Biblical Foundations for Health and Healing

James F. Jekel

Department of Epidemiology and Public Health
Yale University School of Medicine
60 College St., New Haven, CT 06510

From: PSCF 47 (September 1995): 150-158.

Whether we acknowledge him or not, God is heavily involved in both healing and in promoting health. Acknowledging God's healing role and following biblical guidelines for healthful living should enhance both healing and health promotion. However, not even good nutrition, a clean environment, and healthful behavior will guarantee health. All of these, individually and together will help, but our health problems have their root in the world's (and too often in our own) sin and disarray, which come to us in a myriad of subtle ways.

There is no simple fix to sin and its effects. Ultimately health is the process of being reconciled to the Creator, to other human beings, and to the creation. Biblical health promotion involves making covenant-like commitments to God, to our fellow human beings, and to the creation. This requires embracing the creation as its stewards; embracing other persons, who are made in God's image, as our neighbors; and above all, embracing God Himself as our redeemer.

Do Physicians Heal?

Early in my medical career I became uncomfortable with the gratitude of patients, especially when it was expressed as, "Thank you, doctor, for healing me." I would protest by saying that physicians could only make conditions right for the body to do the healing, but we could not actually do the healing. When it seemed appropriate, I would add that it was the Lord who healed by working through the body's processes (sometimes in unusual ways). These convictions are best expressed by a sign at the Tenwek Mission Hospital in Kenya, which reads, "We treat; Jesus heals."¹

My denial of healing power was as much a personal defense as a philosophical statement, but its truth is seen daily in the lives of acquired immunodeficiency syndrome (AIDS) patients. If there ever was a disease designed to humble the medical profession of this day, AIDS is it. When the God-given healing power of the body is destroyed, medicine can offer very little.

 Why Medicine's Healing is Incomplete

Everyone is familiar with the inability of medicine to prevent or to cure the common cold, although there are medications that can help with the symptoms, and there are effective treatments if complications develop. If there is a deficiency of various clotting factors, insulin, or a hormone (such as thyroid hormone, growth hormone, or anti-diuretic hormone), scientific medicine has substitutes available. These do not represent healing because the substitute must be given regularly, and the normal body capacity to produce and regulate the needed substance is not restored. Because of this, complications often develop that would not if the normal body mechanisms, including appropriate feedback mechanisms, were complete. The disease diabetes mellitus is an example of this. Cardiovascular, ocular, renal, and neurological complications develop in longstanding diabetes. If, in the future, genetic engineering develops a way to correct genetic defects and their expression in the individual, perhaps this could be considered "true" healing.

It is a general misconception to suppose that antibiotics, by themselves, produce complete healing, as AIDS has repeatedly shown. Without a sound immune system, antibiotics provide at best a respite from the offending organisms. Many antibiotics are only bacteriostatic and just slow the growth of microorganisms. Moreover, bacterial resistance develops even to bactericidal (bacteria-killing) antibiotics, and as we are finding out, microorganisms are finding a way to become resistant to antibiotics faster than we can produce new types.²

Even if an antibiotic is bactericidal and the microorganism is sensitive to it, the body must still repair the damaged tissues. Additional problems include the fact that the individual may have an allergy to the antibiotic, or the organism may be in a place where only low concentrations of the antibiotic can penetrate (e.g., bone, brain). Equally important, antibiotics often upset the natural flora of the body, producing superinfections with other organisms (such as fungi) that are resistant to the antibiotic and are kept in check only by the normal flora. Because of mutations, even bactericidal antibiotics probably do not kill all of the bacteria in an infection. (This is why antibiotic resistance develops even to bactericidal antibiotics.) The body still must destroy the residual bacteria, fungi, and other microbial agents. Only a few viruses are susceptible to antimicrobials, and our current armamentarium is weak against many protozoa.

