A Tale of Two Deaths

The stories of two impending deaths has recently come before our society’s attention, and justly so. Brittany Maynard, a 29-year-old who recently transplanted herself from San Francisco to Oregon, explained why she is planning to commit physician’s-assisted suicide.  Her account was elegantly and movingly countered by that of Kara Tippetts, who has documented her own ongoing struggle with cancer in a forthcoming book.From the publisher

It is nearly impossible to speak well of such matters: there are few aspects of our lives that are as intimate or personal as the manner of our death. Whatever theological claim we might make about it, even if none at all, many of us are gripped by an inescapable instinct that death poses a challenge to us, that it raises a question about the meaning of our lives to which we must provide an answer. We cringe, rightly, at the banality of a ‘funeral selfie’; but we lack a category altogether, thank God, for a ‘dying selfie.’ Television stations still shield us from showing videos where people die, and rightly so. There is perhaps no greater proof of our fundamental and universal commitment to the sacredness of human life than that we endeavor, whenever possible, to protect ourselves from voyeuristic viewings of the moment of its passing. We may wish them to be known, but only by those who already know us well. To have it otherwise is a kind of profanation of the mystery of human life and mortality.

So there is a serious danger about reflecting on the manner of these two coming deaths: to write about them risks trespassing upon the holy and terrible moments that they will respectively face. What is more, my own death is not imminent, at least that I know: while I have reflected more on it as a possibility than most people my age I know, I have been assured (and readily believe it) that there are few matters where the gap between theory and the encounter is wider.

Still, the way they have spoken of what is before them invites such reflection: they have, for better or worse, made available to us the stories they are telling themselves in order to prepare for that final day. Those stories are different, and those differences matter: but there is a kind of boldness beneath each that I wonder whether I would have.  To invite a kind of publicity into one’s own death requires a unique kind of confidence: I would be tempted to falsify my own existence under such scrutiny. That is a temptation for all of us even now, no doubt, but beneath the shadow of death such temptations take on a new force.

But their stories contain two separate worlds. Continue reading

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Medical Missionaries and the Role of Evidence

Matthew Loftus is a family doctor who lives with his wife Maggie and his daughter Naomi in Baltimore , where they are blessed to be a part of New Song Community Church. He aspires to finish his novel and to teach medicine overseas. You may follow him on Twitter @matthew_loftus if you’d like.

Slate’s Brian Palmer is right: missionary medicine in Africa is largely unregulated, unstudied, and understaffed. I have seen with my own eyes—and performed with my own hands—clinical decisions that would rightly be considered malpractice in a developed setting because they required that procedures or medications used reserved for specialists be attempted in order to save a life (ask me sometime about the time I did hand surgery.)

What’s more, I did so in Jesus’ name, praying with and for patients whilst frequently consulting a chaplain to do some heavy-duty proselytization. Doing good for the sake of others doesn’t require that one believe in Jesus; there are plenty of organizations and individuals who are providing medical care without any spiritual strings attached. But neither does believing in Jesus necessarily inhibit people from doing good, as Palmer seems to suspect.

This, however, is not the end of the story, though it’s about all that Palmer bothers to talk about. The story of missionary medicine is more complicated— and expansive—than he realizes. One might think that a writer ostensibly dedicated to reason and scientific study might want to investigate the evidence that does exist—sparse as it may be—on the role of faith-based organizations and Christian missionaries within the medical systems of developing countries. Unfortunately, Palmer is content to fire off a few statistics about this bizarre tribe of missionaries and their backwards religious customs, then revel in horror at their unquantified habits of practice.

I have personally sat in meetings and seminars dedicated solely to exploring the ethical issues raised by practicing medicine in limited resources, using Biblical principles to sort out how to best care for patients in a way that is sustainable and merciful. I have listened to countless Christian medical professionals discuss the lengths that they go to in order to invest particularly in professional development for indigenous health practitioners. I have even been party to forums in secular professional meetings where the benefits and risks of an explicitly religious approach to medicine were openly debated. What’s more, these aren’t just my personal vignettes—they are an essential part of the numerous institutions that Christian missionaries train and serve in.

I certainly appreciate the historical nods that Palmer gives in his piece, acknowledging that criticism of missionary doctors goes back a long way. What he doesn’t mention, however, is the fact that the modern enterprises of community health and international development were not only founded on the precepts of missionary medicine, they continue to be shaped by the work of missionaries. Much of the evidence regarding community-based primary health care strategies comes from Christian projects. The Alma Ata Declaration—a WHO document that lays out the foundational principles for evidence-based primary care health systems—was based strongly on the work of Christian missionaries who helped to convene multiple conferences in the 1960’s and 70’s on international health. As Carl Taylor, who helped write the Declaration, stated:

“Coming out of the conference, the entire global health community, developed and developing, was energized to ramp up health care around the world. The tenets of serving the poor, service to the community as a whole, disease prevention, and the pivotal role of women in health, developed following [Christian medical conferences] and refined by Christian Medical Commission, were firmly built into the evolving framework of Primary Health Care.” from The Christian Community’s Contribution to the Evolution of Community-Based Primary Health Care (PDF)

Beyond the crucial role that Christian missionaries played in helping shift the WHO’s conception of health from the previously dominant compartmentalized, top-down model of care delivery to a more generous understanding of health as a function of human flourishing that must be secured as part of a social justice agenda, there are numerous initiatives within missionary organizations today to carry on this legacy. For example, both the ongoing Global Missions Health Conference and the recently launched Christian Journal of Global Health are dedicated to the exact sort of research, analysis, and quality improvement that Palmer thinks are missing from modern missionary medicine– which makes one wonder how hard he (or his editors) actually bothered to look into this subject. Most of the residencies dedicated to training indigenous physicians in Sub-Saharan Africa–whether surgeons or family doctors–are linked to one missionary organization or another. The “current emphasis of international health delivery” of education and training that he mentions? The Christian Medical and Dental Association even has a whole enterprise dedicated to it. A study to quantify who is working where and what they are doing that he hasn’t seen? It’s been out for 4 years! All of this is still bare-bones, but it’s disingenuous to suggest that medical missions is “a mystery,” as Palmer does.

