香 港 天 主 教 醫 生 協 會 THE GUILD OF ST. LUKE, ST. COSMAS & ST. DAMIAN HONG KONG

SEPTEMBER 2000

1

Chief Editor: Dr. Michael Poon Board Members: Dr. Francis Mok Dr. Rebecca Yeung Dr. Kenneth Tsang Dr. Martin Lau Home Page: http://medicine.org.hk/guild Correspondence: Newsletter Editorial Board, 1, Tai

Shek Street, Sai Wan Ho, Hong Kong

e-mail: alleluia@netvigator.com FAX: 26838240

Our GuilFederatiolinkage wyear throFederatioRebecca Hong Koour Churhealth caPaul Ho

ynod.

tou

S Again wsufferingspiritual come clo

gh wo

FROM THE EDITOR COUNCIL NEWS: 1. Graduation Mass 2. AGM 3. New Council 4. Report on the conference of

Asian Federation of Medical Catholic Association.

5. Report on Synod Forum THE CATHOLIC DOCTORS’ CHALLENGES FOR THE NEW MILLENNIUM – by Gian Luigi Gigli, MD, President of FIAMC at Jubilee of the Sick Persons and of the HealthCare workers, Rome on 9/2/00 BIOETHICS NEWS

U.S. and British government support HUMAN EMBRYO EXPERIMENTATION

SPIRITUAL REFRESHMENT1. The new prayer of the

catholic doctor 2. A sign in the ward 3. Whose hands 4. How, if at all, does the book

of Job address the issue of suffering? (II) by Prof. Yu

APPEAL LETTER from Sister Ann Gray

FROM THE EDITOR d is one of the members of the International n of Catholic Medical Associations. Our weak ith other countries’ Guild was strengthened this

ugh the participation of the conference of Asian n of Medical Catholic Association. Dr. Yeung had a detail report on this golden event.

ng Diocesan Synod is the current hot issue of ch. We are particularly concerned about the re policy and direction of our Church. Dr. made a nice summary on the 1st draft of the

God who give us strength to continue our

e have the second part of the reflection on from Professor Yu as well as a number of refreshment. Through their words we may se tork.

CONTRIBUTIONS ARE ALWAYS WELCOME. Correspondence can be sent to the editorial board through the above address or e-mail.

COUNCIL NEWS GRADUATION MASS

n June 18, 2000 we celebrated a Graduation Mass for the Medical and Dental students in the Class of 2000 t Wah Yan College Kowloon. We were grateful to

have Father Stephen Chow to hold the Mass for us. This year it was record breaking to have 6 dental graduates and only one medical graduate attending the Graduation Mass. The 6 dental graduates were Charles Li, Polly Kou, Angela Suen, Vera Lam, Cecilia Fung and Janly Mao. Coleman was the only medical graduate attended the Mass. Rebecca Yeung and other council members celebrated with us. During the Mass, all the songs and music were prepared by Dr. Martin Lau. The liturgy given by Fr. Chow and the sharing from Dr. Bosco Chung was very touching and enlightening. At the end of the Mass, souvenirs were distributed to all graduates as a blessing for their future to come

Oa

ANNUAL GENERAL MEETING

I did not attend the Annual General Meetings of the Guild before my graduation.

Somehow I believe that the word "AGM" by itself means lengthy, continuous tedious evaluation and report for 12 hours or mor, as what I experienced during my medical school days. This was proved to be wrong at the Guild. The AGM this year was held at the Hong Kong Club on 23rd June. Fr. Peter Newbery was our guest speaker. He was the executive director of Youth Outreach since its foundation. Fr.Harold Naylor S.J. was our principal celebrant and Fr. John Russell S.J. was our co-celebrant. The beginning of the AGM with a mass reminds me of the ultimate reason that we all come together--we are the annointed servants of God who work in the medical field for Him. There were lots of encouraging sharings and support from the members of the Guild during the reporting session. The audience showed their appreciation to all the effort the council members paid in the past year with applause. After introducing the new council

members to the audience, we had our dinner served, and Fr. Peter Newbery delivered his speech to us. He told us with his vivid voice the situations he and his co-workers at Youth Outreach met on the street during the night time in Hong Kong. By lending a helping hand to the young folks hanging around on the street, they are virtually competing with the others who are also eagerly searching for 'new blood' in their business. Fr. Newbery's sense of humour while delivering the speech did not in any way masked his heartful concern and worries to the young generations in Hong Kong, and he urged us to pay more attention and show the support to their work in helping these children on the street. The AGM ended at around 10pm. It was a pretty new experience to me. Besides remembering the good food, the 'nice' songs we sang on that night, and the old friends I met there, I sometimes would think of those young people the Youth Outreach and the gangsters are 'preying' for while I was on-call at night time. Hope that the Guild will continue to grow with lots of God's blessings and love among

members ourselves.

