Surgery and Uncertainty: Elaborating Surgical Ethics in the Tests of Abraham
Yael Shinar, MDiv, Medical Student, University of Michigan Medical School
The biblical stories of Abraham include several morally complex episodes. Among these are the initiation of circumcision as a sign of the covenant and the binding of Isaac as a sign of receptivity to G-d. In this paper, we read these stories as allegories for the moral and ethical stakes of contemporary surgical encounters.
The binding of Isaac involves Abraham’s near sacrifice of his beloved son, by G-d’s instruction. The story emphasizes Abraham’s attentiveness and receptivity to G-d’s call and elaborates Abraham’s negotiation of risk, uncertainty, discipline, and faith. The story resolves in Isaac’s unexpected release from the sacrificial pyre and the substitution of a ram in his place. For his willingness to sacrifice his son to G-d, Abraham is promised numerous, blessed descendants.(1)
The story of the binding of Isaac resonates against the initiation of circumcision as a sign of the covenant.(2) G-d requires Abraham to circumcise himself and all males among him, in return for which G-d promises to “make nations” of Abraham. Abraham accomplishes the task, creating a synecdoche between a surgical cut and a beneficent contract.
Isaac is spared, the circumcision is achieved, and both suggest that a measure of physical violence may facilitate a measure of good—not only spiritual good, as in a covenant, but also material good, as in increased descendants and possession of land.
Between Isaac’s deferred sacrifice, in which an angel intervenes between the knife and the son, and the achieved circumcision, the survivable cut that initiates its bearers into blessings, is the morally treacherous space where surgeons and patients meet.
For example, Abraham may be read as a surgeon, and his receptivity to G-d’s call may be read as a surgeon’s receptivity to her fiduciary obligation. Dr. Christian J. Vercler writes, “Of the medical specialties, surgery is the one that is most self-consciously a calling.”(3) Responding to G-d, Abraham becomes violent and vulnerable, dispossessed and blessed. Responding to illness, the surgeon becomes similarly implicated in violence, uncertainty, and great potential for healing. Abraham’s surrender to G-d’s will is double-edged and its outcomes are unpredictable. So is the moral negotiation of the surgical encounter and so are its outcomes. Citing LB McCullough,(4) Vercler continues, “[In surgery,] uncertainties abound, and only a limited number of variables can be controlled.”(5)
Thus, in this paper, we read these episodes of Abraham as allegories of surgical encounters, in order to articulate some moral parameters of the contemporary surgeon-patient relationship, including the impulse to heal, the willingness to injure, the fiduciary obligation, and the surrender to some measure of uncertainty.
The biblical stories of Abraham include several morally complex episodes. Among these are the initiation of circumcision as a sign of the covenant and the binding of Isaac as a sign of receptivity to G-d. In this paper, we read these stories as allegories for the moral and ethical stakes of contemporary surgical encounters.
The binding of Isaac involves Abraham’s near sacrifice of his beloved son, by G-d’s instruction. The story emphasizes Abraham’s attentiveness and receptivity to G-d’s call and elaborates Abraham’s negotiation of risk, uncertainty, discipline, and faith. The story resolves in Isaac’s unexpected release from the sacrificial pyre and the substitution of a ram in his place. For his willingness to sacrifice his son to G-d, Abraham is promised numerous, blessed descendants.(1)
The story of the binding of Isaac resonates against the initiation of circumcision as a sign of the covenant.(2) G-d requires Abraham to circumcise himself and all males among him, in return for which G-d promises to “make nations” of Abraham. Abraham accomplishes the task, creating a synecdoche between a surgical cut and a beneficent contract.
Isaac is spared, the circumcision is achieved, and both suggest that a measure of physical violence may facilitate a measure of good—not only spiritual good, as in a covenant, but also material good, as in increased descendants and possession of land.
Between Isaac’s deferred sacrifice, in which an angel intervenes between the knife and the son, and the achieved circumcision, the survivable cut that initiates its bearers into blessings, is the morally treacherous space where surgeons and patients meet.
For example, Abraham may be read as a surgeon, and his receptivity to G-d’s call may be read as a surgeon’s receptivity to her fiduciary obligation. Dr. Christian J. Vercler writes, “Of the medical specialties, surgery is the one that is most self-consciously a calling.”(3) Responding to G-d, Abraham becomes violent and vulnerable, dispossessed and blessed. Responding to illness, the surgeon becomes similarly implicated in violence, uncertainty, and great potential for healing. Abraham’s surrender to G-d’s will is double-edged and its outcomes are unpredictable. So is the moral negotiation of the surgical encounter and so are its outcomes. Citing LB McCullough,(4) Vercler continues, “[In surgery,] uncertainties abound, and only a limited number of variables can be controlled.”(5)
Thus, in this paper, we read these episodes of Abraham as allegories of surgical encounters, in order to articulate some moral parameters of the contemporary surgeon-patient relationship, including the impulse to heal, the willingness to injure, the fiduciary obligation, and the surrender to some measure of uncertainty.