AIDS and the Church
by Earl E. Shelp and Ronald H. Sunderland
Dr. Shelp and Dr. Sunderland are research fellows at the Texas Medical Centerís Institute of Religion in Houston. This article appeared in The Christian Century, September 11-18, 1985, pp. 797-800. Copyright by The Christian Century Foundation; used by permission. Current articles and subscription information can be found atwww.christiancentury.org. This material was prepared for Religion Online by Ted and Winnie Brock.
The church, however, was noticeably silent. In fact, since 1981 when AIDS was first described, the personal tragedies and social failures associated with the disease appear to have been largely ignored by the church -- except for those strident segments that view AIDS as Godís retribution on a sinful people.
This silence may imply assent to the view that certain at-risk populations (gay and bisexual men, drug addicts, prostitutes) deserve the disease and the horrible death it portends. Or the silence may indicate a lack of knowledge of the disease and of the opportunities for ministry it generates. Whatever the reason for the shortcoming, AIDS raises basic issues of pastoral and prophetic ministry that involve the churchís role in the community as well as its responsibility for societyís dispossessed. Whether or not the federal government or other agencies provide resources to meet this crisis and some of the needs of people touched by it, the church itself must respond if it is to reflect in its life the spirit of its Lord who commanded his fellow servants to do for one another what he had done for them.
The Gospel of Luke is noted for its emphasis on Jesus as the humble, loving, compassionate Christ who holds the poor, the outcast and the dispossessed in special regard (see particularly Luke 4:16-30 and 7:18-23). Liberation theologians have developed this theme as the springboard for their theologies. An uncompromising affirmation of the churchís ministry to the poor is central to the churchís servanthood, they urge, since Jesus came preaching the Good News to the poor, and announcing freedom to the broken victims of human indignities and oppression. Godís servants have a special responsibility to act with justice and righteousness, and to speak prophetically in the name of a just, righteous and compassionate God.
The Jewish community could not fathom that the offer and blessing of the end-time would be extended to the despised of society. Yet this was exactly what Jesus proclaimed, drawing on the prophetic understanding of the poor as those who are oppressed, and who, therefore, cannot speak for themselves. The nature of grace and faith revealed in the life and mission of Jesus is demonstrated by his identification with isolated and outcast individuals. The political and religious establishments turn away all too easily from those who are outside the realm of social and religious respectability. Lukeís Jesus, however, deliberately turned toward those who had been rejected not only by their community but often by their families. He touched them, ate with them, and announced that they had a place of honor at the heavenly feast.
Jesus never stopped proclaiming that all are equal beneficiaries of Godís grace and forgiveness. In fact, he strengthened the proclamation by providing grace and forgiveness through healing, reconciling families and satisfying hunger. In short, Jesus responded compassionately to those broken by life. Often his acts of "pastoral ministry" express Godís acceptance and love of those judged unacceptable and unlovable by society, but often Jesusí mere presence beside the dispossessed was itself a manifestation of Godís favor toward the powerless.
Lukeís Jesus leaves us little room for negotiation, as indicated in the Parable of the Feast (14:15 ff.) in which the invitees state their reasons for declining the invitation to the feast, only to be excluded altogether. Servanthood involves being a sign of the Good News. Our care for others witnesses to our belief that they are also worthy of Godís love, and that they can be related to God. Caring not only means that one meets anotherís immediate needs, but it also calls us to tell the disenfranchized that she or he may become a liberated, loved and loving being.
As is well known, about 73 per cent of AIDS patients are homosexual or bisexual men. An additional 17 per cent are intravenous drug users. The mainstream of society tends to stigmatize both groups. If their "personal lives" become known, too often they are rejected by family, friends and church, lose employment, and experience other subtle and overt forms of discrimination. And, in the cases of homosexual and bisexual men, the stigma applies to who they are -- a matter about which they have no choice -- rather than (or in addition to) what they do -- a matter about which they do have a choice.
These injustices are compounded when one is diagnosed as having AIDS or ARC (AIDS-Related Complex). When heterosexual men and women, children, hemophiliacs and people who have received blood transfusions are labeled with AIDS or ARC, they begin to learn what it means to be unjustly isolated and ostracized. Nearly all AIDS or ARC patients have been shunned in some way by a public that fears their disease, objects to their sexuality or disapproves of their conduct. However, in light of Lukeís message, the latter two reasons are insufficient to justify Christiansí turning away.
Neither should fear of contagion stop Christians from ministering to AIDS patients. The virus associated with AIDS and ARC -- LAV/HTLV-III -- is not airborne, and there is no evidence that casual contact with patients results in infection. A person would have to be in contact with an infected persons bodily fluids (blood, excretions, secretions) to be at risk of contracting the virus. Protective precautions (gloves, mask, garments) are usually needed only during a patientís hospitalization or when certain nursing procedures are performed outside of the hospital. It should also be noted that some people who have been infected by the virus for as long as three years have not as yet manifested the disease. This suggests that factors in addition to infection by LAV/HTLVIII may contribute to the development of AIDS. Adequate instruction and proper precautions, as indicated, should ease, if not totally remove, any fears that might hinder ministry to these people in need.
