One of the things I've appreciated about Ed Payne in the 15 years I've watched his work is his professional courage. A member of the faculty at the Medical College of Georgia, specializing in family medicine, Dr. Payne is anything but establishment. When he's persuaded that the course his colleagues have chosen is wrong, he says so bluntly-and almost always with biblical warrant.
So I wasn't surprised to learn that Dr. Payne had last month thrown a heavy-duty accusation against the modern medical establishment. Medicine's failure to recognize the inherently religious nature of its task, Dr. Payne said at a Chicago meeting of the Association of American Physicians and Surgeons, brings about even more morbidity and mortality than modern medicine alleviates.
"The crisis of American medicine," says Dr. Payne, "is not tobacco, AIDS, silicone, the Gulf War Syndrome, breast or any other form of cancer, physician-assisted suicide, euthanasia, licensure, medical care for the poor, or any other specific medical or ethical issue. The crisis of American medicine is far greater than any one of these problems; indeed, it is far greater than all of them combined, because the answers to these problems do not come from within them, but from medical ethics. It is the same crisis that faces our culture in every other area: How do we decide ethics? That is, how do we decide what is right and what is wrong? Is there a method which will stand the test of time, or do ethics change with changing cultures? How are medical-ethical decisions made today?"
For centuries, of course, the Hippocratic Oath-still generally taken by medical students when they receive their degrees-has set the standard for tough issues in the medical profession. Now, however, ethicists refer to Hippocrates only when it's handy. The historic oath's prohibition of abortion and euthanasia is regularly dismissed as outdated. "So," says Dr. Payne, "the oath is really no standard at all when one has the freedom to pick and choose what one does or does not like about it." The real issue is not so much the content of the Hippocratic Oath, or of any other standard-but how the standard is derived in the first place.
In his bi-monthly newsletter Biblical Reflections on Modern Medicine, Dr. Payne shows how some folks argue naively for a democratic approach to standard-setting. When enough momentum for a particular point of view is achieved, a "might-makes-right" approach takes over. Or, if agreement seems impossible to achieve, "pluralism" becomes the highest good, as citizens agree to forfeit justice and truth and instead pursue agreeableness as the highest good. If other citizens die in the process, of course, you'll just have to charge that up to the high cost of being agreeable.
But the problem with such thinking, according to Dr. Payne, is that it's not just a few citizens who get sick and die in the process. It's thousands and thousands-and the medical community's deliberate naiveté in the matter carries terrifying consequences. Under four different headings (family, abortion, psychiatric disorders, and crime), Dr. Payne outlined for his Chicago audience the manner in which modern medicine's rejection of biblical values contributes to the problem-and ultimately to the death rate-rather than solving any issues.
A recent report from the Centers for Disease Control included typically common knowledge that is nonetheless far too easily forgotten: 87 percent of all reportable disease is sexually transmitted. Sexual abstinence before marriage and fidelity within marriage absolutely prevent all sexually transmitted diseases. Promotion of biblical standards, and adherence to them, could eliminate 87 percent of all reportable disease. But since modern medicine cares more about trends than statistics, doctors can talk about the impact of tobacco, but not about the impact of sexual behavior.
The result is that the budget at the National Institutes of Health produces these per patient expenditures for research on various diseases: HIV/AIDS: $2,403; breast cancer: $209; Alzheimer's disease: $78; Parkinson's disease: $34; heart disease: $20; diabetes: $20. The dollars flow not in the direction of statistical need, but to those with the biggest megaphones.
Dr. Payne's critics focus on what some call his "preachy" attitude. To the contrary, Dr. Payne would be quite content simply to have his profession engage in straightforward honesty about the statistics they confront. "Should our medical journals become 'religious tracts'? Should physicians 'preach'? No, our medical journals should not become religious tracts, but there ought to be open and honest debate about behavioral issues that are religious with medical consequences. Apart from purely religious journals, that debate is not allowed today. As I have pointed out, ill health and poor medicine have been a result."
If a culture gets the answers to its religious questions wrong, everything else will be on the wrong track as well. At first, the deviations will be small; but pretty soon, they will literally become matters of life and death.
Details about Dr. Payne's publications may be secured by writing P.O. Box 14488, Augusta, GA 30919-0488.