Tuesday 13 August 2013

Compassionate Jesus

Compassionate Jesus: Rethinking the Christian's approach to modern medicine, by Christopher Bogosh, takes a look at modern medicine from a Christian point of view.

Having worked as a doctor for over twenty one years and as a consultant in medicine for older people for nine of these, before my "retirement", two and a half years ago, this book was something that I had wanted to see before. Whilst I was working there were many ethical issues yet there seemed to be nothing that dealt with the issues that I met, day to day, from a Christian point of view. Yes, there are books about abortion and euthanasia but there didn't seem to be anything that dealt with the complex day to day issues.

For example, Mrs X is bed bound and doesn't speak from her advanced Alzheimer's Disease. She has had two chest infections in the last six weeks, both were treated with oral antibiotics. She has now come into hospital with a third chest infection which hasn't responded to oral antibiotics. In addition, she has stopped swallowing. Mrs X looks dry, has low oxygen levels and has signs of a chest infection. What do you do? Let's assume that she was given oxygen, intravenous antibiotics and fluids. Her chest improves but she still doesn't take anything by mouth. What do you do?

Mrs X isn't a real patient but typical of many that I saw over my time in medicine. Is she dying? Would another course of antibiotics make any difference? Should she have a feeding tube? Would that make any difference? Is she not eating because she is dying or dying because she is not eating?

This new book doesn't answer all these questions but does start to provide a framework for thinking about this. It seems to be written for American Christian lay people.

The basic tenets of the book are
  • that the modern medical worldview is naturalistic, humanistic, agnostic and evolutionary. The Christian views a person as body and soul but medicine assumes that we are beings with only a body.
  • we should seek God's will rather than a blind desire to prolong life
  • life ends when the heart stops rather than when the EEG is flat.
Taking these points
-Much of modern medicine is humanistic and agnostic. However, we can see common grace in much of medicine as well as the influence of an earlier Christianised society. It would have been useful to have quoted the principles of medical ethics and examined these Biblically. The much quoted principles are said to be
  • beneficence-doing good
  • non-maleficence-not doing harm
  • autonomy
  • justice
-We should seek God's will rather than a blind desire to prolong life. Yes, of course. I suspect that some of the extreme methods of trying to prolong life are more common in the US than here. Mr Bogosh comes from  a palliative care background and seems, in my opinion, rather negative about cancer treatments. Yes, of course they don't always work and they do have side effects but often they do work although they have side effects. It might have been worth saying something about the use of numbers in making decisions. If a condition has a 75% cure rate then it doesn't mean that an individual will be cured but this information is a useful factor in making a prayerful decision.

-life ends when the heart stops. Mr Bogosh argues against the unBiblical thought that the brain is the mind and argues for dualism i.e. we have bodies and souls. He therefore argues against lack of brain activity meaning that life has left and argues for cessation of the heart as the sign of death. This means, that he describes a patient whose heart has been restarted as having "died". The Bible texts that he quotes to support this talk about life do not seem to prove the point. Surely, the soul leaving the body is the moment of death and both cessation of brain activity and the heart beat stopping are merely symptoms of this. 

What I liked about this book
It is really helpful to have a look at modern medicine from a Biblical standpoint and I am grateful that Mr Bogosh has done this. I hope that this book will lead to more Christians examining the issues and particularly, those which face Christian medical professionals in their day to day work.

The first chapter looks at healing and makes some helpful points about the temporary nature of healing, in this life, and the dangers of idolising health and unconsciously imbibing the belief system of modern medicine.

Chapter Four on the book of Job which lists ways to pray when facing illness and death.

The emphasis on God's will being paramount.

Points to note
  • Some of the legal issues are different in the UK. For example, in the wording for a living will it is suggested that this includes asking for a feeding tube in certain circumstances. In the UK, only negative requests in a living will are binding, for example, "I would not want to be ventilated if...".  Similarly, in the UK, the only adult who can make health decisions on behalf of another adult is someone who has been appointed by a Lasting Power of Attorney (health and welfare).
  • This book is directed towards Christian lay people and not doctors. It doesn't give clear guidance for doctors thinking through these difficult issues.
Whilst I think these caveats are important, I recommend this book. It is helpful for those Christians who are employed in healthcare to have some basis on which to start to think about these issues and, subject to the  differences in the UK, it would be a useful starter for others wanting to think through modern medicine from a Biblical worldview.

Compassionate Jesus is available from Reformation Heritage Books both as a paperback and as an e-book and in the UK, from the Christian Bookshop Ossett as a paperback and Amazon as an e-book for Kindle.

Disclaimer 1: I received an e-copy of this book in exchange for this review. The opinions are all my own.

Disclaimer 2: Whilst I am a qualified physician and practised for over twenty years, I no longer hold a licence to practice, having voluntarily given this up in order to devote more time to my family.


  1. Thanks soooooo much for this Sarah. I wrote an email to all the 'older' doctors I knew a few years ago asking some of the questions the books appears to debate and try to answer. I will definitely be reading soon.