OUR NEW COUNCIL

Spiritual Adviser: Fr. John Russell 劉勝義神父 Master: Rebecca Yeung 楊美雲 Honorary Secretary: Michael Poon 潘志明 Honorary Treasurer: Caroline Tsang 曾守衡 Council Members: Kenneth Tsang 曾慶廉 Kwan Chi Keung 關志強 Albert Lee 李大拔 Fung Chiu Fai 馮照輝 Robert Yuen 阮嘉毅 Constantine Au 區建恒 Irene Kam 金偉幗 Gary Ying 英浩雲 Jonas Yeung 楊漢明 Tsang Sam Fung 曾三峰 Li Tai Cheong 李大昌 Martin Lau 劉之瑩 Immediate Past Master: Paul Ho 何曉輝

2

3

THE 12TH AFCMA CONGRESS, 12 – 15 JULY 2000, KUALA LUMPUR

T

he AFCMA congress was organised by the Asian Federation of Catholic Medical Associations (AFCMA), and was held at Kuala

Lumpur from 12 to 15 Jul 2000. Dr Rebecca Yeung had attended the conference and would like to highlight a fews points here. About 150 participants from 14 countries attended. Participants included mainly doctors, nurses and pastoral workers etc. The theme of this congress was “Health Challenges in Asia in the New Millennium”. The following is the summary of a few keynote lectures. HEALTH CHALLENGES FACING ASIA IN THE NEW MILLENNIUM – DR DAVID QUEK • The topic is large and a lot of my ideas will be

reflected by other speakers. • So often the fruits of scientific research has not

benefited the human person. Public health challenges • Longevity is a new development and many are

living to advanced ages. Less true of course in countries that are less developed.

• World population is expected to decrease substantially. But people will live longer.

• In 1997 the population over 75 was less than 5% but in 2025 it will be up to 20% in many countries, and profiles will change with a squaring off of the population curve at least in advanced countries.

• We will see greater penetration into urban communities.

Changing patterns of disease • Heart diseases currently predominate, but in some

African countries AIDS is the major killer. Malaria is a growing concern.

• WHO is hoping to contain malaria which often consumes a large part of the national income.

• Anti-malariar strategies: insecticides, vaccines, good drainage, larvicides etc

• Transgenic Green Mosquito? Some developments among researchers point to progress in this direction. Is it safe?

Emerging infections: • more virulent forms of certain diseases,

intrusions new viruses • DALY – disability adjusted Life Year • Neuropsychiatric ailments, cancers, cardiovascular

diseases. • Tobacco related deaths will increase greatly in 3rd

world. • Principles for tobacco control policies must be

advocated strongly in Asia Persistent problems: • Poverty and disease remain related in India and

elsewhere. • Poor government policies are also a factor. • HIV will be a large burden for many, despite

modern medicines, and risk of retrogression. • Immunisation does not reach all areas or people,

and NGO’s need to be supported in their efforts. • Statistics for HIV/AIDS become more horrific by

the day, extending increasingly even to children – with some 33 million world-wide Dec 1999.

• South East Asia countries are increasingly affected. • Expected loss in life expectancy for children born

with HIV is rising rapidly. • A gene remedy for HIV? Economic factors • Economics of health are complex, affecting levels

of fertility and child health. • Many Asian countries still have low income. But

by 2010 most Asians will be close to developed nation status.

• WHO challenges us to reduce excess mortality. • WHO feels 6%-10% of the GNP should be spent

on health care. • Health care is becoming incredibly costly. • Need for wider access to quality health care,

without penalising the cash poor. • Financing options: protecting people from the

financial costs of treatment. • Health care in future – bare essentials? • Internet will change our approach to health care,

with patients who are highly informed about their problems.

• Ethical issues: how we view the human genome, in addition to other problem. How will the new bio-technology affect us, e.g. DNA testing leading to unjust discrimination.

• How will the religious dimensions of human reproductive process. Are these outside the realm of humankind? Are we becoming creators rather than followers and believers? Are we faced with the forbidden fruit? The genetically ideal child?

PROFILE OF THE CATHOLIC DOCTOR IN THE NEW MILLENNIUM - PROF GIAN LUIGI GIGLI (PRESIDENT OF INTERNATIONAL FEDERATION OF CATHOLIC MEDICAL ASSOCIATIONS)

• Let us spend a few moments on the crisis of identify for doctors, for Catholic doctors.

