Fall 2013 · Vol. 42 No. 2 · pp. 275–277 

Book Review

Health, Healing and the Church’s Mission: Biblical Perspectives and Moral Priorities

Willard M. Swartley. Nottingham: InterVarsity, 2012. 268 pages.

Reviewed by Denny Smith

Health, Healing and the Church’s Mission provides a vigorous and satisfying argument for understanding health as part of God’s gift of shalom, a model drawn from the Bible (Old Testament and New) and delivered in terms accessible to the lay reader. Swartley sets three goals for the book: to engender a passionate response to the health care issues facing American citizens, to recall the relationship between the triune God and human efforts to effect healing and sustain health, and to propose a proper Christian understanding of the work of health care professionals and the God they serve. The second goal, however, is the principal focus of the book. {276}

Swartley provides an exceedingly rich account of health and healing drawn from the biblical principle of shalom. Shalom is “ ‘wholeness’ in physical health and communal relationships,” but Swartley emphasizes that God intends it for the entire creation. However, God’s creation—a creation that grants agency to humans—is challenged by sin and Satan. Therein lies the source of ill health. Humans, in their frailty, fall victim to illness manifested in suffering. Humans find themselves in a quandary before God but they are not deserted. God is present during illness and suffering in the person of Jesus, our healer and savior. Moreover, the Holy Spirit is a healer and the divine pledge of complete healing. Finally, the church serves as God’s face of shalom. This solidly biblical account of health as part of shalom has the potential to guide the development of a distinctive and comprehensive Christian ethic of health care practice.

Drawing upon several biblical themes and early Christian practices, Swartley outlines the Anabaptist theological foundations for health care, specifically by reflecting on the Anabaptist practice of mutual aid. He conceives of mutual aid as flowing from godly love as present in creation and expressed in the imago Dei. In mutuality, the upholding and aiding of one another, one can see reflections of the Creator’s grace. This mutual upholding occurs in community, in “fellowship, sharing, participation, members[hip with] one another.” It is on this Anabaptist foundation, centered about mutual aid in the spirit of koinonia, that Swartley sets his understanding of the proper work of Christian health care professionals.

Swartley advances his project by addressing modern health care practice, particularly access to health care services in the United States in the second decade of the twenty-first century. Three aspects of this book render his efforts to elucidate the relation between God’s healing and the actual work of health care professionals less successful than his identification of its biblical-theological foundation. First, the author’s objective is to bring “moral passion to the current health care challenges in the United States.” While this is a legitimate and laudable goal, it makes the work a provincial document, particular to a nation, and thus of limited use to those whose interests are wider than American health care issues.

Second, Swartley consistently emphasizes access and cost, leaving the issue of the quality of health care to occupy a diminutive place in the book. For example, Swartley notes that in 2000, the World Health Organization (WHO) ranked the United States thirty-seventh in the overall quality of its health care system. Immediately he cites articles that challenge the validity of the WHO rankings, while he tucks away the counterpoint to these challenges in a footnote: “However this figure is assessed, these authors point out that it is ‘hard to ignore that in 2006, the United States was number 1 in health care spending per capita but ranked 39th for infant mortality, {277} 43rd for adult male mortality, and 36th for life expectancy.’ ” A robust body of American literature on medical errors provides warrant for addressing the broad issues of quality as a substantial part of a passionate response to health care challenges. Lucian Leape, in his Harvard Medical Practice Study of iatrogenic injury in patients hospitalized in New York in 1984, concluded that if the rates of injury in the study cited “are typical of the United States, then 180,000 people die each year partly as a result of iatrogenic injury, the equivalent of three jumbo-jet crashes every two days.” Quality of care is clearly a huge issue.

Third, and most importantly, Swartley leaves the reader without a clear definition of human health and, therefore, its relationship to shalom remains uncertain. He dismisses the WHO definition as too broad and as idolatrous while referring numerous times to some general elements of health. Neither individually nor collectively do these references provide a comprehensive inventory of the elements in life that constitute health. On the other hand, Swartley defines shalom as “ ‘wholeness’ in physical and communal relationships” including “a person’s physical, emotional and mental well-being,” and concludes that “shalom and health cannot be equated.” Interestingly, Webster’s identifies the etymological root of “health” as a Middle English, Anglo-Saxon term meaning whole, “physical and mental well-being.” I note this similarity not to suggest that health must equal shalom, only that the reader is entitled to a forthright explanation of why they must be unequal. Without a clear definition of health and some clarification of its relationship to shalom, the reader is left to wonder how they differ.

Though we will need to look elsewhere for a rich explication of modern health care practice vis-à-vis Christian principles of health and healing, Health, Healing and the Church’s Mission delivers an insightful account of health in the Bible and in early Christian practice. Lucid and accessible expositions of biblical and theological concepts make the book a valuable resource for those who seek to ground their lay and professional health practices in Christian faith.

Denny Smith is a retired professor and a practitioner of dentistry whose scholarly interests included health care ethics and errors in health care. He has lived approximately equal halves of his life in the United States and in Canada. He worships at a Mennonite church.