Our opportunity to reimagine faith
14 MINUTE READ
From Luke’s Journal 2022 | Technology | Vol.27 No.2
In today’s world, in almost any sphere of human endeavour, we encounter a science and technology world. This is very true of the current practice of medicine. Technique and technology have led to paradigm shifts in the management of most health care problems. Are we on a path of endless medical progress?
One French geriatrician claims that with our current state of scientific awareness, there is a person alive today who will live up to 1,000 years! Are we wise to be so enthusiastic? Pope Francis has written, “Technical products are not neutral, for they create a framework which ends up conditioning lifestyles and shaping social possibilities along the lines dictated by the interests of certain powerful groups. Decisions which may seem purely instrumental are, in reality, decisions about the kind of society we want to build.”1
In this paper I want to reflect on the rise and rise of technique and technology, and then discuss the good, the bad and the ugly associations. Throughout this piece I will seek to explore connections between faith and ‘technique’. French scholar, lay theologian and pastor, Jacques Ellul has written widely and provocatively about technology. He defines technology through a broader term, ‘technique’, which he describes as “the totality of methods rationally arrived at and having absolute efficiency (for a given stage of development) in every field of humanity”.2
“…we have seen a ‘transition from society relying primarily on the cultural approach to life, to societies relying primarily on the technical approach.’”
Ellul sees technology as one of the branches of technique. He also argues that technique is the dominant factor, the determining factor, within our modern society. His thesis is that over the past 250 years, arising from the enlightenment and the industrial revolution, we have seen a “transition from society relying primarily on the cultural approach to life, to societies relying primarily on the technical approach.”3 We use terms like ‘what the evidence says’, ‘how the data informs us’ to describe our experience of such a world. The collective wisdom of life lived on the “basis of tradition, of experience and culture handed down from generation to generation” (ebid 2, p.93) makes way for a world objectified through science, data, and technique.
At one level, this can be observed sometimes at a restaurant where everyone is looking at mobile phones rather than conversing over their meal. In medicine, ward rounds can become an evidence-based exercise with a bewildered sick person looking on. Ellul asserts that neither catholic or protestant Christianity have been prepared for such a change and indeed may be quite negatively impacted by the ‘age of technique’. His argument goes on to suggest that “technique reduces Christianity to the inner life, to spirituality, to public space for secularity and as desired private Christian faith.” (ebid2,p9).
In his work, Ellul draws out or highlights important consequences of living in the age of technique. I draw our attention to some of these:
- In the milieux of techniques, we can recognise that “people create and develop technique, and that technique simultaneously influences humanity” (ebid2, pg XV Introduction). Human beings characteristically adapt to our environment and our adaptations to technology push us toward an objective, mechanistic understanding of self. Ellul argues that this neurobiological rewiring accelerates as “technique takes on a measure of autonomy with respect to human life” (p105).
- Ellul recognises that technique is a ‘power’, “covering the full range of human life” (ebid2, p31). So we should not be surprised to recognise “the expansion of technique to human groups, to human life, is one of the essential characteristics of our world” (ebid2, p31). The apostle Paul helps Christians see that all ‘powers’ are ultimately under the authority of Christ.
- Growth is a ‘buzz’ word for technological power. “It is both economic and political” (ebid2, p63). The link between technique and power is strong and as humans we ‘lose’ our power as individuals and local communities in order to control it. Bureaucrats and owners of capital ride the wave of the power/growth reality. This is despite, as Ellul notes, “the great number of technical errors and technical misapplications which lead to nowhere” (ebid2, p21).
- For Ellul, the illusion of techniques is that “nothing more valuable can be imagined” and so now “we are in the presence of the secular sacred world, with the ensuing difficulty of regulating and dominating the creations to which ultimate value has been assigned” (pXVII). To me, the ideology of ‘autonomy’ has also been co-opted to this regulatory crusade.
- The next conclusion is to accept that “technique becomes our destiny, a kind of growing fate that takes over all human realities” (ebid2, p 83). It is worth also noting that Ellul sees Christian religion falling into the clutches of technique and so losing its gospel calling to “announce God’s salvation”. In the world of technique, we need a freedom that is given to us from outside this system.
- Ethics are fundamentally changed in the self-evident world of technique. Ellul argues that technical specialists are objectively set at arm’s length from their humanity. So, for specialists, experts, and power brokers, this objectification implies “they neither know nor can take responsibility for the consequences of their decision-making because these fall mostly beyond their domains of competence” (ebid2, p99).