• In a very few years we have moved from an

4

experienced based evidence to one which is based on scientific diagnosis – with a stress on continuous study, research.

• It has changed the way we view the body, the border between life and death, techniques that give us a view of the brain, for example, unheard of just a few years ago.

• We are in the midst of a great revolution, resulting from a post scientific era, a new technological era depending on research and big money.

• This new era is an ideology in itself, assuming for example that nothing exists outside the universe, that man is but another animal species.

• It has a common faith in itself, with a dream of defeating every disease, health and life forever. And the doctor who fails to deliver is seen as a failure.

• It claims to be amoral, but in fact it is immoral. • Man is seen as a disposable object, a subject for

laboratory research and experimentation. • These developments are threatening, especially the

lack of moral principles combined with its sense of invincibility.

• There are no more immutable moral principles, we can now do whatever our society is ready to accept. There is no intrinsic limit to what we can do.

• In medicine as in other disciplines when we move away from moral principles and basic reference points, we come under the power of political forces which demand submission to their agendas.

• The Hippocratic oath in some places is already losing its traditional force and meaning, and Doctors no longer feel morally obliged to serve the

truth of the entire person. • Medicine of today is medicine of effectiveness and

has nothing to offer to terminally ill persons, to those with disabling diseases.

• The doctor is becoming more and more a technician, without compassion or care. The new relationship is between user and supplier. The doctor no longer recognises the dignity of the person, not just in the human embryo.

• Life is not longer an absolute, a human right. The measure is its quality.

• Such medicine no longer appeals to the patient, and many now seek ‘alternative’ medicines.

• It is therefore a crisis not just for the Catholic doctor, but for us all in our intimate relationship with God.

• We are no longer aware of our sins. We find it difficult to accept the authority of the Church. Even bishops are sometimes out of line.

• As Catholic doctors we have to recognise and promote the dignity of the human person, the love and respect for life, to pursue charitable work, express our love of God and prayer, and feel a pastoral responsibility in the life of the Christian community by word and service.

Suggest you read the Charter of the Health Care Workers.

HONG KONG DIOCESAN SYNOD IN YEAR 2000

T Introduc

he Diocesan Synod is a way to express the communion and unity of people of God within a diocese. It is the assembly of selected priests

and other members of Christ’s faithful of a particular Church, which suggests new pastoral projects and, in doing so, assists the diocesan Bishop.

tion

A diocesan synod was established as early as the 4th century and it became normative by the 11th century. During 1969–71, the first Diocesan Convention in the history of the Church of Hong Kong was convoked by the late Bishop Francis Hsu. 30 years have elapsed since the last Diocesan Convention. Cardinal Wu, motivated by the need to review the past and to meet the challenges of the Third Millennium, have judged it opportune to convoke the Diocesan Synod at the being of this millennium. Composition of the Diocesan Synod

membership and their function A preparatory committee was appointed by the Cardinal in October 1999, who consisted of 6 reverend fathers, 1 reverend sister and 2 lay fellow catholic. Rev. Dominic Chan chairs the committee. The committee will propose 13 topics to Cardinal to approve for synodal discussion The total membership of the Diocesan Synod assembly will be around 200 Church members, chosen from among the diocesan clergy, men and women religious and the laity. They will join up into small groups, discuss selected topics and draw up drafts. The first draft has to finish in 3 months’ time. Public consultation to the whole diocese will then take place. 2nd and 3rd drafts will be drawn and the Cardinal will sign the resolved synodal document during the concluding Mass.

7 Groups were organised for synodal discussion :

5

1. Faith Formation of the Laity & lay ministry 2. Youth & young teenage pastoral care 3. Social concerns (servant & prophetic roles) 4. Evangelization (Ad gentes) 5. Marriage & family pastoral care 6. Education & culture 7. The vocation & continuous formation for the

Diocese Priests Group on Social Concerns Being inspired by scripture and stimulated by the teachings of the Church, the social concern group identified six areas of major targets of concern. They are : 1. The new arrivals; 2. The unemployed, later extended to foreign

workers and all workers in their work environment;

3. The marginalized and special needs groups such as the disabled, the elderly, the homeless (streetsleepers), and the sex workers;

4. The care of the environment; 5. Peoples’ health; 6. Peoples’ political participation.

HEALTH CARE

Reflection Message for World Day of the Sick for the year 2000 : Contemplate the face of Christ in the Sick” August 1999“Jesus did not only treat and heal the sick, but he was also a tireless promoter of health through his saving presence, teaching and action. Called to continue Jesus’ mission, the Church must seek to promote a full and ordered life for everyone. In the context of the promotion of good health and quality of life correctly understood, two duties deserve the Christian’s special attention. First of all is the defense of life. The second duty which Christians cannot shirk concerns the promotion of a health worthy of the human being.”