Research and quality improvement are indeed lacking in Sub-Saharan Africa (although Palmer’s mention of PubMed is laughable because you can use PubMed to find all sorts of papers written by missionaries, they just don’t write “Christian Missions” in every title.) This is largely due to funding; most African countries have yet to devote the state funds necessary for ensuring basic healthcare provisions for their people, much less an ample funding source for research akin to the vast resources that NIH, charitable foundations, and pharmaceutical companies pour into investigation in the First World (and let’s not forget that in America we have to have big public campaigns to get our highly educated professionals to actually follow the evidence that has been amassed because said professionals are so bad at following it). Many missionaries—already working long hours with limited resources—still find the time and money to collect clinical data, report it to whatever entity is willing to crunch the numbers, and use the results to shape their practice.

Beyond these concerns—which Palmer freely admits he might relinquish if secular physicians were carrying out the work—lies the question of faith. His willingness to admit that his discomfort about this issue won’t motivate him into an ideological crusade against health professionals who proselytize is certainly commendable. For a non-religious person steeped in a non-religious environment, it certainly seems apropos to be skeptical of missionaries who are open about their faith and wag a finger at those who would dare to use their position as a medical provider to share their beliefs with others. However, such an outlook is downright ignorant of non-Western conceptions of health and disease, which are far more open to spiritual causes of disease and more frank discussions of faith as it relates to health. In a world where cell phones and reverence for one’s ancestors are equally valuable and many people inquire of a witch doctor before seeking medical attention at a hospital, it is not at all unusual or inappropriate to practitioners to discuss their own religion and how it might offer a better perspective on the suffering and fear that their patients are facing. I don’t know if Palmer’s piece was vetted by any Africans, but it doesn’t seem to reflect any understanding of the holistic worldview that I have encountered among non-Western health professionals.

We do need to address the disquieting motivations that medical missionaries sometimes have for their work. Again, the white and wealthy cultural milieu finds animating spiritual convictions frightening for legitimate reasons and has ample historical basis for such fear (although the legacy of colonial missionaries is far more positive than most give credit for.) However, the dedication with which missionaries apply themselves to their work and the places that they choose to invest their labors are inseparable from the theological distinctives of evangelical Christianity. Just as the American Civil Rights Movement or the British anti-slavery movement cannot be understood without a deep appreciation for the religious teachings that shaped them, so missionary medicine is inseparable from the doctrines discerned from the Bible. Jesus’ ministry of preaching and healing are inseparable—the Gospels are full of incidents where He challenges, exhorts, encourages, or rebukes one who has been healed or a crowd around Him as a part of the healing. At the very heart of Christian doctrine is the understanding that as Christ’s suffering delivered us unto life, so our suffering as believers can produce similar fruit in others. Kent Brantly, Olivet Buck, and Jerry Umanos stand as excellent examples of such Passion-motivated compassion. Dr. Brantly survived his suffering for others, but Drs. Buck and Umanos did not—these theological convictions are what make Christian missionary medicine uniquely effective and continue to drive the disproportionate (but still insufficient) number of religiously based medical providers.

The deficiencies that Palmer notes in his piece are real, and mission work is desperately in need of the sort of resources we apply to Western medicine. However, both the spiritual aspects of Christian mission work and the rigor already applied to such medical endeavors are indispensable to the story of healthcare in Africa—even if if Palmer can’t be bothered to discuss them when he bemoans the lack of data plaguing health care abroad. Rather than casting aspersions and “standing aside,” those who love evidence-based practice ought to celebrate what has been done through missionaries, apply what they have to teach us, and follow them to places where just and equitable health systems are still being built.

The Evangelical Roots of the Benedict Option

In 1948 the Bible Presbyterian Church, a quasi-fundamentalist evangelical denomination, sent a 36-year-old pastor and his family to Europe to check on the state of the church after World War II. The family settled in Switzerland and worked mostly in child evangelism before coming back to the United States in the early 1950s on furlough. They returned in 1955 and settled down in a village called Huemoz, a small Swiss village about one mile up into the Swiss Alps near Lausanne. At that time their oldest daughter began attending university and would bring her friends back home with her to visit on weekends.

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This Demon Only Comes Out By Prayer and Prozac

Matthew Loftus is a family doctor who lives with his wife Maggie and his daughter Naomi in Baltimore , where they are blessed to be a part of New Song Community Church. He aspires to finish his novel and to teach medicine overseas. You may follow him on Twitter @matthew_loftus if you’d like.

“It’s a chemical imbalance.”

You may have heard or said those words before in reference to mental illness. I have done both myself a number of times in my practice as a primary care doctor. One good example of opening the conversation about them can be found here from Ed Stetzer; one of Stetzer’s explicit goals is to decrease shame and stigma against mental illness by locating the pathology of mental illness in neurobiology and then asserting the need for medication to rectify the dysfunctional biology. As Christians across the world grapple with the modern understanding of mental illness, it is helpful to not only understand what these imbalances are and how medication might address them, but also to challenge a point of view that reduces mental illness to a mere malfunction of biology.

The impetus behind the use of the words “chemical imbalance” is good. After all, confining mental illness solely to the untouchable realm of feelings and thoughts is not only ignorant of biology, but also of orthodox anthropology. Furthermore, such a harsh dichotomy happens to be extraordinarily ineffective in the lives of most sufferers of mental illness. You may or may not have heard of an excellent book that sought to make clear the theological importance of our physical bodies; affirming that deficiencies or excesses of certain chemicals in our brains play a role in mental illness is an important step in the process of rightly treating our bodies as part of the created order. In turn, the judicious use of other chemicals to rein in the torment and harm caused by mental illness is as much a part of using our God-given power to exercise dominion over the earth as is carefully using pesticides on our crops so that more people can eat.

However, saying “you’ve got a chemical imbalance” does not go far enough and, paradoxically, can often take us too far in the wrong direction.

