Matthew 25:40 - And the king will answer them, "Truly I tell you, just as you did it to one of the least of these who are members of my family, you did it to me."
In this series, those working within health care were asked to consider the words of Matthew 25:40 and then answer: Who are the least of these? How do they impact your ministry?
Mrs. Smith has a very difficult case. Her biopsy was inconclusive, but strongly suggestive of cancer. As her oncologist, I requested additional reviews of her pathology, but outside departments refused to review her results because she has state funded insurance. Her benefits would not pay them enough for second opinions. Although conclusive pathology would help determine her need for future surgeries, radiation, and chemotherapy, additional reviews would cost her hundreds of dollars out of pocket, or she would have to make an appointment with an outside institution and travel to have them evaluate her slides. If Mrs. Smith had the means to do either of these things she would likely already have the insurance that would allow her pathology to be reviewed in a far away city while she sat comfortably in her own home. Advertisements abound claiming cutting-edge cancer care and health care systems compete fiercely for the title of the best cancer center. But I ask myself: For which patients? Do we mean the ones with money?
In America, it is difficult to look at cancer treatment and not consider finances. Cancer care is incredibly expensive involving CT scans, PET scans, MRIs, bone scans, biopsies, lab work, and chemotherapy. Should access to these high-price items be restricted or rationed? What about second opinions? As a physician, I know that my family will receive all of these. We have the means and connections that allow this. But while my family has boundaries, I wonder about the limits of God’s family?
While Mrs. Smith is terrified, she is not “the least” within our health care system. Her husband attends her every appointment, providing encouragement and support. She does have some insurance, even if it does not pay doctors well. Regardless of affluence, everyone is terrified by the “C” word. What obligations do doctors have to the sick? Should physicians have a choice as to whom they will see as a patient based on insurance and income level? The problem starts with defining the suffering as an “other,” a somebody else that is not part of my family. In Matthew 25:40, Jesus implores us to broadly define family as all of humanity: to treat everyone, regardless of means, as if he or she was a part of God himself; to care for the patient as if he was a member of my family; to provide the same treatment as I would want for myself; to open our hearts.
As for Mrs. Smith: she is going to surgery. The surgery is potentially lifesaving, or completely unnecessary. We just can’t know for sure.
Mike Martin is a Medical Oncologist in Memphis, TN.