Friday, July 31, 2009

Young pups in love

Forty-one years ago last March, when David and I went to get our marriage license, he had to bring a letter of permission from his parents. In California in 1968, a woman could marry without permission at age 18, but a man had to be at least 21. I was 19 and David was 20—though in the excitement of the moment, he forgot his age and told the clerk he was 18. Good thing he had that letter.

Twenty-one years later, our 18-year-old daughter Molly brought an entire choir to our Illinois home from Rice University in Houston, Texas. After the choir left, one young man stayed. As we were getting ready to sit down for Sunday dinner, Molly said, “Byron and I have something we’d like to discuss with you and Dad. Would you rather do it now, or after dinner?”

I gulped, thinking of only two possible conversational topics. “Now,” I said.

“OK,” said Molly. “We would like to get married as soon as we can support ourselves. We were thinking maybe next year.”

“Whew!” said David and I.

This was the first time we had met Byron, and at age 19 he had a lot in common with a half-grown yellow lab. We trusted Molly’s judgment, though—and besides, I had clear memories of my parents’ reservations about the young pup I had brought home when I was exactly Molly’s age and he, exactly Byron’s. “Are you sure?” they asked me (they thought his manners needed polishing, and they didn’t quite get his sense of humor). “Are you sure?” David’s parents asked him (they were concerned that I ate too much and that my bikini was too scanty). “Yes!” we both said, and all four of them kindly switched into supportive-parent mode.

I believe in young marriage. When I saw Mark Regnerus’s cover article in the August issue of Christianity Today, “The Case for Early Marriage,” I sat right down and read it, smiling the whole way through.

It makes sense to marry when your sex drive is strongest, your body is most fertile, and you’re young enough to adapt to someone else’s idiosyncrasies. That is, if you’ve figured out how to support yourself (or if your parents are willing to help), if you’ve met the person you want to spend your life with, and especially if you both believe that marriage is a lifelong commitment and are willing to take one another “for better or for worse, for richer or for poorer, in sickness and in health.”

It’s been twenty years since Molly and Byron made plans to marry, and 42 years since David and I did. Our two granddaughters are now teenagers. I don’t know if, in four or five years, they’ll be bringing home young pups for their parents to inspect. If they do, Molly and Byron, take a deep cleansing breath and—if you reasonably can—give them your blessing. If young marriage turns out as well for them as it did for you and for us, we’ll all be blessed.

P.S. Before you leave a comment pointing out dismal statistics about young marriages, be sure to read Regnerus's article. Also, the fact that I am for young marriage does not mean that I am against later marriage or no marriage at all. I have happily married friends who married for the first time in their 40s, 50s, and 60s; and I have happily single friends who intend to remain that way. My daughter Heidi wisely broke her engagement to her high-school sweetheart when she was 18. All I'm saying--and what I think Regnerus is saying--is that society, and individuals, can benefit when young marriage is a socially approved and supported option.

Wednesday, July 29, 2009

Catholics, Protestants, the via media, and roadkill

If you have any interest in the Episcopal Church, you've already been exposed to far too many summaries, comments, analyses, predictions, outbursts, and uncharitable remarks about what Bishop N.T. Wright has called "the slow-moving train crash of international Anglicanism." I am not going to offer an opinion here about what has been done or should be done. Instead, I'd like to point out something very interesting about Archbishop Rowan Williams's official response to the Episcopal General Convention 2009: one of his major concerns is not just holding the Anglican Communion together, but also preserving unity with "the Church Catholic."

In 2006, some three years after Rome suspended ecumenical talks with Canterbury because of Gene Robinson's consecration, Williams met with Benedict XVI. This is part of what the pope said to the archbishop:

Recent developments, especially concerning the ordained ministry and certain moral teachings, have affected not only internal relations within the Anglican Communion but also relations between the Anglican Communion and the Catholic Church. We believe that these matters, which are presently under discussion within the Anglican Communion, are of vital importance to the preaching of the Gospel in its integrity, and that your current discussions will shape the future of our relations. It is to be hoped that the work of the theological dialogue, which had registered no small degree of agreement on these and other important theological matters, will continue to be taken seriously in your discernment. In these deliberations we accompany you with heartfelt prayer. It is our fervent hope that the Anglican Communion will remain grounded in the Gospels and the Apostolic Tradition which form our common patrimony and are the basis of our common aspiration to work for full visible unity.

Williams appears to share Benedict's wish for "full visible unity." Though several years ago he wrote that "an active sexual relationship between two people of the same sex might ... reflect the love of God in a way comparable to marriage," his response to General Convention has quite a different tone. It is not the time, he says, for the Church to bless same-sex unions and thereby change the way it has "consistently read the Bible for the last two thousand years." It is not the time for admitting people living in such unions to the ordained ministry. Not enough "painstaking biblical exegesis" has been done. The necessary consensus for so far-reaching a change does not yet exist.

