Monday, April 30, 2012

God's Name

Exodus 4:10-16: “Then Moses said to the Lord, ‘O my Lord, I am not eloquent; neither before nor since You have spoken to Your servant; but I am slow of speech and slow of tongue.’”

Moses thus complains and tries to excuse himself from God’s call on the basis of flawed speech.

“So the Lord said to him, ‘Who has made man’s mouth? Or who makes the mute, the deaf, the seeing, or the blind? Have not I, the Lord?’”

God, who is the maker of mouths and all that they can do, refuses Moses’ complaint.

“‘Now therefore, go, and I will be with your mouth and teach you what you shall say.’ But he said, ‘O my Lord, please send by the hand of whomever else You may send.’”

Moses persists in his complaining and excusing.

“So the anger of the Lord was kindled against Moses, and He said; ‘Is not your brother Aaron the Levite your brother? I know that he can speak well. And look, he is also coming out to meet you. When he sees you, he will be glad in his heart. Now you shall speak to him and put the words in his mouth; And I will be with your mouth and with his mouth, and I will teach you what you shall do. So he shall be your spokesman to the people. And he himself shall be as a mouth for you, and you shall be to him as God.’”

God condescends to Moses even in His anger and resolves the language issue.

May God likewise resolve our limitations with His Name. Let us not be unwilling to speak it as best we can know it, reverently, to others along with all the meaning that comes with it. The “Great I AM,” or “Yahweh” in my ignorance and suspicion are the closest I believe I can come at present to speaking the Name of God. The name of the second Person of the Trinity is quite certain, and easy -- Jesus.


Excerpt from "Names"

Monday, April 23, 2012

Licensing Monopoly

When [Steve Cooksey] was hospitalized with diabetes in February 2009, he decided to avoid the fate of his grandmother, who eventually died of the disease. He embraced the low-carb, high-protein Paleo diet, also known as the “caveman” or “hunter-gatherer” diet. The diet, he said, made him drug- and insulin-free within 30 days. By May of that year, he had lost 45 pounds and decided to start a blog about his success. 
That blog has created legal trouble for Cooksey. Because of licensing laws, Cooksey could be looking at jail time. Read the entire Carolina Journal article here and some of Dr. Terrell's comments on licensure here.

The Teacher and the Student

John 10:2-4: “But he who enters by the door is the shepherd of the sheep. To him the doorkeeper opens, and the sheep hear his voice; and he calls his own sheep by name and leads them out. And when he brings out his own sheep, he goes before them; and the sheep follow him, for they know his voice.”
Modern teaching methods imagine that the goal is to transmit data, information, facts, from the teacher, textbook, institution, PowerPoint slides, etc., to the students. It is a transfer of information, and information is held to be power. Interpersonal knowledge between the student and teacher is omitted. It is a terrible omission.

Luke 6:40: “A disciple is not above his teacher, but everyone who is perfectly trained will be like his teacher.” The relationship is thus not like one between a faucet and a bucket. The teacher and student need to have a fuller, personal relationship for there to be completeness in the task. Imagine teachers who are academically expert in, say, counseling and psychology imparting information in these areas to their students. Some such teachers have personal lives which are amazingly, stunningly, out of order. Yet, they teach. Luke 6:39 says, “And He spoke a parable to them: ‘Can the blind lead the blind? Will they not both fall into the ditch?’”

Exactly so. We should not imagine that education is complete just in the accurate information transfer from the faucet to the bucket, so to speak. The student needs to see something of what is taught in the teacher, and the teacher needs to see evidence (or an instructive lack of evidence) in the life of the student. For this reason, teaching by parents in the household has all of the burden and all of the advantages over that by professionals. [Deut. 6:5-9; 20-25]

Real education is downright personal. It is not abstract, though it may contain abstractions. Graduate schools, medical schools, seminary colleges have big advantages in their concentration of brainpower and wide subject matter expertise. Yet, we see medical school graduates who cannot relate to their patients, pastors who have not been mentored by more senior pastors, counselors who know theories but have not been tried by fire.

