Thursday, May 31, 2007

Something New

I think I am going to try a different approach to my blog. I’ll continue to write about the works that I have read (although I have missed a couple), but I feel as if my blog is not as honest or as helpful as it could be. I have been compartmentalizing my doctoral work, separating it from the rest of my life, and I feel as if I am starting to wear myself out. I am finding that I am tired more and more, and that one part of my life is not necessarily fueling the other – this is the road to burn-out. One of the reasons I decided to pursue the doctoral track was because I felt it would positively influence my ministry. Yet in the past couple of months I do not feel as if this has been the effect. So, I am going to try to have a little more breath over all of my life, as well as some more depth over my own struggles and concerns, challenges and joys.
My hope is that it will offer a platform for me to express my own questions in an honest way, and at the same time offer more to the public (all 5 of you) an approach to ministry.

Wednesday, May 23, 2007

Medical Ethics and Truths

I am working slowly, but moving forward because my exam date is set for August. With that said, I just read some clippings from the New England Journal of Medicine, in the Correspondence section (May 3, 2007, 1889-1891) "Religion, Conscience, and Controversial Clinical Practices." They were in response to an article about doctors choosing or not choosing to provide options for treatment if they had a "conscienciance objection" I have not yet read the article, but plan to. Anyway, here was my response to the person who gave me the articles:


I just read the “Correspondence” from the NEJM that you sent to me. Very interesting stuff asking a very good question. The way I think of it is in terms of “truth.” Which “truth” should prevail in patient-doctor relationship. One of the contributors stated that an individual should not have to forfeit his or her conscience when joining a profession. Yet another stated that there is a class difference between the physician and the patient, and the onus is on the physician to assume the mantle of responsibility in offering the very best care (M. Foucault would have some interesting insights on the relational power differential).
Here are my thoughts. As far as I know, there is a code of ethics for the medical profession, starting with the Hippocratic oath and developed through time and tradition. If this is the case, than this code, as it has been passed down, is a kind of “truth” under which one practices medicine. While that “truth” may at times be vague and amorphous, it is still present in the practice of medicine. At the same time, a physician may come from a faith or community context where another set of “truths” are practiced (Christianity, Judaism, Jehovah Witness, etc). The values and ideals of the two “truths” may overlap and at times they may clash. When a patient visits a physician he or she may not come from the same community context as that individual physician, but may be expecting that the “truth” of the medical profession will be observed and practiced. This is why Jews should be able to use Muslim doctors without worry – the “truth” of the medical profession prevails in that particular context. Thus, I would argue that a physician can hold onto his or her “truths” as long as they do not clash with the “truth” of medicine, realizing that in the context of the exam room, the “truth” of medicine prevails over the “truth” of the physician’s particular faith community.
In my own context, I have had to compromise what I hold as my own “truth” for the sake of the larger community. When I took on the vows of ordination, I realized that I would not be able to fully and freely speak the truth of Christ as I understand it. Instead I would have to speak it in a way that the community can hear it and grow into it. The truth of my profession (to help lead churches, and share Christ) prevails over the particular truths found within my own relationship with Christ. (With that said, the dissonance is far less than the congruence; otherwise I would not be able to serve at all. When finding a church, one needs to find something that matches up fairly well, realizing that a perfect match will only be found in heaven.)
This may not seem do different from what others have in the clipping, except that I have used the word “truth” instead of “conscience.” This is a deliberate choice in terms. Conscience suggests that the individual physician is just that, an individual physician who thinks on his or her own without any input from any outside source. I would argue that one does have a conscience, but only within the context of a community. Within that community are truths, and the individual conscience dictates how he or she interacts with those truths. I wonder if naming the truths of the medical profession, the truths of the individual’s community and then comparing will help the physician prepare for those moments when he or she is faced with the individual ethical dilemma.
Just some thoughts, feel free to reply – thanks for the articles!

Peace,
Jonathan