Spirituality in Patient Care

Through most of recorded history spiritual beliefs and religious practices have been assumed to play a central role in health. Religious leaders were often also seen as healers, or at least mediums through whom healing might come. The 20th century particularly saw a separation between the practice of medicine and spiritual/religious belies and practices. Harlod G. Koenig’s book  Spirituality In Patient Care: Why, How, When, and What addresses this gap and argues for the inclusion of patient’s religious and spiritual life as an essential element in “patient-centered medicine” (8). He makes use of volumes of research data to demonstrate the value of religiosity to health, and the importance of health professionals addressing this aspect of their patients’ lives.

The book outlines, as the title suggests, the why, how, when and what of including the spirituality of the patient in the treatment conversation and plan. He then proceeds to discuss some risks – i.e. some ways that religious and spiritual beliefs and practices might be problematic, and how do address these. One example is the notion that illness or suffering is somehow “God’s will” which might dispose a patient to resist treatment or might interfere with that patient’s openness and capacity for healing (108). He outlines professional boundaries for health professionals, and then spends a chapter on each of the following disciplines and how they might address spirituality in patient care: Chaplains and Pastoral Care; Nursing; Social Work; Rehabilitation; Mental Health.

His final two main chapters are spent outlining a model curriculum for including religion and spirituality in medical training, followed by an overview of beliefs and practice found in world religions. These chapters are helpful not only for medical schools but particularly for staff development and inservice training in medical facilities. Ongoing conversation is needed to develop the ability of all health practioners to address these issues effectively with patients and their families. The failure to do so can hinder the ability of patients to develop a relationship of trust with their medical team and to make full use of these resources for their progress toward wholeness.

I highly recommend this book for medical practioners as well as clergy and other religious professionals and lay leaders who function in healthcare settings or interact regularly with people in matters of their health. Below are links to chapter summary notes for use in a book club or other study.

Spirituality in Patient Care – Overview & Intro
Spirituality in Patient Care – Chapter 1
Spirituality in Patient Care – Chapter 2
Spirituality in Patient Care – Chapter 3
Spirituality in Patient Care – Chapter 4

(Other notes coming soon)

Baptism as a beginning of being beloved

Ten years ago this month, October 2002, I began to serve my call as senior pastor of Forest Grove Christian Church. That is an important moment in the life of a congregation, as well as for pastor and family. Everyone wants to be sure to get off on the right foot. Think about the first time you meet your sweetheart’s family, or your first day at a new job, or the first game of the season. First impressions often become lasting impressions, for better or worse. “You never get a second chance to make a first impression.”

Of course we also like to talk about a “honeymoon period” – that time when everyone is on their best behavior, everyone is still filled with joy and anticipation at the newness of the relationship. Then someone gets the flu. Something interrupts the almost saccharine atmosphere of ebullient enthusiasm. Suddenly you realize, “Honeymoon’s over”. Now, that can be both good and bad. Sure, that effervescent season was pleasant, but that is not really where the growth takes place. We get to demonstrate love when our companions are not at their best, and we love them in and through that. Our love is tested, we are tested to see what we are made of, what kind of people we are. And then, when that season passes, we begin the real work of building a relationship based upon long term commitment to covenant love.

I was looking forward to the season of honeymoon, honestly. It had been a difficult year – a difficult couple of years. I had come from a place where folks were acting like they didn’t like me, didn’t really want me around. The efforts of the church had been frustrated by a stubborn few who insisted on controlling rather than letting the Spirit flow. We could use a fresh start. And every indication was that Forest Grove would be just the kind of place where we would find it.

The evening before my first Sunday in the pulpit we were guests at a wonderful celebration – a 60th birthday party of one of the church members. I saw this as a chance to get to know more folks socially, to introduce myself, “let my hair down” as it were and relax and enjoy being together with these new folks who were welcoming us into their lives.

Our daughter was 7 and in first grade. Our son was 10 months old – still being carried around like a 40# sack of potatoes. There was food in the house, and live music on the patio, under a cover near the pool. Tables and chairs were scattered around. The birthday girl seemed to be having the time of her life – everyone was in good spirits.

