A Christian View Of Sickness

A large portion of pastoral care, including the portion addressed in Christian worship, is directed to those who battle sickness in some form. Every culture and worldview has a unique way of thinking about sickness, with important implications for how care is administered. The following article describes one way of viewing sickness from a Christian perspective.

Most religious traditions have attempted to make sense of illness and disease. The interpretative frameworks they employ involve elements of medicine, religion, and magic; and in some religions all three elements are totally intertwined. The basic question frequently dealt with is the cause of illness, though this is scarcely adequate. A theological and pastoral approach to illness can not be reduced to questions of origin and cause; it must answer the question of the significance of illness in the economy of creation and salvation. This significance is closely tied with the meaning of suffering in human existence. Illness is a complex reality. It is a physical, spiritual, psychological state with deep social and cultural consequences. Emphasis in the recent past has been put on the physical causes of illness and on the necessary science and technology to eradicate illness. Today, however, there is a greater awareness of the social and cultural factors affecting health and illness and a deeper understanding of the interactions of the physical and emotional. Given the concept of health as a structural and functional wholeness, disease can be defined as the breakdown of such wholeness and integration. Illness represents a disharmony of many forces and fronts. A common denominator of serious illness is the radical disruption of one's ordinary life. Sickness modifies the ordinary patterns of a person's existence, sets the person out of the ordinary sphere of his or her social activities and roles, and brings about a new personal world. Such an occurrence can be accompanied by melancholy, confusion, anger, outrage, depression, and a variety of other confusing feelings. The collapse of one's ordinary world often leads to passivity and a sense of helplessness. Because religion is a basic shaper of attitudes and dispositions, Christianity as a religious tradition can profoundly inform the way believers perceive and respond to illness, and can provide a significant resource for coping with it. The relationship between the experience of illness and faith is a two-way street. If Christian faith can help form interpretations of sickness, sickness itself can alter the shape of one's faith. Severe illness often leads to questions about God and involves a reevaluation of one's whole faith-stance. Illness in the Hebrew Scriptures The Christian stance towards illness has been shaped by a long faith tradition with roots in the Hebrew Scriptures. Judaism is marked by its monotheism. God is the Creator of everything and the existence of everything including man and woman depends totally upon God. Everything is subordinated to God, even evil forces. Furthermore, God is characterized as a God of justice and compassion, attributes revealed in God's covenantal relationship with Israel. Within that theology, illness cannot be attributed to a god of evil, such as the spirit of darkness in Zorastrianism. In the Hebrew Scriptures, a close relationship exists between sin and illness, illness being God's punishment for sinfulness. In Deuteronomy 32:39, God affirms: "?I kill and I make alive; I wound and I heal.?" Both health and sickness are under God's control. The acknowledgment of and repentance for sin is necessary for the restoration of health (Ps. 32:3–5). Sickness is finally not simply vindictive punishment, but a corrective, a possibility for spiritual growth. Illness in the New Testament In its approach to illness, the New Testament reflects the greater influence of Persian thought than earlier Jewish writing. We find in the New Testament a certain modified dualism. Within God's creation, which is basically good, there exists certain evil powers such as Satan who insinuate evil into the world. A real struggle between such forces and God is taking place in the world. Jesus himself, whose ministry is characterized by healing, appears to break through the understanding of illness as a consequence of sinfulness and thus posits illness in a very different light (John 9:31; 11:4; Luke 13:1–11). Jesus does not declare that illness contributes to one's salvation nor does he interpret illness as divine punishment. God does not provoke illness, either as a reprisal or to put women/men to the test. Illness is seen as going against God's compassionate love and as a contradiction to God's plan for creation. Illness in the Church's Tradition The development of New Testament material in the early church took various directions. It seems that the Alexandrian and Capadocian Fathers, especially Basil, were the first to develop a theological doctrine of illness. Their positions were influenced by their understanding of original justice and original sin. Women and men were created to image God, a God understood as impassible and unchangeable. So whence illness? Illness can only be seen as a consequence of original sin, the product of human sinfulness. Basil offers various reasons why Christians are affected by illness. Illness can have a corrective effect. It can be seen as punishment for sin. It can test one's faith and provide a way to develop detachment and the acceptance of death. Discerning