To be human, Stanley Hauerwas claims in this volume, is to be “in the business of learning to die” (xvii); to be Christian is to learn to die in light of the eschatological promise of the gospel. These are by no means new claims for Hauerwas, but rather represent consistent threads running throughout his extensive work. This new book also finds Hauerwas continuing his decades-long conversation with familiar interlocutors, in particular John Howard Yoder, Karl Barth, and Thomas Aquinas. After reading the lines I have just written, one could be forgiven for concluding that Approaching the End is thus simply a rehashing of familiar Hauerwas concerns and tropes, a retrospective look by a scholar transitioning into retirement (not too quickly, as Hauerwas's recent appointment to a chair in theology at the University of Aberdeen suggests) at the preoccupations that have shaped his career. To be sure, anyone with Hauerwas's voluminous theological output will find much that is familiar in these pages. Yet those many points of continuity should not fool the prospective reader into assuming that there is nothing new here. Not only does Hauerwas bring new guests like Stanley Cavell and J. M. Coetzee to his theological symposium at which Yoder, Barth, and Aquinas are permanent fixtures—some of these new guests push Hauerwas's thought in intriguing new directions.
As in most of his books, Hauerwas here collects occasional papers and presentations, loosely grouped under a common theme (in this case the importance of eschatology for Christian discipleship and for understanding the place of the church in the world). Some essays have a predominantly doctrinal focus (e.g., thinking with Barth about the connection between creation and eschatology), while most explore the implications of the church's calling to witness to God's apocalyptic action in Jesus Christ for how the church thinks and acts about war making, cloning, disability, dying, and more. Christian discipleship as witness both testifies to what God has done in Jesus Christ and to how that action is the apocalyptic disclosure of a coming future: as Hauerwas writes, “the witness of Christians does more than carry forward from what has happened; it also carries back from what will happen” (45).
In some of these essays Hauerwas extends and deepens arguments he has made earlier, bringing new conversation partners into the mix, as when he engages Peter Leithart on Constantine's legacy and its implications for the church's witness. In other instances, he tackles issues that he has been criticized for neglecting. So, for example, in one essay Hauerwas responds to George Lindbeck's friendly challenge to spell out the implications of Hauerwas's theological approach for ecumenism. Hauerwas challenges what he views as “the ecumenical movement's attempt to distinguish between matters of faith and order and faith and works” (112). The ecumenical vision Hauerwas presents is not an ecumenism of institutions or denominational structures (“denomination” is a derogatory term for him), but rather an ecumenism from below, one in which “Christians discover how they need one another if they are adequately to learn to live in a world that Christians created but no longer control” (119).
The chapters on illness, care, suffering, dying, and disability, for this reviewer, exemplify the strengths and limitations of Hauerwas's approach. For instance, Hauerwas and his chapter coauthor Gerald McKenny are undoubtedly correct that the lack of communication between physician and patient, which they take to be one of the key problems plaguing medical practice today, is attributable in part to the fact that they “share no common moral world,” and they are also undoubtedly correct that the church should be a place that trains Christians to accept death in the faith that death unfolds against the backdrop of resurrection. Christians who are ill, they argue, are sometimes called to “do nothing gallantly” (201). Yet after reading these chapters one comes away with the sense that Hauerwas's critics are correct in their assessment that he assumes “a far too idealized account of medicine” (179). Hauerwas pays far too little attention to the institutional constraints and processes that shape the practice of contemporary medicine. Hauerwas and McKenny, for example, approvingly cite Jerome Groopman's assessment that “language is still the bedrock of clinical practice” (201), without attending to how new technologies change clinical practice in such a way as to severely limit communication between physician and patient. Arnold Relman and others have argued that electronic record-keeping and other technologies have led to sharply curtailed interactions with patients on the part of doctors.
Hauerwas and McKenny's admonition to Christians that they must be prepared to “do nothing gallantly” points, from one perspective, to a profound truth. But it is also profoundly incomplete, failing to account for studies that have shown that patients who have been proactively involved in their care, or who have persons who can help them navigate institutional processes that limit communication with medical providers in order to advocate for their needs and concerns, have better health outcomes. One could go on at length about additional institutional realities that shape the contemporary practice of medicine in the United States that Hauerwas does not engage: how race and class have an impact on access to medical care and to communication with doctors; the role of pharmaceutical companies in underwriting medical research (including the ghostwriting of academic papers) and in helping to shape treatment protocols; the complexities of insurance (or lack thereof); and so on. All of these realities contribute significantly to the lack of communication between physician and patient that Hauerwas laments and views as a bedrock problem plaguing medicine today—certainly at least as much as the lack of a shared moral world. Hauerwas's insistence that the church should train Christians to be prepared to die and in some instances to do nothing gallantly is an important message that he has rightly returned to multiple times over the past decades; yet these arguments would become richer and less idealized if developed within a grittier and more textured account of the practice of medicine today.
Yet this criticism should not detract from this volume's very real strengths. In some essays Hauerwas breaks new, surprising ground. In particular, the chapter “Bearing Reality,” originally delivered as the 2012 Presidential Address to the Society of Christian Ethics, shows Hauerwas pushing his thought in exciting directions. Through engagement with J. M. Coetzee's novel, Elizabeth Costello, Hauerwas recognizes criticisms of the tendency in his work to pose “church” as a “solution” to the “difficulty of reality,” and here instead modulates his argument to name the hope that the church can “help us to bear the difficulty without engaging in false hopes” (157). Hauerwas confronts and names the theological challenge of speaking “unapologetically as Christians without denying the obscurities” (144), acknowledging that “a strong theological voice does not make reality any less difficult” (xvi). Drawing on Alex Sider's critical analysis of Yoder's doxological interpretation of history, Hauerwas asks, “Does praise threaten to make us ignore the voice of penitence, intercession, and lament? Does praise silence the cry for justice?” (145). Put another way, does an eschatological theology mean a closed narrative of complete wholes in which “church as witness” stands as a ready, all-too-simple answer to life's difficulties? Or might “seeing history doxologically,” as Hauerwas suggests here, make it “possible for us to recognize realistically the difficulty of reality and yet be able to go on” (156)? Hauerwas shows in this essay that an eschatological theology does not present a ready-made answer to life's brokenness, but rather presents a way of going on amidst that brokenness. God willing we will have many more such essay collections from him over the coming years, fragments that help the church go on.
