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Health/Medicine and the Faith Traditions:
An Inquiry Into Religion and Medicine
Edited by Martin E. Marty and Kenneth L. Vaux
Philadelphia, Fortress, 1982. 350 pp. $16.95.

This is the first report of a long-term study group sponsored by the Lutheran General Hospital of Park Ridge, Illinois. The book is called a "background volume" that "sets forth the rationale" for the entire project, which is expected to continue over "several years." The hospital itself is clearly represented in this book as well as in the project as a whole, but the services of many outside persons have been secured, including that of the two editors.

The enterprise as a whole is nicknamed "Project Ten," referring to the ten categories of human existence through which it proposes to study the relations between medicine and religion. These are: well being, sexuality, passages, morality, dignity, madness, healing, caring, suffering, and dying. The project will study the views of major faiths throughout the world toward health and medicine, and give serious attention to their historical development as well as to where they stand now. Thus the project, including this and later reports, deals with three basic intersecting kinds of ideas: the religions of the world, views of religions about health, and the human categories believed to be most relevant.

I

If it were not for the many publications in the field of medical ethics during the past twenty years, Project Ten would be the most ambitious of this century in relating religion and medicine. In terms of more general relations, its aspirations appear to be unique, especially if it follows through as planned on dealing with the major religious traditions of the world and not just with those of the West.

The present volume includes chapters focusing on historical developments, and others on construction and critique of the way things are today. The historical chapters on classical and Christian views up to the beginning of the modern period are very well done considering their brevity. The critical and constructive chapters, which are written by both physicians and theologians, are also competently done. Martin Marty provides the cross-cultural introductions, and Kenneth Vaux supplies the material in the categories chosen for emphasis. No doubt these materials will be extended and elaborated in future volumes.

What I have called the categories of human existence are called, in the project itself, "topics at the interface of medicine and theology."

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Will the ten topics (well being, sexuality, etc.) help the larger project to accomplish its purpose? Or, since they clearly interpenetrate each other, may it be a hindrance if they are treated as distinct categories? It seems also possible that this list is far from inclusive of the concerns that may be shared by medicine and theology in some traditions.

It is clear that the authors and editors want readers to take another look at the relation of medicine and religion in whatever way they see best, rather than in some kind of orthodox lock step. The absence of a party line should enable the series to reach more readers in a useful way.

Nevertheless, the decision to be as non-partisan as possible means that the very conception of health that is taken for granted in the project emerges from the secular individualism that has become the takenfor-granted groundwork of modern medicine. Since this issue is not even mentioned in the present book, it is unclear whether the authors and editors understand the implications of this decision about definition.

In the Bible, for instance, as Paul Tillich and others have noted, health is understood first as a cosmic phenomenon, and only derivatively as focused on individual persons. In sharp contrast, the focus of health for modern medicine is the individual person. Even when the health idea is extended more widely, as in public health, preventive medicine, or social planning for health concerns, these are regarded as corollary to the true reality, health in the individual. To understand health in the modern sense, of course, the individualistic definition must be respected and pursued. But if it never becomes an object of critique, it may be impossible to appraise the significance of the most profound grasp of the health question that we can find in the Christian tradition. I would be relieved if assured that the project is not unaware of this question.

II

It seems significant that this ecumenically-minded project is sponsored by a denomination-related agency rather than by an official interdenominational or interfaith group. It was not always so. In 1938, I became the executive of the "Committee on Religion and Health" of the Federal Council of Churches, which preceded the National Council of Churches. The founding group believed that there should be a corrective to the widespread notion that an interest in religion and health necessarily implied a peculiarity of some special groups, such as Christian Science. Until that time, most of the serious twentieth century interest in aspects of religion and health had indeed come from smaller groups rather than the mainline churches. Of course, churches still ran hospitals, set up programs of medical missions overseas, and many pastors still called on sick people. But there were almost no hospital chaplains in the modern sense of persons trained to help in crisis situations. Although Clinical Pastoral Education (CPE) had begun a few years earlier, few ministers knew of its advantages, and most pastoral work was still done

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by ear. Some individual physicians and clergy were friends, but they seldom worked together and almost never sat down in small groups to discuss their professional relationships.

In the face of this inauspicious situation, it required both vision and courage for the Federal Council to launch its new endeavor. Once begun, however, it was astonishing how denominations, and some of their sub-organizations, began to take hold with new programs.

By the 1950s, advances had been made in many areas. The number of trained hospital chaplains had increased at least tenfold. Clinical Pastoral Education centers had grown several times over, and it had become usual for most seminaries to be related to that movement. Theological schools, with few exceptions, took on their faculties persons skilled in the modern approach to pastoral care. Concern was expressed programmatically with many fields involving religion and health such as sexuality, alcohol, mental health, older people, and similar topics. From then until now the growth of cooperation between physicians and clergy has continued at a practical level. There was even a brief period in the 1960s when the American Medical Association maintained a Department of Health and Religion, principally attempting to foster discussion sessions between clergy and physicians under the auspices of state and county medical societies. The demise of the Department, in the early 1970s, was officially reported as due to budgetary problems, but it is also true that the period when the Department flourished was the halcyon one for churches.

The big news of the past fifteen or twenty years has been, of course, the great increase of interest in medical ethics. Many medical schools include on their faculties specialists in this area. Even a few special bodies, like the Hastings Institute, have been founded to promote study and publication. A number of those emerging as experts in this field, like Kenneth Vaux himself, are trained in theological ethics. Promising as it is, however, this new interest in ethics by medical schools is being fuelled mainly by concern over the life and death decisions that are more common than ever before. There is a strong desire for quick answers and often a reluctance to do the background work needed for movement toward reflective answers. I cannot help hoping that the present series will assist movement in that direction.

III

I am intrigued that the present study proposes to take seriously the other principal religious traditions of the world. Even modest progress there would be significant; for there has been little study across cultures and religions as related to health concerns. In one of the "Gallahue Conferences" at Princeton Seminary a few years ago and for which I had some responsibility, an Indian psychologist reexamined all the universal faith traditions in relation to contraception, concluding that, with a bit of prodding and promoting, they could all be associated in a

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contraceptive program worldwide if a way could be found to alter slightly the views of the Roman Catholic Church.

As I read the illuminating reports on health care around the world, especially in the Third World, as reported by the World Council of Churches, I continue to be impressed that so much still needs to be done at the level of basic medical care, nutrition, and public health. However modestly, the help of the churches can still be important in many ways. But in countries like our own there is a great danger not of undervaluing health but of treating it too highly or idolatrously. Health is regarded as so desirable that we are supposed automatically to be in favor of anything that promotes health. Even our religion and our ethics are often judged simply by their being healthy or otherwise.

It would not take any great change for our system of thought to become an imperialism of health, with the prestige and power of practitioners be-coming even greater than today. I wish I saw in the present book a clearer awareness of the dangers of health treated idolatrously. This kind of exploration can be done only if it is recognized that health practitioners are to some extent victims of public demand, even though they can hardly be guiltless if they fail to critique the "hybris" within the demand itself.

Seward Hiltner
Princeton Theological Seminary
Princeton, New Jersey