Assigning mental illness solely to such imbalances is inadequate firstly because it underappreciates the complexity of neurobiology. For example, we know very well that people with depression have lower serotonin levels (most potently demonstrated in studying the brains of those who have committed suicide.) Selective serotonin reuptake inhibitors (SSRIs) such as Prozac or Zoloft raise serotonin levels in the brain. However, while many of the measurable effects of SSRIs on neurons can be seen within hours of first taking the drug, the effects of these medications are rarely appreciated until at least 4 to 6 weeks, making it far from clear that raising one’s low serotonin levels is their sole useful effect. Furthermore, the fact that any of these medicines has roughly a 30-40% chance of working in isolation on the first try is evidence that any “imbalances” we discuss are less like our car’s windshield wiper fluid and more like our food’s soil. When dealing with even more complex illnesses like bipolar disorder (which responds to a wide range of medications that are also effective for epilepsy) or schizophrenia (which involves a greater variety of neurochemical pathways), it is clear that the language of “chemical imbalance” is simply a starting point.

Secondly, while it is obvious that there are many aspects of brain biochemistry that we cannot consciously control, there are many others that we can. The choices we make shape our physical bodies– including our brain structure and genes. This is most apparent in the cycle of addiction, wherein an addict’s brain is often demonstrably altered to have a minimal response to normal pleasurable stimuli and to require greater and greater doses of the drug of choice to not feel agonizing withdrawal. However, as we learn more about the bodies that God has given us, we see that chronic stress and traumatic events (often caused by the sin of others) can shape the brains of children with immature decision-making ability in ways that last for a lifetime. Thus, there is a reciprocal relationship between our environment, our bodies, and our feelings. Both our moods and our decision-making abilities are shaped by constant internal decisions and external stimuli.

The most potent example of this principle is the case of a sexually abused child who overeats not only to soothe the excess quantities of stress hormones that may or may not be predisposing them to depression later in life, but also to appear less attractive to their abuser. Even without immediately jumping to the conclusion insisting that the government must do something (as part 3 of the article linked above does), it is clear that we must jettison any simplistic understanding of the complex interaction between brain and body as a matter of individuals choosing to either sinfully wallow in mental illness or righteously embrace freedom in Christ. Similarly, we must also not succumb to a materialistic view that defines people stuck in mental illness solely as victims of circumstance.

We go too far in the wrong direction in this manner when our appreciation for the power of pharmacology to help guide our brain chemistry into a more ordered pattern becomes a helpless veneration of medicine. I have seen this, too, in my practice– patients who have been trained to believe that their own efforts to calm their nerves or pay attention are useless when compared to the power of Xanax or Adderall. The danger of these medications is that they are powerful enough to abrogate our efforts; as prescriptions for these (and similar) medications continue to dominate the market in a way that disquiets many clinicians, a sense of restraint and discipline is necessary for all parties involved.

Health is a discipline. The bodies that God has given us require care and attention to maintain in a way that fits the pattern he established for our being; while our appetites can sometimes be helpful guides to our needs, they are often magnified or minimized by sin in such a way to lead us astray. Whether we are choosing certain foods, actively exercising, or avoiding other substances, our health requires active management and control.

These individual choices are also clearly shaped by our environment, from the simple unavailability of fresh vegetables in certain neighborhoods to the more complex changes caused by chronic stress described above. Disciplines, while individually practiced, are shaped by the communities that we live in and the values we collectively affirm. Wendell Berry points out that “autonomy” is a false cure for our modern ills, saying, “Healing is impossible in loneliness; it is the opposite of loneliness.” When we do not pay heed to the disciplines– either individual or environmental– that shape our health, the breakdown of our bodies is attended by the breakdown of our minds and spirits.

In regards to mental health, it is often said that “food is the most overused antidepressant and exercise is the most underused antianxiety medication.” A variety of well-designed studies have borne out the efficacy of behavioral interventions for a variety of mental illnesses, demonstrating that our power over mental illness is not limited to pharmacology. That said, anyone who has ever seen a loved one struggle to take medication for mental illness can see that even the act of using pharmacology’s power (and bearing its side effects) is itself a discipline. Even more telling are the studies that show that some of the sickest people who burden emergency rooms with repeated visits see great improvements in their physical and mental health when they are brought into closer personal contact with caring people and housed.

Talk of health as a discipline or health choices as being shaped by culture brings to mind the issue of personal responsibility, which is a useful rallying cry for helping oneself feel less perturbed about the suffering of others, but by definition cannot be embraced as a corporate policy. Personal responsibility is clearly a component of discipline, but it is not the only one. For those who are struggling with mental illness, it is imperative they are approached first as persons with dignity whose ability to make rational decisions and take responsibility has been impaired– whether by themselves, by another, or by the happenstance of neurobiolog. Once this relationship of trust and respect is established, we can walk with them through both the personal and professional interventions necessary to learn or rediscover the skills that attend to personal responsibility.

Similarly, shame can be useful; the things that people with mental illness say and do when swayed by the winds of their depression or mania are often a powerful motivator to change their behavior when they feel ashamed of them. While we want to rightly eradicate the effects of shame that keep people from seeking help and being honest, it is possible to strain out a gnat and swallow a camel if we take the language of “chemical imbalances” too far and put personal responsibility out of reach for those who suffer from mental illness.

In the end, both the people who wish to eradicate shame from mental illness and those who wish to use it as a hammer for every health-related nail they see will find themselves in conflict with a holistic worldview that embraces the continuity between physical existence, knowledge, indiscernably complex emotions, and meaningful spirituality. The bodies that God created us with are prone to the corruption of sin in ways that science can both illuminate, abet, or help to heal– but only if we can appreciate the full complement of healing means that He has given us.

Tolkien and Violence

There’s a further Tolkien-related question that needs to be discussed after last week’s comments by George RR Martin, concerning the role of violence in Tolkien’s legendarium. Martin asked in the interview if Aragorn hunted down and killed all the orcs after his ascent to the throne, “even the little baby orcs in their orc cradles?”