I expected Archbishop Williams to do whatever he could to keep Anglicans under the Canterbury roof. I was surprised, however, at his strong concern for "the Church Catholic," by which he appears to mean not only the Anglican Communion but also the Roman Catholic Church and probably other Anglican ecumenical partners as well. Eight of his 26 paragraphs appeal to ecumenicity:
7. ... it is clear that a positive answer to this question would have to be based on the most painstaking biblical exegesis and on a wide acceptance of the results within the Communion, with due account taken of the teachings of ecumenical partners also....

8. ... a blessing for a same-sex union cannot have the authority of the Church Catholic, or even of the Communion as a whole....

9. ... So long as the Church Catholic, or even the Communion as a whole does not bless same-sex unions, a person living in such a union cannot without serious incongruity have a representative function in a Church whose public teaching is at odds with their lifestyle. (There is also an unavoidable difficulty over whether someone belonging to a local church in which practice has been changed in respect of same-sex unions is able to represent the Communion's voice and perspective in, for example, international ecumenical encounters.)

15. ... This again has an ecumenical dimension when a global Christian body is involved in partnerships and discussions with other churches who will quite reasonably want to know who now speaks for the body they are relating to when a controversial local change occurs. The results of our ecumenical discussions are themselves important elements in shaping the theological vision within which we seek to resolve our own difficulties.

18. To accept without challenge the priority of local and pastoral factors in the case either of sexuality or of sacramental practice would be to abandon the possibility of a global consensus among the Anglican churches such as would continue to make sense of the shape and content of most of our ecumenical activity...

19. ... some see this as best expressed in a more federalist and pluralist way. ... But it is not the approach that has generally shaped the self-understanding of our Communion – less than ever in the last half-century, with new organs and instruments for the Communion's communication and governance and new enterprises in ecumenical co-operation.

22. ... there is at least the possibility of a twofold ecclesial reality in view in the middle distance: that is, a 'covenanted' Anglican global body, fully sharing certain aspects of a vision of how the Church should be and behave, able to take part as a body in ecumenical and interfaith dialogue; and, related to this body, but in less formal ways with fewer formal expectations, there may be associated local churches in various kinds of mutual partnership and solidarity with one another and with 'covenanted' provinces.

23. ... perhaps we are faced with the possibility rather of a 'two-track' model, two ways of witnessing to the Anglican heritage, one of which had decided that local autonomy had to be the prevailing value and so had in good faith declined a covenantal structure. If those who elect this model do not take official roles in the ecumenical interchanges and processes in which the 'covenanted' body participates, this is simply because within these processes there has to be clarity about who has the authority to speak for whom.
Anglicans pride themselves on being neither Catholic nor Protestant, but rather a via media incorporating elements from both traditions. The Episcopal Church in the U.S., by insisting on its own view of truth and justice without general worldwide concurrence and in the face of much opposition, is acting in a very Protestant way. The Archbishop of Canterbury, by appealing to tradition, authority, and consensus, is sounding quite Catholic. And yet, in his genial Anglican way, he doesn't want to banish the Protestant dissenters--"there is no threat of being cast into outer darkness," he writes.

But can the via media persist as a viable ecclesiological model? Or has it already become the median strip where roadkill piles up as traffic rushes past in opposite directions?

Tuesday, July 21, 2009

Is national health care hazardous to your health?

Various websites and e-mails are reporting that cancer survival rates are much higher in the U.S. than in various European countries. Some quote Mark Tapscott in the Washington Examiner, who quotes Jim Hoft in the American Issue Project, who quotes Michael D. Tanner of the Cato Institute, who quotes ... well, quite a group of conservative pundits and politicians are involved. They appear to be using the same set of statistics to argue that national health care results in dramatically increased mortality rates from breast, prostate, and other cancers.

To check the facts, I went to the World Health Organization and made myself a chart. Using the most recent statistics available, I compared the health outcomes of six Western nations. No nation's health-care program is totally private, and no program is totally nationalized. Government funds pay for a percentage of health-care expenses in all six countries: the United States (45.8%), Germany (76.6%), Italy (77.1%), France (79.7%), the Netherlands (81.8%), and the United Kingdom (87.4%).