If the body produces an excess of something, such as gastric acid, medications such as the H-2 antagonists can reduce the acid production of the stomach. It now appears many peptic ulcers can be cured by antibiotic treatment of Helicobacter pylori in the stomach, at least for a time. Alternatively, gastric surgery can remove acid-producing cells and change the acid-production feedback mechanisms. If the problem is not H. pylori, then the H-2 antagonists must be taken regularly (and thus do not represent true healing), and the body must heal any surgery and subsequently function normally. Permanent digestive problems often remain following gastric surgery. Hypersensitivity problems including allergies and autoimmune diseases often can be helped with desensitization or medications, but these represent control and not healing.

If certain hollow organs are inflamed (such as the appendix or gallbladder), they usually can be removed surgically. Nevertheless, the body must heal the surgical incisions and fight off residual infection. As always, if the body is unable to heal the incision or fight infection, the surgery does not lead to healing.

If there is a localized cancer, physicians can probably remove the cancer. Occasionally with diffuse cancers such as early Hodgkin's disease or acute lymphatic leukemia, the cancer may be destroyed with chemotherapy and/or radiation. Here, too, the body must heal the surgical incisions or survive the insults of the anti-cancer drugs and radiation. If, as it sometimes happens, the therapy also destroys the body's ability to fight infection by damaging the bone marrow, death is likely to result. Likewise, when cancer cells have spread via the blood or lymphatic circulation, usually medicine is helpless to destroy the tumor, and the most that medical science can offer is to treat the patient's symptoms.

Believing Christian and Jewish physicians should be quick to acknowledge their own limitations and be truly humble about their healing powers. This means they should consciously, even forcefully, acknowledge that they share the healing role with God (such as by acknowledging his role to patients and encouraging prayer for, or engaging in prayer for, patients).

God's Role in the Promotion of Health

Within society, general health-enhancing activities of individuals, society, and cliniciansósuch as working for good nutrition, a healthy environment, and a health-supporting way of lifeóare usually called "health promotion." The more technical of these activitiesósuch as giving immunizationsóare usually referred to by the narrower concept of "disease prevention." In health promotion and disease prevention, fully as much as in disease treatment, the healer's role is adjunct to that of God. Those who seek to promote health and prevent disease, just as much as those who seek to treat patients with illness, are at most co-promoters of health with God. The God who created us and the world pronounced the creation "good."³ He knows how we should live to strengthen and honor our bodies and to be in harmony with the material and spiritual forces he created.

What is "Health"?

Most of the thoughtful definitions of "health" from scientists, among whom Rene Dubos is prominent, emphasize two things: our ability to react adaptively to those forces causing us stress, and our ability to function to our satisfaction in the society of which we are a part. Just as physicians seek to make conditions ideal for healing to take place in those who are ill, they should work to make conditions ideal for the promotion of health for everyone in their communities. This includes helping individuals and families adapt to the negative stressors in their lives so that they might remain healthy and function satisfactorily.

The social dimension is extremely important. If the environment of a community is so stressful that a person living in that community has difficulty remaining healthy, the community itself should be considered sick. Those societies are sick which cannot provide the basic needs of life: adequate pure food and clean water, clean air, soil that will grow crops, proper disposal of all forms of waste, and a physically and emotionally safe environment. Recent examples of sick societies due to violence and food deficiency include Somalia, the Sudan, Rwanda, and Colombia. (The latter due to the violence caused by the drug cartels.) Severe environmental pollution occurred following the Bophal chemical and the Chernobyl nuclear disasters. Behavioral disasters include civil wars, such as those in Bosnia, Rwanda, and Somalia, and the social disruption in many cities in the Western Hemisphere overwhelmed by the effects of illegal drug use.

Where the Bible does not guide the norms of behavior, anarchy will reign. Indeed, Proverbs 29:18 says, "Where there is no revelation, the people cast off restraint; but blessed is he who keeps the law"(NIV). Where people do not keep God's covenants, many will perish from the social anarchy that results. Directly or indirectly, anarchyóas violence, financial and political greed, and abuse of illegal drugsómay be the most important underlying cause of premature death throughout the world, despite what death certificates say.

