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124 - Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapp |
Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church
By Stanley Hauerwas
Notre Dame, University of Notre Dame Press, 1986. 221 Pp. $19.95 ($9.95 Paper).
Stanley Hauerwas, who teaches in the Divinity School at Duke, is surely the most prolific author writing in Christian ethics today and among the most significant. He can also be the most frustrating. No one writing on related topics reads more widely or brings learning to bear on the moral life more creatively. Over the last decade, he has done more than anyone but the liberation theologians to set the agenda for Christian ethics. It is hard to imagine what recent work on character, the virtues, narrative, and the relation between the church and liberal society might look like in the absence of Hauerwas' influence. Indeed, it is hard to know whether these topics would seem as central as they do had Hauerwas not helped make them unavoidable.
Why, then, the frustration? Most distinguished ethicists polish gems. They take pride in well-rounded articles and precise lines of argument. They borrow technical innovations from neighboring disciplines in hope of keeping the cutting edge of inquiry sharp. Hauerwas, meantime, pans for gold. He often gives us the whole pan, sludge and all, leaving us to do the sorting. Each pan contains enough nuggets to attract a crowd of prospectors-all of them eager to size up the latest find. By the time the crowd assembles, Hauerwas is already working against the current farther upstream, following up a tip from somebody named MacInytre or Yoder, staking out a new claim. But filtering out the sludge can be frustrating, and more than one reader has wished Hauerwas would put more effort into that task (as he did, for example, in The Peaceable Kingdom) before moving on to another site.
This time the site is care for the ill and the retarded. The sludge includes: unintelligible sentences (e.g., halfway down p. 31), subjects and verbs at odds (pp. 134, 153, 162, 192, 207), infelicitous expressions (e.g., "increasingly less certain," p. 164), repetition (cf. pp. 207 and 213), misleading hyperbole, undefended assertions, and assorted non
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126 - Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapp |
sequiturs. Yet the gold is equally abundant: compelling anecdotes about the moral significance of being present with people in suffering, amusing reflections on the theological scene, thoughtful questioning about our reasons for having children or for desiring a quick and painless death, and a sensitive appreciation of what the mentally handicapped have to teach us about normality and finitude.
The book's most important contribution is the second chapter's account of medicine as a social practice. For here Hauerwas helps us see those who care for the ill not simply as experts and technicians in faceless bureaucracies but also as moral agents involved in an activity directed toward its own "internal" goods and governed by its own standards of excellence, role-specific duties, and patterns of authority. To view medical care stereoscopically-as a moral practice necessarily, if precariously, embodied in a network of instructions-is in fact the best way to bring it into ethical focus.
Characteristically, Hauerwas does not develop his account in detail. But inquiry along the lines suggested in the second chapter of Suffering Presence does, I think, yield deep insight into the place of medicine in our lives. Extending the same sort of analysis to other practices and institutions might have an added benefit. It might complicate our understanding of liberal society, lessening the temptation to view it, as Hauerwas sometimes seems to do, with one eye shut-as nothing but a set of institutions for managing isolated individuals in search of money, status, and power. If Hauerwas undertook such analysis himself, it would be harder for him to portray the plight of medicine as that of a moral practice in a "morally incoherent society."
It would also be harder for his critics to write him off as a sectarian. He does not want to be written off in that way, and Suffering Presence is intended in part to demonstrate that "the particularistic starting point" from which he begins allows him to affirm medicine as a practice while addressing himself constructively to related matters of public policy. This response to the charge of sectarianism marks a refreshing turn in Hauerwas' work. How far he is prepared to take his own insights toward a more nuanced assessment of liberal society remains to be seen.
JEFFREY STOUT
Princeton University
Princeton, New Jersey