DO NO HARM: A HIPPOCRATIC OATH FOR PASTORS

Randy Freund

When asked to address the conference title, “The Office of the Ministry,” I was given wide discretion. Having recently addressed a related theme at the Augustana Theological Convocation (LCMC) on "Pastoral Care: Battling Doubt, Despair, and Desperation,” I decided to take up where I left off on that topic as it relates to this one. But the odd title, “Do No Harm—A Hippocratic Oath for Pastors?” should suggest a different landing.

Pastor Care or Counseling?

At the February conference, I mentioned that pastors need to think carefully about words, and how they are used and how they change and how they can subtly shape the way we minister and understand the office of the ministry. Starting in the 18th and 19th centuries (with its fullest expression in the 20th Century) the term “pastoral care” was largely switched to pastoral counseling. It doesn’t seem like a big deal, but it turned out to be―especially as we think about the importance and uniqueness of the “Office of Ministry.” The change was made largely because the word “counseling” seemed more acceptable in the academic world, generally, and the professional world of counseling, specifically. Pastors, of course, want to be taken seriously, we are “professionals,” after all! So, we went along with this.

But with this change came other meanings. What was traditionally seen as “care of soul” shifted to “transformation of the mind.” And worse, “absolving sin” moved to “accepting sin.” One of my CPE instructors wrote a book that demonstrated this, called –“Make Friends with Your Shadow.”

Applying the Hippocratic Oath to Theology

All of this got me to thinking about what it might look like if we were to apply the Hippocratic Oath to theology, and more specifically, to the office of the ministry. This oath, to which medical doctors are to subscribe, is loosely translated: "First, do no harm." A related phrase is found in Epidemics, Book I of the Hippocratic school, and goes like this: "Practice two things in your dealings with disease: either help or do not harm the patient." When a colleague of mine noticed my title, he said, “Do not harm?” he thought that would be an interesting case to make when the whole point is to kill to make alive. I realize this and will address this.

The Hippocratic Oath struck me as a rather minimalist way of thinking about the role of a doctor. In the oath, one does not sense an aggressive motive to Heal! Cure! Be bold! Save lives! And if one were to apply it as an “oath” for pastors, it might read this way: "Practice two things in your dealings with sin (rather than disease): Either help or do not harm the parishioner." This reminded me of a new term I learned from Dr. John Pless (one of the speakers at the AD theological convocation). It was the term “Clerical pessimism” or what I might term, “clerical shyness.” It refers to the way how we often underestimate the power of the Word and what God does with it. Part of the point of this presentation is to reflect on God’s word and the gift of faith as it relates to the specific and unique role of this office we hold. Martin Luther’s “one little word” is the greatest power on earth. It needs to be released! It needs a voice. We are the vessels of it, but it is all on God. That fact is good news. We not only seem to forget this, but we can actually undermine, that is, do harm to the very Word we proclaim the greatest power on earth (clerical pessimism).

So going back the Hippocratic oath as applied to pastors, we understand the Word of God as accomplishing far more than simply “helping” or at least “not harming” our parishioners. Jesus came that we may have life and have it abundantly. The new life offers a bit more than “helping” or “not harming.” All of this implies a death! We all get that. But in this presentation, I want us to think about how we use words and how we perceive their effect as we carry out our office in the daily life of being a pastor. As mentioned earlier, something not helpful, even harmful, happens when we forfeit the office by submitting to the subtle shift in pastoral ministry from “pastoral care” to “pastoral counseling.” This shift in language is not insignificant. It can actually derail us from the core of our pastoral office as it relates to the absolution of sinners. Again, this may not simply “not help,” but could “do harm.” The same can be true about the way we use phrases like “theology of glory” versus “theology of the cross,” “law/gospel,” and “right-hand-” and “left-hand- kingdoms.”

So, I will briefly give some other examples of how language can shape (for good or ill) the people we serve. Then, I will shift to reflections on the third article. How does faith come? What does this imply for preaching? Is there a possible heresy we don’t often talk about? Is this more than just sloppy or imprecise language?

This crisis of the word is …a failure to believe that the distant God can draw near to us, as near as our hearing (his word).

