illness, friendship, and moral agency

"For to me to live is Christ and to die is gain. But if I am to live on in the flesh, this will mean fruitful labor for me; and I do not know which to choose. But I am hard-pressed from both directions, having the desire to depart and be with Christ, for that is very much better; yet to remain on in the flesh is more necessary for your sake. Convinced of this, I know that I will remain and continue with you all for your progress and joy in the faith."--Philippians 1:21-25

I’ve just returned from the annual meeting of the Society of Christian Ethics in Dallas, where, among other things, I heard a very edifying paper by Sarah Moses titled “Why Survive?: Discipleship, Friendship and the Elderly.” She puts forward “an understanding of Christian friendship as the mutual relationship in which Christians enable one another to live out discipleship” as a better model for engaging with the elderly than prevailing models of caregiving, in which the elderly are viewed primarily as passive recipients in need of services.

At one point, she references Barth’s discussion of friendship and aging in Church Dogmatics III. Barth’s point there is that when we stop calling upon people to participate socially as responsible moral agents we dehumanize them. It belongs to the human vocation to have something to give to one’s community and to live in a manner that serves the larger common good. Whatever acts of assistance we give to those in need of help, if they are truly acts of friendship, are given not as unilateral gifts of charity, but as steps toward enabling the other person to live out his or her calling for the sake of us all. When we stop expecting and calling forth the best in each other, we cease to be true friends.

Of course, this applies not only to our relationships with the elderly, but also with the seriously ill. As grateful as I am for many words and acts of indulgent kindness and encouragements to go out and do whatever will make me happy, the times I feel most fully human—fully alive—are when I remember that I still have work to. This is why I’m glad I dragged myself out to Dallas in the first place, even though I’d been virtually bed-ridden for several days leading up to it. I had something to present to the group of Baptists ethicists who met on Thursday, feedback to receive, people to interact with. I come home reminded that the long hours of research and writing are pointed in a direction, and that my work is of real benefit to others.

On the other hand, the utter disregard for my responsibility as a moral agent is part of what makes the weekly experience of receiving chemotherapy so horrible. For two hours I sit comfortably in a chair as a patient among patients, none of us with any other duty than to relax, think happy thoughts, and receive medicine from the professionals who take care of us. More than the pain in my hands and feet, more than the itching or trouble swallowing my food, I dread those two hours. And I think it is because, for that time, I am not a responsible member of a community that benefits from my life and work, but a patient in need of unilateral care. Perhaps if I can think of my treatment in more mutual terms, as an act of friendship maximizing my ability to give back, I will be able to do something better with the time than squirm and wish it would end.

The reason I attended Sarah’s reading in the first place is that the title question was one that I had been pondering over the last week. This recent round of treatments gave my body a pretty serious beating. The question arises: what exactly am I fighting for, and at what point do I stop? How many trips to Yosemite or the San Juans, how many visits with old friends, how many movies or card games, how many evenings alone with Karla, before I can finally say “enough” and go peacefully? But this is the wrong question. The better question is, what has God given me to do? What am I to contribute in the time I have? How does my life relate to God’s intention to bless the nations?

But this way of relating to one another is difficult for many of us to grasp. Culturally, we’ve more or less agreed to place no expectations upon each other, to give each other absolute freedom to do whatever one pleases. But such freedom has a dehumanizing, alienating effect. It sends the message that we are not connected to each other, that one person’s actions have little or no meaning to another, that we do not belong to something larger than our own selves. Absent some kind of moral and communal connection, especially as people grow old, sick or needy, we become at best objects of charity with nothing to give in return, and at worst a nuisance. If instead we can talk more seriously about common good and the responsibilities we have to one another as members of communities, perhaps we can move into disease, old age and death with the confidence that, as long as we draw breath, we have something worth giving.