Biblical Words for Health

The biblical ideas of health may be summarized in the words that can be translated "health" or "healing" in the Bible. One word is the Hebrew word for "repair" (rapha), which comes from a root word meaning "to sew up." When bodies, lives, and relationships have been torn through sin, and we have been alienated from God, from our fellow human beings, and from the world in which we live, we need to be reconciledóto be "sewn back" into harmony (at-one-ment) with our physical, social, and spiritual homeóand then kept safe.

Both the Hebrew and Greek words for "safety" (yeshua and sotaria, respectively) also mean "salvation." The Scriptures provide several pictures of God as a source of safety. For example, God is described as a rock in whose cleft his people (those who have been restored to fellowship with him) can dwell safely, and as a shepherd who guides his people into green pastures and beside still waters.

A third Hebrew word that may be translated "health" is shalom, which has the root meaning of "wholeness" or "soundness" and is often translated "peace." A related New Testament Greek word is hugiase (from which we get our word "hygiene") which, as an adjective, means "sound" or "whole." This wholeness, this soundness, indeed this peace, is the result of having been reconciled to our God, to others, and to the world in which we live.

Health: Reconciliation on Three Levels

Several years ago after studying these words and their use in the Bible, I proposed a concept of health based on the idea of reconciliation:

The word reconciliation, it is my hope, will convey sufficient and relatively unbiased meaning both to scientists and to theologians. The term implies restoration to harmony. Theologically the world is often found in the Scriptures. Medically speaking, it implies removal of bad stressors (which produce distress) and restoration to harmonious function.⁴

Reconciliation is a positive response to the torn and separated relationships between creature and Creator, between creature and creature, and between creature and the creation.

The New Testament word for "reconciliation" (katallasso) is based on the Greek word for "to change" or "to transform" (allasso), expanded by adding kata, which usually means "down," although it can mean "against," "across," or "throughout." In the New Testament, the word seems to mean "a mutual changing," that is, both parties to a previous disagreement now have changed in a positive direction toward the other. This change has included new commitments for both parties, and submission for at least one of the parties. The Concise Greek-English Dictionary of the New Testament defines katallasso as "(to) put (someone) into friendship with God; (to) reconcile (of husband and wife.)"⁵

This change involves acceptance by each party of the other, that is, a new relationship of commitment toóand a new behavior towardóeach other. True reconciliation requires all three of these (acceptance, commitment, and behavior change), and one or even two of these alone is not sufficient. Relationships and mutual behaviors would not change if there were no change in attitude toward each other. Attitudes and acceptance would not change if there were no change in behavior and no commitment to the new relationship.

Thus the process of reconciliation is not merely changing a few behaviors, but rather making a fundamental change in relationships and commitments. Here the secular approach to health misses the essence of the biblical insights, by assuming that true health can come merely from changing our behavior (for example, regarding nutrition, exercise, health habits, and the environment). Such changes usually will be helpful, but they are not sufficient for the biblical idea of health.

The model of reconciliation described here holds that reconciliation is needed on three levels (see Figure 1 below):

1. with the Creator,

2. with our fellow creatures (other human beings)⁶

3. with the creation.

Reconciliation with the Creator occurs within at least three dimensions: (1) the existence of moral guilt requires God's forgiveness (grace); (2) the meaninglessness of life apart from God requires the recovery of meaning and purpose in life; and (3) the spiritual aloneness of sinful human beings requires a knowledge of God and a restoration to his love and fellowship.

Second, reconciliation is needed with others in at least three dimensions. (1) Personal aloneness reveals the need for fellowship with other persons. (2) Anomieóa word used to denote a sense of alienation from the society of which we are a part, particularly from the social "megastructures" such as big government or businessóreveals our need to relate to our society in meaningful ways. People with anomie can be helped by identifying with a social group with which they share values.⁷ (3) A feeling of powerlessness is eased by the development of mutually supportive relationships, which should come from participating in the life of Christ's church, and by the way "mediating structures" such as churches give a person a sense of being able to influence the "megastructures" of the society through their group.