- The rise of artificial intelligence (AI) may challenge another of Ellul’s observations that “machine memory stores information already separated from any context in a manner unaffected by any previous or subsequent storing of information. It is contextless memory” (ebid2, p113). In distinction to humans, “it is not a question of mindlessly storing and retrieving facts but of mindfully living a life in the world” (ebid2, p113). It can be true to conclude that the memory of technique can contribute to human alienation.
- My final association is to recognise with Ellul that the hope we hold around technique, is in essence a ‘religious’ hope, whether it be “unconditional admiration for the great works of technique (ie, internet) or in the potential for future developments and growth” (ebid2, p81-82).
This thinking around ‘technique’ is more than awareness raising. Ellul sees faith as leading to a deeper understanding of our world that is willing to embrace critical reasoning and act for love as we find the world. He playfully chose the word ‘mutant’ to describe an alternate way to ‘technique’. A ‘mutant’ is “someone who can use techniques and at the same time not to be used by, assimilated by, or subordinated to them” (ebid2, p66). People of faith, he argues, need to be discipled to both ‘live-in-technique’ and at the same time ‘live-against-technique’ (ebid2, p66). For people of faith, he concludes:
a. Christians should not reject technique (iconoclastic), but subject science and technique to the critique of Revelation.
b. Christians should be the bearers of hope, those who affirm the love of God in a world alienated and often overwhelmed by neuroses related to the technique.
c. With this courage to live, Christians are called on to be bearers of freedom, as we participate in Christ, and in the world (ebid2, p89-90).
Against this broad canvas, I want to briefly explore the good, bad and ugly of technique and technology. The truth of Ellul’s thesis accelerated for me two decades ago in a clinical context: I am a general practitioner and enjoyed intermittent encounters with an American male patient who had settled here with an Australian partner. Digital blood pressure measuring devices have streamlined the diagnosis and care of hypertension. As this condition became apparent, I initiated appropriate investigations including an echocardiogram. This excluded the serious outcome of ventricular wall hypertrophy. All other tests were normal, and his blood pressure was successfully controlled with a standard antihypertensive medication. My male patient became restless as he discovered a positive family history. He sought a specialist referral. I co-operated despite his excellent response to medication and lifestyle change. The specialist carefully reviewed this patient and then reinforced his care plan. Nevertheless, he remained restless and started the next consultation with the opening gambit, “Doc when am I going to get the MRI? If I were in America, I would have had my MRI by now.” In the world of technique, people easily confuse ends and means.
Very recently, a competent GP registrar under my supervision became anxious and panicky when he discovered new onset atrial fibrillation in an elderly gentleman complaining of fatigue and shortness of breath. He loudly summoned reception staff to call an ambulance. Although this may have been an appropriate course of action, the panic of ‘technical incompetence’ so overwhelmed this young doctor that it alarmed this man and his family. A calm measured response would have retained a patient-centred, humane approach. This old man refused to see the young doctor again. This story also confirms the powerful hold of ‘technique’ over medical care.
Technique and good technology
From preventive care guidelines to cardio-respiratory transplants, dermatoscopes to MRI scans, technology has benefited scores of individuals and populations with improved health outcomes. In the era of evidence-based medicine, our imaginations seem to be the only limit for the western health juggernaut. New techniques and products come online in breathtaking repetitions. The mastery of some technologies requires new specialisation within specialties, and then Artificial Intelligence (AI) poses a new ball game of functionality. Medical education now demands significant technological dexterity. Medical practice has been an inherently conservative venture. The mantra, “Do no harm,” is a voice of caution. While Hippocrates is engaging in a merger with technique, some are asking, “Can healthcare catch up with technology?”3
The answer has an inevitability driver. Without the uptake of technologies “no physician can be up-to-date to make informed decisions or be able to legally practice medicine.”5 Regulators, decision-support technologies and consumer empowerment (“I’ve googled this, doctor”) all underpin the Silicon Valley gold rush. Mesko has cleared some conceptual confusion by noting the difference between Health Information Technology (IT) and digital health (ebid5). The Medical Futurist Institute defines digital health as “the cultural transformation of how descriptive technologies (computers, mobile phones, etc.) that provide digital and objective data accessible to both caregivers and patients leads to an equal-level doctor-patient relationship with shared decision-making and the democratisation of care” (ebid5). The physician needs to be the master of new technologies with inherent software issues, power failures, virus corruption of data and interoperability deficiencies. Mesko suggests it is an IT health issue when we need to invoke “Gary” the IT techno. He describes the process of solving IT issues as applying “Gary’s rule” to a technology context. I think I know “Gary” very well and most days he looks like my children and grandchildren!