Areas of Concerns of Health Care Services in Hong Kong : 1. Health Maintenance Organisations (HMO) 2. Increasing demand from elderly patients 3. Hospice : 4. Community care : 5. Children & Youth 6. Mental Health 7. Commercial ethics 8. The Marginalized (AIDS) 9. Pastoral Care 10. General

Recommendations Health Maintenance Organisations (HMO) The Church should respond to specific issues, for

instance, healthcare financing issues. Since the Diocese has influence on Government policies, there will be impact on HA and other hospitals. Elderly To nurture care and concern attitudes for elderlies among Catholics in Parishes as from their childhood. For instance, Parishes can organise health check-up days and to anoint the elderlies. Parishioners can provide support and care to singleton & sick elderlies when they are in need. Hospice : To consider setting up Hospice Care Units at Catholic Private Hospitals. Community care : The Church can help in the promotion of awareness among Catholics and the general public about patients’ rights and responsibilities as stipulated in the Patients’ Charter so as to enhance their sense of partnership in their own health. Parishes can actively promote and encourage care & concern for needy patients, especially chronic patients. Children & Youth Diocesan Schools can coordinate the establishment of a committee with representatives from schools, parents, doctors, and hospitals/health institutions to promote physical & mental health for children & adolescents. Education Department, Health Department/Hospital Authority, Catholic institutions, social welfare agencies can jointly organise an “Adolescents Healthy Growing up Day” to promote awareness among children/adolescents in health. Mental Health Parishes can help those who have recovered from mental illnesses to build up confidence/spirit basing on Gospel values and integrate into the community Commercial Ethics Parishes can promote education/awareness among Catholics about food health. The Diocese can also influence the Government for better monitoring measures. The Marginalised (AIDS) Thorough research of local services to refer HIV/AIDS affected persons for volunteer chore assistance, case management, counseling, support groups, housing and food assistance.

Recruitment of volunteers from the parishes for AIDS service agencies. Education for all parish constituencies about the experience of AIDS that people have, issues around preventing transmission of the virus and importance of acceptance for HIV/AIDS affected persons to avoid unnecessary discrimination.

6

The mission and role of Catholic private hospitals should be reviewed in relation to services for the Marginalized, e.g. HIV/AIDS affected persons should be accepted by Catholic hospitals for services. The Catholic Church is to raise the standard, upgrade professional status and personal emoluments of pastoral care workers so that they can be well accepted by other healthcare professionals to join the team for holistic care. Pastoral Care The approach of the Diocesan Pastoral Care Services in serving all hospitals need further thinking. Credibility of pastoral care services may be built up through focusing on a few hospitals. It was suggested that resources and manpower allocated to pastoral care services should be increased, development of volunteers’ services should be enhanced. A Sunday can be designated as “Pastoral Care Day” and promotion at Parishes can publicise the work of Diocesan pastoral care services among Catholics and the general public. General In Catholic Hospitals, there should be briefing/orientation sessions on topics like abortion, euthanasia to train the careers. More time & resources should be designated for education in attitude, values, and philosophy. Chances like Team Building

Workshops as well as evaluation/reflection seminars and retreats could provide good opportunities to build up caring spirit based on Gospel values. Catholic Staff Association can be set up at individual hospitals to re-cultivate Catholic spirit and enhance linkage amongst Catholic staff through bible & experience sharing, weekly mass for staff and patients. More support from layman to take up some duties of the priests to release them for religious activities, (e.g. to visit/anoint the sick, especially on Sundays) should be considered. We should revive the role of Catholic priest & pastoral workers, review the objectives of the Church in establishing Catholic Hospitals and enhance religious atmosphere in Catholic Hospitals. Education relating to medical ethics on life/death issues should be promoted. An Ethical Committee can be set up to establish policies/guidelines for healthcare workers to handle difficult situations, making front-line staff more accountable for their actions. The Church should make official statements on issues like euthanasia, abortion. There should be an official spokesman from the Church on healthcare issues. Setting up of Hong Kong Catholic Medical & Health Care Professionals Association should be considered. Setting up of Hong Kong Catholic Hospital Association should be considered. The Church should give more support to Catholic Hospitals and recognize their united force. Prepared by Paul HO

THE CATHOLIC DOCTORS’ CHALLENGES FOR THE NEW MILLENNIUM

BY GIAN LUIGI GIGLI, MD, PRESIDENT OF FIAMC AT JUBILEE OF THE SICK PERSONS AND OF THE HEALTH CARE WORKERS, ROME ON 9/2/00

(synopsis by Dr. Mok Chun Keung)

Expanding knowledge in biomedical sciences and the dramatic changes in society

changed the medical profession tremendously at the end of the 20th Century.