Third, reconciliation with the creation includes good nutrition, a clean environment, healthful behavior, and biomedical interventions to assist when anatomic and physiologic disruptions occur. Epidemiology has done much in recent decades to clarify how much of our premature death and disease is related to our nutrition, our environment, and our behavior.

True reconciliation requiresº acceptance, commitment,
and behavior change, and one or even two of these alone is not sufficient.

In nutrition, Dr. Dennis Burkitt spent many years doing research and education on the critical role that dietary fiber plays in good health. One motivation for his work on fiber was his cross-cultural research showing that many diseases common in the West are rare in the third world, or at least in that part of the third world where he was (Central Africa). These diseases included: coronary heart disease, gallstones, diverticulitis, appendicitis, hemorrhoids, varicose veins, hiatus hernia, colon cancer, breast cancer, and diabetes mellitus.⁸ Without these diseases to treat, most U.S. hospitals and many U.S. physicians would have inadequate work to do. Yet these diseases may not be necessary; we bring them on ourselves, especially by our diets, which are too low in fiber and too high in fats and refined sugar.

º the general principles of concern for nutrition, environment, and
 behavior found in [the Old Testment health] code are quite relevant today.

Epidemiologists have estimated that at least 80% of U.S. cancers are caused by environmental, nutritional, and behavioral factors. In their book entitled The Causes of Cancer, two of the world's leading epidemiologists, Richard Doll and Richard Peto state:

In the years since that report [a WHO expert committee report in 1964] was published, advances in knowledge have consolidated these opinions and few if any competent research workers now question its main conclusion. Individuals, indeed, have gone further and have substituted figures of 80 or even 90% as the proportion of potentially preventable cancers in place of the 1964 committee's cautious estimate of "the majority."⁹

Unfortunately, many people have interpreted the term "environmental factors" to mean only "manmade chemicals," which was not the intent of the WHO committee.

[It]º included, in addition to man-made or natural carcinogens, viral infections, nutritional deficiencies or excesses, reproductive activities and a variety of other factors determined wholly or partly by personal behavior.⁹

How do epidemiologists come to these conclusions? One way is by determining the "attributable risk percent," i.e., the percentage of new cancers that are due to one or another factor, based on the risk ratios or odds ratios found in epidemiologic studies. A second method is to take the age- and sex-specific cancer incidence rates from each country that has the lowest rates of a given cancer, and then apply those rates to the U.S. population. By either method, the U.S. has about five times as much cancer as if we had the same age and sex-specific rates as the best countries in the world, which may be the lowest achievable rates with current knowledge.

Our behavior, especially cigarette smoking, is one of the major contributors to disease. In 1987 it was estimated that 87% of lung cancer deaths in the U.S., and about 95% among smokers, were attributable to cigarette smoking.¹⁰ Many other body cancers, and most cases of chronic obstructive pulmonary disease (COPD), are due to cigarette smoking as well. Cigarettes kill more people, however, by coronary heart disease than by lung cancer. This is because the overall risk of heart attacks is so much greater than lung cancer that the net effect is more cigarette-related deaths from heart attacks.

Alcohol and drug abuse, drunk driving, homicide, suicide, and a sedentary, fast-food lifestyle are all behaviors which contribute to the fact that most of our premature deaths (i.e., before 65 years), serious diseases, and serious injuries are preventable. The God-given pattern for healthy living in Old Testament times is found in the Torah, especially Leviticus. Though the details of the Old Testament health code are less relevant to life in the industrialized world, the general principles of concern for nutrition, environment, and behavior found in that code are quite relevant today.⁴ Although no pattern of living can remove the curse of death from us, there are biblical principles and many current guidelines that will usually promote human health and longevity.