“Evidence-based medicine seeks to apply science and its new techniques and technologies to every aspect of health care. It does this with the blessing of the health industry…”
Evidence-based medicine seeks to apply science and its new techniques and technologies to every aspect of health care. It does this with the blessing of the health industry seeking to close gaps in treatment, improve efficiency and streamline cost. The huge profits of, say, Big Pharma, also suggest the driver of commercial growth.
Indeed, there is no reluctance to push down the health technology path with nanotechnology, gene therapy, gut biome therapy, 3D printing technology, block chain technology, AI, virtual technologies, etc, all surging to create new and better treatments and products to sustain human health. It is difficult to estimate the value of all the emerging possibilities opened by technologies.6-14
The ‘bad’ of technology
In a book published in March 2022, Nick Ripartrazone15 tells the story of Marshall McLuhan, the electronic media guru. McLuhan, who converted to Christianity, is described as a “digital prophet” who foretells a “digital age full of blessings and sins”. McLuhan, while optimistic, recognised dangers in the application of technology in mid-2021. At that time, a cartoon emerged of the horsemen of the apocalypse. A fifth horseman had joined the group of war, famine, pestilence, and death. “And who are you?” was the caption. “Misinformation” was the reply.
While COVID-19 has reduced a world chasing its technological tail to lockdown for a while, the emergence of dependable science has rapidly evolved to helpful vaccines, anti-COVID drugs and new intensive care technologies. I have found it very hopeful that intensivists from around the world have gathered weekly via Zoom (all praise to God for Zoom!) to share information and problem-solve for both advanced and low-income health environments. The partnership developed out of the Prince Charles Hospital research unit in Brisbane has been commerce-free and voluntary.
“At the same time, COVID-19 has also seen an explosion of fake health news, premature claims reaching to the White House itself and serious vaccine hesitancy, even amongst health professionals.”
At the same time, COVID-19 has also seen an explosion of fake health news, premature claims reaching to the White House itself and serious vaccine hesitancy, even amongst health professionals. The democratisation of health through the internet has inherent potential for ‘cybermania’ and other terrible health consequences. There are occasional glimmers of hope. Despite an anti-vaccination stance by Brazil’s Christian president, that country has (after a slow start and high initial death rates) one of the highest percentage rates of vaccination coverage in the world. Brazil has a vaccine-literate community and has responded to an electronic media campaign from Public Health physicians.
While we almost implicitly trust science and its interpretation of data, there are serious challenges. Critical analysis suggests up to 80% of all scientific publications contain errors resulting from out and out fraud (think Wakefield and the false link made between autism and measles vaccination ) and simple statistical errors. In addition, other reviewers have recognised that a similar figure of concern exists with exaggeration and sleight of hand in reporting of research findings. Professor Peter Gibson16 (p16) issued a ‘call to modesty’ about medical research in 2018, when he identified the highly selective populations of randomised controlled trials (RCTs) as almost unrelated to everyday practice.
It seems the funding of university research budgets and the profits of health technology companies means we live with a bending of the truth. This lowers public confidence and puts lives at risk. Almost 23 years ago, I responded to an invitation for the launch of a novel calcium-channel-blocker anti-hypertensive. It was an extravagant affair with what seemed like most of Brisbane’s physicians attending. A razzmataz blitz was aimed to convince us to be early adopters lest the world itself would end. Unbelievably, a volley of unsuspecting Australians died within the first week of its release to market. Promoters, regulators, scientists, and Big Pharma had egg on their faces. I no longer attend such “launches”.
The list of bad consequences is disturbingly long, even without exploring complementary medical approaches. Some examples are:
- Women’s health. The #BreakTheBias campaign highlights that “women are dying because of the gender data gap in medicine – in medical research, in medical education, in medical practice – and it needs to be closed as a matter of urgency.”17
- ‘High-wealth-exceptionalism’. Today’s 2,750 world billionaires (and many others clutching at this goal) have mastered the avoidance of tax responsibilities in their countries of origin and have made an art form of plundering the wealth of the world’s poorest and most vulnerable populations. The unavailability of this wealth to deliver secure health for all is a heist on the world’s poor. A few brave souls like Bill and Melinda Gates swim against the tide, but even this commitment is a charitable, rather than justice, approach. 