As it happens, this is a terrible way of raising an interesting point. We need to talk about violence in Tolkien if we are to talk intelligently about his politics, but talking about the orcs is the wrong way of doing that. Tolkien is fairly dodgy about the origins of the orc, but the best hints we have are that orcs were originally elves who joined with Morgoth, the original Dark Lord for whom Sauron was a mere lieutenant. Due to their allegiance to Morgoth, the orcs were, by definition, evil to their core and were incapable of redemption. So the only thing left was to fight them and attempt to eradicate them. You can find ambiguity in Tolkien’s work regarding violence, but if you go looking for it in his treatment of the orcs you’re looking in the wrong place.

Martin’s comment about “little orc babies” is especially telling as it betrays a surprising ignorance of Tolkien’s world—it’s far from clear that there ever were such things as baby orcs. Tolkien never describes how exactly an individual orc comes to be, but there’s some reason to suspect that Peter Jackson’s view that orcs were made rather than born is correct. Indeed, if one reflects on the fact of Tolkien’s Catholicism it’s not hard to imagine him thinking that orcs, by virtue of their essential selfishness and lack of even the most basic form of affection or love, would be incapable of having sex and giving birth in the same way as the free peoples of Middle Earth. The simple act of sex, as Tolkien understood it, would have been the least orc-ish thing one could possibly do. (It is perhaps unsurprising that a man who writes sex in the way that Martin does would fail to pick up on this point.) So while it may seem an obvious place to go in thinking about violence in Tolkien’s work, the orcs are not the best place to begin.

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Noah: A Theological-Aesthetic Rorschach Test

Last week saw the premiere of Darren Aronofsky’s Noah, and with it a (predictable) storm of controversy from the evangelical community. Reviews have ranged from predictably critical to outright disdain to hostile readings, and from strongly (though not unreservedly) positive to more restrained affirmation of the film on aesthetic and spiritual grounds to especially measured theological and artistic engagement. In short, the responses spanned exactly the range one would expect from the evangelical community, which is itself deeply divided on the purpose, value, and meaning of the arts—decades of conversation on the topic notwithstanding. Noah[1] works as a sort of theological-artistic Rorschach test. We seem to find it in what we expect given its origins and our disposition.Noah_film

Rather than offer another review (which would add nothing to the conversation at this point), or decry once again the predictable evangelical response to the arts, or even critique reviews with which I disagreed, I thought it might be useful instead to ask where we stand today and point to a few places we might grow from this. Continue reading

An Interview with Dan Siedell on Faith and Art

Last fall I had the chance to meet Dan Siedell, a fellow Lincoln native, when he made a trip back to Nebraska. (Dan teaches classes at both Knox Theological Seminary in Fort Lauderdale and at The King’s College in Manhattan.) We were able to have lunch as well as organize a brief discussion night at my church on issues related to Christianity and art. After our time together, I had several questions I wanted to ask Dan based on his comments at the event. So Dan and I stayed in touch and over the next few months did a long interview about the relationship between art, worldviews, and the life of local communities.

JM: In an interview in Curator, you said that if your first introduction to modern art had been with Hans Rookmaker, the Dutch critic who influenced Francis Schaeffer so deeply, you would have been forced to either give up your art or your faith. Why is that?

DS: I came to Rookmaaker, like I came to Schaeffer, after I’d already completed my course work for a Ph.D. in the history of modern art, after I’d moved to New York to study with a critic, moved again to pursue doctoral studies. When I was writing my dissertation, I’d already been married for three years, had our first child, and so I already had considerable skin—and bone—in the game. I’d sacrificed so much and knew that I would be called on to sacrifice a lot more to pursue my passion for modern art. [Rookmaker’s work] just rang hollow to me.

And I think it rang hollow for me because Rookmaaker’s and Schaeffer’s worldview focus was intellectual—it was about ideas and thoughts—and art was always just an expression of such things. For both [of them] there was a certain distance—art was kept at arm’s length, as it were. And that was not my experience. Now, I’ve had many people who studied with those two men tell me that they were passionate about it and encouraged their students to engage it. But their writing didn’t communicate that to me. I was converted to modern art through writing, through words, and so I’m very sensitive to my own voice and communicating a passion for my subject, a passion that encourages participation, not dismissal. Their work was also about a particular moment in which the “Christian artist” was a viable way to be faithfully present in culture. I don’t think that’s the case now.

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Young, Restless, and Reformed Homeboys on Lenten Fasting

Last spring, I wrote about my skepticism about the newfound trendiness of lenten fasting among Evangelicals of my generation. The trend continues apace. Here’s Glenn Packiam, pastor of New Life Downtown in Colorado Springs (it’s a “parish” of the more famous New Life) explaining why his charismatic and low-church congregation is holding an Ash Wednesday service today:

So, no, you don’t have to observe Ash Wednesday. You don’t have to have a service or even go to one. But it is a beautiful way to join with the Church—for the past 1200 years—and with the people of God—for thousands of years before that!—and humbly repent and seek God’s face. It is the beginning of a fast season, Lent. Lent—like every other season of the Church Calendar—is about marking time around the life of Christ. We tend to mark time around our own events; there’s nothing evil about that. But there is another way to keep time. Christians for centuries have marked time in way that reminded them of the life, death, and resurrection of Jesus Christ. So, in short, this is about being centered on Christ and being connected to the Body of Christ, historic and universal.

Packiam is endemic of how most Lent-adopters talk about church history: They denigrate (explicitly or implicitly) their low-church Evangelicalism as unmoored from tradition and underscore how adopting the liturgical practice connects them to the historic church. But what if the best way to express trans-generational solidarity with the millions of believers who have walked before you is by eschewing Lent? That’s the argument I want to support below.

Jonathan Edwards is my Homeboy

Here’s the thing. Evangelicalism has been around for centuries and its practice is strongly rooted in the past. In the churches I’ve attended over the past decade (sometimes called Young, Restless, and Reformed), most worship songs are rearrangements of lyrics penned by eighteenth-century figures Isaac Watts, Augustus Toplady, and Charles Wesley. And what’s true of the songs is true of the theology, long-dead folks like John Calvin and Charles Spurgeon are revered, a phenomenon summed-up by the famous Jonathan Edwards is my Homeboy t-shirt on the cover for Colin Hansen’s article describing this movement. In their sermons and theological treatises, these YRR Homeboys said quite a lot about keeping the season of Lent. Here’s a sampling of takes from the sixteenth (John Calvin), seventeenth (John Owen), eighteenth (Jonathan Edwards), nineteenth (Charles Spurgeon), and twentieth centuries (Martyn Lloyd-Jones).

