The interviews describe how many Christian physicians are psychologically isolated and spiritually endangered because of compliance to secular expectations within academic teaching hospitals. In contrast, the key to undoing secular atomization stems from the nature of the church as a people gathered in the presence of Christ. Thus, the essay develops an ecclesiology that focuses on the manifestation of unity in its local relationships and embodied practices. Despite severe time constraints, Christian physicians have the opportunity to reconstitute a unified church within the secular by pursuing one another in love and offering tangible signs of solidarity.

May Doctors Refuse Infertility Treatments to Gay Patients?

One of the most sacrosanct principles of medical practice in the United States is that physicians have a right to choose their own patients as long as the patient is not in a medical emergency. During the 1980s, a minority of health care professionals invoked this prerogative in refusing to treat AIDS patients. (1) More recently, doctors incensed over malpractice premiums have refused to care for lawyers and their family members. (2) However, this sort of physician autonomy is not without certain limits--most notably the restrictions found in various federal and state civil rights statutes. No physician or hospital receiving government funding, including Medicare and Medicaid, may discriminate against potential patients on the basis of race, color, religion, or national origin, (3) and many states have expanded these protections to cover gender and sexual orientation. What remains unclear is whether physicians with bona fide religious objections to treating certain patients are exempt from these proscriptions. A California case, currently on appeal before a state court, may soon decide the matter. (4) The plaintiff in the case, Guadalupe T. Benitez, is a thirty-three-year-old medical assistant currently living with a same-sex partner in suburban San Diego. (5) She received infertility treatments at the North Coast Women's Care Medical Group starting in August 1999 and running until July 2000, when her physicians, Christine Brody and Douglas Fenton, refused to continue treating her because of her sexual orientation. According to Benitez, Dr. Brody told her that she had religious-based objections to treating homosexuals to help them conceive children by artificial insemination, while Dr. Fenton refused to authorize a refill of her prescription for the fertility drug Clomid on the same grounds. (6) In response, Benitez filed suit under California's Unruh Civil Rights Act, charging illegal discrimination on the basis of sexual orientation. (7) The case gained widespread attention when the California Medical Association, historically friendly to gay rights, backed the two Christian physicians in their claim that their freedom of religion under the federal and state constitutions trumped the requirements of the state statute. (8) It is the CMA's position that such claims should be addressed on a case-by-case basis, rather than by a blanket rule. The controversy in Benitez v. NCWC stands at the nexus of two competing approaches to the issue of conscience exemptions. On the one hand, most states have statutes that shield medical students and physicians from having to perform procedures, such as abortion and sterilization, to which they object on religious or moral grounds. Several public policy reasons are advanced for these conscience clauses: First, highly qualified physicians, forced to compromise their sincerely held religious beliefs, might leave the field of medicine entirely, and similarly, some prospective physicians might choose to pursue other career paths instead. Second, physicians who object to a particular procedure are not in a position to provide the level of emotional and moral support that their patients have a right to expect. In contrast, our society seems highly unwilling to tolerate physicians who refuse or limit service to an entire class of patients, even when they act out of sincere religious beliefs. It is highly unlikely that any court would permit an Orthodox Jewish physician to provide separate waiting rooms for men and women, or allow a Muslim physician to require all female patients to wear head coverings. (9) The Benitez case, however, presents an instance where both an objection to a specific procedure and to a general class of patients overlap. The physicians at NCWC are unwilling to perform a specific procedure on a general class of patients. Two further concerns in many conscience cases are the impact of an exemption on the overall availability of the procedure and the social stigma and discomfort associated with being refused care. …

Kabbalistic Physiology: Isaac the Blind, Nahmanides, and Moses de Leon on Menstruation

Science and faith were inextricably intertwined in the Latin Middle Ages. Clerics would attend to both spiritual and physical needs because the need to care for the body coincided with the need to care for the soul. Until the rise of universities in the twelfth century, monasteries were the centers of scientific knowledge. And, even after the professionalization of medicine in the thirteenth century, Christian physicians continued to look to the Bible, in addition to their license, as the source of their authority. Indeed, many Christian physicians who received medical degrees went on to pursue higher degrees in theology. It is therefore not surprising that several Christian theologians used medical theories in the service of theology.

