"Sufficient for the Day is its Own Trouble": Medicalizing Risk and the Way of Jesus
Farr Curlin, MD, Josiah Trent Professor of Medical Humanities, Trent Center for Bioethics, Humanities and History of Medicine; Co-Director, Theology, Medicine and Culture Initiative, Duke Divinity School.
It is common wisdom that today’s medicine focuses too much on treating those who are sick and too little on preventing the sickness in the first place. Jesus’ teaching in the Sermon on the Mount, however, challenges that assumption and the preventive medicine to which it has given rise. In light of Jesus’ teaching, this paper offers a theological critique of preventive medicine. It begins by identifying four apparent theological problems with much of preventive medicine: 1) medicalizing risk often stirs up anxiety about the future; 2) such anxiety often contradicts the truth that God cares for us; 3) such anxiety often contradicts the truth that medicine is powerless to secure our future; and 4) such anxiety often distracts us from and hinders our vocations. It then offers four corresponding heuristics that might form a basic Christian logic for medicalizing risk—for discerning when and why it would be fitting, wise, and faithful for Christians to make use of medicine to avoid future illness and death: 1) focus on the present; 2) cooperate with God’s care for the body; 3) respect the limits of medicine, and 4) emphasize vocation as a clinical standard.
In the spirit of the conference theme, “Space for the Sacred Care of the Sick,” the second half of the essay looks to identify fruitful points of convergence between this theological critique and other secular critiques of the medicalization of risk through preventive medicine. Secular critiques have focused on what we know scientifically about both the effectiveness, and the burdens and side effects, of long-term administration of different pharmaceuticals to prevent future adverse events. These critiques also have raised questions about how the medicalization of risk relates to the goals and limits of medicine. This paper will attempt to put these theological and secular critiques together to propose how clinicians might practice preventive medicine in a way that honors the value of future health and life while but also respects the limits of pharmacotherapy to prevent future illnesses, acknowledges the side-effects and other burdens of using such medications chronically, and does not equate fullness of life with maximal reduction in statistical risk of future disease.
In the spirit of the conference theme, “Space for the Sacred Care of the Sick,” the second half of the essay looks to identify fruitful points of convergence between this theological critique and other secular critiques of the medicalization of risk through preventive medicine. Secular critiques have focused on what we know scientifically about both the effectiveness, and the burdens and side effects, of long-term administration of different pharmaceuticals to prevent future adverse events. These critiques also have raised questions about how the medicalization of risk relates to the goals and limits of medicine. This paper will attempt to put these theological and secular critiques together to propose how clinicians might practice preventive medicine in a way that honors the value of future health and life while but also respects the limits of pharmacotherapy to prevent future illnesses, acknowledges the side-effects and other burdens of using such medications chronically, and does not equate fullness of life with maximal reduction in statistical risk of future disease.