John Calvin, Institutes of the Christian Religion, 4.12.20 (1536)
Calvin is clearly hostile to describing lenten fasting as an imitation of Christ.

Then the superstitious observance of Lent had everywhere prevailed: for both the vulgar imagined that they thereby perform some excellent service to God, and pastors commended it as a holy imitation of Christ; though it is plain that Christ did not fast to set an example to others, but, by thus commencing the preaching of the gospel, meant to prove that his doctrine was not of men, but had come from heaven. And it is strange how men of acute judgment could fall into this gross delusion, which so many clear reasons refute: for Christ did not fast repeatedly (which he must have done had he meant to lay down a law for an anniversary fast), but once only, when preparing for the promulgation of the gospel. Nor does he fast after the manner of men, as he would have done had he meant to invite men to imitation; he rather gives an example, by which he may raise all to admire rather than study to imitate him. . . . It was therefore merely false zeal, replete with superstition, which set up a fast under the title and pretext of imitating Christ . . .

John Owen, On the Mortification of Sin in Believers (1656)
Owen is a very interesting case because he wrote extensively on the Christian practice for mortification of the flesh. However, he was very clear to differentiate the gospel practice of mortification from practices of “popish devotionists.”

That the ways and means to be used for the mortification of sin invented by them are still insisted on and prescribed, for the same end, by some who should have more light and knowledge of the gospel, is known. Such directions to this purpose have of late been given by some, and are greedily catched at by others professing themselves Protestants, as might have become popish devotionists three or four hundred years ago. Such outside endeavors, such bodily exercises, such self-performances, such merely legal duties, without the least mention of Christ or his Spirit, are varnished over with swelling words of vanity, for the only means and expedients for the mortification of sin, as discover a deep-rooted unacquaintedness with the power of God and mystery of the gospel.

Later, in the same piece, he specifically condemns the practice of abstaining from “sin for a season.”

And herein is the Roman mortification grievously peccant; they drive all sorts of persons to it, without the least consideration whether they have a principle for it or no. Yea, they are so far from calling on men to believe, that they may be able to mortify their lusts, that they call men to mortification instead of believing. The truth is, they neither know what it is to believe nor what mortification itself intends. Faith with them is but a general assent to the doctrine taught in their church; and mortification the betaking of a man by a vow to some certain course of life, wherein he denies himself something of the use of the things of this world, not without a considerable compensation. Such men know neither the Scriptures nor the power of God. Their boasting of their mortification is but their glorying in their shame. Some casuists among ourselves, who, overlooking the necessity of regeneration, do avowedly give this for a direction to all sorts of persons that complain of any sin or lust, that they should vow against it, at least for a season, a month or so, seem to have a scantling of light in the mystery of the gospel, much like that of Nicodemus when he came first to Christ. They bid men vow to abstain from their sin for a season. This commonly makes their lust more impetuous. Perhaps with great perplexity they keep their word; perhaps not, which increases their guilt and torment. Is their sin at all mortified hereby? Do they find a conquest over it? Is their condition changed, though they attain a relinquishment of it? Are they not still in the gall of bitterness? Is not this to put men to make brick, if not without straw, yet, which is worse, without strength? What promise hath any unregenerate man to countenance him in this work? what assistance for the performance of it? Can sin be killed without an interest in the death of Christ, or mortified without the Spirit? If such directions should prevail to change men’s lives, as seldom they do, yet they never reach to the change of their hearts or conditions. They may make men self-justiciaries or hypocrites, not Christians.

Jonathan Edwards, An Attempt to Promote Agreement in Extraordinary Prayer (1745)
Edwards ridicules the no-flesh-but-fish rule while discussing how the capture of the French fortress of Louisbourg (on an island named Cape-Breton by the English) during King George’s War heralded the ascendance of the gospel and the downfall of superstitious Roman Catholic countries.

And one thing with relation to the taking of Cape-Breton, though it may seem trivial, yet I do not think to be altogether inconsiderable in the present case; and that is, that thereby the antiChristian dominions are deprived of a very great part of their fish, which makes no small part of the food and support of popish countries; their superstition forbidding them to eat any flesh for near a third part of the year. This they were supplied with much more from Cape-Breton than from any place in the world in the possession of papists. And the contention of France with the Dutch, deprives them of most of their supplies of this sort, which they had elsewhere. When the prophet Isaiah foretells the depriving Egypt of its wealth and temporal supplies, under the figure of drying up their rivers, this is particularly mentioned, that they should be deprived of their fish.

“And the Egyptians will I give over into the hand of a cruel lord. And the waters shall fall from the sea, and the river shall be wasted and dried up; and they shall turn the rivers far away, and the brooks of defense shall be emptied and dried up. The fishers also shall mourn, and all they that cast angle into the brooks shall lament, and they that spread nets upon the waters shall languish.” Isaiah 19:4-8.

This is expressed in the prophecies of drying up the waters, i.e. the supplies of Egypt; and this probably is implied in the prophecies of drying up the waters of that city which is spiritually called Egypt. And it may be noted, that this is not only a supply that the church of antichrist has literally out of the waters, but is that part which is eminently the supply and food of their antiChristian superstition, or which their popish religion makes necessary for them.

 Charles Spurgeon, Treasury of David (1885) and sermon on Song of Solomon 1 (1886)
Spurgeon expresses general reservations about all traditions of men.

When it can be proved that the observance of Christmas, Whitsuntide, and other Popish festivals was ever instituted by a divine statute, we also will attend to them, but not till then. It is as much our duty to reject the traditions of men, as to observe the ordinances of the Lord. We ask concerning every rite and rubric, “Is this a law of the God of Jacob?” and if it be not clearly so, it is of no authority with us, who walk in Christian liberty.

