'Change is the only certainty' is a popular but erroneous catch phrase. The changes in medicine over the last century have indeed been dramatic, but what has actually changed? We frequently change the organisation of the UK National Health Service (and sometimes appear to be going round in circles) and we can treat far more conditions more effectively than ever before. However, we hardly ever cure anybody's disease and the maximum length of life has not increased since the days of Noah: physical death always wins in the end, as it has done since the beginning of time.
Our ethical dilemmas, although more complex and pressing, are still about the same issues as they have always been - the value of the human person, fairness in allocation of resources, patients' autonomy and confidentiality. The challenge to all in the medical world is to distinguish temporary changes and cultural differences from eternal unchanging values and to apply these values in the very varying situations around the world.
That is why this book is so important at this time. The International Christian Medical and Dental Association (ICMDA) links groups of Christian doctors and dentists in many countries throughout the world and this volume is a selection of addresses given at the ten world conferences and fifty regional conferences which have been held over the last thirty five years. The editors have done a magnificent job in selecting from a huge amount of material and then grouping and correlating the different contributions.
There are 61 authors from more than 20 countries and they range from those in western academic practice, to pioneer missionaries and rural practice in developing counties, to theologians and experts in palliative care.
The contributions are grouped under five sections: The Firm Foundation, Relationships, Ethical Principles, Christian Practice, Responsibilities. Where there has not been room to print a whole talk, a short summary has been included and this whets the appetite for more!
The Firm Foundation contains a most lucid, succinct and comprehensive account of the unchanging Christ, given by Arnold Aldis - a surgeon - in 1978. Many household names of the Christian world appear in the other sections: Denis Burkitt, John Stott, Paul Brand, Stanley Browne, Martyn Lloyd-Jones and Paul Tournier. But some of the most challenging contributions are by less well-known people, with special experiences.
It is always difficult to pick out one or two from such a fine collection but the pair entitled 'Medical excellence in poverty' and 'Medical excellence in affluence' from rural Uganda and urban Germany respectively are particularly relevant to our own 'excellence culture'. How can there be excellence in poverty? one might ask. Here it is defined as 'God-centred commitment to service'.
There is a wide range of topics including families, sexuality, lifestyle, suffering and the drug problem. The subject index enables one theme to be traced through different chapters and studied from different angles. Throughout, the book shows how Christian values, aims and motivation can be applied to every aspect of medical and dental practice. The final chapter entitled 'The sickness of man - the solution' by Martyn Lloyd-Jones leaves the reader in no doubt that the fundamental human need is spiritual renewal not just physical health.
This collection is a gold mine of wisdom, advice, challenge, reassurance and encouragement and can be dipped into again and again. One is profoundly grateful that these talks are no longer hidden in conference reports but are now available in such an attractive and readable form.
Reviewed by
Alan Johnson MB MChir FRCS
Professor of Surgery, University of Sheffield and Chairman of the International Christian Medical and Dental Association (ICMAD)
