https://orcid.org/0000-0002-0709-683X
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ABSTRACT
Healthcare policy and practice is undergoing a major turn towards philosophy, the social world and responsiveness to persons. This turn opens up contested questions about what constitute goodness in healthcare. Answering these questions matters practically for understanding health-related social agency conducted by churches, ecclesial organisations and non-religious organisations. A revised understanding and practice of diakonia can speak apologetically into these matters. In this article, John N Collins’ work is critically developed by interweaving the dual political and ecclesial senses of diakonia. The social authority of diakonia proceeds from its commissioned, representative nature and its eschatological, missional purposiveness. Thus conceived the duality of diakonia clarifies the conception and practice of health-related social agency and of ‘service’ more generally. The outcome is an Anglican political theology which avoids certain difficulties in German Protestants’ concept and practice of Diakonie while addressing key issues raised in the other papers in this special issue.
Acknowledgement
I gratefully acknowledge funding from the Sir Halley Stewart Trust which supported the initial workshop that lay behind this collection of papers. The views expressed are those of the author and not necessarily those of the Sir Halley Stewart Trust.
Disclosure statement
No potential conflict of interest was reported by the author.
Notes on contributor
Joshua Hordern is Associate Professor of Christian Ethics at the University of Oxford and a Fellow of Harris Manchester College. He leads the Oxford Healthcare Values Partnership, collaborating closely with a range of clinicians, researchers and health-related organisations, including patient groups. Formerly, he was an elected local authority councillor.
ORCID
Joshua Hordern http://orcid.org/0000-0002-0709-683X
Notes
1 Cribb, Healthcare in Transition, 51.
2 Ibid., v.
3 Ibid., 50; see 29–30 for description of the biomedical model as reductionist in its focus on bodies rather than persons; diseases management rather than health promotion; and on scientistic problem solving and clinical authority.
4 Ibid., 150.
5 Ibid., 51.
6 Ibid., 151 (my italics).
7 Ibid., 21.
8 “One train of Christian thought that carries apologetic weight in our times is the capacity of faith to display the intelligibility of political institutions and traditions.” (O’Donovan, The Ways of Judgment, xiii).
9 Cribb, Healthcare in Transition, 182.
10 Ibid.
11 Ibid., 30.
12 Ibid., 161 (my italics).
13 Ibid., 182.
14 Feiler, “Political Challenges to the German Diakonie” (in this special issue).
15 Ibid.
16 Ibid.
17 Ibid.
18 Collins, Diakonia; Collins, Diakonia Studies. For a useful survey, Gooder, “Diakonia in the New Testament,” 38–45. See also Gooder, “Towards a Diaconal Church.”
19 Faith and Order Commission, The Mission and Ministry of the Whole Church, 8.
20 Gooder, “Diakonia in the New Testament,” 37.
21 I note that, while the focus here is on the German Diakonie, there is a wider, similar set of trends across the ecumenical movement which is deeply invested in a particular usage of the term diakonia. For example, a major ecumenical report on diakonia notes and seemingly affirms the work of John Collins but does not acknowledge his denial of the simple equivalence of diakonia with caring service. Instead, the report comments that “it makes sense to limit the use of the term diakonia to the caring ministry of the church and of Christians; the term expresses the distinctiveness of its faith-based action.” (Lutheran World Federation, ACT Alliance and World Council of Churches, Called to Transformative Action: Ecumenical Diakonia (2018), 47).
22 Collins, Diakonia, 11.
23 Hentschel, A., Diakonia im Neuen Testament. Collins comments that
Hentschel’s claim will engender unease … while sections of the German Protestant theological establishment, church administration, and pastoral arm will voice a mixed chorus of incredulity, protest, and perhaps dismay before this dismantling of one of the key constructs within modern Lutheran and Reformed ecclesiology and spirituality. (Diakonia Studies, 23).
24 I acknowledge my dependence on Therese Feiler for this observation.
25 Faith and Order Commission, The Mission and Ministry of the Whole Church, vii; Senior Church Leadership, 24 §62.
26 For measured argument on this, see Faith and Order Commission, The Mission and Ministry of the Whole Church, 24–31.
27 Collins, Diakonia Studies, 35.
28 Schindhütte, “God desires everyone to be saved,” 278.
29 Collins, Diakonia, 228.
30 It is footnoted without discussion in the Church of England’s report on The Mission and Ministry of the Whole Church (ch.2fn4, 165) and receives a sentence pointing to the monarch in Senior Church Leadership (46fn32).
31 Plotting the nature of this interrelation requires an interweaving of New Testament scholarship with political theology to cut through some of the thicket of scholarship about the standing of political authority vis-à-vis the church. Inasmuch as Collins’ scholarship may be taken to endorse an authorised role for government, it should be taken to add clarity and exegetical rationale to the so-called “Doctrine of the two”, as discussed by O’Donovan, The Desire of the Nations, 217–24. In that sense, it may be recruited as a further witness against Hauerwas on the point of the vocation of secular authority to obedience to Christ and the vindication of the church (ibid. 214–7).
32 “An authority is someone I depend on for showing me the reasons for acting.” (O’Donovan, The Ways of Judgment, 131).
33 This seems the natural gospel thread to interweave with Mark 10:45, lucidly reframed by Collins, via the epexegetical kai to refocus the nature of the diakonia Christ enacts precisely in the obedient fulfilment of the Son of Man’s commissioned task to give his life as a ransom for many (Gooder, “Diakonia in the New Testament,” 41–2).
34 Ibid., 52.
35 Gooder, “Diakonia in the New Testament,” 43–5.
36 As one public document of the Church of England puts it,
The ordination of a deacon may be regarded, therefore, as an ecclesial sign – a visible sign of what is true of the Church, of its essential calling, and is carried out in many ways by all the faithful and particularly by those who are called to a recognized ministry, lay as well as ordained.
37 Schindhütte, “God desires everyone to be saved,” 281.
38 Gooder, “Diakonia in the New Testament,” 43.
39 Ibid., 54–6.
40 Collins, Diakonia, 245; Gooder, “Diakonia in the New Testament,” 48.
41 Schindhütte, “God desires everyone to be saved,” 278.
42 Thus O’Donovan comments that the “service rendered by the state to the church is to facilitate its mission.” (The Desire of the Nations, 217)
43 O’Donovan, Resurrection and Moral Order, 122.
44 Feiler, “Political Challenges to the German Diakonie”.
45 Ritchie, “Beyond help” (in this special issue).
46 Hordern, “Compassion in Primary and Community Care”; “Covenant, Compassion, and Marketisation in Healthcare.”
47 Matthews, “A Social Gospel for the 21st Century,” 16.
48 Doherty and Mendenhall, “Citizen health care,” 253–4.
49 Doherty, Mendenhall and Berge, “The Families and Democracy and Citizen Health Care Project,” 391.
50 Doherty and Mendenhall, “Citizen health care,” 255.
51 Bickley, “Neighbourhood resilience” (in this special issue).
52 Ibid.
53 Ibid.
54 Ibid.
55 Ibid.
56 Ibid.
57 Cribb, “Shaping ethical and civic identities” (in this special issue).
58 For my own discussion of David Cameron’s Big Society vision at an early stage, see Hordern, One Nation but Two Cities, esp. 54–61.
59 Cribb, “Shaping ethical and civic identities”.
60 The critique is close to the problem of a civil religion which O’Donovan critiques (The Desire of the Nations, 225–6).
61 For discussion of love and self-love, see O’Donovan, The Problem of Self-Love in Saint Augustine.
62 Cribb, “Shaping ethical and civic identities”.