The Koran is a good example of the bad method of mere transmittal of data -- it is impersonal. Our Bible transmits data, but does it in the unfathomable depths of human experience. It is personal, from cover to cover. The abundance of names in it testify to its concern for and relevance to individual souls.

Monday, April 16, 2012

Medical Licensure

Medical licensure laws render to Caesar authority God has deposited elsewhere. God places the physical health of individuals into the hands of the individual, the family, and the church (see 1 Cor. 6:15-20). Whether such laws "worked" or not is secondary to their biblical propriety. The civil state figures in only for contagious diseases in which coercive isolation measures are called for. The civil ruler's power is coercive. Except for contagious diseases where coerced measures may be beneficial to the whole community, medical care is a business contract or a ministry of compassion and mercy – hardly fit tasks for the hand that bears a sword.


Excerpt from "Quackery"

Monday, April 9, 2012

By What Standard?

Medical ethics are those principles which govern conduct in medical decisions. It is unfortunate that most attention is paid to the "big," knotted, snarled, questions, such as: “Should this 13 year old child on Medicaid, with liver failure, the son of a Christian Scientist mother and a Jehovah's Witness father, receive a baboon liver transplant over the objections of animal rights activists and his parents, and should the state of Oregon pay for it, though it is not on their Medicaid list?” That kind of issue is a headline maker along with all those ethical decisions which cluster around the plugs of ventilators in intensive care units.

I am more concerned with the mundane decisions.
  • Is mother competent to decide that she does not want surgery for her cancer, or is she too senile?
  • What do you tell a 15 year old girl who tags a request for birth control pills onto the end of her visit for an ankle sprain?
  • Is it right to "chemically restrain" an elderly demented person who is disrupting the home with spitting, shouting, cursing, and refusal to eat?
  • How do you deal with a 75 year old man with no urinary symptoms who heard a radio ad encouraging retired men to have themselves checked for prostate cancer and wants you to do the testing?
  • What about the nasty patient who has fallen out with every doctor in town, and is now furious with you, threatening lawsuit, but bound to you financially by his managed care plan?

Although it is less interesting than plunging into these questions, there are some necessary preliminaries. Before we decide the “right” pathway, we have to consider the means by which we determine what is right. It won't do to assume that we will agree, because we almost certainly will not. The first principle of an ethical decision, one that is normally overlooked because it poses difficulties, is that a standard is required by which the decision is to be made.
  • Not everybody shares the same standard.
  • Individual freedom of decision is a highly valued principle in the U.S.

Different standards can lead to very different conclusions. By no means do all standards share some essential elements which lead to the same outcome. One common way these problems are “solved” is to avoid explicit confrontation of the matter and slip in a standard by implication. That is cheating.

An article favoring, say, euthanasia may describe the suffering of terminal disease and conclude that, therefore, mercy killing is right. By implication, the proponent of mercy killing has decided that the suffering is the determinative factor when the situation looks hopeless. Now, if one just came out and said that baldly, it would be evident that the decision is based on a corollary to hedonism – that life is about maximizing pleasure and minimizing pain. The principle governing this proponent of euthanasia – I don't claim, by the way, that all proponents of euthanasia would own this as their principle – relates to the standard of hedonism. It should be so recognized, so stated, and defended if possible. Or, a proponent of say, socialized medicine, may support the position by saying that most of the people of the world are in such systems, and/or that most people in the U.S. favor it in some poll. Bootlegged into this statement is the assumption that right and wrong is decided by majority action. That standard deserves to be stated outright.