He is especially critical of Lent’s call to mourn as if our Lord was taken away.

Come, then, and for your own good hang up the sackbut and take down the psaltery—put away the ashes! What if men call this season, “Lent”? We will keep no Lent, tonight—this is our Eastertide! Our Lord has risen from the dead and He is among us, and we will rejoice in Him!

Martyn Lloyd-Jones, sermon from John 1 (1962)
Lloyd-Jones is blunt in his appraisal.

Lent, of course, is a relic of Roman Catholicism. One can easily understand it in such an organization – it gives power to the priest, and so on – but there is, I repeat, no evidence whatsoever in favour of it in the New Testament, and it simply leads to this show of wisdom and human will power. It is people adding their works to the grace of God, and this is essentially Roman Catholic teaching. Well, my friends, let us get rid of this, let us not waste our time with it. We are to be led by the Spirit always.

Evangelicalism is a tradition too

I’m sure that an Evangelical Lent-adopter would protest that he isn’t going to do Lent in a “popish” way and thus evade the censure of the YRR Homeboys. If that were the case, why did none of these figures advocate for a reformed lenten fast instead of condemning the practice entirely? Furthermore, if the point for the adopters is to participate in an ancient tradition along with saints of previous centuries, it doesn’t make sense to radically alter the practice as traditionally performed.

My point is simple. Evangelicalism is a tradition with attendant folkways and liturgical practices. One of the practices low-church Evangelicalism has long embraced is not participating in lenten abstention. As a traditionalist, I walk in the steps of these historical homeboys and am the richer for it.

On the Number of Zygote Deaths and the Meaning of Pro-Life

What does it mean to be “pro-life”? Judging by the recent conversation about contraception, it would be easy to think that the point and purpose of the pro-life position is to reduce abortions in the world.

But as important as that is to pro-lifers, it by no means encapsulates the entirety of the pro-life position. In a brief but punchy essay, Frank Beckwith sums up the point:

The truth, however, is that the prolife position is not merely about “reducing the number of abortions,” though that is certainly a consequence that all prolifers should welcome. Rather, the prolife position is the moral and political belief that all members of the human community are intrinsically valuable and thus are entitled to the protection of the laws. “Reducing the number of abortions” may occur in a regime in which this belief is denied, and that is the regime that the liberal supporters of universal health coverage want to preserve and want prolifers to help subsidize. It is a regime in which the continued existence of the unborn is always at the discretion of the postnatal. Reducing the number of those discretionary acts by trying to pacify and accommodate the needs of those who want to procure abortions—physicians, mothers, and fathers—only reinforces the idea that the unborn are objects whose value depends exclusively on our wanting them.

In a post that I’ve seen referenced a few places, blogger Libby Anne follows Sarah (last name not given) does a bit of math and contends that fewer zygotes wind up dead when women use birth control than when they don’t.  Here’s the conclusion from Sarah:

So let’s get this straight, taking birth control makes a woman’s body LESS likely to dispel fertilized eggs. If you believe that life begins at conception, shouldn’t it be your moral duty to reduce the number of zygote “abortions?” If you believe that a zygote is a human, you actually kill more babies by refusing to take birth control.

If it were the case that the pro-life view was simply constituted by the number of people who lived and died, then Libby Anne and Sarah might have a case. But there are qualitative moral differences between the two. Suppose that two people are nearing death. In one case, we do nothing at all. In the other, we act in such a way that we know will erode the conditions for their ongoing life. Perhaps we put something in the air conditioner that makes it hard to breathe, or put a clamp on the tube that is feeding them food. In both cases, the patients die—but one died without our involvement, and the other died within conditions that we created. It’s true that they both would have died anyway. But the analogy is meant to show that the life or death of the person is not the only criteria by which we judge the morality of the action.

Now, there are two things worth saying about the above analogy. First, someone might claim that by taking birth control they are not in fact intending the death of the zygote: they are only intending that any zygote that *might* have been created to not be created. And that’s a fair claim. Second, it is an analogy where we know (with considerable likelihood) that both people are going to die. In birth, we don’t know if we use contraception whether the zygote will continue living or be “flushed out.”

Happy pro-lifers for the win.

Happy pro-lifers for the win.

These two counterclaims, though, actually mean less than they might seem on the surface. For one, even if in the above analogy I am not intending to kill the person I’m still responsible for creating the conditions in which they died. And given that we do not know whether the zygote would live or die *without our involvement,* if the zygote dies we take on responsibility for the death that we would not have otherwise precisely because of our action in the matter. To put it bluntly, our intentional acting is what distinguishes the abortificient from the natural death and which creates a degree of moral gravity about the situation that would not occur otherwise.

That’s an argument, but beneath it stands the principle that we tried to establish at the beginning: the prolife position is not measured by the number of zygotes that survive pregnancy or not, but by the quality of our wills and decisions inasmuch as they relate to human life. Hypothetically, if a couple knew that by not using an abortificient every zygote they had would die and be “flushed out”, but if they used an abortificient and one of the children lived, using the abortificient would still be wrong. Why? Because the decision would have been one that would have been contrary to the presence of human life and because the morality of the decision is not determined solely by the consequences that result from it. To deploy the classic anti-consequentialist conundrum, if we could demonstrate that statistically killing one innocent person would save the lives of a hundred or thousand others, that would not make the intentional taking of human life right or good.

One final point: let’s suppose for a second that it’s simply uncertain whether in my analogy the person died because they were really old or because we put the hypothetical clamp on their feeding tube. Analogously, it may be uncertain when someone is on contraception whether any given zygote is “flushed out” naturally or because of the drug’s effect. (Again, statistics don’t matter—action and involvement does.) In such a case, a strong dose of ethical humility would entail that we should err on the side of not involving ourselves in the process, *even if* statistically more humans die as a result. Theologically, we can entrust ourselves and our decisions to the providence of God, and contend that we have knowingly kept ourselves free from even the possibility of intentionally creating the conditions that caused the death of human life—of doing evil that good may come. We cannot have too much integrity of the will in this world.

