Dying And Death
Death, Dying, and the Biological Revolution, by Robert M. Veatch (Yale, 1976, 323 pp., $12.95), Death, Dying and the Law, edited by James T. McHugh (Our Sunday Visitor, 1976, 88 pp., $1.75), Who Shall Live?, by Leonard J. Weber (Paulist, 1976, 138 pp., $3.95), and Should Treatment Be Terminated?, by Thomas C. Oden (Harper & Row, 1976, 93 pp., $2.95), are reviewed by Robert A. Case II, associate in ministry, McLean Presbyterian Church, McLean, Virginia.
Every seminarian learns of the Babylonian epic of Gilgamesh, the ancient pagan myth of Edenic morality. Gilgamesh, half-god and half-man, searches for immortality only to have the hope taken from him when he least expected to lose it. The moral theme of this story is that since Gilgamesh cannot escape from death, he must come to terms with it. These four books seek to bring us mortals to a similar point.
We seem to think that medical science has thrust upon us new moral choices with which our ancestors did not have to wrestle. Such arrogant foolishness! Do we really think that during the plagues of Egypt there was no anguish in the Egyptian families as their loved ones died excruciatingly painful deaths? Are we to suppose that during the horrible bubonic plague years in Europe family members never thought of suicide or homicide (“mercy-killing”) in the face of the terrible suffering? Death and its attendants, sickness and suffering, have dogged mankind since the Fall. Francis Schaeffer has rightly noted the profundity of Genesis 5:5.
Since 1969, when Elisabeth Kübler-Ross’s seminal work On Death and Dying appeared, an entire literature on death has developed. These four books fit into that genre and are above average in clarity and usefulness.
Robert Veatch has written perhaps the benchmark volume on death and medical science. It deserves a place on every serious Christian counselor’s bookshelf, not because its author is an evangelical (he is not) or does any exegesis, but because he has given us the most comprehensive discussion of death now in print. Unlike the other three books, this one is heavy going. It is for the reader with the time and stamina to do some detailed study in the area of death and could well be considered a companion volume to Kübler-Ross’s work.
Seeking to define death, Veatch concludes that it occurs when all spontaneous respiratory, circulatory, and cerebral functioning has irreversibly ceased. The patient (or family) will set the criteria in the final analysis, he says, and the death-pronouncing physician shall not have conflicting interests (i.e., the possibility of transplanting organs from the patient after death).
Veatch moves through chapters dealing with the patient’s (or family’s) right not to “prolong dying” and to refuse treatment. Underlying these chapters is the clearly stated assumption that the physician is an agent of the patient and must respond in a way that benefits the patient. As he points out, “The right to refuse medical treatment, for any reason, is well established in the Western legal tradition.” Veatch has a tendency to beg the question in these chapters by using such quality-of-life rhetoric as “prolong the dying process” and “death prolonging treatment.” He calls such treatment in some cases “torture,” and a judge who allowed such “torture” to be stopped (and the patient to die) “compassionate.” Unfortunately, he has not proven his ethical reference points well enough for those characterizations to be valid.
Veatch spends a good deal of space differentiating between “death prolonging treatment” and “lifesaving treatment.” His conclusion is that it is really the patient’s choice how long and under what circumstances he or she wants to continue life.
In the last half of the book, Veatch makes specific proposals for public implementation of the conclusions he drew in the first half. The first half, therefore, has the best chance of retaining its importance, since after the current legislative season the last chapters may be passé. He discusses the mechanics of decision-making (e.g., ad hoc committees and “living wills”) and the legislating of a decision-making structure. He stresses the need for truth-telling in the near-death situation, but before doing this he gives a helpful survey of the argument over this point, which is currently getting a lot of attention in the medical community. He devotes a chapter to organ transplants and ends the book with a call for a national public policy committed to the goal of extending life as long as possible and yet enabling death to be as uncomplicated as possible. In the end, the Judeo-Christian ethic continues to be persuasive, even in thanatology (the science of death); Veatch concludes that we need to affirm “simultaneously that death is an evil and yet certain deaths ought to be accepted.”
