Christian bioethics: Non-Ecumenical Studies in Medical Morality
Women’s pain remains underappreciated, undertheorized, and undertreated in both medicine and theo... more Women’s pain remains underappreciated, undertheorized, and undertreated in both medicine and theology. The ascetic practices of women in pain, however, can help Christians understand and navigate their own pain and suffering, particularly because they are experienced in the context of chronic illness and disability. In what follows, I argue that Christians would do better to view the pain that accompanies disability and chronic illness as a potential resource for spiritual practice rather than an example of sin or evil. I begin with a brief overview of the most common theological explanations for the relationship between disability and sin within contemporary Christian writings on disability. What is often neglected in these conversations is the acknowledgment of pain in the disability experience. Likewise, discussions of evil often attempt to explain the existence of pain and suffering, but rarely address the practical realities of pain. As a way to begin to remedy the lack of atte...
In this paper I will show how the medical image, presented to the patient by the physician, parti... more In this paper I will show how the medical image, presented to the patient by the physician, participates in medicine’s cold culture of abstraction, objectification and mandated normativity. I begin by giving a brief account of the use of anatomical imaging since the Renaissance to show how images have historically functioned in contrast to how they are currently used in medical practice. Next, I examine how contemporary medical imaging techniques participate in a kind of knowledge production that objectifies the human body. Finally, I elucidate how physicians ought to place the medical image within the context of the lived body so as to create a healing relationship with the patient. In all this I hope to show that the medical image, far from a piece of objective data, testifies to the interplay of particular beliefs, practices and doctrines contemporary medicine holds dear. To best treat her patient, the physician must appreciate the influence of these images and appropriately plac...
The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine
For centuries, philosophers and theologians debated the meaning of monstrous births. This article... more For centuries, philosophers and theologians debated the meaning of monstrous births. This article describes the debates that took place in the early modern period concerning the origins of monstrous births and examines how they might be relevant to our understanding of disability today. I begin with the central questions that accompanied the birth of conjoined twins in the early 17th century as well as the theological origins of those questions. I then show the shifts that occurred in philosophical debate in the 18th century, which reveal the changing understanding of God’s interaction with creation, as well as the burgeoning medical responses to monstrous births. By reexamining these earlier debates, I claim some of the earlier questions posed by philosophers and theologians have been neglected but remain relevant in bioethics debates concerning how best to consider and treat newborns with certain disabilities.
Christian bioethics: Non-Ecumenical Studies in Medical Morality, 2021
Christians have an obligation to attend to the voices of persons who are crying out that their di... more Christians have an obligation to attend to the voices of persons who are crying out that their dignity and very lives are in jeopardy when physician-assisted suicide (PAS) becomes legalized. The following essay begins with an account of the concept of “disability moral psychology,” which elucidates the unique ways persons with disabilities perceive the world, based on their phenomenological experience. The author then explores the disability critique of PAS and the shared social conditions of persons who are chronically disabled and terminally ill. Finally, the author positions the disability critique within Christian moral deliberations on PAS to unearth its significance for Christian ethics. To bear witness to a compassionate God, theological and ethical judgments concerning PAS must seek perspectives from persons who claim that their dignity and even their lives are in jeopardy by the practice.
All people are created in the image of God, which gives every human being a dignity that can neve... more All people are created in the image of God, which gives every human being a dignity that can never be lost or diminished. This article develops a biblically sound understanding of what it means to be in God’s image. Next, it explores how important such an understanding is for people with disabilities. Finally, it traces out a number of implications of that understanding for people with profound intellectual disability.
Jean Vanier offers a unique concept of beauty in which beauty is described as inherent in all hum... more Jean Vanier offers a unique concept of beauty in which beauty is described as inherent in all human beings and revealed in right relationships. According to Vanier, revealing the beauty of every individual is part of the Christian mission and one that requires Christians to properly see and care for persons with disabilities. This essay explores how Vanier’s conception of beauty fits into the larger context of Christian notions of beauty, as well as ways in which revealing beauty through art can be transformative for Christians. The essay begins with a short history of the Western conception of beauty, focusing on the “Great Theory of Beauty” and how it was taken up by Christian theologians. Next, the authors explore Vanier’s own writings on beauty to see how they cohere with and depart from other philosophical and theological conceptions. Finally, the authors discuss how disability art can provide another way in which to recognize the beauty of disability as Vanier understands it.
When a patient is declared dead using neurological criteria, intense emotional and ethical challe... more When a patient is declared dead using neurological criteria, intense emotional and ethical challenges can follow. In our experience as clinical ethicists, consults surrounding the declaration of “brain death” can be some of the most difficult. In what follows, we describe some best practices related to death by neurological criteria (DNC). We begin with important policies hospitals need to have in place to ensure that death is properly understood by all members of the clinical team and place some limits on the authority of families to demand continued “treatment” for deceased patients. Next, we explain how best to prepare families for the diagnosis. We then discuss how to talk to families when breaking the news concerning DNC. Finally, we describe how to approach a family that is resisting the determination of death. Summary: This article advises clinicians on how to talk to families about brain death.
