The Shift in Healthcare and the Impact on the Definition of Medicine

In their 2021 book The Way of Medicine: Ethics and the Healing Profession, Duke University professor of medical humanities Farr Curlin and philosophy professor Christopher Tollefsen argued that the Western approach to healthcare has shifted in recent decades from the pursuit of objective wellbeing to a consumer industry. In the process, doctors are increasingly seen as “service providers” whose main job is to help patients do whatever they want with their bodies. Just two years later, their analysis seems spot on.  

For example, the healthy functioning of a woman’s body during pregnancy is often treated and even labeled a “disease.” Same-sex couples, who have chosen inherently sterile sexual unions, sue and then lobby legislatures to redefine their inability to procreate as “infertility.” They act as if there’s no difference between a man and woman unable to conceive due to some medical situation and a man and a man unable to conceive due to, well, reality.  

This shift–from medicine as the pursuit of health to medicine as confirmation of our self-expression–is most evident in the transgender movement. In Virginia, a man who claims to be a woman is suing a county for placing him in the men’s jail. He argues that prison officials should be legally bound to accommodate his gender dysphoria under the Americans with Disabilities Act. The ADA was designed to address conditions in which a person was injured or disabled. In this case, a fully functioning and capable person is claiming “disability” because his local prison does not accommodate his individual wishes. The very existence of so-called “transgender medicine” is, in fact, a case in point. Hindering the body’s natural development or cutting off healthy body parts in service of an inner sense of self is an abject perversion of medicine as a “healing profession.” 

According to Curlin and Tollefsen, the way back to a healthy (no pun intended) healthcare system is by recovering the definition of health as “an objective bodily norm for all living organisms.”  

"[L]iving beings have characteristic bodily activities and tendencies, and these activities and tendencies determine what is appropriate—the norm—for them in regard to the well-working of their organic bodies." 

Though that seems obvious enough, restoring this understanding of health requires that the “well-working of our organic bodies” is understood to be a moral good:  

"If health either is not real or is not good, patients have no intrinsic reason to choose health rather than other desired states; nor do physicians have any intrinsic reason to make health central to their practice and profession." 

Of course, despite a great deal of moral confusion infecting medicine, an objective understanding of “health” remains uncontroversial in many areas. Physical pain is real. Hunger is real. Fatigue is real. Currently no one is demanding disability pay because they have to sleep at regular intervals when they’d rather not. 

In the wake of the sexual revolution, doubts about the objectivity and goodness of health are aimed mostly at the makeup and function of our bodies that have to do with sex. That’s not surprising given that the West has spent decades steeped in the idea that sexual activity can be disconnected from morality. 

Once the normal and healthy functioning of human bodies are considered “oppressive” and “optional,” healthcare is reduced to a highly consequential and potentially fatal art project. Gone from the equation are all givens, all purpose, and all moral limitations. If something can be done, and someone wants it to be done, then it should be done.  

The biblical narrative, in contrast, describes human beings (and therefore human bodies) as created by God with purpose. This purpose implies the kinds of physical and moral norms that can undergird a stable understanding of health. The fall explains why things aren’t as they were created to be, undergirding a helpful and objective understanding of “sickness” and disability.  

The redemption provided in Jesus Christ aims at the restoration of God’s creation, which means healing is possible. Thus, the work of medicine is a redemptive activity, with ethical possibility and moral boundaries. Medicine was built on this framework of reality and, without it, could devolve into a moral chaos, where up is confused with down, right with wrong, and health with “whatever we want.” Canada’s so-called “Medical Assistance in Dying” program is the most obvious case in point. There’s nothing about the program that is medical, or assistance, or about dying. Rather, it’s a harm done to unburden us of having to care by killing the one who needs it. 

In a more rational age, MAiD would be seen as the horrifying evil it is. But in ours, evil and destruction are seen as good. This is how a society runs toward death: not only by denying God but by denying the obvious realities of the world He created. 

This Breakpoint was co-authored by Maria Baer. 

For more resources to live like a Christian in this cultural moment, visit Colsoncenter.org