The Context and the Motive: God's Covenant

Although this model of reconciliation (see Fig. 1) was well received at the time, it still was inadequate. It was incomplete because it did not delineate how we were to achieve this desired reconciliation. No motivational framework was provided, nor was it placed in a context that showed how to proceed.

The biblical method of reconciliation is a covenant, which is a treaty establishing a new relationship between two parties who previously were at odds. It is an instrument that: (1) defines the process of reconciliation, and (2) guides the future relationships between the two parties. A covenant is the entering into, and remaining in, a relationship of mutual commitment and understanding, as shown by signs, seals, and behaviors which establish ongoing obligations.

If health can be understood as the process of reconciliation in three levels, then this reconciliation, in turn, results from human beings entering into a covenantal relationship with (1) the creation, (2) our fellow creatures, and (3) above all, the Creator. For this idea to have meaning and value, there must be an understanding of what is meant in the Scriptures to enter into and to maintain a covenantal relationship.

 If health can be understood as the process of reconciliation in three levels,
then this reconciliation, in turn, results from human beings entering into
a covenantal relationship with (1) the creation, (2) our fellow creatures,
and (3) above all, the Creator.

Biblical scholarship over the past 40 years, especially that of Mendenhall¹¹ and Kline,^12,13 has shown that the biblical covenants bear a striking similarity to the "suzerainty (vassal) treaties," or "treaties of the great King" common in the ancient Near East. According to Kline, the biblical (and suzerainty) treaties contained six standard sections. (1) First, they began with a preamble, which identified the "Great King" in terms designed to inspire awe and fear. (2) Next, there would be a historical prologue, including statements of how the King had been beneficent to the vassal. (3) Third, the covenant obligations would be defined. In this section, the vassal would acknowledge the power and goodness of the suzerain and vow to serve him and him alone, including bringing tribute. Kline states:

º the fundamental demand (in treaties of the great king) is always for thorough commitment to the suzerain to the exclusion of all alien alliances (pp.14-15).¹²

In turn, the suzerain would promise protection and other benefits to the vassal. Then, (4) there would follow rituals for solemnizing the treaty, including the invocation of the gods of the great king and the vassal to be witnesses to the oaths taken. (5) There would be a pronouncing of imprecations and benedictions: imprecations if the vassal turns away from faithfulness, and, on the other hand, promises of benefits to be obtained by the vassal's obedience. (6) Last, there were stipulations for depositing a copy of the treaty with both the suzerain and the vassal.

Note that the suzerainty treaties were personal and had commitments, obligations, and rights on both sides. Kline argues convincingly that the Decalogue, for example, is written as a "treaty of the Great King." Referring to the Decalogue, he states:

Such a covenant is a declaration of God's lordship, consecrating a people to himself in a sovereignly dictated order of life.¹²

Such, I argue, is the kind of relationship that we, as human beings, need to enter into with the creation, with our fellow creatures, and with the Creator, if we are to know the fullness of the biblical understanding of "health."

A Covenant with Creation

Entering into a covenantal relationship with the creation means an awareness of the greatness and beneficence of God's created world, as well as a commitment to "serve" the earth,¹⁴ acknowledging the creation's power to do us harm or good, and, in turn, seeking the creation's welfare. Health books by Christian evangelicals have emphasized rules we should follow if the creation is to benefit us, but usually they include little emphasis on the need for us to make a commitment to the welfare of the creation in which we live.

The result of our general lack of commitment to the welfare of the creation is that the human race is fouling its only nest, the earth, opposing the stewardship command of Gen. 2:15. Instead of "dressing and keeping" the creation, we are spoiling it. This must change through our covenantal commitment to the creation as stewards of the Creator.

What is the "commitment" the creation gives in return in this covenant? Ultimately it is God's commitment to be dependable and faithful in the way he oversees the laws of nature. Col. 1:17 implies that God in the second person of the Trinity is constantly keeping the world from falling apart. Heb. 1:3 implies that God in the second person of the Trinity keeps the world moving along. In Gen. 8:22 God promises never again to curse the ground because of man, and also promises regular seasons and productivity. A major question is whether man, by sinful behavior, is cursing the ground in a way God did not.