But before we go there, first “a word about words” (the primary tools in our office). In his great little book called Spoken Word, Sheldon Tostengard put it this way:

“There is a crisis in the church. It is, above all, a crisis of the Word. This crisis of the word is rooted in some form of unbelief. It is a failure to believe that God will come to us as promised, a failure to believe that there will be any saving word from beyond, a failure to believe that the distant God can draw near to us, as near as our hearing (his word). It is a failure to believe in a present God, a God who is at hand. The word crisis is rooted in the failure to believe in Jesus, the One who still wishes to speak a word of love and mercy to us.”1

This would be the definitive way to describe clerical pessimism and clerical shyness, as it relates to the Word and our office.

So, let’s go back to our Hippocratic Oath for pastors and show some examples of how we don’t help our parishioners and can actually do real harm with the way we sometimes toss words and phrases around. I highly doubt anyone would admit to espousing a “theology of glory” over a “theology of cross.” But we have all fallen into the trap from time to time. Lutherans prefer one of two legitimate options. We like to lift up the theology of the cross. Other Christians are more prone to a theology of glory. But, in truth, one of these two does not help and can cause real harm. As an example, let’s go back to pastoral care for a moment and compare what pastors have to offer that is similar, but something other than what a good secular counselor can offer. One of the things a counselor tries to do is minimize the distance between one’s expectations and one’s reality. The bigger the difference between the two, the harder it is to live and to cope. The gap between the two is called disappointment. Good pastoral care does the same in order that one may live, not merely cope. Luther’s genius in mental health/pastoral care field is that he understood the human psyche, the human condition and human nature. He was exactly what he said a true theologian is - someone who calls a thing what it is. So, what is our expectation and our reality? How do these line up? The reality is that we are sinners until we die. The expectation, therefore, is not a healthy dose of optimism and a positive outlook to deal with and tamp down sin. Positivity is not what is given, but something far greater: hope. Hope is based on a person (Jesus Christ). It is true and given no matter the circumstances or feelings. Our expectation is based on the truth that it is “no longer I who live but Christ who lives in me.” The expectation is to die in order to live. When these things (reality and expectation) are honestly laid out, it changes everything. Any “disappointment” sounds more like Paul in 2 Corinthians 4:8-12:

“We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be made visible in our bodies. For while we live, we are always being given up to death for Jesus' sake, so that the life of Jesus may be made visible in our mortal flesh. So death is at work in us, but life in you.”2

And here, we could spend some time talking about how looking deeply within is not only a problem of the wrong starting point for truth (inside the autonomous self) but suggests a climbing that is possible (theology of glory). It may be well intended, but it is not helpful and can even be harmful.

I was reminded recently of the anniversary of my sister’s death. She died of leukemia. A coffee mug she received reflected the well-intentioned encouragement she often received. It simply said: “You Got This!” It is not that this theme did not serve as encouragement. It did. But there came a point where it did not. At one point she confessed to me that she did not have this. She knew she was dying, and I had something to offer her at that moment no one else did or would.

C.S. Lewis

In a piece by C.S. Lewis, entitled, “Is Christianity Hard or Easy?” Lewis gets at the radical nature of this gospel we have. Stopping short or pulling back or thinking that the Word needs our help: some bolstering, some dressing up, or our charisma; does not help anyone and can actually do harm by putting the onus on us. Lewis reminds us that dying to self, to sin, is a different way, an alien kind of help. It offers a different kind of harm, a killing, in fact. The whole article is referenced in the endnotes, but this excerpt gives you a sense of his point. Lewis writes,

“Christ says “Give me All. I don’t want so much of your time and so much of your money and so much of your work: I want You. I have not come to torment the natural self, but to kill it. No half-measures are any good. I don’t want to cut off a branch here and a branch there, I want the whole tree down. I don’t want to drill the tooth, or crown it, or stop it, but to have it out. Hand over the whole natural self, all the desires you think innocent as well as the ones you think wicked – the whole outfit. I will give you a new self instead. In fact, I will give you Myself: my own will shall become yours.”3

Without being clear about the radical truth of our human condition, and how Christ enters into it, and what he promises, the preacher is not helping. He can actually be hurting. The Law will always accuse us, and it in fact kills, no matter how we try to soften it. In fact, attempts to soften it can make it even more deadly.