Update:  Guttmacher has a study out saying that the abortion rate has decreased to its lowest point since 1973 and credits contraceptives for part of that.  It’s obviously good news that the rate is dropping.  Predictably, it’s being deployed as a reason why the pro-life movement should support the contraception mandate.

The Locust Effect: Why the End of Poverty Requires the End of Violence

It’s probably appropriate and wise to begin a review of Gary Haugen and Victor Boutros’ newly-released The Locust Effect by admitting my biases up front: I’ve been an unabashed supporter of International Justice Mission since the early 2000s, particularly after seeing IJM’s work highlighted on Dateline NBC in June 2003. I’ve applied to work for IJM, have attended the organization’s Global Prayer Gathering and Christmas Benefit gala, occasionally carpool with the CFO, and up until a recent re-allocation of our family’s charitable giving, have been a monthly supporter. So when you read me asserting that over the last fifteen years IJM has revolutionized how the evangelical community in the United States thinks about, talks about, and actually pursues, justice in the developing world, you should know that these are the words of a less-than-neutral observer.bookAngle-GalleryPage

The thesis of The Locust Effect is straightforward: without effectively addressing the “locusts” of “common, everyday, predatory violence” (50) and lawlessness that eat away at the politically and economically disenfranchised in the developing world, no amount of poverty-alleviation work is going to do any lasting good. (94-97) The world, argue Haugen and Boutros, has arrived at a “critical inflection point” where the total percentage of individuals living in dire economic conditions has dropped significantly from years past; however, due to a host of factors, there has been little change in absolute numbers (47-49).

The Locust Effect is meant to spotlight how in conjunction with continued poverty-alleviation programs aimed at well-known challenges of clean water, sanitation, public health, education (especially women’s education), and access to capital and seed money, there has to be concerted efforts at reforming public justice and law enforcement systems. “[P]eople,” the co-authors insist, “do not commonly see [violence] as intrinsic to the problem of poverty…poor people—by virtue of their poverty—are not only vulnerable to hunger, disease, homelessness, illiteracy and a lack of opportunity; they are also vulnerable to violence.” (50) In the developing world, the poor are decidedly more vulnerable to the predations of the strong and corrupt. The strong and corrupt must therefore be deterred, and the Locust Effect insists that deterrence arises out of functioning, non-corrupt law enforcement organs.

The book is structured in three distinct parts. First, in chapters one and two the authors provide a descriptive and typological analysis of the overall problem. The first chapter is not for the faint of heart; it is emotionally trying. The authors describe without apologies real-life cases including, among others, (a) an intentional police and local authority cover-up of a sexual assault/murder of an eight-year old girl in a Peruvian town; (b) the use of physical assault and rape in India to keep bonded laborers from fleeing a brick factory, followed by a litany of failures in the Indian court system. Chapter Two is a more systematic examination of sexual violence (including trafficking), forced/slave labor, “property grabbing” or land expropriation, and police abuse (particularly police predation, arbitrary detention and torture). Haugen and Boutros explain how physical and psychological coercion operate in each of these four categories, but they go into greater detail on how sex trafficking and forced/slave labor are business operations reliant upon deception (to lure economically-vulnerable victims away from the protection of their families and local communities with promises of better jobs or more pay) and violence (what they label the “coercive moment” that keeps victims from leaving and/or reporting).

With respect to police abuse, the chapter touches on extortion and torture, but devotes most space to the injustices associated with lengthy and often-capricious pre-trial detention: lost files, sclerotic legal systems, lack of sanitation, jail overcrowding, and, the longer-lasting damage this does to one’s family, livelihood and psyche. Chapters three and four round out this first part, reiterating the overall argument that this unrestrained violence, the “de facto lawlessness” (111) bred from an ongoing absence of enforcement, impedes human flourishing and cries out not just for attacking “root causes,” but for good policing.

In the middle section, Haugen and Boutros offer an entire chapter (five) describing the chronic infirmities that typically beset law enforcement and public justice in the developing world, and then, over the course of four subsequent chapters, they attempt to locate the origins of the more common political and organizational maladies. I found the discussion in these middle five chapters some of the most engaging of the entire book, particularly Haugen and Boutros’ careful outline of how systemic dysfunction proliferates throughout the three public justice branches (investigational, prosecutorial and judicial), and their analysis of how 19th and early 20th century models of colonial policing combined with late 20th and early 21st century proclivities for privatized corporate security to bring about the current state.

Take, for instance, their discussion of present-day, developing world police forces. It isn’t as simple as the stereotypical coterie of corrupt officers who shakedown the vulnerable and unwary in order to make up for their paltry salaries, arrest those who can’t pay up, and take bribes from those who they should be arresting. There is that, of course, which the co-authors characterize as a “bidding war” over enforcement. (128) But Haugen and Boutros don’t just stop there. Instead, they carefully outline a host of interconnected problems: politicos who aim their country’s scarce policing resources away from ‘poor neighborhood’ problems to protection of state (and, truth be told, often their own personal) companies and assets; little to no training when it comes to interviewing techniques, non-physical interrogation, evidence collection and storage, processing of both criminals and victims; and a woeful lack of infrastructure (i.e. paper, copy equipment, computer hardware, database management; archive retrieval). (123-132)

Chapter seven and eight show that colonial legacies and privatized security are part and parcel of the same problem – that of the relationship between law enforcement and political economy. As Haugen and Boutros clearly bring out, law enforcement in colonial settings was not oriented, in the main, at punishing or deterring colonial subject-on-colonial subject crime or predation, but rather was aimed at guarding and protecting the economic—and typically extractive—interests of the colonial power from labor interruptions, internal dissension, riots and espionage (all of which are encapsulated in Charles Gwynn’s 1934 treatise, Imperial Policing, as enforcement duties rendered in “aid of the civil power”). Indeed, if one can get hold of a library copy of Martin Thomas’ recently-released Violence and Colonial Order (roundtable located here), it makes for an excellent tandem read with these two chapters of Locust Effect. In the developing world, imperial political economy drove the evolution of law enforcement and public justice—the languages used, the way resources were allocated, the overall goals of local enforcement (166-167). The incoherent, rapid, and unprepared way by which former colonial police, intelligence and justice systems were taken over by newly-decolonized states fostered the vacuum one sees today, which, in turn, precipitated the growth of the private security industry. The overwhelming use of privatized security is simply a late 20th and early 21st century manifestation of the same political economy driver.