Someone walked up to the table where I was seated, but there were no empty chairs. I gave her mine, and proceeded around the yard to where the extra chairs were leaning against the house. On my way back I navigated between pairs and triplets eating, talking and laughing. As I turned the corner of the pool, at a particularly narrow place in the deck, my left foot came down out over the water – I’d missed the coping by a good 6 inches. Into the water I went. This was not a swim party, or had not been up to that point. I was fully clothed, and as I came up sputtering I heard a gasp and a shout. You see, for the last half hour I had been holding our son. I had handed him off to the person to whom I also gave my chair – but many did not realize this. Once they realized that the baby was safe, laughter erupted from all corners, including from me. Someone helped me out, I dried off, and the party resumed.

On the way home we were talking about the evening’s events. We agreed that this was perhaps the best thing that could ever happen on an inaugural weekend. The honeymoon was over. No more wondering when the new guy was going to step in it, as they say. No more pretension of having everything together. The whole church had been invited to the party, and most had come, so this was now a shared story, the first in our history together.

The next morning there were many smiles and grins and even a few chuckles. Yes, it was funny. Yes, I’m ok, thanks for asking. When it came time for worship, I had my notes that my predecessors had given me to guide me through the nuances of how worship flows here at FGCC. At one point in the service, it may have been announcements or the prayer time, I don’t recall, I asked if anyone had anything else, at which point the choir began to hum shall we gather at the river, and our resident choral thespian stepped forward, and in his best southern camp meetin’ preacher drawl, proceeded to expound on the virtues of the previous evening’s festivities, and in particular how the pastor had duly baptized himself. Recognizing this second gift – the congregation receiving in love what I had offered the previous night – I stepped down and knelt before the self-appointed evangelist as he laid hands upon me and prayed for me. Here is the baptismal certificate I received that day.

That is one of my baptismal stories – you may have some of your own. I remember baptizing my daughter and several of the other children here. I have had the pleasure of baptizing several adults, and of celebrating a ritual of remembrance for others who had been baptized as infants in other traditions. As a Christian, as a parent, and as a pastor, I have thought a good deal about baptism, what it means, how and why it is done.

My own story is that I was raised in the Presbyterian church as a young child, following the tradition of my mother. As is the practice among Presbyterians, Methodists, Lutherans, Congregationalists, Episcopalians, Orthodox and Catholic Churches, I was baptized, or christened, as an infant. Resulting partly from that experience, I grew up always knowing that I belonged at the church, never feeling like an outsider waiting for some particular moment when I would be invited or let in. My earliest consciousness includes the awareness that I belong to God and that Jesus loves me and that the church is a place of safety and peace and hope – a place where we learn to follow Jesus and thus become who we are created to be.

When I was 10, we had moved to Texas from Pennsylvania, and we joined a Disciples congregation after the tradition of my father. I am actually the fifth generation in my family to be theologically trained in the Disciples’ tradition. That 5th grade year was the time for what in some churches is called Pastor’s Class. In this instance it was a special class taught by the pastor to a group of 8-12 ten year olds in preparation for our public profession of faith and baptism.

As I said, I had always known myself to be a baptized Christian. I had not ever formally made what one might call a public profession of faith, though I had talked about my faith and trust in Jesus many times with others. I also had not been immersed, I could not remember my baptism. And all my peers were doing it. To my recollection we never had a conversation about whether it was appropriate to rebaptize someone, or just how this would be understood and described. I just did it. I recall it being a joyful experience.

I developed the habit of saying regarding baptism, “I just like to cover all my bases, so whoever is right, I’m ok.” I didn’t actually think of it that way though. For me, the experience when I was ten served as a reaffirmation of my one baptism as an infant.