Left-Hand and Right-Hand Kingdoms

We, of course, lift up the left-hand kingdom’s function and goodness in all this. The law needs to prevent harm, keep order and help us cope. This is part of the way God so loves the world and loves the neighbor. As Gerhard Forde once succinctly put it: the left-hand kingdom holds us in readiness to hear the gospel (right hand kingdom work). So, these two kingdoms must be distinguished and held in tension, one serving the other.

Preachers need to know and remember the specific and unique right-hand kingdom role in the office of ministry.

Part of what this means is that pastors must ask things like: Does John 15:5 really mean nothing? Yes! Is John 14:6 really this exclusive? Yes! But there is an inclusive promise found in John 3:16 to accompany this. Is it true that our wills are bound (Romans 7:14ff)? Yes! When we are not clear about such things, our people will start to imagine the autonomous self is the final and most important source of truth. Or we might imagine that we can improve ourselves and rise above our sin with a little effort, or at least, some earnestness.

All of this goes alongside the fact that “justification by faith” is one New Testament theme among many. It is not like Lutherans have their favorite NT themes and other Christians have theirs. One ought to never present it this way. There is a reason for the reformers’ order: 1- God, 2 - Original Sin, 3 - Son of God, 4 - Justification by faith, and 5 - Office of the Ministry.

There is a reason for the reformers’ order: 1- God, 2 - Original Sin, 3 - Son of God, 4 - Justification by faith, and 5 - Office of the Ministry.

The Holy Spirit

At this point, we could encourage thought about our use of words as they might apply to a pastoral Hippocratic oath: "Practice two things in your dealings with disease/sin: either help or do not harm the patient/parishioner." But now we are going to move in a different direction with the same theme in mind. We shift now to reflections on the third article, how faith comes, and what this implies for preaching and the office of the ministry. This all relates to the Holy Spirit and how faith comes. When it comes to the Holy Spirit, we often focus on the harm done by separating the Holy Spirit from the Word. Luther has a great (and funny) quote that summarizing this danger: “If you want to become a theologian, you must carefully observe this rule, namely, where the Word of God contradicts your understanding, look for some other word that pleases you and say it is the Holy Spirit. After that, you may arrange and interpret the words as it seems good to you.”4 This is one danger, but another relates to the third article. One can sometimes hear the last gasp of the Old Adam/Eve saying, “But, but, but what about. . . I must do something. . .”

Why now focus on the third article at a conference on the “Office of the Ministry?” I would argue that the third article is primary, in some ways, as we think about Romans 10 and how faith comes by hearing, about who gives faith – namely, the Holy Spirit. Getting the third article right becomes critical in a way we don’t talk enough about. We talk about “Free Will” and the “Bondage of the Will,” but seem to rarely connect this to the third article. “You will be like God, knowing good and evil” (Genesis 3:5) means the Trinity…all three articles of the Apostles Creed matter.

To have all knowledge and wisdom and become like God is not only the original temptation and sin, but also a constant, persistent and ever-present danger. Therefore, the theological task in the pastoral office is a vital one. This is equally the case for each article of the Christian creeds. When Lutherans come to the third article, what can seem like innocent and even recreational debates about “free will” and “third use of the law,” and the like are anything but that. We make passing references to Semi-Pelagianism, but don’t go much further. That original temptation always lurks and has deep implications. How might this be as we contemplate the work of the Holy Spirit, and even more, the Holy Trinity?

Every Christian confesses a great mystery: the Holy Trinity. Week after week, whether one’s worship style is “traditional” or “non-traditional,” Christians, by definition, believe and gather to confess that God is one: Father, Son and Holy Spirit. The very confession, gathering and believing that happens week after week, has everything to do with this great truth and mystery of the Trinity. Our age-old rebellion called sin, our Old Adam/Eve will fight this, even to our dying breath. How does this happen? How does this function?