James McHugh, a pro-life priest in Washington, D.C., has compiled four essays into the little volume entitled Death, Dying and the Law with the intention of illuminating the legal and medical issues surrounding euthanasia. Although the authors are Roman Catholic, they do not use the standard casuistic approach to their morality. James Doyle notes three reasons for the current interest in death: new medical technology, the advancing “art” of transplantation, and the contemporary “rights” movement. McHugh calls us a “comfort-oriented society” that rejects physical suffering as an inhuman indignity. Ned Cassem gives us five reasons why the “death with dignity” movement has met with well-founded opposition: (1) the moral domino theory; (2) the difficulty of defining irreversible illness; (3) the fear of being accomplices to suicide; (4) the fact that it limits care for the sick; (5) the distrust of human nature. The final essay, written by McHugh and Michael Taylor, makes the crucial point that laws defining death must deal with the death of a human being, not simply the cessation of vital functions of cells, tissues, or organs. They write, “Human life exists in a human person, and the absence of certain qualities or the inability to perform certain functions does not reduce a human being to the animal level or to being nothing more than a ‘human vegetable.’ ”
There are several appendixes dealing with legislation and euthanasia. Although written in 1976, this section is already dated, in view of the recent developments in California, New Jersey, and Tennessee. There is also a limited but useful bibliography of books and films.
The Leonard Weber book deals with medical intervention in cases of deformed infants. Like McHugh, Weber is a Roman Catholic who does not emphasize the casuistic approach to moral problem-solving. His book is eminently readable and instructive. He clearly sees the logical extension of the question of the minimal criteria for humanness (the question being asked in the abortion context)—that if the question is asked with the unborn, it will in time be asked of the born also. Indeed, Joseph Fletcher has already asked (and answered) the question. Incidentally, Weber claims that the minimal requirement for humanness is the ability to reflect consciously.
The author sees two prevailing points of view in the current discussion of death and medicine. One view sees life as a possession that the possessor can handle however he or she wants (Veatch), while the other sees life as a gift with certain limits on what can be done with it (Weber). He also sees three main categories of “value-of-life” positions: one claiming that life counts for everything; one claiming that life counts for much; and one claiming that only a life free from suffering and pain counts for anything.
In the chapter entitled “The Debate,” Weber outlines six current positions on treating the handicapped newborn infant and sees that their proponents can be roughly divided into those who want to decide in terms of the child’s interest (as they see it) and those who want to decide in terms of society’s interest.
Other chapters in this small volume cover such topics as who should make the decision to treat the child and the “role of the public” in this matter. There is also a profound chapter entitled “The Value of Life,” in which the author moves with eloquence through the moral landmines of death and medical technology. He writes in one place, “The fight against discrimination has been made by insisting that, once you get beyond the individual differences, we are all equally good. The quality-of-life ethic (as opposed to the sanctity-of-life ethic) says that once we get beyond the circumstances there is nothing of value whatsoever.” In another place he writes, “To say that life is good and that its value is not man’s to give or take or decide upon is to stand before life with an attitude of acceptance rather than one of control.” Finally, he draws the bottom line when he states, “For an adult who has long had a grasp on life, success may be interpreted in terms of the fullness of life; for the infant who has never really had much of a grasp on life, just to be alive may be a great success.”
Thomas Oden is a Protestant ethicist who in Should Treatment Be Terminated? posits forty-two ethical guidelines to help families of the seriously ill deal with their traumatic situation. Putting himself in such heady company as Ramsey, Vaux, Gustafson, and Thielicke, Oden argues for the sanctity of life. And yet his list of seven factors to be considered in each case of serious illness lacks an important eighth factor, the philosophical appreciation of life. Furthermore, in an amazing bit of ethical game-playing he used a computer and some colleagues to develop an order of priority for his twelve guidelines for determining when to withhold treatment from a deathly ill patient. Between them, the academicians and the computer relegated “religious beliefs or moral convictions” to last place on the death-determining dozen.
Despite the omission on the list and the grotesquely absurd computer game, Oden shows himself elsewhere to be a person of moral courage and sensitivity. For instance, he notes that a severe temporary depression may come on a patient during major illness or surgery and that the physician, knowing this, has an obligation to the patient to prolong his or her life during this phase, despite the expressed desires of the distraught patient.
He also notes that there is almost complete freedom for any person to control his or her last days outside a hospital but that the hospital, by moral necessity, assumes a degree of surveillance and medical control over the person committed to its care. Oden correctly states that consensus ethics is foolhardy ethics and yet that poll-taking does give us an idea of what will constitute workable legislation.
He later writes, “There is a serious danger that ‘quality of life’ can inadvertently become an upper-class elitist concept. ‘Equality of life’ is more likely to be preferred by the poor as a principle for making treatment judgments.” Oden calls the practice of applying the term “vegetables” to deathly ill or comatose patients “a pejorative, prejudicial, and dehumanizing use of metaphor.” A target hit!
Oden waits until the last chapter to open the Scriptures, but when he does so he takes them seriously and knowingly. He brings the Word of God to bear at several crucial points in his sanctity-of-life position. I wish he had given us the benefit of his exegesis throughout his book.
My recommendation on these four books is this: if you are a Christian counselor by profession, you need the Weber, Oden, and Veatch books. If you are a pastor doing counseling, then Oden and Weber ought to be in your study. If you are a layperson who wants to begin a study of death, then Weber is your best bet.