The increase of scientific knowledge in biomedical sciences enhances the process of hyperspecialization which transformed the medical profession, substituting the holistic approach to a practice based on organ

pathology. Nobody seemed to be able to organize the new items of medical knowledge in an harmonic and coherent picture. Technological invasion of medicine led to the decline of the old medical art, made of observational abilities, skillful hands and wisdom. Technology undermined the essential communication of doctor-patient relationship and replaced it by tests. The development of internet also reinforced this development.

As traditional medicine became more and more impersonal, people turned away to alternative medicines. With an almost sacred charisma, these therapies attracted the patients despite any evidence of real effectiveness. There is also an increased request of freedom of choice by our patients especially over modalities of treatment that are not sufficiently validated by scientific research in conditions of chronic disabling pathologies. The

7

other end of this is paternalism. Both attitudes corrupt the necessary mutual trust between doctor and patient leading to legitimate suspicion. Limitation of resources is universal both in affluent and developing countries. In developed countries, health authorities tried to limit the role of public finances in health assistance. Many disadvantaged groups e.g. the elderly, patients requiring expensive intervention, might lack the coverage of health needs. On the other hand, there is an explosion of medicine based on personal desires e.g. sex changes, cosmetic dermatology etc. for those who can afford. Poor societies lack the necessary resources to improve basic health needs of their people. High maternal and infantile mortality, malnutrition, infections etc. are still the daily problems they are facing.

At the turn of the millennium, we are also equipped with the knowledge on human reproduction and genetic intervention. Moral issues like embryo elimination in in-vitro fertilization, embryo for tissue banking etc. need serious study and monitor. What should Catholic doctors do? There are three levels of response to these challenges. At personal level, we should witness the Christian perspective, looking at birth, disease, sufferance, care, healing and death as opportunities of growth. We should oppose the current health culture of avoiding suffering, aging, death and even birth. At the level of the Associations of Catholic Doctors, they should be places for spiritual growth and not just clubs for some good doctors. They should be a strong support to their members to live their faith. A

spirit of communion should be present between member associations inside FIAMC and between the associations and local Churches. Communion is the fundamentals of our credibility. Service to sick person, not just for the body but also for the soul, is an evangelical sign for the world. The third level is to act as social and political witness to promote our beliefs and way of living. Some considerations are: transform some catholic hospital reserved to rich people to hospital opened to everybody; promote international co-operation for justice and charity; take up the sociopolitical task to promote legislation in favor of life. The latter is probably one of our most important contribution to human civilization. (For the full text, please contact Dr. Francis Mok)

8

BIOETHICS NEWS

U.S. and British government support HUMAN EMBRYO EXPERIMENTATION

On AUGUST 24 the U.S.government, for the first time authorized the

use of public funds for human embryo experimentation, specifically, with embryonic stem cells. Just in the preceding week, the British government made proposal to parliament for supporting "therapeutic" cloning.

The following is extraction from an interview with Daniel Callahan, who founded the first Bioethics Center in New York in the 1960s. What are the ethical problems? Callahan: Every genetic technique entails ethical problems. The cloning of cells obtained from the embryo seems like an atomic bomb. Today we have no idea where it could lead us. This is

really slippery ground. Moreover, biotechnology in medicine affects a minority of people with health problems, whereas nourishment is a primary good that – like air and water - affects the human species. We wonder if it is really safe, if there are health risks, what happens in countries where it is produced. Then, if the production is controlled only by some multinationals, what will poor or developing countries do, if they must depend completely on these giants? These are the ethical problems. Avvenire: What do you say to scientists who, contrary to the limits imposed by governments, justify their own research, claiming plurality of options? Callahan: Although pluralism must be respected, it is necessary that general solutions and norms be elaborated that are not just based on consensus or procedure, but that

commit groups. If personal morality is lowered to the mere exercise of free choice, without any available principle for a moral judgment on the quality of these choices, then the law will be inevitably used to fill the resulting moral void. This is a situation in which science, technology and, almost inexorably, medicine itself are debating. The Pope is not opposed to scientific progress; on the contrary, he urges human progress. "Science itself points to other forms of therapeutic intervention, which would not involve cloning or the use of embryonic cells, but, rather, would make use of stem cells taken from adults. This is the direction that research must follow if it wishes to respect the dignity of each and every human being, even at the embryonic stage."

