The Christian Hippocratic Tradition in Medicine

 

To some people it may seem anachronistic that the aim of Ethics & Medicine is to ‘reassert the Hippocratic consensus in medicine as seen through the lens of the Judeo-Christian tradition.’ What is Hippocratic medicine? As Hippocrates once stated, ‘The medical art has to consider three factors, the disease, the patient, and the physician. The physician is the servant of his art, and the patient must cooperate with the doctor in combating the disease’ (Epidemics, I, 11). These three factors—the disease, the patient, and the physician—informed the moral responsibilities of a physician. The Oath of Hippocrates was written against the backdrop of the patient’s dis-ease. The patient was sick. He or she had a disease which required the physician’s skills to treat. Treatment of disease might consist of a change of diet, the administration of drugs, or surgery. In the application of therapy, the chief concern was the good of the patient. Above all, the physician was to ‘do no harm’. The patient, not the disease, was the primary focus of the Hippocratic physician’s art.

Over time, the Judeo-Christian tradition helped to refine the Hippocratic tradition. In his recent volume, Medicine & Health Care in Early Christianity (Johns Hopkins, 2009), Oregon State University professor of history, Gary B. Ferngren, shows that in classical Greek literature there was little sympathy for the physically impaired or oppressed. Attitudes towards the physically disabled reflected a belief that health and physical wholeness were essential to human dignity, so much so that life without them was not worth living. According to this belief, citizenship, kinship, status, merit, and virtue formed the foundation of claims to human rights or human worth. The basic human worth of orphans, slaves, foundlings, prisoners, and the physically defective was not recognized.

Contrary to these classical views, early Jewish and Christian views of human worth were shaped by the notion that humans were created in the image of God. As Ferngren points out, the doctrine of the imago Dei (image of God) was formative in shaping Christian views of humanity, ethics, and ministry. First, the doctrine gave impetus to Christian charity and philanthropy. Just as concern for the poor was an important feature of the Hebrew scriptures, so charity and compassion were regarded as manifestations of Christian love (agape) and devotion to Christ. Christians were to imitate God’s love for humans by extending love to a brother or sister made in the image of God (John 13:34-35). True religion was defined, at least partially, as caring for ‘orphans and widows in their distress’ (James 1:27), two classes of vulnerable people.

Second, the doctrine of the image of God provided the ground for the belief that every human life had intrinsic value as a bearer of God’s image and the object of redemption through Christ. This was the basis for Christian repudiation of abortion, infanticide, the gladiatorial games, and suicide.

Third, Christian understanding of the imago Dei gave Christians a new perception of embodiment and human personality. Both Greek ascetics and, later, the Gnostics showed no admiration or concern for the body. On the contrary, they despised it and looked forward to the day when they would be released from its prison. The image of God, especially as reflected in the Incarnation, gave rise to notions of a more integrated body and soul, Christ himself being the exemplar. ‘The Christian conception of Jesus as perfect man contributed,’ says Ferngren, ‘to raising the body to a status that it had never enjoyed in paganism’ (p. 102).

Finally, the doctrine of the image of God led to a redefinition of the poor. ‘The human body in all its parts shared in the divine image,’ argues Ferngren (p. 103). This was true of everyone’s body, not merely those of Christians. The poor, sick, and disabled were not to be shunned, but were objects of Christ’s love. ‘Just as God demonstrated in the Incarnation his solidarity with those who suffer, so the members of his ‘body’ must demonstrate their solidarity with the suffering poor’ (p. 104). Celebration of the Eucharist allowed Christians to embrace solidarity with Christ and with all of those made in God’s image. In sum, the image of God, especially as refracted through the prism of the Incarnation, was the basis for Christian compassion and care for those in need.

Together, then, the Christian and Hippocratic traditions offer a robust framework for the virtues of medicine and compassionate care for those who are compromised by illness or disability. The retrieval of those traditions seems a goal worthy of pursuit—for the patient’s good.

 

Editor’s Note: This editorial originally appeared in Ethics & Medicine: An International Journal of Bioethics 26, no. 2 (2010) and is used by permission.

 

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