- In the 1970s, British economist, EF Schumacher, coined the phrase ‘appropriate technology’. This term alerts us to the necessity of the thoughtful application of technologies since (as this 2016 report notes) “technology is cruelly polarized. The rich world enjoys more than its fair share (through mobile phone coverage). And, for the poor, the lack of technology is the defining feature of their poverty. The injustice is not an absence of technology, but the unfair exclusion of certain groups to access technology that already exists”19 (p11). Market forces alone are unlikely to solve this problem despite the possibility of technologies to contribute to a solution.20
- IT waste – the global volume of digital waste increases by a third every two years. Much of this is dumped in low income countries. The lack of recycling of rare earth minerals and other materials is concerning.
- Other negatives include clinician burnout, high costs of innovation, leverage of data and ‘big data’, negative mental health issues for children/adolescents, and so on.21-26
You can add to this list with your own awareness.
It may be hard to draw a line between the bad and the ugly. I am simply attempting to alert our thinking to the possibility that some technology and its associated up-or-downstream issues are heavily negative, burdensome to health endeavours or simply evil. I will pose some such examples that fit the bill for ugly. Others may come to mind.
- The commercialisation of tobacco sustained by marketing techniques casts a significant cloud over global health.
- Environmental pollution. From poor mining practices; through to waste at multiple levels of production, distribution, and consumer use; to poorly regulated end-of-use waste products. Pollution impacts almost every ecosystem, every waterway.
- The threat of nuclear accidents (Chernobyl, etc.) and war.
- Online and poker machine gambling.
- The gathering clouds of climate change can draw links to ‘technique’. An example is fossil fuel technologies. These carbon energy sources are required to sustain the industrial/technology projects. Negative health outcomes are a looming problem associated with climate change. Green technology offers hope.
- Online bullying/trolling leading to poor mental health.
- Ready access to pornography and child pornography.
“Technology won’t solve anything if the human heart isn’t moved.”27
These words of Elan Young capture the essence of our journey with technology. Yes, current and emerging technologies offer wide hope for improved health outcomes. Yet, as we have seen under the tutelage of Jacques Ellul, the age of technique has entrapped human health in an imminent, lonely, objectified world. An unspoken casualty of this paradigm change is the therapeutic effect of a personal doctor. Objectified medical care cannot replace the value of presence of heartbeat.
“An unspoken casualty of this paradigm change is the therapeutic effect of a personal doctor. Objectified medical care cannot replace the value of presence of heartbeat.”
The narrative trajectory of the Bible includes an awareness of changing technology. A nation that starts out as wandering Arameans ends up building the city of Jerusalem, where the incarnate Son of God dies to establish a new global people of God. Eventually, as the New Jerusalem comes from heaven to the ‘new earth’, we discover the “kings of the earth will bring their glory into the city” (Revelation 21:24). Presumably this will include the best of new technologies.
Today in our ‘technique milieux’, Christians have an opportunity to reimagine faith, and to action the power of the Spirit in order to restore the hope of freedom for the human heart. Ellul suggests, “Think globally and act locally,” as we undertake this task. It can be overwhelming to see the big picture of technology, yet acting in our own context – our medical and dental practices and faith communities – will allow for the faithful capacity to carry out our calling.
Dr Paul Mercer Dr Paul Mercer is a Brisbane GP who is still trying to remember how to use his slide-rule. He is the former editor of Luke’s Journal and continues to write as the Spirit moves. He is Chair of HealthServe Australia, a member of Theology on Tap team in Brisbane and a part of the Holy Scribblers writing co-op.
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- Burford, L. (2022, April). Can blockchain help create world peace? Sojourners.
- Ellul, J. (1981). Perspectives on our age: Jacques Ellul speaks on his life and work – Rev. and expanded ed. (W. H. Vanderburg, Ed.) Toronto, ON: House of Anasi Press Inc.
- Ellul, J. (1964). The technological society. New York: Vintage Books.
