Like many contemporary ethical dilemmas revolving around religion, this question pitting patients’ interests against religious conviction presumes a fault line or dualism, characteristic of modernity, which has now led us into what T. S. Eliot called a wasteland. It is hard to believe that just a few hundred years ago the great philosophers, theologians and religious figures like Maimonides were also the era’s greatest doctors. And it would have been unimaginable to them that patients’ interests (to be cured) and God’s desires (to choose life) could conflict. No wonder, that well into this century, this sensibility was expressed by many like my grandparents who saw doctors as gods!

The explosive advances in medicine since the enlightenment were to a great extent dependent on the differentiation (Kant) between the knowledge spheres of science and religion, and the emergence of scientific and empirical methods to study the body. This healthy differentiation became, over the centuries, an unhealthy separation and even antagonism between medicine and religion with the unfortunate consequence of medicine seemingly always associated with pushing the limits (a good thing) and religion seemingly always being associated with holding the line (a bad thing). The fact that this question feels so pressing reflects the failure of both physicians and religious leadership to understand their respective expertise’s, roles, limits, and to ultimately see the patient as a whole human being.

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In recent weeks Pope Benedict XVI has unnerved liberal Catholics as well as many Protestants and Jews with two pronouncements. The first removed restrictions on celebrating the old Latin Mass which since Vatican II has been replaced by a more accessible version of this core Catholic rite. The second pronouncement reasserted that the Roman Catholic Church is the one and only true church through which salvation can be achieved. Many people, both within and outside the Catholic community, are perplexed and apprehensive that the Pope is taking the Church back to its exclusivist and even intolerant pre-Vatican II days.

But perhaps something very different is transpiring. Anyone familiar with Pope Benedict’s work knows that while he is indeed a deeply traditional thinker he is not some pre-modern religious fanatic. He is a genuine intellectual and theologian. Strikingly, in these pronouncements, he repeatedly points out that these decisions are “continuous with Vatican II” and that he remains “deeply committed to ecumenical dialogue” and the “mutual openness” necessary for such dialogue to be “truly constructive”. As if to make clear that he not be misunderstood regarding these commitments, the Pope approved the document on June 29, the feast of Sts. Peter and Paul — a major ecumenical feast day.

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The answer to the question how does God allow disasters like hurricane Katrina depends on what kind of God we believe in. The question assumes a God living high up above, a Divine Puppeteer or Shepard of sheep who rewards and punishes as he sees fit.

This conventional and most common God image of the Axial Age monotheistic religions, founded in the time of the great city-states with their kings ruling from on high, is simply one very limited and partial image of God. Using this puny, patriarchal, and punitive attempt to describe our experience of God (one I admit still works for me at times) leaves us with a number of explanations of the “problem of evil” each of which captures a partial truth about our experience of Reality and therefore does speak to us at different moments.

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After close to three decades of profound experiences sitting with people who are dying and with their families, I am very pragmatic about the question of life after death. Rather than worry about intellectual consistency or religious dogma, or simply adhere to a scientific or secular materialist view or to one of the many spiritual and religious “truths”, my criteria is simple: Does your view – whether that there is no life after death and this life is all there is, or the many after-life intuitions, e.g., immortality of the soul, the next world, resurrection, reincarnation, rebirth, heaven, hell, the bardos, Kabbalistic mansions – create less or more fear around death? Does your view support you as you fight for life until you’re ready to die? Does it allow you and those around you to be more honest, more hopeful, more compassionate, more present, more loving and even more joyful in the face of death? Does it allow you to grasp the truth of the Ecclesiastes poet who wrote that there is a time for birth and a time for death?

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