9

SPIRITUAL REFERESHMENT

Lord Jesus, Divine Physiand entrustethe trials of entrusted to of your mercand compasyour divine F You who areas medical dsick to treadYou. You who arepenetrate theorder to disc You who are'Gospel of lconception tespecially th Make us O encounter inpreceded uscare structur Bless our stgrant to us, hend of our experience tpeace. Amen. The Vatican,

THE NEW PRAYER OF THE CATHOLIC DOCTOR, RECENTLY WRITTEN BY THE HOLY FATHER

cian, who in your earthly life showed special concern for those who suffer d to your disciples the ministry of healing, make us ever ready to alleviate our brethren. Make each one of us, aware of the great mission that is him, strive always to be, in the performance of daily service, an instrument iful love. Enlighten our minds, guide our hands, make our hearts diligent

sionate. Ensure that in every patient we know how to discern the features of ace.

the Way, provide us with the gift of knowing how to imitate you every day octors not only of the body but of the whole person, helping those who are with trust their own earthly path until the moment of their encounter with

the Truth, provide us with the gift of wisdom and science in order to mystery of man and his transcendent destiny as we draw near to him in

over the causes of his malady and find suitable remedies for it.

the Life, provide us with the gift of preaching and bearing witness to the ife' in our profession, committing ourselves to defending it always, from o its natural end, and to respect the dignity of every human being, and e dignity of the weakest and the most in need.

Lord, Good Samaritans, ready to welcome, treat, and console those we our work. Following the example of the holy medical doctors who have , help us to offer our generous contribution to the constant renewal of health es.

udies and our profession, enlighten our research and our teaching. Lastly, aving constantly loved and served You in our suffering brethren, that at the

earthly pilgrimage we may contemplate your glorious countenance and he joy of the encounter with You in your Kingdom of joy and everlasting

29 June 2000

10

11

WHOSE HANDS A baseball in my hands is worth about $6 A baseball in Mark McGwire's hands is worth $19 million It depends whose hands it's in A tennis racket is useless in my hands A tennis racket in Pete Sampras' hands is a Wimbledon Championship It depends whose hands it's in A rod in my hands will keep away a wild animal A rod in Moses' hands divided the mighty sea It depends whose hands it's in A sling shot in my hands is a kid's toy A sling shot in David's hand is a mighty weapon It depends whose hands it's in Two fish and 5 loaves of bread in my hands is a couple of fish sandwiches Two fish and 5 loaves of bread in God's hands fed thousands It depends whose hands it's in Nails in my hands might produce a birdhouse Nails in Jesus Christ's hands produced salvation for the entire world It depends whose hands it's in As you see now, it depends whose hands it's in. So put our concerns, your worries, your fears, your hopes, your dreams, your families and your relationships in God's hands because it depends on whose hands it's in.

A SIGN IN THE WARD :

Interns think of God Residents pray to God

Doctors believe they’re God

W

FO

MASS FOR THE DECEASED

12/11/00 10:00AM – 11:00AM

AN YAN COLLEGE HONG KONG

LLOWED BY SHORT GATHERING

HOW, IF AT ALL, DOES THE BOOK OF JOB ADDRESS THE ISSUE OF SUFFERING? (II)

Prof. Victor Yu Professor of Neonatology

Monash University Director of Neonatal Intensive Care

Monash Medical Centre

We would like to acknowledge and thank Victor for his kindness and support for the Guild in agreeing to print

his work in the Guild's publication.

WHY DOES SUFFERING HAPPEN?

What is the cause of suffering?

Many think that this is the important question to ask about suffering. At a personal level, the question is, ‘Why am I suffering?’ Unfortunately, the book of Job gives only a partial answer to this question:

The acute pressure of the problem of suffering is not the pain. The pressure point is that one is forced into suffering without knowing whether or not there is any reason to have to suffer . . . As far back as the 6th century BCE when the book of Job was composed, the poet of that book was convinced that the encounter with suffering could not be understood.1

All Job’s three friends contended that his suffering was a sign of hidden sin (5:7-11; 5:8-16; 8:11-22; 11:4-6, 14-20; 18:5-21). Eliphaz implied (4:11) and Bildad stated (8:2) that Job’s children were killed as punishment for their sins. No single meaning for suffering was offered: for the wicked, it was judgement (15:20-35); for the ethically unsteady, it was a preventive warning (33:14-30); and for the morally immature, it was a form of educational discipline (5:17-19). The reiteration that Job was blameless and upright in the prologue (1:1, 8, 22; 2:3) and the final condemnation of the three friends by God (42:7-8), help reject the idea that Job suffered because of sin.