The last part of the book examines possible avenues for improving or reforming law enforcement in the developing world. Haugen and Boutros insist that when it comes to international aid (whether governmental or non-governmental in character), the program flavor du jour is overly focused on broad, “rule-of-law” approaches that often don’t get down to the nuts-and-bolts of law enforcement infrastructure or training. Moreover, because governments like the United States are (understandably) more interested in protecting citizens from threats which directly impact domestic well-being—terrorism and drugs, for instance—the emphasis on US foreign police training has been almost exclusively centered on counterterrorism and counternarcotics, with comparatively smaller amounts aimed at human trafficking.

In contrast, Haugen and Boutros talk in depth about IJM’s dual approach of “structural transformation” through “collaborative casework.” Over the years, IJM has honed its ability to identify jointly with local law enforcement concrete violations that can be investigated, brought to trial, and result in convictions. In the realm of sex trafficking, this can also include jointly-run surveillance, management and debriefing of confidential informants, undercover operations, and brothel raids. As the co-authors put it, by doing “collaborative casework,” one slowly identifies systemic and structural problems which can then be addressed— jointly—at the local, national or even international level. “Collaborative casework” builds trust and, just as importantly, empathy, between IJM personnel and national law enforcement and public justice officials on the ground. IJM’s Project Lantern—a Bill and Melinda Gates Foundation—funded initiative that successfully decreased the number of available children in the commercial sex industry in Cebu City, Philippines – gets top billing in this section (and I would recommend reading the project report in conjunction with Locust Effect).

Haugen and Boutros have no illusions about the existence of “magic bullets” or the possibility of overnight improvements to law enforcement in the developing world. One thing I appreciated as a historian about Locust Effect was the co-authors’ discussion about the time and effort it took to professionalize policing in the United States, and how such transformation was often undesired and only able to take hold in fits and starts.

This perspective is valuable because, I would argue, this effort is likely to inaugurate a new phase in IJM’s institutional evolution. In the conclusion, Haugen and Boutros call for both increased participation of law enforcement experts in development and human rights circles and for more local-level projects, and so I wonder if IJM’s organizational future in its role as a liaison broker and “standards protocol” or “best practices” provider. In this way, IJM and its field offices might act organizationally like the FBI and Joint Terrorism Task Forces (JTTFs). Under the JTTF banner, the FBI leads, organizes, liaises with, deconflicts, strategizes, and trains up personnel from a myriad of government, state and local agencies, and as the number of actors—especially private actors—entering the law enforcement reform arena increases, IJM’s reputation, its institutional memory, its existing local footprint, and its methodologies will be at a premium.

This brings up a second, related point. The work and details involved with policing, prosecutorial, and judicial reform in the developing world may not be able to garner the same level of ‘movement cachet’ (or, for that matter, the theological comfort) for churches and individual evangelicals as has the organization’s rally cry for justice. If I could tweak the Gospel Coalition’s “theological famine relief” motif for a minute, I’d like to see churches or denominations adopt individual IJM field offices in order to stave off “law enforcement or justice famine.” I can also see where churches and denominations might be hesitant to do so given limits on resources and/or concerns about condominium with foreign government entities, negative impact on missionary efforts, and doubts about how such an effort directly connects to gospel outreach. I think it’s going to take greater effort to secure long-term evangelical interest in the subject matter of Locust Effort, and I’m curious if the “neo-Anabaptist turn” popular among the Relevant crowd could result in that “tribe’s” hesitancy about sustained, cooperative involvement with foreign law enforcement. One avenue of theological connection to that particular constituency might be found in some of the “just policing” literature, and I also wonder about a larger, positive role that might be played by Christian police associations and ministry groups (like Fellowship of Christian Police Officers, International Christian Police Fellowship, and Christian Police Association).

In conclusion, it is interesting and certainly understandable that Locust Effect was not directly written or marketed for just evangelicals. Haugen ‘s earlier books (Good News About Injustice, Just Courage, and Terrify No More) were directly aimed at the Christian market and were published by evangelical presses. In them, Haugen focused on imago dei as a justification for Christian involvement in the struggle for international justice and worked diligently (and I would say successfully) to overcome the common evangelism vs. social action dichotomy.

The Locust Effect is definitely more advocacy-oriented than other Oxford University Press books I’ve seen, but there is only one section that explicitly addresses IJM’s Christian character (226). And, honestly, I have zero qualms about this. It is exactly the type of book evangelicals need, and it ties nicely together with the current crop of intra-evangelical writing about vocation, “gospel at work” and ordinary vs. radical Christian lifestyles. What does it mean to involve oneself as a Christian in an arena where direct and explicit “workplace evangelism” may be impossible, but where substantial Kingdom dividends could accrue through longevity, steadfastness, and a commitment to what Richard Mouw has labeled “uncommon decency?” Police, crime analysts, detectives, prosecutors, paralegals — these are not the categories of Christian professionals that usually make the so-called “radical” lifestyle cutoff, but through the targeted application of their “ordinary” skill set (guided by organizations like IJM, hopefully in conjunction with a local church body), the Kingdom impact is immeasurable.

In the end, law enforcement and public justice reform in the developing world is going to require steady, disciplined, and trained expertise— Christians and non-Christians experts alike. It is going to require evangelicals who are just plain good at their jobs, and who are able to use their everyday skills for the common good, knowing that Christ is the Lord of all.

Brian J. Auten currently serves as an intelligence analyst with the United States government and is an adjunct professor in the Department of Government at Patrick Henry College. All non-attributed views, opinions and conclusions in the review are those of the author and not the US government, or any entity within the US intelligence community. This review is based on an advance reading copy provided to the author directly from Oxford University Press.