Week after week, whether one’s worship style is “traditional” or “nontraditional,” Christians, by definition, believe and gather to confess that God is one: Father, Son and Holy Spirit

The Christian confession that God is God generally holds up pretty well with the first article. God is Sovereign. God gives us breath and life. God is the Creator and Owner of all things. By saying and confessing this, we may even go so far as to admit that we truly don’t own anything because God owns everything. I can’t even own a loaf of bread. A little meal prayer reminds me of this. “In back of the bread is the flour and in back of the flour is the mill. In back of the mill is the sun and the rain and the Maker’s will.”5 The source of everything begins with God. This includes our brains and bodies and hands that do all kinds of work in order to receive wages for our labors. No one receives a paycheck without God’s power providing the means. Likewise, no one can choose or command one’s heart tobeat or one’s body to constantly produce cells. In the same way, we cannot order the planets to change their orbits any more than we can cause the angle of the sun to change in such a way so that the earth either burns up or freezes. It is in this sense that Christians would not argue with the truth of the first article of the creeds. God is God. God is sovereign. God is the eternal creator of all that is, was or ever will be—100%. “God has created me and all that exists…and has given me and still preserves body and soul with all their powers.”6

Likewise, we do quite well with the second article of the creed. C. S. Lewis once put it this way: Jesus is a liar, a lunatic or the Lord. Christians, obviously, and by definition, confess he is “Lord.” And by confessing Jesus as Lord, we confess the salvation won for us on a cross and an empty tomb. Jesus accomplished all that was necessary for our salvation by his death and resurrection. He did this while we were yet “sinners” and “enemies,” as Paul rightly notes. There is nothing we can claim here. Jesus did this “at great cost” (Luther) and out of sheer mercy, grace and unconditional love. Jesus rose from the dead with forgiveness on his lips for his denying and fleeing disciples. He does the same still to this day. He opens up a future for his undeserving followers, of all times and places. All of this is to say that no true Christian would ever suggest that they participated in Christ’s salvific work. That would be both unconscionable and heretical. The salvation won for us on the cross of death and the empty tomb is completely a salvation of Christ’s own doing— 100%. We play no part in this. We are the undeserving recipients of a gracious and merciful God.

So far, so good. Nearly all Christians have generally been able to agree on these basic things. It is when we get to the next article that the trouble comes. Our Old Adam/Eve can only yield so much and will only be pushed so far. All of this is true about God the Father (Creator) and God the Son (Savior) but now comes the believing part.

It is when we come to the third article that the confusion comes. Again, the old self can only give up so much ground before the pushback comes – the last gasp for control and power. I first discovered this, in earnest, when I found my way into a theological dispute with a good friend. He was and is a devout Christian. But he seemed to have everything backwards. One day I simply made an observation and asked him: Have you ever wondered why it is that you give the little things to God (job hunting, dating and good parking spots at grocery stores) and leave the big things to you (baptism, salvation and eternal destiny)? That question pretty much ended our theological discussion and greatly hampered our friendship.

Again, the old self can only give up so much ground before the pushback comes – the last gasp for control and power.

The offense here is real and should not be taken lightly. Luther may have thought he ended the discussion by his fine explanation of the third article, but that did not do it. It only increased the offense of the “bondage of the will.” “I believe that I cannot believe in Jesus Christ my Lord or come to him.”7 That is a clear declaration and confession. To say that our natural wills are bound to sin only, it requires that something or someone supernatural must break in. The offense of bondage of the will language is that it seems to imply that we have no power here and are even puppets and robots (my friend’s argument). This reaction gets right at the problem. It is not about US! The bondage of the will is about confessing a dynamic and active God, “in whom we live and move and have our being” (Acts 17:28). We worry about our wills, our power, our believing, while God is all about pursuing us, having us, taking us over, and loving us to death and then back to life. We have this need to hold onto “free will” language, but in truth, only God has free will. Luther saw “free will” language (the “things below” vs the “things above”) as a concession, not some truth to hold onto. He worried that the language tempts the Old Adam/Eve with a power that is not his own. His distinction of having freedom in the “things below” but not in the “things above” was simply an attempt to move conversation forward, but it was a concession. And honestly, when one really thinks about this battle of the wills, you must ask: Whose will do you want to WILL out? Even if one had total free will and it was in your power to choose the big things (like mustering up saving faith….like securing your eternal destiny), in the end, who would you rather trust with your life, death and eternity destiny – you or God? That is an easy answer.