Do mortality rates increase with a higher percentage of government funding? Here's what I found:
  • The United States ties with Italy for the lowest cancer mortality rate of all six countries. Interestingly, the U.S. and Italy also have the lowest smoking rates. The Netherlands and the U.K. have the highest smoking rates and also the highest death rates from cancer. The cancer mortality rate in the Netherlands is 15% higher than that of the United States and Italy.
  • However, cancer accounts for fewer than a quarter of all deaths in the United States. Heart disease is an even bigger killer, and statistics on cardiovascular mortality are not so good in America. Of the six countries, the U.S. has the second highest mortality rate, with 59% more heart-related deaths than France.
  • The U.S. also has the second highest death rate from injuries. American mortality in this category is more than 100% higher than that of the Netherlands.
  • In the largest category, non-communicable diseases, the United States has the highest mortality rate of all six countries, with 25% more deaths than France.
  • The adult mortality rate--that is, the probability of dying between the ages of 15 and 60--is highest in the United States. The next runner-up, France, is 20% lower, and Italy is 70% lower.
Personally, I don't want to die from cancer. I don't want to die from heart disease or other non-communicable diseases either, and I'd rather not be smashed to death in an accident. In fact, I'd just as soon stay healthy as long as possible, so I'd be very happy if the United States had the best health care in the world. Alas, we have a long way to go.

Of the six countries I compared, the United States is at the bottom in terms of healthy life expectancy: 69 years here compared to 71 in the Netherlands and the U.K., 72 in France and Germany, and 73 in Italy.

The U.S. is also at the bottom in terms of total life expectancy: 78 years here compared to 79 in the U.K., 80 in Germany and the Netherlands, and 81 in France and Italy.

Please, when you get an e-mail or see a web page giving statistics to argue that the United States already has excellent health care and doesn't need to revamp the system, stop and ponder. We currently spend roughly twice as much per capita on health care (counting both public and private sources) as these European countries.

What lots of Americans don't realize is this: the U.S. government already spends more per capita on health care than do the governments of these other countries--over 50% more than the Italian government spends, for example. And yet the Italians manage cancer just as well as we do, and their health-care outcomes are better than ours in every other category.

Saturday, July 11, 2009

Stop this malicious e-mail

When I wrote that health-care reform probably should include less care for the elderly, I meant only that dying people should not have their deaths prolonged by unnecessary and painful medical intervention. Of course seniors should have good health care. I believe that, you believe that, and President Obama believes that too.

I want to be clear about that because an e-mail is circulating that, like most scary e-mails, is entirely false. According to this e-mail, people over 59 can't get heart surgery in England (actually, they can and they do). The e-mail implies that Natasha Richardson's death was due to failures in Canada's health-care system (actually, they responded very quickly once the family allowed them to). It says that President Obama wants our system to be based on Canada's and England's (actually, he doesn't). It likens the President's health-care plans to signing "senior death warrants."

And that's only for starters. It is hard to find a single fact in the e-mail. Even quotations are attributed to the wrong people. You can read the e-mail and a thoroughly researched response at the FactCheck website, and I hope you will.

Please, whether you love or hate the health-care proposals now being discussed, check out the facts before ever passing on an e-mail. Any e-mail. Especially if it, like this one, says, "Please use the power of the internet to get this message out." E-mails that beg to be passed on are always annoying, usually false, and often malicious. This one is all three.

Thursday, July 9, 2009

Welcoming Brother Death

A few months ago my older daughter, who is a Texas Republican, and I--a Chicago Democrat--were discussing health care reform. Surprisingly, we agreed about a lot of things, including the near certainty that if health care is extended to all Americans, older people will get less of it.

I will be 61 next month, and I think that could be a good thing.

I don't want a prolonged, high-tech death. On the other hand, I don't want a pill and a plastic bag either. Even apart from the ethical implications, both extremes suffer from fantasies of control, and death has a way of resisting control--often in ways that hurt the person whose death is supposedly being controlled.

There are better ways to die that focus not on control but on community. Jane Gross describes one such way in her July 8 New York Times article, "Sisters Face Death with Dignity and Reverence," featuring the elderly Sisters of St. Joseph in Rochester, NY, who have become known for their gentle approach to dying.

The sisters are experienced with death: "On average, one sister dies each month, right here, not in the hospital, because few choose aggressive medical intervention at the end of life, although they are welcome to it if they want.... Nobody can remember the last time anyone died in a hospital."

Instead, a geriatrician provides primary care, and the sisters discuss among themselves their various options before deciding what kinds of treatment to pursue. When it is time to die, the sisters do so "with reverence," says one nun. "Dying belongs at home, in the community."

What factors make for a good death? Gross lists "a large social network, intellectual stimulation, [and] continued engagement in life and spiritual beliefs, as well as health care guided by the less-is-more principles of palliative and hospice care — trends that are moving from the fringes to the mainstream."