Recent Religious Education
Foundations for Christian Education in an Era of Change, edited by Marvin J. Taylor (Abingdon, 1976, 288 pp., $5.95 pb), is reviewed by Kenneth O. Gangel, president, Miami Christian College, Miami, Florida.
The tip-off is in the table of contents: we see that the chapter on “Simulation-Games Theory and Practice in Religious Education” is nearly twice as long as the chapter on “Theology and Religious Education.” James Michael Lee, representing the Roman Catholic position in this compendium, surely speaks for the majority of the contributors when he says, “There appears to be an emerging trend—sometimes explicitly stated, more often implicitly enacted—among religion teachers, curriculum developers, and administrators toward the social-science approach to religious education and away from the theological approach.”
The feeble efforts of Sara Little in the chapter on theology are only brief flickers in this otherwise dense theological fog. Evangelicals would surely agree with Little’s concluding sentence: “In the final analysis, then, whatever the shape of the future, the ‘health’ of religious education is intertwined with that in theology.” But, Little’s theology is relative; she rejects the “theology as norm” approach.
To be sure, she refuses the alternative that “theology is irrelevant.” She wants to see theology related to psychology and the social sciences but not as any more crucial in the scheme of religious educator than any of these other disciplines. Theology, like Toynbee’s Christianity, is among the great influences but is not essentially superior to any of them.
One brightens up at the beginning of chapter four, when H. Edward Everding, Jr., states: “My thesis is that hermeneutics provides the proper frame of reference within which to develop educational theory.” But though some useful material appears in this chapter as Everding discusses such important matters as the linguistic context, literary context, and historical context, he ultimately pits “traditional historical interpretation” against “existentialist interpretation,” opts for the latter, and raises again the dusty Bultmannian banner with new stripes offered by the works of Pannenberg and Jurgen Moltmann.
Consequently, we are not surprised to learn that “the Bible is interpreted as the unrepeatable primal form of the historical emergent, Christian existence, as well as the occasion for trajectories of meaning into the present, Christian tradition” and that “there is, then, no absolute and unchanging interpretation, for each person’s interpretation is correct since it is his own.”
There are, of course, bright spots, such as Wyckoff’s chapter on “Curriculum Theory and Practice” and Snyder’s refreshing “Worship as Celebration and Nurture.”
Evangelicals are thrown a sop in the form of one chapter, and we can be grateful that this chapter was written by Hayes, whose scholarship and articulateness make him a good spokesman for the evangelical side. Hayes emphasizes the theological commitments of evangelical Christian education. He does, however, give a somewhat more positive nod to psychological relationship than I think it deserves (“A proper ‘I—thou’ relationship, ‘I’m OK, you’re OK’ attitude is essential”).
Marvin Taylor’s “Selected Bibliographies Since 1966” is very disappointing. Of its 253 entries, fewer than 10 could be called evangelical.
Evangelical educators need to know what’s going on in liberal religious-education circles, and this volume can be useful in showing them. It makes it clear that there is no return to any kind of serious biblical position. It also shows the continuing bias (which is anything but “liberal”) against evangelical institutions, publishers, and scholarship. Really, Taylor ought to know better. He is associate director of the Association of Theological Schools in the United States and Canada and so has a firsthand view of numerous flourishing evangelical seminaries.
Barth’S View Of Politics
Karl Barth and Radical Politics, edited by George Hunsinger (Westminster, 1976, 236 pp., $6.45 pb), is reviewed by Jack Buckley, teacher, Covenant Circle, Berkeley, California.
Karl Barth was a socialist.” With that thesis, Friedrich-Wilhelm Marquardt began a flurry of revisionist theologizing among German professors and churchmen in 1972. Marquardt is professor of systematic theology at the Free University of Berlin. Even those who sympathize with his interpretation of Barth’s sociopolitical stance grant that when Marquardt pried into Barth’s politics he was motivated not a little by the socialist students’ challenge to the relevance of the church.
Modern theology is known for its faddish fickleness. One of the contributors to this book laments that “American theologians continue to ignore Barth. His influence, if even acknowledged at all, is viewed with suspicion. At best his thought is accorded only historical interest; one phase in the evolving theology of the modern period.” Marquardt in Germany and now George Hunsinger in America aim to revive his credibility and to move the church leftward in keeping with the spirit of our times. Barth’s famous name, they seem to hope, will help.
