In the fall of 2023, Dr. Jaime Konerman-Sease gave the keynote address at the annual Christian Medical & Dental Association conference in the Twin Cities. In her address, Dr. Konerman-Sease calls our attention to the deficiencies of what is known as the “cure model” of healthcare; that is, she pushes back on a posture of healthcare that sees a sick patient as merely one holding a disease that must be eliminated. As you’ll read below, Dr. Konerman-Sease is calling Christians to frame our approach to medicine and to healthcare in an teleological sense.

Dr. Konerman-Sease is a Clinical Ethics Assistant Professor at the UMN Center for Bioethics, which provides clinical ethics consultation and policy education for MHealth Fairview. Her scholarship focuses is on disability bioethics, medicine and literature, and religious bioethics. She has published articles in  Christian Bioethics and The American Journal of Bioethics on how the novels of Jane Austin can inform contemporary approaches to healthcare for those with chronic and incurable diseases. 

      —Casie Szalapski, Associate Director of the Center for Faith & Learning

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Dr. Konerman-Sease is one of several Christian voices in the field of medical ethics seeking to change the way we understand the role and pursuit of health as either a healthcare professional or as a human with a mortal body (that is to say, all of us!). In August, we’ll host Farr Curlin, MD, and Chris Tollefsen, PhD, authors of The Way of Medicine, to help us understand and practice healthcare more Christianly. To learn more about the symposium, visit anselmhouse.org/healthcare-symposium.

The greatest commandment in Christianity is to love God and love our neighbor as ourselves (Matthew 22:36–40). But what role do healthcare and medicine play in rightly loving our neighbor? The parable of the Good Samaritan in Luke 10 instructs Christ-followers to care for those in need who we encounter. Luke 10:34 says, “But a Samaritan while traveling came near him and when he saw him, he was moved with pity,” according to the NRSV. However, the original Greek (ἐσπλαγχνίσθη) is more aptly translated “He was moved in his gut”—that is, his entrails or his bowels. The Samaritan had a bodily reaction to help the beaten man, which revealed his deep sensitivity to human life and connection to human need. This story sets the stage not for a universal command to love everyone with efficiency and utility, but to love someone personally, deeply, and because they have been placed in your path. The story ends with the Samaritan paying for the innkeeper’s work with a request to “take care of him.” Because we never learn if the Jewish man recovers in this parable, we can conclude that Christian love does not necessarily mean fixing or resolving the problems we encounter. Rather, to love is to respond. 

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The teachings of Jesus radically changed the way the ancient world conceived of the idea of health, healing, and the practice of medicine. Christianity was surrounded by the Greco-Roman belief that disfiguration, sickness, and dying were events which threatened the health of the nation state and required placation of volatile supernatural powers. The teachings of Jesus, on the other hand, saw illness or disability not as a result of sin but as a witness to God’s love and mercy (“He was born blind so the works of God may be displayed in him”, John 9). The Christian idea that we should keep the sick and disfigured inside the city walls as members of the community and provide them with food, shelter, and medicine, radically destabilized the powerful Greco-Roman elite and established a new moral framework based on caring for vulnerable community members. Taking up medicine was seen as the highest expression of neighbor love. The primary goal was to provide care, treatment, and relief of suffering for the sick and dying. This meant attending to those ostracized because of their illness: the lepers, the disabled, and the unclean. 

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The Christian framework of neighbor love and the limitations of Hippocratic medicine framed the understanding of health and care until the rise of scientific medicine. In a world where elimination of disease was a distant possibility reserved for the miraculous, the word “health” both conveyed a sense of bodily as well as spiritual or mental soundness. Health has clear linguistic connections to “healing” and conveys an understanding of restoration or treatment when it comes to the body. The word cure was also bound up with this understanding. Cure prior to the 1600s was primarily understood as a verb. It designated concern and regard that one must care for the person or object before oneself. Medieval texts that include the latin cura or curatio describe treatments of disease and focus on prevention and palliation. It did not mean elimination of a disease. 

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We can find more guidance on the role that health plays in the Christian life in the 1664 Book of Common Prayer. Daily liturgies like The Lord’s Prayer and the Confession of Sin shape our understanding of how the body serves the ultimate goal to love God and love our neighbors. “The Lord’s Prayer” reveals that Christians are called to use our bodies to physically and spiritually nourish our neighbors, especially those in need (“give us this day our daily bread”). It also recognizes that we face limitations to rightly loving others both on an individual and communal level (“forgive us of our trespasses”). An important theme in the Confession is moderation: “That we may hereafter live a godly, righteous, and sober life.” Moderation leads us to the importance of balance in the Christian life. Life is not totally depraved yet perfect happiness is not possible on earth. As Christians, we should neither give into despair nor should we expect a life without challenges. We do know that flourishing is possible only in God’s eternal reign. God’s reign on earth manifests through the church. While we cannot find that perfect flourishing here on earth, we can work towards some kind of flourishing, a moderate one balanced between extremes. Christians are called to work towards earthly flourishing specifically through acts of love to our neighbors. 

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Health, in the Christian tradition, is only important in its ability to help us love others. Therefore, bodily health is a means to an end. Having a healthy body is not the ultimate goal. Healthy people can still live morally corrupt lives. What matters more than a healthy body are healthy habits—virtues—which allow us to love our neighbors and God well. Health is only a good worth pursuing if it assists towards the ultimate good of Christianity—participating in God’s kingdom. The Christian understanding of health is clearly different from the understanding we have in medicine and healthcare today. In the scientific tradition of medicine, health is the integrated functioning of the mechanistic body. Bad health or disease occurs when there is a failure in a particular organ system—be it the nervous system, the cardiovascular system, or the skeletal system. To provide care to those with bad health is to provide a cure or to solve the organic cause of the failure. Health, therefore, is something that is well within the control of human ability, either through regular habits of health management like diet and exercise or through the ability for science to intervene in the body to reverse the cause of bad health. With the rise of scientific medicine in the 1600s the word “cure” transitions from a verb meaning “to care” into a noun, an object, which encompasses the complete elimination of a disease. The transition of the word “cure” was wrapped up in the idealism of science and philosophy at the time. Scientists and philosophers in the early modern period were captivated by the possibility that science could transform not only the human body but the entire human experience, preventing even death itself. 

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The question for Christians living in a healthcare culture oriented towards cure is not whether to pursue a cure, but rather to what extent should a cure be pursued. A cure is worth pursuing if it will assist us in rightly loving our neighbors. Once the pursuit of a cure takes on such an extreme quality that the pursuit itself prevents us from loving those we encounter, then the cure is no longer a work of neighbor love. Moderation means we avoid both the extreme of forgoing relatively available treatments that could extend our ability to engage in neighbor love and pursuing a cure at all costs so that it harms the relationships around us. When we are supporting others who are sick and searching for treatment, works of neighbor love look like accommodating their needs to ensure they can participate in community life as long as possible. For healthcare providers, neighbor love looks like prioritizing a personal connection with patients and offering support even when a cure is not available. On the community level, we should take seriously our commitment to neighbor love when it comes to the environmental and social harms that can arise from pursuing a cure. If a cure is available, but so costly that it would lead to the exclusion or exploitation of other vulnerable groups, that cure might not be worth pursuing as it is counter to the command to love our neighbors as ourselves. Good health is not the ultimate goal of the Christian life. Good health is only worth seeking if it can assist us in loving our neighbor. Rather than making health our priority, we should shift to questioning how good health can help us love others well and show Christ’s love.