The recent rise in women seeking cosmetic surgery of their genitalia (labiaplasty) coincides with... more The recent rise in women seeking cosmetic surgery of their genitalia (labiaplasty) coincides with the increasing number of surgeons posting videos of these operations on social media accounts and websites. Sociocultural influences significantly contribute to our ideas of what constitutes healthy and pathologic, and surgeons have historically played a role in defining "normal" and "abnormal" anatomy. In the nineteenth century, Saartjie Baartman-a woman with a large posterior and unusually long labia minora-was used by physicians to "educate" the public about these differences. We examine the parallels with the twenty-first century practice of surgeons using social media to educate patients about the operations they perform and discuss ethical and professional hazards associated with this practice.
Significant challenges arise for clinical care teams when a patient or surrogate decision-maker h... more Significant challenges arise for clinical care teams when a patient or surrogate decision-maker hopes a miracle will occur. This article answers the question, "How should clinical bioethicists respond when a medical decision-maker uses the hope for a miracle to orient her medical decisions?" We argue the ethicist must first understand the complexity of the miracle-invocation. To this end, we provide a taxonomy of miracle-invocations that assist the ethicist in analyzing the invocator's conceptions of God, community, and self. After the ethicist appreciates how these concepts influence the invocator's worldview, she can begin responding to this hope with specific practices. We discuss these practices in detail and offer concrete recommendations for a justified response to the hope for a miracle.
Journal of pain and symptom management, Jan 10, 2017
Ill patients may make decisions to continue aggressive life-prolonging care based on hope for a m... more Ill patients may make decisions to continue aggressive life-prolonging care based on hope for a miraculous recovery, and clinicians can find goals of care discussions with these patients extremely challenging. Thus, palliative care providers may be asked to help in these discussions. The concept of "miracle" can express a multitude of hopes, fears, and religious commitments. Effective, sensitive engagement requires the palliative care provider to attend to these variegated hopes, fears, and commitments. This case presents a typology of ways patients express hope for a miracle along with analysis of the motivations and beliefs underlying such hopes and suggestions for tailored responses by palliative care providers.
Christian bioethics: Non-Ecumenical Studies in Medical Morality
Women’s pain remains underappreciated, undertheorized, and undertreated in both medicine and theo... more Women’s pain remains underappreciated, undertheorized, and undertreated in both medicine and theology. The ascetic practices of women in pain, however, can help Christians understand and navigate their own pain and suffering, particularly because they are experienced in the context of chronic illness and disability. In what follows, I argue that Christians would do better to view the pain that accompanies disability and chronic illness as a potential resource for spiritual practice rather than an example of sin or evil. I begin with a brief overview of the most common theological explanations for the relationship between disability and sin within contemporary Christian writings on disability. What is often neglected in these conversations is the acknowledgment of pain in the disability experience. Likewise, discussions of evil often attempt to explain the existence of pain and suffering, but rarely address the practical realities of pain. As a way to begin to remedy the lack of atte...
In this paper I will show how the medical image, presented to the patient by the physician, parti... more In this paper I will show how the medical image, presented to the patient by the physician, participates in medicine’s cold culture of abstraction, objectification and mandated normativity. I begin by giving a brief account of the use of anatomical imaging since the Renaissance to show how images have historically functioned in contrast to how they are currently used in medical practice. Next, I examine how contemporary medical imaging techniques participate in a kind of knowledge production that objectifies the human body. Finally, I elucidate how physicians ought to place the medical image within the context of the lived body so as to create a healing relationship with the patient. In all this I hope to show that the medical image, far from a piece of objective data, testifies to the interplay of particular beliefs, practices and doctrines contemporary medicine holds dear. To best treat her patient, the physician must appreciate the influence of these images and appropriately plac...
The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine
For centuries, philosophers and theologians debated the meaning of monstrous births. This article... more For centuries, philosophers and theologians debated the meaning of monstrous births. This article describes the debates that took place in the early modern period concerning the origins of monstrous births and examines how they might be relevant to our understanding of disability today. I begin with the central questions that accompanied the birth of conjoined twins in the early 17th century as well as the theological origins of those questions. I then show the shifts that occurred in philosophical debate in the 18th century, which reveal the changing understanding of God’s interaction with creation, as well as the burgeoning medical responses to monstrous births. By reexamining these earlier debates, I claim some of the earlier questions posed by philosophers and theologians have been neglected but remain relevant in bioethics debates concerning how best to consider and treat newborns with certain disabilities.