Hunsinger, a Ph.D. candidate at Yale in religious studies, has gathered together some essays on Barth’s socialistic concerns. We are given a translation of an address on Jesus Christ and the movement for social justice that Barth delivered in 1911, Marquardt’s 1972 essay, and five response pieces (three by Germans, two by Americans). While Marquardt comes in for some criticism, especially from his Berlin colleague Hermann Diem and from Dieter Schellong of Münster, none of the contributors doubts his basic theme that Barth’s theology was organically related to a socialist praxis. Each, in one way or another, accepts it as given and works to develop it as today’s hope for tomorrow’s church in the world.
One wonders how it was that Barth-as-socialist was not discovered long before liberation theology came into vogue to unsettle the already restless post-death-of-God theologians. These essays suggest that no one was really looking for him. Barth’s social conscience is well known, from his anger at the German intelligentsia’s endorsement of World War I to his opposition to Hitler and rallying of the Confessing Church in the 1930s. But he was strenuously criticized for his refusal to speak out against the Russians during the Cold War. Former friends supposed that he was not so much politically motivated as perhaps emotionally involved in the German crisis. Certainly, they saw no clear connection between his theology and his social thought.
Hunsinger et al. maintain that Barth’s biography must be known if one is to understand just how directly his dogmatics and his social praxis affected each other. It is a fact that in his Safenwil pastorate Barth was a member of the Swiss socialist party, and that he joined the German Social Democrats in 1932. Marquardt and Hunsinger trace his development from old liberal (theologically) to neo-orthodox radical (politically), insisting that his radical doctrine of God inevitably fed his radical outlook on how society might be made more just by means of socialism.
If these writers are right, the interesting question arises: Did Barth’s concept of God and his transforming work in Christ convince him of socialism as a way of life, or did his political leanings give birth to the great volume of new theology for which he has been famous these many years?
Many theologians, to Barth’s left and right alike, might be inclined to wonder what difference it really makes. But those who contributed to this book obviously put a great deal of hope in their rediscovery of Karl Barth’s affinity with the political left. If they have their way, Barth’s influence within and outside the Christian community is far from dead.
Briefly Noted
Fine, vivid poems by a Christian are offered in The Secret Trees, by Luci Shaw (Harold Shaw Publishers, 80 pp., $3.95).
Self-esteem is often thought to be somehow unchristian, but there is nevertheless a command from Jesus to love our neighbors as ourselves. See Loving Ourselves, by Ray Ashford (Fortress, 104 pp., $3.50 pb), The Art of Learning to Love Yourself, by Cecil Osborne (Zondervan, 154 pp., $5.95), and Celebrate Yourself, by Bryan Jay Cannon (Word, 138 pp., $3.95 pb). For a short, colorfully illustrated attack on the vultures of self-put-down, see Vulture by Sidney Simon (Argus, 72 pp., $1.95).
Freedom through forgiveness of oneself and of others is explored in Come Clean, by Charles Keysor (Victor, 155 pp., $1.75 pb), and Start Loving: The Miracle of Forgiveness, by Colleen Townsend Evans (Doubleday, 119 pp., $4.95). Keysor, of Asbury College, uses Psalm 51 as a springboard for discussing confession and total surrender to God as the key to removing guilt. Evans offers an easy personal account of learning how to forgive.
Readings in Third World Missions (294 pp.) and The How and Why of Third World Missions (248 pp.) both by Martin L. Nelson (William Carey, 1977, $6.95 ea., pb), are two excellent source books for the student of current missiological thinking. They follow up a 1973 survey of Third World churches. Case studies and extensive bibliographies are included. The later book draws especially on the author’s Korean experience.
Christian Politics: False Hope or Biblical Demand, edited by James W. Skillen (available from the editor at Gordon College, Wenham, Mass. 01984, 85 pp., $3.95 pb), contains five short, scholarly essays on politics and government, American civil religion, American political parties, and the idea of progress from a Reformed perspective. Thoughtful and challenging.
Pius Wakatama in Independence For the Third World Church (InterVarsity, 118 pp., $2.95 pb) seeks to end the employer-employee relationship between the missionary and national church through a “selective” moratorium that limits American missionaries to those particularly qualified to train nationals for future responsibility. Wakatama also makes a good case for furthering indigenous Christian publishing.
You Must Be Joking, by Michael Green (Tyndale, 220 pp., $1.95 pb), tells how to take the offensive in answering “hard” questions most commonly asked by those who want to avoid commitment to Christ.
Moishe and Ceil Rosen of Jews for Jesus explain how to witness sensitively to Jewish friends with an understanding of their presuppositions in Share the New Life With a Jew (Moody, 80 pp., $1.50 pb).
How to Conduct Backyard Bible Clubs, by Pamela R. Prichard (Moody, 72 pp., $1.50 pb), tells how to supplement more traditional VBS in reaching unchurched children in the neighborhood.