- Queen, D., & Harding, K. (2018). Editorial – Can healthcare catch up with technology. International Wound Journal. doi:10.1111/iwj.13035
- Mesko, B. (2017). Health IT and digital health: The future of health technology is diverse. Journal of Clinical and Translational Research, 431-434. doi:http://dx.doi.org/10.18-53/jctres.03.2017S3.006
- Kemp, J., Zhang, T., Inglis, F., Wiljer, D., Sockalingam, S., Crawford, A., . . . Strudwick, G. (2020). Delivery of compassionate mental health care in a digital technology-driven age: A scoping review. Journalv of Medical Internet Research. doi:10.3196/16263
- Belisle-Pipon, J.-C., Couture, V., Roy, M.-C., Ganache, I., Goetghebeur, M., & Cohen, I. (2021). What makes artificial intelligence exceptional in health technology assessment? Frontiers in Artificial Intelligence. doi:10.3389/frai.2021.736697
- Fiks, A. G. (2022). A better future for children through innovations in health information technology. Current Problems in Pediatric and Adolescent Health Care. doi:10.1016/j.cppeds.2021.101107
- Milani, R. V., & Franklin, N. C. (2017). The role of technology in healthy living medicine. Progress in Cardiovascular Diseases. doi:10.1016/j.pcad.2017.02.001
- Morris, S. (2018). Future of 3D printing: How 3D bioprinting technology can revolutionize healthcare? Birth Defects Research, 1098-1101. doi:10.1002/bdr2.1351
- Saeed, H., Malik, H., Bashir, U., Ahmad, A., Riaz, S., Ilyas, M., . . . Khan, M. I. (2022). Blockchain technology in healthcare: a systematic review. PLoS ONE. doi:10.1371/journal.pone.0266462
- Armstrong, J. P., & Stevens, M. M. (2019). Emerging technologies for tissue engineering: From gene editing to personalized medicine. Tissue Engineering Part A. doi:10.1089/ten.TEA.2019.0026
- Gupta, D. K., Ali, M. H., Ali, A., Jain, P., Anwer, K., Iqbal, Z., & Mirza, M. A. (2022). 3D printing technology in healthcare: applications, regulatory understanding, IP repository and clinical trial status. Journal of Drug Targeting, 131-150. doi:10.1080/1061186X.2021.1935973
- Ramey, L., Osborne, C., Kastinon, D., & Juengst, S. (2019). Apps and mobile health technology in rehabilitation. Physcical Medicine and Rehabilitation Clinics of North America, 485-497
- Ripatrazone, N. (2022). Digital Communion. Minneapolis, MN: Fortress Press.
- Gibson, P. P. (2018, February 1). Analysis – Randomised controlled trials – a case of false idols? The Medical Republic, 16.
- Author(s), T. (2022, March). Empowering women in health technology. The Lancet Digital Health, 4(3). doi:https://doi.org/10.1016/S2589-7500(22)00028-0
- Collins, C. (2022, April). How to hide wealth. Sojourners, 36-37.
- Godrej, D. (2016). Technology as if people mattered. New Internationalist, 10-15.
- Schumacher, E. F. (1993). Small is beautiful: Economics as if people mattered. London: Random House UK.
- Zarif, A. (2021). The ethical challenges facing the widespread adoption of digital healthcare technology. Health and Technology. doi:10.1007/s12553-021-00596-w
- Galea, S., & Vaughn, R. (2017). Editorial – On the promise and peril of technology for population health: A public health of consequence, November 2017. American Journal of Public Health. doi:10.2105/AJPH.2017.304046
- Logeswaran, A., Munsch, C., Chong, Y. J., Ralph, N., & McCrossnan, J. (2021). The role of extended reality technology in healthcare education: Towards a learner-centred approach. Future Healthcare Journal. doi:10.7861/fhj.2020-0112
- Kim, M. O., Coiera, E., & Magrabi, F. (2017). Problems with health information technology and their effects on care delivery and patient outcomes: a systematic review. Journal of the American Medical Informatics Association. doi:10.1093/jamia/ocw154
- Holis, C., Livingstone, S., & Sonuga-Barke, E. (2020). Editorial: The role of digital technology in children and young people’s mental health – a triple-edged sword? The Journal of Child Psychology and Psychiatry. doi:10.1111/jcpp.13302
- Poon, E. G., Rosenbloom, S., & Zheng, K. (2021). Editorial – Health information technology and clinician burnout: Current understanding, emerging solutions, and future directions. Journal of the American Medical Informatics Association. doi:10.1093/jamia/ocab058
- Interview with Elan Young (2021. Sojourners, 50(11), p37.