As with suzerainty treaties, the details of an Old Testament covenant were specifically written out for both parties, so that ignorance was no excuse. Frair has suggested that three dimensions of the human problem were ignorance, inertia, and irresponsibility.¹⁵ Clearly, these problems are addressed by the O.T. covenant agreements, and DeWitt's suggestion that we need to progress from awareness to appreciation and then to stewardship appears to fit the covenant pattern well.¹⁴

A Covenant with Other Creatures

A covenantal relationship with other creatures (human beings) surely implies that we must be as concerned with their welfare as with our own (the golden rule, Luke 6:31). We are witnessing a decline in the commitment of people to each other. People act as though commitments do not have to be kept when they are no longer convenient or to their personal benefit. We see this in sports contracts (for example, where players feel they have the "right" to renegotiate their contract if they are doing well but do not give the owner the right to renegotiate if they are doing poorly), and in marriage, where partners often feel they can dissolve the union if things are not going as well as they would like. The Psalms describe what is needed when they say that the person who shall abide in God's tabernacle (surely a good image for true health, among other things) includes the one who "º keeps his oath even when it hurts,º " (Ps. 15:4, NIV). Health is generally better when people keep their commitments to one another.

The "golden rule," however, is not enough. What happens if others interpret the rule differently, or do not hold to it at all? From where comes forgiveness now? If we have been unjustly, irreversibly wronged by someone else, the gospel is needed to keep us from dehumanizing each other. First, we must always be aware that the one who wronged us is still made in the image of God (Gen. 1:26 ff). Moreover, though we may have been grievously wronged, we must remember, with King David, that all sin is ultimately against God only.¹⁶ The anger, carelessness, or calculated evil directed against us by others is really, whether or not understood by the perpetrator, part of that person's rebellion against God, which is perpetrated against other people as God's image bearers. (Perhaps this is like defacing a picture of someone one hates; other people are God's "picture.") Therefore, because Christ was wounded for our transgressions and forgave us, we too must forgive them. Even in the Old Testament, Joseph saw that his sufferings were not cause for anger but were being used by God for good (Gen. 45:2-8, cf. Rom. 8:28).

Increasingly the social and interpersonal aspects of life are being appreciated as crucial to both mental and physical health. In the landmark Alameda County study, Berkman et al. showed that those who had good social support systems were more healthy than those who did not, and that being very religious also contributed to mental and physical health and longevity.¹⁷

Matthews et al. (1993) developed an annotated bibliography of 158 clinical studies in the medical literature relating to the relationship between religiosity or religious commitment and health. They found that religiosity or religious commitment was generally a positive factor. For example, they stated that of 146 studies which permitted such an analysis, "º 77% demonstrated a positive effect of religious variables, 25 (17%) were neutral or mixed, and only nine studies (6%) demonstrated negative effects from religious variables." Moreover the positive effects of the religious variables were "º found in every domain examinedº , including drug and alcohol use, psychologic symptoms, physical symptoms and general health outcomes, and psychosocial variables and well-being measures."¹⁸

A Covenant with the Creator

In the Old Testament treaties, the vassal responded to the suzerain (and God's people responded to God) as the weaker party responding to the stronger. Often suzerain treaties were entered into under duress, because monarchs, no matter how minor (like ourselves), usually do not like to give up their autonomy and self-determination. Yet the covenant treaties often were very much to the benefit of the vassal. Although he and his nation would owe total allegiance and some tribute to the suzerain, the benefits in terms of peace and protection may have been considerable.