The difficulty of achieving a standard seems to some people so insurmountable that they bail out by asserting that the problem is impossible and we must, somehow, just go on without solving it. “You'll never get everyone to agree,” they say. Well, never is a long time, but even to say that is to imply that a right standard requires group agreement. Are right decisions invariably held hostage to group agreement? Acting on a decision may indeed be blocked by a powerful group, but making a decision, advising a course of action, are not subject to group consensus unless you presuppose that they are. I do value group consensus in medical ethics. However, I do not believe it to be ultimate. When I am having difficulty in advising an ethical course of action, I find that my desire for consensus is sometimes merely a lack of the courage of my convictions. I don't like to be different.

Another way Americans deal with the different standards dilemma is to confuse data with wisdom. We heap up information. Computers help. Estimates are that there are six million articles annually published in English alone which relate to medicine. We do computer searches. We find out how much it costs. What the risks are. What the various treatments are. These are statements of what is. We will return to them, for they are important in making ethical decisions. However, ethics is about what ought to be, or what ought not to be. Data is about what is, or what is not. Even stacked exceedingly high and heated, a pile of “is” statements will not convert to an “ought” statement. Empirical statements do not transform under pressure and heat to normative statements.

Lest I now fall under my own condemnation of making ethical pronouncements without making clear the standard, I wish to state my own. My ultimate ethical standard is the Bible. I recognize that many will not agree with that, and, of course, some who would disagree with the interpretation and application. I do not pretend to have solved all problems with that assertion. Nonetheless, to pretend to be able to go very far at all without having a standard is foolishness, and to withhold the standard or apply it implicitly is deceptive. Neither is it essential that patients agree with me on the standard. Ordinarily, we are able to work out an agreed-upon course of action though we do not share the underlying reasons for the action. If we are unable to agree upon a right course of action, we may be able to see that the failure comes from different standards. The foundation for counseling persons with questions on medical ethics, then, is to see that ethics requires a normative standard, that the counselor needs to know his/her standard and be explicit about it if difficulties arise. "Oughts" come from "oughts" not from knowledge of what is.


Excerpt from "Counseling Persons with Questions on Medical Ethics"

Friday, April 6, 2012

Two Deaths on a Tree

While I am being poorly poetical and uncharacteristically mystical, contrast the cross of Christ with the tree upon which Absalom died. Absalom has rebelled against his father, again. Absalom is defeated in battle, his force scattered.

“So the people went out into the field of battle against Israel. And the battle was in the woods of Ephraim. The people of Israel were overthrown there before the servants of David, and a great slaughter of twenty thousand men took place that day. For the battle there was scattered over the face of the whole countryside, and the woods devoured more people that day than the sword devoured. Then Absalom met the servants of David. Absalom rode on a mule. The mule went under the thick boughs of a great terebinth tree, and his head caught in the terebinth; so he was left hanging between heaven and earth. And the mule which was under him went on.” [2 Sam. 18:6-9]

Joab, David’s general, was told of this and came and killed Absalom with three spears to the heart.

Amazing! Jesus hung on a tree, suspended between heaven and earth, in obedience to His Father, and redeemed His people. Absalom hung on a tree, suspended between heaven and earth, in rebellion against his father, and brought death to thousands in one day. Jesus rides into Jerusalem on a colt, the foal of a donkey, a peaceful creature unsuited to warfare. Absalom rides on a mule, a sterile hybrid, adequate for war and an image perhaps of unfruitful alliances. Absalom hangs by his head or hair, perhaps metonymy for his proud handsomeness. Jesus hangs by his hands and feet, organs and images of service to others. Think what you will of Joab, a complex character, but Joab spoke the truth to Absalom’s father David when he said, “...today I perceive that if Absalom had lived and all of us had died today, then it would have pleased you well.” [2 Sam 19:6b] Yet, in the death of Christ, it pleased the Father to forsake His Son so that His elect, His very enemies, should live. (Can you not detect the supernatural authorship within the human authorship? These events, these accounts occurred many centuries apart, but are one amazing story.)


Excerpt from "Are We Christians Dying to Meet Him?"