Some of you have dramatic conversion stories accompanied by a joy-filled and tearful baptismal experience where you knew yourself claimed and sealed by God for eternal life. Others of you have experiences more like mine – a slow unfolding knowledge and faith that has always been present. Scripture attests to both. Either way, baptism represents God acting in our lives, through the church, to call and claim us as his own, and our willing response to be called and claimed. For those baptized as infants, many churches provide an experience later in life, often called confirmation, where like in my Pastor’s class the basics of the Christian faith are reviewed and the participant is encouraged to give self, body mind, soul and spirit, to the Love and Lordship of Jesus Christ, the Son of God and our Savior. I find that occasionally in my Christian walk I need that confirmation experience – it is not a onetime thing anymore than our profession of faith or our salvation are something that only happened in the past. As followers of Jesus, we like him are called to come daily to the Father to confirm our commitment to God and to receive confirmation from God that we are now and always have been God’s beloved.

Through baptism into Christ we enter into newness of life and are made one with the whole people of God.

These notes are part of a series exploring our Disciples Affirmation of Faith

The form, subject, effect and meaning of baptism have been a topic of deep theological wrestling since the early centuries of the Christian faith. One can look at the Pelagian and Manichean controversies, and the work of Augustine, to further explore this early conversation. The Didache, a second century Christian document that outlines various church practices, describes both believers baptism by immersion as well as other forms. This document indicates that the church sought to determine a ‘preferred’ practice of baptism, while admitting the validity of others. This too, is what we seek as Disciples. While not attempting an exhaustive theology of baptism here, I do want to identify some founding principles and offer some thoughts for consideration as we continue to walk by faith.

Baptism has been a focal concern for the Campbell/Stone movement from its beginning. Three of the four early reformers were Presbyterians (Thomas and son Alexander Campbell, and Barton Stone) by training and practice, the fourth (Walter Scott) a Baptist. The Campbells and Stone all separately developed their ideas regarding believers baptism being the normative form in the New Testament. For Alexander, the matter was brought to the fore when his first daughter Jane was born in 1812, when he determined not to have her baptized, as would have been the normal Presbyterian practice. Rather, he sought out a Baptist preacher who baptized father and son, their wives, and three other members of the Brush Run Church. Over time Alexander Campbell resolved that belivers baptism by immersion was the preferred form, but that it was not something over which to break fellowship with other Christians. The others agreed. (see Toulouse, Joined in Discipleship).

As Disciples, our interest in Christian unity compels us to consider seriously the practices of other Christian congregations. Our humility compels us to acknowledge that our best and most prayerful study and reflection may not lead us to the final, ultimate, and exclusive truth on this or any other matter. Our longing to be faithful followers of Jesus compels us to seek to understand the scriptures, guided by the Holy Spirit in conversation with the teaching of the church, reason and experience. Our trust in the bonds of Christian love compels us to share our understanding in this faith and humility with the expectation that others will do the same, that through this sharing the Body of Christ will be built up and the work of the kingdom of God on earth as it is in heaven furthered, to God’s glory.

We want to begin with scripture, but in order to do so we have to acknowledge our own inherent biases. Each of us has a background history with baptism, either by its presence or absence, its practice or neglect, and perhaps particular teachings about it. Each one of us needs to examine those things carefully and then set them aside for a moment, not to be rejected or neglected, but as though tuning out one voice in order to attend to another. If you grew up in a Christian tradition, what was the teaching and practice there regarding baptism? Was it primarily of infants by sprinkling, or of believers by immersion? What measure of teaching accompanied it, either for the baptized or their family or both, and did it precede of follow? How was confession/profession of faith associated with baptism? What was the teaching regarding the receipt of the Holy Spirit by the believer? Finally, were these practices explained in the light of particular New Testament passages, or more generally by means of statements of the congregation or tradition. Examples of the latter might be selections from a baptism statement, or a catechism. Consideration of these influences will likely impact how one hears and reflects upon the passages found in the New Testament.