Scripture portrays us as people who are weak, needy, and yet rebellious against our creator and suzerain, God. Life confirms this analysis. When we yield our autonomy and accept Jehovah as our suzerain, giving him total allegiance, the implications are manifold for this life and the next. We know it is God in whom we "º live and move and have our being" (Acts 17:28). Life has meaning and purpose, both now and in the future, as we strive to fulfill our obligations to the Great King.

God's forgiveness is possible through what Christ did on the cross, so that we can know forgiveness, no matter how awful our sins. And through reconciliation with God in Christ, we are no longer alone. Life has meaning as we seek to bring glory to God through obedience in the church.

These three covenants (with the Creator, the creatures, and the creation) are not independent of each other. Our covenant with the Creator is the controlling covenant; our submission and commitment to him is the controlling submission. Our covenants with the creation and with our fellow creatures exist in the context of our covenant with the Creator. We make a commitment to the creation and to others to honor and obey the Creator. We are to be stewards of the creation on behalf of God. We have biblical obligations to care for and preserve the creation, whether or not that helps us as individuals.

Naboth was an example of selfless stewardship. He protected his vineyard when King Ahab wanted to buy it from him, and this cost Naboth his life.¹⁹ He did this because he understood that his land was given by God to himself and to his descendants. We need a similar kind of selfless commitment to the creation we have been given, but this commitment, although perhaps costing us financially, should save some lives and help our descendants. We, too, are stewards of this globe but, in contrast to Naboth, there are no other places to which we could move, even if we should want to. Although concern for the environment does not characterize biblical Christian writing and speaking, there are some evidences of increasing concern in this area. For example, the June 1994 issue of this journal emphasized environmental stewardship. There Bube examined the question of whether other religious/philosophical traditions provide as adequate a basis for environmental stewardship as does the biblical Christian faith; he concluded that they do not.²⁰ The health of this planet and our descendants, if not our own, requires that we sacrifice some wealth and comfort now to achieve biblical stewardship of the earth. This must be our covenant with the creation.

Likewise, our covenant with other human beings can only be kept to the fullest if we have already made our covenant with the Creator, and see our covenant with other people in the context of the gospel. When forgiveness is difficult, only a knowledge of the gospel and gratitude to Christ can keep us from usurping God's exclusive right to vengeance.²¹

Our Health and that of our Descendants

The vassal comes under the covenant's dual sanctions: the blessing and the curse. The lordship of the great king might be exercised as protection or destruction. Our failure to keep the covenants with creation, with other creatures, and with the Creator may threaten our own lives and health, and that of our neighbors; and it may threaten the future health of our children, grandchildren, and more distant progeny.

"The wages of sin is death" the Apostle Paul reminds us (Rom. 6:23; Gen. 2:17). We see that covenant promise of our suzerain, God, being kept. If we break the covenant with the creation, the curse is a future for our descendants clouded by desertification of fertile soil, starvation, ozone depletion, global warming, atmospheric change, and toxic buildup on a global scale. Christians should be at the forefront of promulgating and keeping the environmental covenant, even if that requires a temporary or permanent reduction in our profits and/or standard of living. The recently issued "An Evangelical Declaration on the Care of Creation" is a step in this direction.²²

Likewise, failure to make and keep covenantal relationships with other human beings leads to the suzerain's curses ó breakdowns of individual relationships, of families, and of large segments of society. Kline says:

As long as the vassal remained a faithful tributary he might expect to enjoy a relationship of friendship and peace with his suzerain and to receive whatever measure of protection the latter could provide. If, however, the vassal would assert his independence or transfer his allegiance to a new lord he would have to reckon with the vengeance threatened in the treaty against such infidelity and indeed invoked by the vassal himself in his oath of allegiance.¹³

Many who ignore the covenant with the Creator may seem momentarily healthy, but earthly life is brief and then what? Eternal questions cannot be ignored. Moreover, even for individuals and families who try to keep these covenants, difficulties may arise: accidents, cancer, war/genocide, famine, or other illnesses or disasters. What about health then? Only if the covenant with the Creator is strong can we still affirm health, even in the face of disease, injury, and handicaps, such as that of Joni Eareckson. Joni became converted after a swimming accident left her quadriplegic, and has become an internationally known writer and painter (holding the brush in her teeth). We cannot worship "health"ówe make no covenant with health. Only if we worship God and are reconciled in three dimensions through the keeping of covenants can we affirm health (reconciliation and wholeness) in the face of the brokenness of this sinful world.