Christian bioethics: Non-Ecumenical Studies in Medical Morality, 2021
Christians have an obligation to attend to the voices of persons who are crying out that their di... more Christians have an obligation to attend to the voices of persons who are crying out that their dignity and very lives are in jeopardy when physician-assisted suicide (PAS) becomes legalized. The following essay begins with an account of the concept of “disability moral psychology,” which elucidates the unique ways persons with disabilities perceive the world, based on their phenomenological experience. The author then explores the disability critique of PAS and the shared social conditions of persons who are chronically disabled and terminally ill. Finally, the author positions the disability critique within Christian moral deliberations on PAS to unearth its significance for Christian ethics. To bear witness to a compassionate God, theological and ethical judgments concerning PAS must seek perspectives from persons who claim that their dignity and even their lives are in jeopardy by the practice.
All people are created in the image of God, which gives every human being a dignity that can neve... more All people are created in the image of God, which gives every human being a dignity that can never be lost or diminished. This article develops a biblically sound understanding of what it means to be in God’s image. Next, it explores how important such an understanding is for people with disabilities. Finally, it traces out a number of implications of that understanding for people with profound intellectual disability.
Jean Vanier offers a unique concept of beauty in which beauty is described as inherent in all hum... more Jean Vanier offers a unique concept of beauty in which beauty is described as inherent in all human beings and revealed in right relationships. According to Vanier, revealing the beauty of every individual is part of the Christian mission and one that requires Christians to properly see and care for persons with disabilities. This essay explores how Vanier’s conception of beauty fits into the larger context of Christian notions of beauty, as well as ways in which revealing beauty through art can be transformative for Christians. The essay begins with a short history of the Western conception of beauty, focusing on the “Great Theory of Beauty” and how it was taken up by Christian theologians. Next, the authors explore Vanier’s own writings on beauty to see how they cohere with and depart from other philosophical and theological conceptions. Finally, the authors discuss how disability art can provide another way in which to recognize the beauty of disability as Vanier understands it.
When a patient is declared dead using neurological criteria, intense emotional and ethical challe... more When a patient is declared dead using neurological criteria, intense emotional and ethical challenges can follow. In our experience as clinical ethicists, consults surrounding the declaration of “brain death” can be some of the most difficult. In what follows, we describe some best practices related to death by neurological criteria (DNC). We begin with important policies hospitals need to have in place to ensure that death is properly understood by all members of the clinical team and place some limits on the authority of families to demand continued “treatment” for deceased patients. Next, we explain how best to prepare families for the diagnosis. We then discuss how to talk to families when breaking the news concerning DNC. Finally, we describe how to approach a family that is resisting the determination of death. Summary: This article advises clinicians on how to talk to families about brain death.
The recent rise in women seeking cosmetic surgery of their genitalia (labiaplasty) coincides with... more The recent rise in women seeking cosmetic surgery of their genitalia (labiaplasty) coincides with the increasing number of surgeons posting videos of these operations on social media accounts and websites. Sociocultural influences significantly contribute to our ideas of what constitutes healthy and pathologic, and surgeons have historically played a role in defining "normal" and "abnormal" anatomy. In the nineteenth century, Saartjie Baartman-a woman with a large posterior and unusually long labia minora-was used by physicians to "educate" the public about these differences. We examine the parallels with the twenty-first century practice of surgeons using social media to educate patients about the operations they perform and discuss ethical and professional hazards associated with this practice.
Significant challenges arise for clinical care teams when a patient or surrogate decision-maker h... more Significant challenges arise for clinical care teams when a patient or surrogate decision-maker hopes a miracle will occur. This article answers the question, "How should clinical bioethicists respond when a medical decision-maker uses the hope for a miracle to orient her medical decisions?" We argue the ethicist must first understand the complexity of the miracle-invocation. To this end, we provide a taxonomy of miracle-invocations that assist the ethicist in analyzing the invocator's conceptions of God, community, and self. After the ethicist appreciates how these concepts influence the invocator's worldview, she can begin responding to this hope with specific practices. We discuss these practices in detail and offer concrete recommendations for a justified response to the hope for a miracle.
Journal of pain and symptom management, Jan 10, 2017
Ill patients may make decisions to continue aggressive life-prolonging care based on hope for a m... more Ill patients may make decisions to continue aggressive life-prolonging care based on hope for a miraculous recovery, and clinicians can find goals of care discussions with these patients extremely challenging. Thus, palliative care providers may be asked to help in these discussions. The concept of "miracle" can express a multitude of hopes, fears, and religious commitments. Effective, sensitive engagement requires the palliative care provider to attend to these variegated hopes, fears, and commitments. This case presents a typology of ways patients express hope for a miracle along with analysis of the motivations and beliefs underlying such hopes and suggestions for tailored responses by palliative care providers.
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Papers by Devan Stahl