"Moral" Regulations?

Christians share in our culture’s ways, including the less desirable habits. We don’t think people ought to snarf drugs up their noses – therefore we support laws against the possession of snarfable substances. There is no sense here of sphere propriety. We support burdensome regulations – how much water is in each toilet flush. How wide the doorways are in our homes. We get upset only when regulations touch us directly and egregiously. We don’t see the larger picture.

Sphere Sovereignty

“Evangelical” Christians have for decades emphasized essentially two spheres of governance: the individual and the civil state, but especially the former. One might be tempted to think that we have emphasized the family and the church also, but I don’t believe we have.

As to family governance, Christians have abdicated true family governance for a psychologized, democratized family that pretends to perform its duty of nurturance without governance. Headship is abandoned for cooperative negotiation. Children are distracted from sin but not punished for it. We have believed the “research” purports to show that corporal punishment is counter-productive. Christians now commonly buy the “positive self-concept” theory of rearing children.

Churches have lost much of their moral governance. Does your church discipline? Thank God if it does. We have let the world tell us, misusing Scripture horribly, “Judge not, lest ye be judged.” (This is itself a judgment. The point is that we should use the proper standard when making judgments – God’s Word.)

Further, though less often now, Christians have confused patriotism, which is love of nation, with unquestioning obedience to the governance over that nation.

Some means to the ends of understanding proper sphere sovereignty:

1. Personal study. Don’t seek to achieve a certain feeling at the end of a time of devotion. Our families will not be better governed than we are ourselves.
2. Read old material. Some of our fathers in the faith understood these particular matters better than we do.
3. Family worship and study. Discipline in the home. Our nation will not be better governed until our homes are.
4. Support the Church. Don’t let para-church activities supplant the church. Be careful for most end up hurting the church’s authority. Seek accountability within the Church, not some other structure.
5. As you have opportunity, tell others the reason of the hope that is in you. Reason. We have a reasonable faith.
6. Study the practical relationship of your actions to your vocation. At one time I was irritated at the preoccupation of Christians with their own spiritual life, and our ignorance and disregard of public ethics. Both are needful. We cannot have one without the other.

Knowledge vs. Life

We physicians in America have fallen too much in love with the technical aspects of our calling. We busy ourselves with calculating doses, viewing CT scans, looking at panels of blood tests. All very necessary, many times, but sometimes it is better to sit down and visit the sick. More so the dying. We have no time for that. We don’t know what to say. We are more comfortable just to be occupied with irrelevant measures. We are enraptured with the tree of knowledge. We confuse it with the tree of life.


Excerpt from "A Commentary on American Medical Practice"

Beneficiaries Are Better Shoppers

High deductible insurance not only puts the beneficiary back into the position of being a shopper of what he/she consumes, but it also makes the person a better shopper when entering the medical system to purchase services. If your doctor says that you need a $1000 MRI scan and the thousand is going to come out of your pocket, you are much more likely to ask the hard questions that patients almost never ask today: What good is it going to do me?

"Well," says the doctor, "It is possible that you have epiglootis oogagus acutus, and only an MRI scan will show that."

Says the medical shopper, or his designate if he is too ill to think clearly, "Well, just how likely is this to be epiglootis oogagus acutus?"

Now, the doctor is not accustomed to answering questions like that, and may hem and haw a little, but after looking it up finds that the chances of it being that are about one in 40,000.

The astute shopper realizes that this risk is close to the normal risks of ordinary life, such as driving to the next town on a Wednesday morning. The shopper asks further, "If it did turn out to be epiglootis oogagus acutus, what can be done for it?"

"Well, of course, we would treat you," says the doctor, as if he were talking to someone whose elevator doesn't go all the way to the top.

Pressing undeterred, the patient asks, "How successful is the treatment?"

Sure now that he is in conversation with someone with only one oar in the water, the doctor answers, "Thirty-five percent of treated people recover completely," with an air of finality, hoping to shut down this inquisitor so he can get on to the next patient.

Uncaring of his developing reputation as a lamebrain, the patient has one final question: "How many untreated people recover completely?"

The doctor has to look it up. Sheepishly, considerably later, he mumbles, "Thirty-two percent." I hate to run numbers, but roughly, for a mere $1000 MRI, a patient can have a chance of 1 in 40,000 disease diagnosed, but stands only perhaps a 3% better chance at recovery than if he never had it diagnosed at all. That would come to $40 million per case diagnosed, and to about $1.3 billion for each extra cure effected. Actual calculations are more complex than that, but this estimate rather substantially underestimates the expense.

This kind of reasoning is commonplace in medicine. Ordinary medical practices for which the actual payoff to the patient is unknown, marginal, or even negative include: the "complete physical examination," screening for prostate cancer, screening for diabetes, screening for spinal scoliosis, cholesterol screening and treatment, and, I am recently astonished to discover, even for the time-honored Pap smear in most cases. Any medical system which pretends to protect us from risks as low as one in 40,000, or even from more likely risks but at huge expenses running into the hundreds of thousands or millions of dollars, is a system of idolatry.

Where is the money going to come from? From our own better-informed pockets.


Excerpt from talk given at Westminster Presbyterian Church

Constraining Government Insurance

By whatever insurance plan, the biblical role of government in health care is much more limited than now exists in U.S. There is insufficient space to defend this controversial assertion here. The reader is referred to such biblical texts as Romans 13:1-7 and 1 Peter 2:13-14 for statements regarding the purpose of government. I fail to find any biblical warrant for a government role in the provision of individual medical care. A warrant for public health measures could be made from Old Testament texts. Whereas public health concerns may include such issues as environmental carcinogens, they do not include whether to irradiate Aunt Mae's bone cancer, whether she should be admitted to a hospital, or whether she should be put on expensive intravenous hyperalimentation if the time comes when she cannot eat.

Christians who insist upon government involvement in such issues must not only show the biblical basis for the government involvement, they must show how to constrain the government to obey God’s law in managing individual cases. A government which will sanction millions of abortions, which usurps family authority to teach and discipline children, which allows experimentation with human embryos, etc., is not trustworthy to look after Aunt Mae's best interests.


Excerpt from "Ethical Issues in Medical Insurance"