©1995

Acknowledgment

I would like to thank one of the reviewers for his or her many thoughtful and helpful suggestions.

References

¹S.Stocker, personal communication.

²S.Begley, "The End of Antibiotics? A `Medical Disaster' in the Making," in Newsweek, p. 63, March 7, 1994.

³Gen. 1:4, 10, 12, 18, 21, 25.

⁴J.F.Jekel, "A Biblical Basis for Whole-Person Health Care: Theoretical and Practical Models in Health and Healing," in Whole Person Medicine, D.F.Allen et al., Eds., InterVarsity Press: Downers Grove (1980), pp. 121-151.

⁵B.M.Newman, Jr., Concise Greek-English Dictionary of the New Testament. United Bible Societies, 1949.

⁶Some people have asked me why the model does not include the idea of "reconciliation with oneself." As I understand the biblical concept of reconciliation, two independent persons or entities are required, and reconciliation is not a reflexive process. I have no problem with the need for acceptance of self (or at least one's self-image), but this seems to me to be quite different from reconciliation in the biblical sense.

⁷P.L.Berger and R.J.Neuhaus, To Empower People: The Role of Mediating Structures in Public Policy. American Enterprise Institute for Public Policy Research: Washington, D.C. (1977).

⁸D.Burkitt, Lecture at Yale University, April 28, 1989.

⁹R.Doll and R. Peto, The Causes of Cancer. Oxford University Press: Oxford (1981).

¹⁰Centers for Disease Control, "The Surgeon General's 1989 Report on Reducing the Health Consequences of Smoking: 25 Years of Progress (Executive Summary)." Morbidity Mortality Weekly Report 38 (Suppl. no. S-2), p.2, 1989.

¹¹G.E.Mendenhall, "Covenant Forms in Israelite Tradition," The Biblical Archaeologist, 17:50-76 (1954).

¹²M.G.Kline, Treaty of the Great King, William B. Eerdmans Publishing Company: Grand Rapids (1963) p.17.

¹³M.G.Kline, By Oath Consigned. William B. Eerdmans Publishing Company: Grand Rapids (1968).

¹⁴C.B.DeWitt, "Christian Environmental Stewardship: Preparing the Way for Action." Perspectives on Science and Christian Faith 46:80-89 (1994) DeWitt has argued that Gen. 2:15 should be translated "º to serve and take loving care of it."

¹⁵W.Frair, "Ignorance, Inertia, and Irresponsibility." Journal of the American Scientific Affiliation 21, 43 (1969).

¹⁶Psalm 51:4.

¹⁷L.F.Berkman and L.Breslow, Health and Ways of Living: The Alameda County Study. Oxford University Press: New York (1983); and L.F.Berkman, and L.S.Syme, "Social networks, host resistance, and mortality: a nine year follow-up of Alameda County residents," American Journal of Epidemiology 109:186-204 (1979).

¹⁸D.A. Matthews, D.B. Larson, and C.P. Barry, The Faith Factor: An Annotated Bibliography of Clinical Research on Spiritual Subjects. Rockville, MD: National Institute for Healthcare Research, 1993.<P7MJ247>

¹⁹I Kings 21.

²⁰R.H.Bube, "Do Biblical Models Need to Be Replaced In Order to Deal Effectively with Environmental Issues?" Perspectives on Science and Christian Faith 46:90-97 (1994).

²¹Rom. 12:19, Deut. 32:35.

²²"An Evangelical Declaration on the Care of Creation." Perspectives on Science and Christian Faith 47(2):110-111 (June 1995).