This article reflects on the intersection of the New Testament’s witness with current questions of illness, medication, risk, luck, death, and hope. Drawing principally on the Gospel of Matthew and the letters of Paul, I argue that, for Christians, hope in the resurrection—not the ability to avoid suffering and death—provides the best context for prudential judgment in light of the inscrutability of the future and the concomitant opacity that attends medical decision-making. We do not and will not know what we (...) would need to know in order to make decisions we can count on with surety, and we thus read Scripture in order to become the people who can make wise judgments in the meantime called hope. (shrink)

As a way forward in assessing how the Old Testament wisdom tradition might speak to decisions in a modern medical context, in this paper, I propose exploring the iconographic function of the “tree of life” in the Old Testament, which is consistently associated with both wisdom as well as life and health, in order to tease out two-related issues that can help in providing a Christian theological framework for thinking about the problem of the medicalization of risk: first, how should (...) the natural and good human desire for health and long life be framed in terms of the pursuit of wisdom? And, second, how might a sapientially formed character approach risk and uncertainty in making medical decisions? The answers to these questions help establish a framework in which more specific questions related to the medicalization of risk can be assessed. As such, this paper is deliberately programmatic and perspectival rather than prescriptive. (shrink)

Beginning in the nineteenth century, social statistics inspired a vision of society as a population characterized by a certain distribution of risks. The introduction of the risk paradigm has deep implications for central concepts in Christian social ethics like distributive justice, with this vision leading to a new concept of distributive justice as the equal distribution of risk. This essay describes tensions that arise due to the risk paradigm in relation to distributive justice: risks can always be further reduced, risk (...) mitigation creates other risks, and there is no inherent rule of justice for balancing risks. While recognition of shared risk can create social cohesion, it also leads to interest groups struggling over which risks to confront. The essay illustrates these problems with two examples from health care: preventive health programs that manage disease risk through medication, and debates over school closures in respond to the Covid pandemic. Christian bioethics, as it wrestles with issues of justice, must address the problems created by the risk paradigm. (shrink)

The medicalization of risk rests on foundational assumptions shared by economics and public health. Economists, however, think in terms of pursuing an array of goods, and hence, they offer useful critiques of the irrationality involved in trying to subordinate all goods to one narrow good, like avoiding death from a particular disease. Many of our approaches to health do not appear to be fully rational, suggesting that the deeper motivation lying behind our concerns about health are to be found in (...) something other than the impulse to extend human lives as much as possible. This paper draws on the theology of St. Thomas Aquinas to sketch a richer way of thinking about the goods we pursue in health care that can help us to avoid the pitfalls associated with the medicalization of risk. (shrink)

Suicide is a leading cause of death in the United States and in many other parts of the world. As such, suicide is frequently framed as a medical and public health problem for which solutions are best recommended by medical and public health authorities. While, medicalized suicide prevention strategies often resonate with traditional Christian commitments to preserve life and to discourage suicide, there is little evidence to date that medical approaches to suicide risk-reduction decrease population rates of suicide. Further, by (...) treating suicide as a phenomenon that can be eliminated through technical managerial control, modern suicide prevention efforts construe suffering persons as carriers of risk best managed by standardized and often dehumanizing environments of care. This emphasis on the medical management of risk also erodes the clinician–patient relationship and inappropriately centers medical (e.g., systematic health screenings) rather than non-medical (e.g., access to housing) forms of response. Although, medicalized suicide prevention efforts should not be dismantled, those working to prevent suicide would do well to prioritize a positive commitment to human dignity and worth and to engage social and political systems beyond medicine and public health, while drawing on specific contributions that clinicians can offer. (shrink)