These passages are of several general types. The first are those stories which relate the work of John the Baptist, and in particular the event of Jesus receiving baptism from John (Mark 1; Matthew 3; Luke 3; John 1). The next is a reference to Jesus’ disciples practicing baptism (John 3). At the scene of his ascension, Jesus is seen giving instruction to his apostles that they are to baptize (Matthew 28). Luke relates several stories of the practice of baptism in the early years of the church (Acts 2; 8; 11; 16; 18; 19; 22). And finally, the epistles, particularly of Paul, discuss baptism from a variety of perspectives (Romans 6; 1 Corinthians 1, 12, 15; Colossians 2; Galatians 3; Ephesians 4; 1 Peter 3)

In the first set, we come to understand what is reinforced by later teaching by both Jesus and Paul, that the baptism of John is a baptism of repentance for the forgiveness of sin, and is an act of preparation for the coming kingdom of God which John foretold and which the incarnation and work of Jesus (ministry, death, resurrection, ascension, sending of the Holy Spirit) ushered in. John finds it odd that Jesus would come for baptism, thinking their roles reversed and that he, John, needs to be baptized by Jesus. The Lord insists, stating simply, “Let it be so now, for it is proper to fulfill all righteousness” (MT 3:15). This does beg an interesting question that is never answered in scripture, namely why exactly Jesus would receive John’s baptism which is expressly described as “of repentance for the forgiveness of sins” (MK 1:4). It is the much later writer of Hebrews who will suggest to us that Jesus was sinless (HB 4:15) so perhaps such a notion was not understood during Jesus’ own lifetime. I have elsewhere suggested that, because repentance means to turn from one way of life to another, in this broader sense Jesus did need to repent, turning from the life of a carpenter and family man to this new life taking on the full weight and meaning of being the Messiah – and perhaps given this change it was important to him to have an experience like baptism that marked the transition. It has also been suggested as necessary because Jesus picked up the mantle of the ministry of John – John being like Elijah who must precede the Messiah (MK 9:11-13) and that John would decrease as Jesus increased (JN 3:30) and therefore must begin his ministry as an outgrowth of John’s to establish the line of continuity, which may be what Jesus meant by “fulfill all righteousness”.

In John 3-4 we do get a reference to Jesus, or more precisely the disciples of Jesus, practicing baptism of followers in parallel with John’s own continuing practice. I find it interesting to note that this is the only reference to said practice by Jesus’ disciples before the ascension. Baptism seems not to have been an important feature of Jesus’ earthly ministry. Similarly, Paul will note that he only rarely and sparingly practiced baptism as a part of his evangelistic ministry (1 Cor 1:14-18). One might ask in both instances why baptism would not be a primary feature, particularly given the great weight it receives in later centuries of Christian faith and practice. When Jesus gives his final speech in Matthew’s gospel, he does instruct that the apostles (as representing the work of the church and the ministry of all believers? Cf JN 17:20) “…make disciples of all nations, baptizing them in the name of the father, the son, and the holy spirit, teaching them to obey all that I have commanded you…” This is the one place in all of scripture that Father, Son and Holy Spirit are identified in the same verse, and the only time that the “baptismal formula” (i.e. words used at baptism) is found in this form. We will note other forms from Acts and Paul’s writings.

In Luke’s account of the work of the Holy Spirit in the birth of the church (as the book of the Acts of the Apostles has often been described) we get several different teachings on baptism. Peter instructs the Jews in Jerusalem to respond to the gospel message “Repent, and be baptized every one of you in the name of Jesus Christ so that your sins may be forgiven; and you will receive the gift of the Holy Spirit.” (ACTS 2) Here the formula is “in the name of Jesus Christ” in contrast to the instruction given by Jesus in Matthew 28. Again, the baptism is described as connected to repentance and the forgiveness of sins, as the baptism of John, with the addition that it will be accompanied by the receiving of the Holy Spirit into the life of the new believer. In Acts 8 we see Phillip preaching the gospel and baptizing new believers, but the receipt of the Holy Spirit only follows some time later, with the visit from Peter and John who came down from Jerusalem to Samaria where Phillip was, laid hands on the newly baptized believers, and prayed that they might receive the Holy Spirit, which they then did. In this instance we see new belief followed by baptism as one event – repentance is perhaps understood but not mentioned here, nor is forgiveness, and the Holy Spirit comes only with a separate act by other apostles.