Disease and Medicine in World History (review)

Reviewed by: Disease and Medicine in World History William H. McNeill Sheldon Watts . Disease and Medicine in World History. Themes in World History. New York: Routledge, 2003. x + 166 pp. $75.00 (cloth, 0-415-27816-3), $17.95 (paperbound, 0-415-27817-1). This brief, sometimes quirky, yet well-informed introduction to the history of disease and medicine has the virtue of being just what its title claims: a genuine world history. Sheldon Watts treats the written medical traditions of Greek, Muslim, and Christian physicians and those of their Indian and Chinese analogues as only part of the practice of medicine, being intent to emphasize the existence (and occasional value) of folk healers whose empiric discoveries of herbs and sanitary practices were usually disdained but sometimes accepted by literate, upper-class physicians. The book is schematic, deliberately emphasizing "differences, disconnectedness and discontinuities" (p. 12). After an introductory manifesto, "Sickness and Health: A Global Concern," chapter 2 accordingly groups Pharonic Egypt and the pre-Columbian New World under the rubric "Before the Advent of Acute Epidemic Diseases." Subsequent chapters include "Pluralism in Ancient Greece" (chap. 3); "The Evolution of Medical Systems in the Middle East, c. 632 to Modern Times" (chap. 4); "Health and Disease in the Indian Sub-continent before 1869" (chap. 5); "Medicine and Disease in China, c. 1900 B.C.E. to 1849" [End Page 699] (chap. 6); "Globalization of Disease after 1450" (chap. 7); "Medicine and Disease in the West, 1050-1840" (chap. 8); "The Birth of Modern Scientific Medicine" (chap. 9); and finally, "Health and Medicine in the World, 1940 to the Present" (chap. 10). Throughout, Watts tends to disdain medical book learning. He calls Galen "a synthesizer and simplifier" who "all but closed the door of intellectual inquiry" (p. 41), and says of Ibn Sina's Canon: "It has all the advantages of a book for teenage students which can be easily memorized even though students do not know what key words mean. It was this scholastic triumph of rote learning over medicine that was the principal contribution which, in due course, the Islamic world passed on to the West" (p. 45). The baleful influence of Ibn Sina's Canon also tainted Indian medicine, according to Watts, but Chinese doctors remained immune. Instead, "there was often fruitful bottom-up as well as top-down exchange between itinerant health care providers and the philosopher-physicians who wrote learned treatises on medical-related issues. . . . By way of contrast, in the medieval and early modern West no respectable physician would ever admit that he had anything to learn from itinerant practitioners, all of whom he regarded as fakes and charlatans" (pp. 72-73). On the other hand, Watts warmly endorses the "science of clinical bacteriology" (p. 114) inaugurated by Robert Koch in 1876; but he scorns British "sanitary science," embodied in Edwin Chadwick's sewers: "an engineering solution to the nation's disease problems" (p. 116). Indeed, Watts says the theory that the cause of epidemic disease was airborne miasma, arising from dirt and excreta, which had inspired Chadwick's successful reforms in Britain, persuaded British medical officers in India to "smother the germ theory" and permit cholera and other epidemics to ravage that subcontinent until 1947 (pp. 116-24). His judgment of the triumphs and failures of organized medicine since 1940 is similarly ambiguous: "Massive decline in the percentage of a given population that died of infectious diseases in early childhood or before the age of 50" was balanced by "the great increase of the number of people, who in middle and old age, suffered from chronic disease conditions" (p. 128). Moreover, long-standing inequities between health services for rich and poor widened, and many infections have started to come back in forms resistant to once all-powerful antibiotics. Watts concludes his book on an apocalyptic note by quoting Robert Koch: "We cannot be fully self-realized [or happy] so long as everything around us suffers and creates suffering. . . . We cannot be moral so long as the course of human affairs is determined by force, deception and injustice," and then affirms in his own voice that "as historians of medicine and of disease we are aware...

Principles of Bioethics for Christian Physicians: Autonomy and Respect

Principles of Bioethics for Christian Physicians: Autonomy and Respect

Ethical decision making for Christian physicians: inspiration from Saint Ignatius of Loyola.

Ethical decision making for Christian physicians: inspiration from Saint Ignatius of Loyola.

Money versus mission at an African-American medical school: Knoxville College Medical Department, 1895-1900.

Knoxville College Medical Department (KCMD) was, to all appearances, a missionary medical school established in 1895 by a small black Presbyterian college in the Tennessee mountains to train African-American physicians. In reality, it functioned as a proprietary medical school organized and operated by a group of local white physicians who were more interested in making money than in furthering the school's mission of educating black Christian physicians. KCMD limped along until 1900 when the college's new president reported to the trustees about the white faculty's greed, irreligious behavior, poor teaching, and bad medical reputation, and about how the presence of the medical school on campus undermined the college's overall mission. KCMD graduated two students before closing its doors in 1900. A group of faculty then reopened the school off-campus as the Knoxville Medical College. That school closed in 1910.

GERRIT BOS, TRANS., Ibn al-Jazzar on Sexual Diseases and Their Treatment, Sir Henry Wellcome Asian Series (London and New York: Kegan Paul International, 1997). Pp. 417. $130.25 cloth.

