Vulnerability and Care, by Andrew Sloane, is a conversation starter. At the very least, this exceptional work elicits, even demands, that its readers respond by starting conversations on the morality, nature, and purpose of medicine. Although Sloane questions the ontology of medicine, and does so as a medical professional (and theologian) to other medical professionals, it would behoove non-medical professionals to read what he has to say. Questions are raised that non-professionals in the field, such as this reviewer, might not otherwise have known to ask. For instance, a reader might not realize that the meaning and purpose of medicine is a fuzzy question that changes depending on who is making the definition.
So, what is medicine, according to Sloane’s argument? He makes the case that medicine is a profession, not a set of technical skills driven by consumerism. Even more daringly, he argues that medicine is not really about health and the alleviation of suffering. Instead, Sloane unapologetically uses theology and philosophy to give medicine its defining purpose, and he further asserts that all practitioners in the discipline should likewise be using their values and belief systems to do so. Belief systems, he argues, should be viewed as “innocent until proven guilty,” and that medicine is not value-neutral as so often is claimed (see chapter 4 for further detail on belief-systems).
Sloane believes that medicine is a social practice that is inevitably moral in its nature, involving normative judgements, and thus a profession in the classical sense. Medicine is one of the ways in which a community expresses their commitment to care for vulnerable members within the community that have physical or psychological ailments that compromise and impede their ability to function relationally within the community in a meaningful way. Its goal, therefore, is to care for these vulnerable individuals in “such a way as to enable them to function as members of their community as well as can be reasonably expected” with the community coming together “caring in solidarity for the weak” rather than leaving them to their fate (147). At its core, medicine is an expression of mercy.
Based on this definition, Sloane challenges what is considered appropriate for medical practitioners, taking changing circumstances, situations, and majority-world as well as first-world settings under consideration. He also re-engages what some might considered non-controversial issues, such as organ transplantations, using his paradigm. Even more fundamentally, Sloane makes his readers reconsider the exact nature of human frailty and death, as well as what it means to flourish.
Other questions raised are: can the body and its parts be viewed as property?; and is there a place for belief in the respect of the human body and its parts? While Sloane gives his answers to these questions, he is very careful to give his readers the majority and/or alternative views, which allows his audience to see why there is so much ambiguity and diversity in bioethical issues. These differences all trace back to a few philosophies and epistemologies that provide the roots of these various stances, which Sloan does his readers great service by explaining. Thus, he doesn’t just explain the whatof these issues, but the why.
This reviewer encourages readers who are interested in pursuing medicine as a profession, bioethicists, theologians, or anyone just curious about an insider’s view to read this work. The history, philosophies, and theologies discussed within, as well as the medical and bioethical questions raised, make Sloane’s work well worth the time spent reading.
To sum up this review, let us end with one last quote: “[o]ur weakness, frailty and finitude is an essential, not an accidental, aspect of human existence and our being confronted by it, even in experiences of weakness and suffering, occasions both the possibility of compassionate inter-relationship, and greater understanding of ourselves as embodied creatures” (72-73).
Kristin Vargas is a doctoral candidate in Ethics at Southwestern Baptist Theological Seminary.
Kristin Vargas
Date Of Review:
April 15, 2019