Too often, we Americans see only two end-of-life options. But the opposite of assisted suicide does not have to be inappropriate medical intervention. I firmly believe that life is a gift from God, and that no one has the right to intervene and end it (except perhaps in self-defense or in defense of another, and yet even then the person who takes life needs God's gracious forgiveness for choosing what was hoped to be the lesser evil).

But there is "a time to die" (Eccl. 3:2). Christians need not fear death "like people who have nothing to look forward to, as if the grave were the last word" (1 Thess. 4:13). God is praised "through our brother death of body," said St. Francis of Assisi. When the body is ready to die--when it has "fought a good fight" and finished its course and "kept the faith"--then it is right and good to be able to say, "I am now ready to be offered, and the time of my departure is at hand" (2 Tim. 4:6-7).

When I was 43 and my parents were 81, they filled out living wills. As I recall, they were allowed to select one of three options in case of cardiac or respiratory arrest--"Do not resuscitate," go ahead and intervene but avoid heroic measures, or do everything in your power to keep this person alive. Neither of my parents hesitated: they wanted the first option.

"Um," I said, finding the conversation difficult, "isn't that a little extreme? I mean, shouldn't some intervention be tried first?"

"You are speaking like a young person," my father gently said. "At our age, DNR makes sense."

They both lived to be 85. Their last years were not easy, and I believe they welcomed death when it finally came--quietly, apparently painlessly, with no tubes, monitors, or medicines to prevent their bodies from doing what tired old bodies naturally do.

Friday, July 3, 2009

Review: Secrets to Happiness

On May 15, the New York Times published Jincy Willett's review of Secrets to Happiness by Sarah Dunn, and I immediately put a hold on it at the library. I love the Wheaton Public Library, by the way. They keep up with the new books--this one, released in March, was on their shelves in April--and if they don't have a book you want, they'll find it for you.

This book is not a how-to guide to happiness, nor is it really about warm puppies (though two dogs are characters, and I came close to buying it purely for its cover). It is, I suppose, chick lit: the main character and most of her friends are single, 30-something city dwellers who obsess about their relationships, which are, at least from my vantage point--I'm the age of their unpleasant mothers--pretty screwed up.

But it's much better than the term chick-lit implies. In fact, after I read a few passages to Mr Neff, who tends to read books with titles like Predestination: The American Career of a Contentious Doctrine, he said he wanted to read it too. I warned him that it contains a lot of gratutitous, um, carnality. That did not appear to faze him.

To learn more about the book's content, read the NYT review. If all you want is a recommendation, try this: Secrets to Happiness is witty, fast-paced, and cheerful. The characters are intelligent, if feckless, and nearly all of them are endearing (I'll make an exception for Spence). Holly's philosophizing is hilarious and sometimes profound. "Somebody should feel guilty," she tells her married friend Amanda, who is about to take a lover, "and I tend to feel all the feelings in the room."

The only thing I don't like about the book is its happy ending. Well, I sort of like it. I mean, I'm glad for all the characters that things work out so well for them, despite their deplorable behavior, and I try to avoid novels that leave their protagonists weeping or catatonic. On the other hand, Holly criticizes psychotherapy for making "it possible for a person to do whatever they wanted to do, with whomever they wanted to do it, when and where and however the hell they felt like it, while reaping no negative emotional consequences whatsoever." So it seems odd when Holly's moral compass--the only one in the crowd, apparently, and a consistent theme throughout the book--turns out to be irrelevant.

Maybe Jack, apparently untroubled by moral questions, gets it right: "'You believe in God,' he said [to Holly]. 'You just don't believe that God is good.'" Maybe a good God would redeem, not smite.

And yet, in Holly's words, "It just feels like there should be consequences.... at least I'd feel like there was some moral center somewhere, like we lived in a universe where things made sense. Instead, in this version, people do whatever the hell they want and everybody gets off scot-free."

* * *
Here's an excerpt I enjoyed. Holly and Jack, post-coitally, are sitting nude on the bed, discussing religion.
"What about finding a church that's Christian, but not so..."
"Not so evangelical?"
"Not so conservative, I was going to say."
"Like, what, one of those Episcopal churches that has an openly gay priest?" said Holly.
"Why not?"
"With the clothes drive in the narthex and the transgendered support group in the basement, antiwar sloganeering from the pulpit, potlucks featuring mung bean and tofu chili, hymns addressed to God our Mother, that sort of thing?"
"In that general neighborhood, yes."
"I can't do it," said Holly. It's completely foreign to me. It's worse than foreign. It pushes more buttons."
"What do you mean?"
"I sit in a church like that and I start to feel like Jerry Falwell. It brings out every long-discarded fundamentalist impulse in me," Holly confessed. "I find myself flipping back through Leviticus and searching for injunctions against sodomy. Honestly, I'm sort of stuck. I can't go forward and I can't go back."