With the series of critical editions and studies of Arabic medical texts from the Middle Ages he has published in recent years, Gerrit Bos has made a significant contribution to the history of medicine in the Islamic world. He has dedicated special attention to the work of Abu Jaעfar Ahmad ibn Abi Khalid ibn al-Jazzar of Qayrawan, a 10th-century physician and prolific author of medical texts. Ibn al-Jazzar was famous and influential not only within his own Arabic– Islamic cultural domain but also—thanks to widely circulated translations of his works into Greek, Latin, and Hebrew—among Christian and Jewish physicians in the East as well as the West. (For Bos's publications on Ibn al-Jazzar's writings see p. 406).

The praxis of practice for the chiropractic physician: A christocentric model for a physician-patient relationship

One of the life's basics needs is health. Health is a universal desire sought by all. Healing allows us to experience a physical liberation from our suffering. As we come to this dialogue to define a type of spirituality in a universal perspective, we need to bring our sufferings. As Christian physicians, we can share the essential truths of the gospel concerning the healing ministry of Jesus when we share in the sufferings of others, as we transcend our own sufferings.

The Christian Physician in the Non-Christian Institution: Objections of Conscience and Physician Value Neutrality

Christian physicians are in danger of losing the right of conscientious objection in situations they deem immoral. The erosion of this right is bolstered by the doctrine of "physician value neutrality" (PVN) which may be an impetus for the push to require physicians to refer for procedures they find immoral. It is only a small step from referral to compelling performance of these same procedures. If no one particular value is more morally correct than any other (a foundational PVN premise) and a physician ought to be value neutral, than conscientious objection to morally objectionable actions becomes a thing of the past. However, the argument for PVN fails. Therefore, Christian physicians should state their values openly, which would allow patients the ability to choose like-minded physicians. Some possible responses to this erosion of conscientious objection include, disengagement from non-Christian institutions, the formation of distinctly Christian medical institutions and political action. However, for the Christian the initial focus should be on a life of holiness which requires each of us to avoid evil.

In the world but not of it: managing the conflict between Christian and institution.

Christian physicians, nurses and other health care workers must manage a daily conflict of conscience between their Christian faith and predominantly secular health care institutions. This essay examines various efforts for managing these conflicts: a turn towards social justice or a seeking of holiness. Seeking social justice, however, is theologically empty. Traditionally, the Christian requirement that we be "in this world but not of it" requires a journey along a narrow path to holiness. Christian medical morality must, therefore, be understood within this light. However, just as there cannot be generic health care, but rather health care for a particular person's needs and problems there cannot be generic holiness, but only a holiness grounded in worshiping God rightly. In so worshiping the Christian will be assisted in negotiating the inescapable and perilous vocation of being in the world but not of it.

Holiness, virtue, and social justice: contrasting understandings of the moral life.

Being a Christian involves metaphysical, epistemological, and social commitments that set Christians at variance with the dominant secular culture. Because Christianity is not syncretical, but proclaims the unique truth of its revelations, Christians will inevitably be placed in some degree of conflict with secular health care institutions. Because being Christian involves a life of holiness, not merely living justly or morally, Christians will also be in conflict with the ethos of many contemporary Christian health care institutions which have abandoned a commitment to Christian spirituality. In this regard, managed care raises the special question of how Christian institutions can act morally under financial constraints and maintain their character while under the control of secular managers. This question itself raises the further question as to why health care institutions need even pose this query when there are Christian physicians and nurses who could work for less, or Christian men and women who could become sisters and brothers and work for nothing. Contemporary challenges to Christians to maintain their integrity in a post-Christian world have much of their force because Christians have failed to maintain traditional Christian sprituality. In the face of that failure, Christian physicans and nurses will find themselves in greater conflict with health care institutions, because few will any longer understand the requirements of traditional Christianity. In its place, they will have put a generic spirituality, a value-neutral understanding of the role of the health professional, and an anonymous commitment to social justice.

For Christian Physicians

To the Editor .—I am currently editing a book on the personal testimonies of Christian physicians and how they view the current medical-ethical issues of today, ie, abortion, euthanasia, organ transplants, when is a person officially dead, sterilization, psychosurgery, semen donors, ovum donors, host mothers, reversed aging, artificial organs, genetic counseling, etc. I would be interested in hearing from any Christian physician who would be interested in contributing to this book.

Opinions Requested

<h3>To the Editor.</h3> —I am currently editing a book on the personal testimonies of Christian physicians and how they view the current medicalethical issues of today, ie, abortion, euthanasia, organ transplants, when is a person officially dead, sterilization, psychosurgery, semen donors, ovum donors, host mothers, reversed aging, artificial organs, genetic counseling. I would be interested in hearing from any Christian physician who would be interested in contributing to such a book or who would be able to suggest a Christian physician to write for it. Please contact me at the following address:

Christian Views of Current Issues

Excerpt To the editor: I am currently editing a book on the personal testimonies of Christian physicians and what they think about the medical-ethical issues of today, that is, abortion, euthanasia...