An Open and Relational God and Modern Medicine

By John F. Pohl

Suffering is commonly seen in the field of medicine, and an understanding of an open and relational God can provide insight regarding how to cope with suffering.

Eli, Eli, lema sabachthani?” (Matt 27:46)

“My God, my God, why have you forsaken me?” is often the cry of many people enveloped in healthcare. The parent who loses a child; the person who loses their spouse; the friend who loses a close friend—all are tragic in the setting of healthcare. The other aspect which often is forgotten is the cry of the healthcare worker, especially in the setting of the recent COVID-19 pandemic and the resultant limited healthcare resources, even in developed countries like the United States. Although this essay will be written in terms of being a physician, all other allied health fields (nursing, clinical psychologists, social workers, laboratory technicians, etc.) are likely to have some alignment with my thoughts.

The field of medicine is hard to peg down among the sciences. Part basic science, part engineering, part tactile, part psychology, part family dynamics, part social work—all combine in a complex milieu that consists of the daily labor of the healthcare worker. This mishmash of needs makes healthcare workers, including physicians, more religious compared to individuals in other science fields. For example, approximately 33% of U.S. scientists specifically believe in God, and 32% of scientists who identify as working in the “biological and medical” field state that they have a belief in God. However, physicians appear to have a greater belief in God as surveys of U.S. physicians suggest that 76% believe in God and 55% state that their religious beliefs influence their medical practice.

This survey information is certainly interesting and makes one consider what is happening to the physician both from an epistemological paradigm and from a religious perspective—both objectively and subjectively. The objective aspect is relatively easy to consider. Medicine has progressed from a primitive-type alchemy to an objective scientific method-led endeavor with an emphasis on epidemiology, statistics, and clinical trials. Subjectively, however, physicians frequently deal with suffering. This difficult aspect of life can lead to mental distress. It is one of the most traumatic experiences in life to watch as a patient suffers not only from symptoms of disease but also from their other life concerns, such as remorse, the purpose of life cut short, and the ponderings of the potential of an afterlife. Oft forgotten physicians (and other health care providers) also suffer in such scenarios. They experience fear and concern about patient comfort and safety and can risk anxiety, depression, substance abuse, and guilt over decision making. Indeed, the rate of substance abuse among physicians may be as high as 15%, and the suicide rate of United States’ physicians is twice as high as the general population. Physician anxiety coupled with the potential of substance abuse and emotional exhaustion leads to burnout, which is currently at record levels.

Knowing that most physicians are religious and realizing that suffering can affect physicians in very difficult ways, it is important to understand where open and relational theology can be a beneficial metaphysics for dealing with the tragedies of life frequently seen in the daily work of healthcare. One way to consider this issue is to follow the trajectory of a “theology of nature” which, simply put, means that scientific findings (including medical science) must be considered when developing theories of how God interacts with Nature, which involves humans. Thus, morbidity (from chronic illness or from social determinants of health) and mortality are to be expected in an open theological framework. God grants free will, both for the singular human and for Nature, and nothing is permanent in the universe. The ever-present march toward entropy—as defined by the second law of thermodynamics—is present. A closed system (a person) will have increased disorder. We can prescribe a medication; we can order an imaging study; we can perform a surgery. However, the random mutation of a bacteria’s DNA allows for antibiotic resistance and infection. The random mutation of a human cell’s DNA can be missed by immune system surveillance leading to cancer. These changes are part of the openness of our future. We do not have a controlling God in all things, which should provide us with comfort.

In other words, we do not have a God who “gives” us illness; rather, we are in the presence of God who loves us enough to not control (openness) and to allow us to have a relationship with God. Healthcare workers can take solace that God did not give the patient a social inequity or a medical issue such as an infection, a cancer, a medical or surgical complication. God gives Nature significant freedom / free will which is a great gift. The ability to respond to the presence of God who does not control every possible outcome, in my opinion, prevents a perverted view of theodicy. God did not cause the infection. God did not cause the cancer. God did not cause the lack of food security. God did not cause the medical complication.

What about a relational God? I think God relates to us in our joy and suffering at multiple levels simultaneously, including at the level of the patient, the family, the individual healthcare provider, the healthcare team, the hospital or medical center, and the greater community. God understands what we go through when we go to the doctor’s office for a check-up; when we are told by physicians that our medical condition is improved or resolved; when we are told by physicians that our disease is getting worse or is perhaps incurable; when the healthcare team has to deliver good or bad news. Also, since God is universally present, we can know that God exhibits universal love and has the capacity to exert efficient but never sufficient causation at various levels of creation. Also, I look at the relational aspect of God (in particular, God’s love) as evidence of our world getting better in many ways, such as in medical science.

And I think the world is getting better. Although it comes from a secular perspective, Steven Pinker’s book, Enlightenment Now, provides a panoply of examples of human progress which he attributes to the effect of the Enlightenment Period (c. 1715-1789). Indeed, his findings are impressive—war, homicide, genocide, child labor, education, and many other societal factors are all getting better. My disagreement with him as a Christian is that I believe the world is improving because of the presence of an open and relational God. In the field that I work in daily, I have seen marked improvements in medicine even in the past 20 years in which I have been a board-certified pediatric gastroenterologist. One simply must look at the worldwide decrease in child mortality to see what a miracle the world is constantly experiencing. As a result, I would summarize my belief in God’s open and relational presence as a derivation of the “Forman thesis.” Instead of seeing the sociology of the times precipitating the science of times, I would offer that the sociology of the times propels us to consider our theology of the times. In other words, this relational God allows us to have brains; allows our brains to do science; allows our science to make scientific progress (although, granted, the progress can be slow); and allows scientific progress to produce the gifts of modern medicine (including vaccines, antibiotics, advances in surgery, etc.). Thus, the universal love of God leads to scientific advances and improvement in the human condition.

In summary, an open and relational theology helps our understanding of human suffering in the setting of practicing medicine, including the potential for a better interpretation of theodicy. God allows us to have freedom; thus, disorder will happen which includes breakdowns in the human body’s natural processes. However, understanding God’s love for us, which allows for freedom, as well as God’s universal love throughout Nature, releases many of us from our old misguided belief that God “caused” our pain. Instead, open and relational theology allows us to consider that God’s love is allowing Creation to get better—including in medical science. From a personal perspective, the incorporation of this idea into my own theology has helped me talk to patients about complex medical issues that are common in my daily work.

Question: How does an understanding of the possibility of an open and relational God provide insight into your view of suffering and theodicy?

John Pohl is a pediatric gastroenterologist and Professor of Pediatrics at Primary Children’s Hospital / University of Utah in Salt Lake City, Utah. He is the editor of one pediatric textbook and is an author/co-author of many articles in the field of pediatric gastroenterology. He enjoys running, fly-fishing, road biking, and skiing with his wife and children. You can follow John on Twitter at @Jfpohl.

To purchase the book from which this essay comes, see Partnering with God: Exploring Collaboration in Open and Relational Theology.

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