Of course, there are other hurdles here. It is tempting to turn sanctification into our work. In Lutheran circles, there is this longstanding argument about the “third use of the law” that comes into play. Once again, Luther may have thought he settled all this by saying “faith is to works as a candle is to heat,”8 but clearly that did not seem to settle the matter. Gerhard Forde made other similar attempts, best summarized by his famous quote that “sanctification is simply getting used to the fact that we are justified by faith alone.”9 This too has not convinced some in the Lutheran family that any third use of the law is simply an unnecessary repetition of the first use of the law. But even worse, does it subtly tempt the Old Adam and the Old Eve when it comes to the work of the Holy Spirit in creating faith (again, we are considering here the importance of language that does not help and can do harm)?

So, to get back to the main point of this article, the title, and our use of language as pastors, Christians do quite well with the fact that every breath and all of life itself is a pure gift of and power from God. Likewise, no one would claim to somehow have a hand in or participate in the salvation event of Christ Jesus. But why do we tend to stumble with the third article? Why doesn’t the total nature of life and breath and salvation translate into the total nature of faith. Why is this? In my mind, it can only be the “last gasp,” the last attempt of the Old Adam/Eve to hang on to some power and control in all this. It is that original and lasting temptation from the garden “to become like God.” And this brings us to the worse offense and the real danger of all this…. this the bombshell part mentioned earlier…

If the total nature of God’s action is diminished in the third article (in ANY measure –even .01%) this undermines the confession of the Trinity that defines us as Christians. God the Father is a total claim - 100%! We did nothing to create ourselves or the universe. God the Son is a total claim - 100%! We did not participate in ANY way in the salvation won for us by Christ’s death and resurrection. So, when it comes God the Holy Spirit, anything less than 100% faith (even 99.9%) to believe that all of this good news is true would logically make God the Holy Spirit less than God. It matters not what the percentage is. If faith to believe in God the Father and God the Son is 100%, but God the Holy Spirit is 99.99%―God’s power and 0.01% mine―then by logic, math, confession and definition, God the Holy Spirit is not God and there is, therefore, no Trinity. Christians would have to confess the Two in One rather the Three in One. This would be foolish, impossible and completely heretical. This is not helpful and does significant harm (back to the Hippocratic oath for pastors). But that is exactly what one might expect from that slippery snake who still whispers and promises that we can have “all knowledge and wisdom (and a bit a faith) and become like God.” Words are the only real tools in our medicine bags…how we use them matters greatly – they are a matter of death and life!

If the total nature of God’s action is diminished in the third article (in ANY measure – even .01%) this undermines the confession of the Trinity that defines us as Christians.

But thankfully, God remains God for all eternity and therefore gets the last word in this world and in our lives. When God silences/puts to death the Old Adam/Eve and raises us to life the New Adam/Eve, we can only say, thanks be to God (Father, Son, Holy Spirit) that we have breath again; that we have gone from death to life again; and that we have faith again.

One can see how the “free will” controversy can subtly, and even unintentionally, undermine the Trinity’s third member. The implication for the preaching office is clear. Faith comes by hearing and faith is the gift of the Holy Spirit….no application, assistance or requirement possible or necessary.

So, going back to where we began – the Hippocratic Oath for pastors to “do no harm” is really about language, how we use it, and the power of the word. The irony in all of this is that, generally, other Christian groups, especially Pentecostals, are known for their strong emphasis on the Holy Spirit, while Lutherans are derided for a “soft” emphasis on the Holy Spirit. We are characterized as people who don’t take the Holy Spirit seriously enough. In reality, and by our language and theology it is just the opposite. What could be more serious or have greater emphasis than to say, like the Father gives life and breath; “still preserves my body and soul with all their power, and that the SON died and rose, giving eternal salvation, so also the spirit freely gives saving faith!”10 Lutherans understand their total dependence on the Spirit for faith. This seems like a pretty “strong” emphasis on the Holy Spirit.

One thing we need to be clear about in our language is that one thing that must die is our desire to control the Spirit, by managing or mustering up saving faith.