To Job, the origin of his suffering remained a mystery to the last, implying that the author of the book never regarded this as the primary question to ask about suffering: ‘In the end, however, readers cannot discover from the book any one clear view about what the reason for their own particular suffering may be, nor any statement about the reason of human suffering in general.’2

Who is the cause of suffering?

We might wonder from reading the book of Job that God is a capricious deity (9:22-24; 21:7-33; 24:1-17), ‘In insecure, immoral, unjust, and suspicious tyrant’.3 The first two chapters make the subtle but important distinction that God did not directly cause Jobs suffering. God permitted it, but Satan acted as the causal agent within the limits of Gods sanction. Thus, all forms of dualism are radically rejected.

The fact that suffering falls within the sweep of Gods sovereignty gives us reason for hope. The fact that Job did not succumb to Satan’s evil plan, but prevailed in his faith (2:10; 13:15), encourages us when we find our own faith severely tested: ‘Faith without dishonesty or illusion, faith that wins in the teeth of savage and senseless chaos - such is the theme of our book.’4

The role of Satan in the book of Job anticipates his role in the rest of the Bible. Satan plagued Job physically and spiritually, not to lure Job into acts of sin but to tempt Job to the sin - disloyalty to God:

Satan’s intentions are harmful. He represents conflict and ill-will. His purposes are contrary to God’s aims and hostile to Job’s welfare . . . He is a creature of God, yet an enemy of God’s will . . .

1 Daniel Liderbach, Why do we suffer? New ways of understanding (New York: Paulist, 1992), 47. 2 David Clines, Job 1-20. World Biblical Commentary, volume 17 (Dallas: Word, 1989), xxxviii 3 Harry Potter, ‘Rebel against the light: Job or God?’, Expository Times 103 (1992): 198. 4 J. H. Eaton, Job (Sheffield: JSOT, 1985), 50.

12

Loyalty, trust, and allegiance are the essence of biblical piety, the roots from which stem all fruits of righteousness. The Satan, as is ever his pattern, sought the root of the matter: Job’s relationship to God.5

As scepticism requires less effort of mind and heart, suffering has been called ‘the greatest single obstacle to faith’.6 Often, disillusionment with God begins in Job-like circumstances. The book illustrates that suffering can have a telling and far-reaching effect on our religious convictions:

The annals of history teem with persons of otherwise mature action who have discarded their religious convictions because after what seems to them sincere and honest efforts to evaluate the situation, they have been unable to reconcile the depth, extent and apparent injustice of suffering in the world generally, and in particular as they themselves have been affected. Against this, however, it is necessary to set the multitudes who have plumbed the depths of human suffering, and who have emerged from that experience with a vastly wider conception of the scheme of things, enriched and ennobled by the dominant spiritual tone which has supplied for them a means of probing the mystery.7

IS THERE INNOCENT SUFFERING?

When we encounter suffering, it is natural to ask, ‘That have I done to deserve this?’ The book convincingly demonstrates the existence of unmerited suffering without denying that sometimes suffering is richly deserved.

Despite their disagreements, a common denominator between the theology of Job and his friends is their belief in divine double retribution: God without exception punishes the wicked and rewards the righteous. In the second cycle of speeches, Job’s initial prosperity was explained by Eliphaz (15:17-35) and Zophar (20:4-29) only as temporary reprieve before God’s retributive judgement. Job challenged the validity of exact individual retribution dogma by citing examples of the prosperity of the wicked and the agony of the righteous (21:7-16; 24:1-17), a fact which is supported by other references in the Old Testament (eg. Ps 37:1-3; 49:5-12; 73:1-9; Jer 12:1-2; Hab 1:5-13). Yet, when Job accused God of unjustly punishing him for sins he had not committed, he subconsciously retained the same dogma himself.

It is true that Old Testament covenant theology presupposes reward for obedience and punishment for disobedience in the Decalogue (Ex 20:1-21), the Covenant Code (Ex 20:22-23:33) and the Holiness Code (Lev 16-26). It is a major theme of Deuteronomy (Deut 4-11, 28-30). Suffering as punishment for sin is a recurrent motif in the historical books (1 Kgs 16:17-19; Chronicles). The Psalms (eg. Ps 1), Prophets (eg. Isa 58:6-14; Jer 7:5-7; 12:14-17; 17:5-8; Hos 10:11-14), Proverbs and other wisdom literature reiterate the message that God punishes both individuals and nations for their sins.