Some Christians might also be reluctant to minister to AIDS patients out of fear that the social isolation of AIDS victims will be extended to those who befriend them. Colleagues and friends may withdraw, apparently fearing contagion, or because they disapprove of the investment in AIDS patients. Physicians, nurses and others who provide medical care to these patients have experienced this type of rejection. Christians should remember, however, that Jesus did not let the reaction of others deter him from having fellowship with the alienated and "unclean."
The course of the disease varies among patients. Part of its insidiousness is its unpredictability. The single constant is that no patient survives. Medical scientists around the world have moved with remarkable speed to identify LAV/HTLV-III -- a virus that can weaken, even destroy, the bodyís immune system. Unfortunately, no antiviral agent, vaccine or therapy to restore an immunity system has been found effective. Though physicians are improving their ability to treat symptoms with approved drugs and experimental agents, at best this enables some patients to live longer. At worst, it prolongs their lives so that they only suffer greater indignities and die more distressing deaths.
More than 600 AIDS or ARC patients have been registered in the clinic where we consult. An additional five to ten patients are treated as inpatients, about half of whom die during their hospitalization. Most AIDS patients valiantly try to maintain their independence as long as possible. But as they become too weak to work, as they lose income, medical insurance and possibly living quarters, as they suffer losses of eyesight and mental function and as they face social ostracism, AIDS victims can slip into almost total dependence on family, lovers and friends -- who may or may not remain committed to them. Indeed, the intensity of this terminal diseaseís physical and emotional toll may provoke the loss of oneís total support system.
Out of a desire not to hurt, embarrass or burden them, some homosexual or bisexual patients keep their sexuality and illness from family members. Even when told that a family member is dying, some families have refused to help. And parents and siblings who do not abandon patients frequently go through this trauma without the understanding and support of other family members and friends, or of their congregations, choosing, for whatever reason or reasons, to bear this burden privately. Their concern for secrecy may extend to requests that death certificates not reveal AIDS as a cause of death.
The personal tragedies, unmet needs and social failures extend far beyond those indicated here. Instead of compassion, the overwhelming public and political response to AIDS has been fear and callousness. For example, some health-care personnel and hospitals in the Houston area have refused to provide services, and nursing homes have closed their doors to AIDS patients. On August 26 the state of Texas, on the basis of a 9-7 decision of the Fifth U.S. Circuit Court of Appeals, reinstated a law against homosexual activity; it appears that that decision may in part have been influenced by an AIDS-induced backlash. And while Health and Human Services Secretary Margaret Heckler has termed AIDS the number-one priority of the public health service, the Reagan administration has consistently requested relatively small sums to combat the disease.
AIDS has already taken the lives of more than 6,000 people. Tens -- perhaps hundreds -- of thousands of people from every walk of life will die before treatments are found either to inhibit the diseaseís progress or to cure it. In the interval, its physical and social ramifications will escalate the suffering or its victims.
The church and individual Christians can help to alleviate the suffering associated with AIDS -- particularly in urban areas, where nearly all AIDS patients either reside or go for treatment. The people of God need to remember that the neighbor whom Jesus instructed his disciples to love excludes no one. Congregationsí ministries to sick people and to their families ought not neglect people with AIDS and their natural or chosen families.
Patents with AIDS can become very weak, either quickly or gradually. Often they do not have enough energy to make the almost daily visits to their physicians that are necessary, or to provide for themselves at home. They could benefit greatly by volunteer help: people to shop for them, do light housekeeping tasks, prepare or deliver simple meals, and visit or phone to check on them. The decline in strength is often paralleled by a deterioration of finances. Whatever assets the victim may have are liquidated to pay for medical care. Cars become an unaffordable luxury, so transportation to the clinic becomes a vital need. Financial assistance to purchase everyday needs may be helpful. AIDS patients are often alone, with no one to hear their fears, frustrations and anxieties, or to engage in pleasant conversation. Being a friend to patients can contribute to the quality of their remaining life.
Distant family members who visit the AIDS patient may not be able (or may not want) to stay in the patientís residence. Commercial housing for days or weeks can be a heavy financial burden on top of the emotional stress of watching a loved one die. Providing a bed, transportation, meals and emotional support to these people would be valuable services that Christians could extend. And at the death of the patient, the family may need assistance in making arrangements with a local mortician and in attending to other legal matters.
Finally, pastors could remind parishioners that reconciliation is a key element of the gospel. Reconciliation in the context of AIDS could take place, for example, between the church and homosexuals where they are estranged. Similarly, reconciliation between families and a separated family member could be promoted. Too often family members rush in when the patient is near death trying to affirm their continuing love. Though these reunions should be celebrated, they usually occur so late that the precious opportunities for each full to enjoy the otherís gift are few or lost altogether.
AIDS sets before the church an opportunity to reflect on its identity and its mission. For the church to ignore the needs that cluster around AIDS, to fail to express itself redemptively, and to abandon a group of people who have almost no one to cry out in their behalf for justice and mercy, would constitute a failure in Christian discipleship.