Our next encounter with new faith in Jesus comes as Peter is taken to preach to the Roman centurion Cornelius, who is described as “a god-fearer” which is a term for gentiles who revere, worship and seek to serve the God of the Jews. The story unfolds in Acts 10, and is retold by Peter in Acts 11. Acts 10: 44 While Peter was still speaking, the Holy Spirit fell upon all who heard the word. 45 The circumcised believers who had come with Peter were astounded that the gift of the Holy Spirit had been poured out even on the Gentiles, 46 for they heard them speaking in tongues and extolling God. Then Peter said, 47 “Can anyone withhold the water for baptizing these people who have received the Holy Spirit just as we have?” 48 So he ordered them to be baptized in the name of Jesus Christ. Then they invited him to stay for several days. I want to focus on the timing of events here. While Peter is preaching, these gentiles spontaneously receive the gift of the Holy Spirit “as at the beginning” and in response Peter concludes that it is not his place to withhold baptism from those who have already received the gift of God – the Holy Spirit. The formula “in the name of Jesus Christ” is the same, but the order is reversed – here the Holy Spirit is given before baptism, even before any public acknowledgment of belief, faith, or repentance. Again, these may be implied or understood as necessarily present in heart and mind if not outwardly testified by the gentiles. But the fact that there is no public profession mentioned prior to the giving of the Holy Spirit is noteworthy.

When we enter into the teaching ministry of Paul, we encounter a different kind of writing. In the Gospels and Acts we are hearing second hand accounts of events that are written down several decades after they happened – these books are believed to have been written sometime between 60-90 AD. With the epistles of Paul, we have the interactions of a teaching evangelist with the churches he planted and nurtured in their infancy and continued to encourage throughout his ministry. Paul acknowledges that he is addressing specific issues, controversies, and concerns in these congregations, and his writing about baptism is in the context of these ongoing conversations. This reality invites us to recognize that, having only part of the conversation, we may not know all that Paul had in mind as he was writing. Some things may be implied, suggested or understood by his audience that are lost to us. This does not prevent us from gaining understanding from his letters, but it might discourage us from being overly dogmatic in what we do conclude.

Paul introduces to the teaching on baptism a correlation to the death, burial and resurrection of Jesus. Therefore we have been buried with him by baptism into death, so that, just as Christ was raised from the dead by the glory of the Father, so we too might walk in newness of life. (RM 6:4, cf COL 2:12) Paul’s concern seems to be, particularly in Romans 5-7, to outline the difference between life without the law, life with the law, and life under grace through faith in Christ. Paul does not spend much time discussing repentance, but perhaps this is his way of exploring the same idea – turning from one way of living to another way by considering ourselves “dead to sin and alive to God” (RM6:11) because we have been “baptized into his death” (6:3) and “The death he died, he died to sin, once for all; but the life he lives, he lives to God.” (6:10)

Paul understood baptism as a way of representing our life in Christ and the effect of Christ’s life upon us. This life includes freeing us from sin and from trying to live by the law. It also joins us not only with the risen Christ, but with His Body, the Church (EPH4). Likewise, Paul connects baptism with the Holy Spirit and with the church when he says, “12 For just as the body is one and has many members, and all the members of the body, though many, are one body, so it is with Christ. 13 For in the one Spirit we were all baptized into one body—Jews or Greeks, slaves or free—and we were all made to drink of one Spirit.” (1 Cor 12) He does not describe the form of baptism, nor offer particular words by which he had or we should baptize. His concern is with what baptism represents for the life of the believer.

In this regard, we need to also look at Colossians 2:11-12, where Paul connects baptism to circumcision: “…you were circumcised with a spiritual circumcision…you were buried with him in baptism“. These parallel statements link the two practices as having similar meaning and effect. They are gifts from God which mark one as belonging to the believing community, a sign of the covenant between God and God’s people (GEN17). Paul is also clear that what matters is the state of one’s heart toward God, not the physical act of circumcision (RM2; 1COR7; GAL5). This idea is also found in Deuteronomy 30 and Jeremiah 4:4. Does it seem reasonable then to suppose the same might be true of baptism – God is more concerned with the state of our heart in humble faith than with the particulars of any ritual, as important as it may otherwise be.

