Eric Metaxis, an evangelical author and speaker, has written a new biography about German theologian Dietrich Bonhoeffer. Bonhoeffer is probably the reason that I am where I sit today as a Lutheran pastor in the Evangelical Lutheran Church in America (evangelical carrying a far different meaning than it does in the media). Metaxis, like many American evangelicals, wants to claim Bonhoeffer as part of the evangelical team. It is a hard sell. Bonhoeffer is German/European and therefore quite far removed from modern American religious culture-specially the more right-leaning Christian movement, which has combined its theology of salvation with public issues like abortion and school prayer and a decidedly anti-government philosophy. It does so as if the Bible, or God, actually takes a position on such things and that they are the representatives of ultimate good in these matters. Liberals, as Metaxis defines them, are the opposition fighting God and God's faithful. There is not a little anger lurking in these woods.

So what to make of the biography? I am reading it and have read a good deal about it from various perspectives. I have read a couple of speeches Metaxis has made regarding his book. So, in a preliminary way, I have to say that I find his work biased. Of course any author has a point of view, but bias is something different. Metaxis has a bone to pick and an agenda to sell. Fundamentally, he is mad at liberals. He believes that the liberals of his imagination are taking this country to ruin. It doesn't take much insight to remark that the extremes of both right and left are afraid that the other will do that very thing, take us either to a fascist or a God-hating future. Both embrace dark and apocalyptic predictions. Metaxis even goes so far as to suggest that there is a connection with Nazi Germany and the Obama administration (you've surely seen those adolescent drawings of Obama with a Hitler mustache). He avoids liability, I suppose, but he walks a thin line.

Personally, I do not recognize myself in his depiction of liberals. And neither do I recognize the Bonhoeffer I read back in college and the years following. I remember a Dutch art historian years ago commenting that the Billy Graham Crusade organization thought, concerned as it was and is with saving souls through an acceptance of Jesus Christ as personal Lord and Savior, that it was giving Europe a gift in one of its overseas soul-saving excursions. He argued that, instead, it was insulting them. That notion has been verified over the years by Europeans I have had contact with and seems to correspond with what I read on the matter. Claiming Bonhoeffer as one belonging to a group that insults Europeans seems a genuine stretch.

Where does he get the idea that Bonhoeffer is more or less an American evangelical? To begin, Bonhoeffer, in his journey to America to study at Union Theological Seminary in New York, favored the black church pastored by Adam Clayton Powell, Sr. in Harlem. He also felt that the liberalism of the time in America lacked a clear classical theological foundation. At least, he said, the fundamentalists were clear and knew just what they were about biblically. He disliked Harry Emerson Fosdick at Riverside Church, a bastion of liberalism. He was uncomfortable at the way Union's students mocked fundamentalism at every turn. But he was deeply taken by the black church and its culture and music. It was alive for him and, as a sensitive and schooled musician himself, he fell in love with the musical heritage he found there. It was quite new to him. As a matter of fact the whole black experience was new to him. He was excited to share his experience where he could.

Some kind of change occurred to Bonhoeffer during this period. As evangelicals are looking for conversion experiences as evidence of religious authenticity, this change has come up as a possible conversion experience. It is suggested that Bonhoeffer moved from being an academic theologian, somewhat detached from his material, to being grasped by the true gospel, entering the company of the saved. He was moved, perhaps. Grabbed by a peak experience, certainly. But he was hardly in need of conversion. The black church may have quickened his social conscience in biblical terms, but he came from a family that taught him the values of justice and concern for the rejected or marginalized in society. But yes, it moved him. It is important not to forget how important the musical experience was in all this. Consider it the sound track to his encounter.

I will need to continue reading the book, but so far I would say it lacks theological and analytical sophistication. It is a good read, as far as that goes, and the anecdotes are interesting. Bonhoeffer is, as always, a charismatic and engaging figure. He inspires. But he knew and accepted higher biblical criticism and read the Bible much differently than modern evangelicals. He knew and respected Rudolf Bultmann, who is famous for "demythologizing" scripture and who strongly opposed evangelical approaches to biblical material. American evangelicals do not as a rule read or even like Bultmann, since his work undermines their basic assumptions about revelation. This side of Bonhoeffer is hardly evident so far.

On the other hand, thank goodness for the conversation. It will only serve in the long term to promote and popularize Bonhoeffer and will encourage many to study his life and work. But careful: he might also be someones ticket out of an evangelical worldview.

Health Care and Theology

I opened my email this morning to find this news alert from the New York Times: 

Monday, August 6, 2012 -- 6:38 PM EDT

Hospital Chain Internal Reports Found Dubious Cardiac Work     


HCA, the largest for-profit hospital chain in the country, is confronting evidence of unnecessary cardiac treatments at some of its medical centers in Florida after a nurse’s complaint prompted an internal investigation. The inquiry found that the complaint was far from the only evidence that unnecessary — even dangerous — procedures were taking place at some HCA hospitals, driving up costs and increasing profits.

HCA, the largest for-profit hospital chain in the United States with 163 facilities, had uncovered evidence as far back as 2002 and as recently as late 2010 showing that some cardiologists at several of its hospitals in Florida were unable to justify many of the procedures they were performing. Those hospitals included the Cedars Medical Center in Miami, which the company no longer owns, and the Regional Medical Center Bayonet Point. In some cases, the doctors made misleading statements in medical records that made it appear the procedures were necessary, according to internal reports.

We all need money and in that sense we all need to make a profit. Businesses need to make a profit. I wonder, though, about necessary human services. We don't tax food because it is a necessity. It could be a significant revenue source for the state and city, but we agree that as a society it would be morally wrong to do it. 

I've often questioned "for-profit" medical care. In my experience those who pursue medical careers do so for the best of reasons. But economics is a powerful force. When a human necessity like health care is based on making a profit, something crucial is lost in the transaction between doctor and patient. When a system knows that the bottom line is making a profit or close down, health care service cannot help but be influenced.

Florida is one location out of many in the country. HCA is one company, even if the largest, providing health care in the country. It is clear that the bottom line has effected how it provides medical care to patients. If the profit lies in medical procedures, increase them. Simple. And corrupt. 

The doctors involved, if they were tampering with medical records, know their own code of ethics and are aware that what they were doing was wrong. There was something more powerful than their own code of ethics at work and it has to be the presence of a bottom line mentality in the system. 

Human services cannot easily embrace a for-profit mentality. What profit, financially, is there in helping the homeless? In providing health care for low income populations? How many can even begin to pay for the expensive procedures available today? Those who work in health care are more aware than I am of the economic issues at hand. I just cannot understand why we would even want to apply the profit motive to health care in the first place. It doesn't fundamentally fit the service. 

Theologically, health is not merely physical. It is a spiritual matter, something that embraces the whole person. It isn't a commodity. It does not, or should not, carry a price tag. But in a capitalistic economy, at least one that has become ideologically capitalistic, nearly everything is subsumed under the idea of economic profit. This is also eating into education, including seminary education for religious leaders. i don't know where this ends, but it seems to have a short shelf life down the road. We will see. But viewing health and health care as a spiritual matter, subject to a code of ethics that honors the dignity, in Christian terms, of the person created in the image of God, then we are bound to consider it differently than as a service designed to maximize profit. Where to draw the lines is complex, but the fundamental assumption we make is important to the outcome.