However, the covenantal formula, ‘If you sin, then you will suffer’ is never so mathematically rigid and symmetrically precise that it becomes an absolute principle. The book of Job is a canonical corrective against the simplistic and faulty reasoning of Job’s friends who reversed the cause and effect to articulate, ‘If you suffer, then you have sinned’. It guards against an ‘overreading and mechanical application of a proper biblical retribution theology’8 by showing us a man who is suffering for a reason other than his sin. Even Jesus himself spoke out against the notion that suffering must imply sin (Jn 9:1-5; Lk 13:1-5). Together with Noah and Daniel, Job was credited by Ezekiel (14:14) as one who was righteous. His blameless record included pure inward motivations and attitudes towards God and neighbour (chapter 31), ethical standards unparalleled until the Sermon on the Mount (Matt 5-7).

This book also refutes the corollary that God owed Job material blessings for his obedience. Firstly, Satan’s claim that Job served God only for profit (1:9-11) was proven incorrect by Job. Secondly, although Job demanded that God gives him a fair trial (10:2) and tried to subpoena God for testimony (31:35), the book shows that God’s free sovereignty is obligated to no one, and divine-human relationship is not a business contract of mutual claims that is binding in court (41:11).

5 William Sanford LaSor et al, ‘Job’, In Old Testament survey, 2nd edition (Grand Rapids: Eerdmans, 1996), 494. 6 Graham W. Hardy, ‘The mystery of suffering’, Expository Times 68 (1957): 215. 7 Roland K. Harrison, ‘The problem of suffering and the book of Job’, Evangelical Quarterly 25 (1953): 18. 8 Raymond B. Dillard and Tremper Longman III, ‘Job’, In An introduction to the Old Testament (Grand Rapids: Zondervan,

1994), 209.

13

APPEAL LETTER FROM SISTER ANN GRAY Dear Friends,

I am writing to you as the coordinator of Action for REACH OUT, a non governmental organisation and charitable institution which was set up in 1993 to offer services to sex workers in Hong Kong. This includes local women and those who come to Hong Kong from

countries in other parts of Asia. With the needs of individual women in mind, the services we offer include referral for health screening, HIV/AIDS and STD testing, other forms of employment, temporary shelter, legal advice, counselling and support groups in their own countries. We also have a telephone hotline which is open to all women who work in the sex industry and we do outreach in the various areas where the women work on the streets and in the nightclubs. Our drop in centre is a place where the women can come to relax, seek advice when they have a problem or bring their children to play. It has taken a long time and much patience to be accepted by this group of women but we are now being richly rewarded in the deep trust they place in us and the genuine affection they share with us. Sex workers are generally looked down upon in Hong Kong as they are in many other countries, but for us in Action for REACH OUT they are women who often make ultimate sacrifices for the sake of their families, especially their children. Many of them are single mothers who work long hours to provide themselves with the financial support they need for their families. The other week during our outreach on the streets of Sham Shui Po, we spent some time talking to A Lin who, a few months ago, gave birth to her third child. That evening she told us how difficult it is for her to make a living. Hong Kong’s economic recession is having a serious effect on her source of livelihood and the previous day she had earned no money. Trying to be optimistic, she told us, “It doesn’t matter if I don’t have enough to eat but, no matter what, my children need to eat.” A Ying is in a similar position, with four children under the age of 14 years and the youngest only a few months old. At least once a week she has been coming to our drop in centre and working with us to prepare our outreach materials. For this we are able to offer her a small remuneration. The first time she prepared to leave after working with us in this way, she told us, “Now I can buy some milk for the baby.” Many people would very quickly decide that women like A Lin and A Ying are not good mothers – working on the streets as they do, exposing themselves to all sorts of health risks, including HIV, and many other dangers. But I have seen both of them with their children and I have witnessed the love they have for them. A Ying’s six year old daughter is one of the brightest and happiest children I know, sharing with us on the staff here the joy she experiences in what we would consider to be a very disadvantaged life. Here in Action for REACH OUT we would like to offer as much support as we can to women like A Lin and A Ying. To ensure that their young babies can have at least a good start in life, we are trying to provide them with a year’s supply of baby milk powder and napkins, both of which are very expensive commodities which they need to buy. I am now writing to you in the hope that you will consider making a donation towards this new project of Action for REACH OUT’s. If you are able to join with us in this project I would be grateful if you would send a cheque made out to Action for REACH OUT (and send to P.O. Box 98108 Tsim Sha Tsui P.O., Kowloon) or deposit your donation directly into our account (Hongkong and Shanghai Bank, Action for REACH OUT 004-500-527981-001). If you make a direct deposit, I will gladly send you an official receipt if you send me your name and address. If you would like me to send you any more information, please do not hesitate to contact me. Yours sincerely, Sister Ann Gray (Coordinator)

14