Letting God Be God

There is one more thing. Let’s end where all matters under heaven and earth begin and end, in the WORD. Let’s go back to my colleague’s comment about the title: “Do no harm.” What about killing? One thing we need to be clear about in our language is that one thing that must die is our desire to control the Spirit, by managing or mustering up saving faith. Dying to self, raised to Christ is the most helpful thing there is to offer. Take the parable of the sower and seed from Mark chapter 4:1-12,

…. Again he began to teach beside the sea. Such a very large crowd gathered around him that he got into a boat on the sea and sat there, while the whole crowd was beside the sea on the land. He began to teach them many things in parables, and in his teaching he said to them: “Listen! A sower went out to sow. And as he sowed, some seed fell on the path, and the birds came and ate it up. Other seed fell on rocky ground, where it did not have much soil, and it sprang up quickly, since it had no depth of soil. And when the sun rose, it was scorched; and since it had no root, it withered away. Other seed fell among thorns, and the thorns grew up and choked it, and it yielded no grain. Other seed fell into good soil and brought forth grain, growing up and increasing and yielding thirty and sixty and a hundredfold.” And he said, “Let anyone with ears to hear listen!” When he was alone, those who were around him along with the twelve asked him about the parables. And he said to them, “To you has been given the secret of the kingdom of God, but for those outside, everything comes in parables; in order that ‘they may indeed look, but not perceive, and may indeed listen, but not understand; so that they may not turn again and be forgiven.’”

There is mystery here. Why would God choose to open and close ears, hearts and minds? I do not know. So, we preach this One who sows the word (indiscriminately). There is an incredible promise/ harvest. We have no choice but to let God be God. The wind (of the Spirit) blows where it wills. But there is a promise as to where this is heading and why we are called to keep preaching, confessing with Paul about what is true now, and in the end. This is the most helpful, truthful, life-giving thing out there. A famous surgeon once said, “I’m just a high grade plumber. I help to make sure THAT people live, but I can tell them WHY they live.”11

We have no choice but to let God be God.

We have been given the why answer to offer, both now and in the end. Now? It is no longer I who live, but it is Christ who lives in me. And the life I now live in the flesh I live by faith in the Son of God, who loved me and gave himself for me” (Galatians 2:20). In the End? “Let the same mind be in you that was in Christ Jesus, who, though he was in the form of God, did not regard equality with God as something to be exploited, but emptied himself, taking the form of a slave, being born in human likeness. And being found in human form, he humbled himself and became obedient to the point of death—even death on a cross. Therefore God also highly exalted him and gave him the name that is above every name, so that at the name of Jesus every knee should bend, in heaven and on earth and under the earth, and every tongue should confess that Jesus Christ is Lord, to the glory of God the Father” (Philippians 2: 5-11).

Rev. Randy Freund is the pastor of Vining Lutheran Church, Vining, MN.

Endnotes:

1Sheldon Tostengard, The Spoken Word (Minneapolis, Minnesota: Fortress Press, 1989), 18.

2Crossway Bibles, The ESV Study Bible: English Standard Version (Wheaton, IL: Crossway Bibles, 2008). This and all subsequent Bible citations in this essay use the ESV translation.

3C.S. Lewis, The Joyful Christian (New York: Macmillan Publishing, 1977), 178-183.

4Martin Luther, Luther’s Works, vol. 38, ed. Jaroslav Pelikan and Helmut T. Lehmann (Philadelphia: Fortress Press, 1955), 297.

5Beliefnet, Prayer, “Table Grace,” https://www.beliefnet.com/prayers/protestant/meals/tablegrace.aspx

6Martin Luther, The Small Catechism, Explanation to the First Article of the Apostles Creed (Graham, North Carolina: Sola Publishing, 2010), 13.

7Martin Luther, The Small Catechism, Explanation to the First Article of the Apostles Creed (Graham, North Carolina: Sola Publishing, 2010), 15.

8Martin Luther, Luther’s Works vol. 35, Word and Sacraments I (Philadelphia: Fortress Press, 1960), 370-371.

9Gerhard Forde, The Preached God (Grand Rapids, Michigan: William B. Eerdmans Publishing Company, 2007), 226.

10Martin Luther, The Small Catechism, Explanation to the First Article of the Apostles Creed (Graham, North Carolina: Sola Publishing, 2010), 13.

11Alvin N. Rogness, Book of Comfort (Minneapolis, Minnesota: Augsburg Publishing House, 1979), 78-79.