the cause or reason for illness was important since it determined whether one should seek possible relief from a physician. Only when sickness is the result of natural causes or is a corrective should a physician be summoned. When sickness is discerned as punishment, it should simply be accepted. Some of this understanding could still be found much later in the church. In 1829, for example, Leo XII declared, "?Whoever allows himself to be vaccinated ceases to be a child of God. Small pox is a judgment of God, the vaccination is a challenge toward heaven.?" Throughout the history of Christianity there has always been a degree of tension between theology and medicine. In certain positions, recourse should be to God alone since God is the source and also the healer of ills for others. In other positions, physicians can be understood as God's instrument in healing the sick. Because of these differing positions, the relationship between the cure of the soul and the care of the body has often been conflictual. A canon promulgated at the Fourth Lateran Council in 1215 (22 Decretales 5:38, 13) affirmed the physician's obligation to call a confessor before taking care of the patient. Following the practice recommended in James 5:14–16, the early church employed a ritual for physical healing, which later came to be used almost exclusively for anointing the terminally ill and for a preparation for death. Compassion for the sick found expression in other ways as well. Already in 372, we find the establishment of a charitable institution, the Basileias, which became the prototype of Christian hospitals. Gregory of Nazianzus in his panegyric on St. Basil refers to this institution as a place "?where disease is regarded in a religious light … and sympathy put to a test?" (On St. Basil, 63). St. Jerome also recounts the establishment of a hospital in Rome by a lady friend, Fabiola. He narrates how she gathered the abandoned sick and nursed them (Epistle 77.6, 1–2). Such institutions as anointing the sick and the establishment of hospitals follow Jesus' example of compassion, whose object was not only the soul but also the body. Moreover, the visitation and the care of the sick has always been encouraged and understood as a basic expression of one's love for God (Matt. 25:35–40). Christian Attitude Toward Illness What meaning, what attitude should a Christian have toward illness? Contemporary existentialist thought has pointed out several important elements of sickness as state of being. Sickness reemphasizes the experience of contingency and the fragility of human existence. Sickness, with all the limitations it imposes on the body, can bring about a deeper grasp of human freedom. Recovery from sickness often entails a greater exercise of one's freedom. Every illness is a limitation upon freedom and an opportunity to transcend such limitation. While illness often tends to isolate, it also leads to a greater sense of dependence upon the "?Other.?" The meaning of every illness is dying; and in a real way every healing is resurrection. In a sense, illness is always a passage point, the threshold between dying and living. Sickness is liminal. Sickness is the enemy of life. The Christian response to illness is a stance of acceptance and of refusal. Acceptance is necessary since illness is the consequence of our finitude and the precariousness of our existence. Refusal is also necessary, for sickness, which is a negative element in life, is often an impediment to human development, weakening one's capacity for spiritual development and self-understanding. Pastoral Approaches Conflicting views on the cause, nature, and meaning of illness have made a pastoral approach to illness difficult. In the medical approach, there is more focus on the illness than on the ill person. In the religious approach, in contrast, there is more attention given to the afflicted person than to the affliction. A holistic pastoral approach would have to pay attention to both the illness and the person. Many contemporary illnesses such as hypertension, cancer, and AIDS do not easily lend themselves to one single pastoral approach. These illnesses are deeply related to stress, to lifestyles, and to relationships. Illness itself affects a person's relationships to God, to oneself, and to one's family and friends. In many cases, sickness is correlative to sin, not in the sense that it is sent upon an individual as punishment, but as a result of personal decision or action. The etiology of many diseases can be directly related to the lifestyle individuals have created for themselves. There is clearly personal responsibility and possible guilt. A pastoral approach to illness must recognize the tendency of afflicted persons either to perceive their sickness as punishment or to excuse themselves completely from responsibility. Furthermore, a pastoral approach must recognize the need to emphasize Jesus' attitude toward the sick. To exhort a sick person to offer her/his suffering to God would imply that there is some virtue in remaining unwell. Jesus never questions the afflicted person's desire for healing. He in fact encourages it. Illness is not meant of itself to "?sanctify?" us, to test our faith. It serves to invite us into the mystery of God's own suffering. What the paschal mystery reveals to us is not the necessity of suffering for salvation, but the great truth that, although sickness tends to isolate us and cause us to withdraw, God is our companion, a fellow-sufferer with us.