Perhaps of greatest import is whether baptism is necessary for salvation. To Nicodemus, “Jesus answered, “Very truly, I tell you, no one can enter the kingdom of God without being born of water and Spirit.” (JN3:5) In Mark 16 we read: “The one who believes and is baptized will be saved” (MK16:16). These two verses are the primary justification for linking baptism to salvation. The experience of Cornelius might suggest that he and his family were already saved before baptism. Could we envision and unsaved person receiving the Holy Spirit and extolling God? Perhaps the best argument for salvation being possible without baptism is the scene from Luke 23:43 where Jesus tells the thief on the cross “you will be with me in paradise.” Here Jesus responds in the grace and mercy of God to the simple plea, “Jesus, remember me when you come into your kingdom.”

What does all of this say about us as Disciples? Over the 200+ years of our history we have embraced a variety of understandings of baptism, from exclusively practicing and accepting baptism by immersion of believers, to our current practice which emphasizes the same, but receives all who claim their own baptism, whether as an infant or a professing believer, and whether by full immersion, pouring or sprinkling. Our normal formula is “I baptize you in the name of the Father, Son and Holy Spirit”, though the New Testament clearly suggests that there is room for variety in belief and practice here. While Disciples generally would not argue that baptism in itself is necessary for salvation, as illustrated above, it is seen as an act of obedience to Jesus, a way of following his example, and a way of sharing in the normative practices of the Christian community. So the question could be asked, “Why would you resist that which Jesus himself received and taught, and which his church has practiced for 2000 years?” In past times churches have taught that baptism was necessary for salvation, and that the exact form and formula were required to make it effective. Because we want to emphasize the primacy of God’s mercy and grace for salvation, and resting on the variety of different baptisms apparently practiced and taught in the first century by the apostles, we affirm that baptism is an important expression and affirmation of the salvation experience on the part of the believer and the church. We seek to be faithful to the New Testament and to our history by our own practice of believers baptism by immersion, representing our baptism into Christ and into His church. Humility prevents us from claiming that this is the only way that God’s grace may be known in baptism, and compels us to maintain fellowship with those who practice differently.

Living our diversity by being part of the wider church

(NOTE: this is a part of where our last DDP conversation on 05152012 went)

We will be “A church passionate to strengthen the work of the Church of Jesus in all its manifestations, within and particularly beyond our congregation.”

We understand that we cannot be all things to all people, if that means meeting every need of every person. That was not actually what Paul meant by the phrase either.

16 If I proclaim the gospel, this gives me no ground for boasting, for an obligation is laid on me, and woe to me if I do not proclaim the gospel! 17 For if I do this of my own will, I have a reward; but if not of my own will, I am entrusted with a commission. 18 What then is my reward? Just this: that in my proclamation I may make the gospel free of charge, so as not to make full use of my rights in the gospel. 19 For though I am free with respect to all, I have made myself a slave to all, so that I might win more of them. 20 To the Jews I became as a Jew, in order to win Jews. To those under the law I became as one under the law (though I myself am not under the law) so that I might win those under the law. 21 To those outside the law I became as one outside the law (though I am not free from God’s law but am under Christ’s law) so that I might win those outside the law. 22 To the weak I became weak, so that I might win the weak. I have become all things to all people, that I might by all means save some. 23 I do it all for the sake of the gospel, so that I may share in its blessings. (1 Corinthians 9)

Paul’s point is that he meets each person, each group, where they are, and does not force his particular position on them, not trying to remake them in his image. In their conversation accepts their terms and distinctives as a starting place. He is able to do this because he understands, as he says in Galatians 3 that “There is no longer Jew or Greek, there is no longer slave or free, there is no longer male and female; for all of you are one in Christ Jesus.” (see also Colossians 3:11) Because he knows that this is our destination, he is able to release his need to cling to the distinctives.

We respond to the prayer of Christ in John 17 that we, his followers, “may be one as the Father and the Son are one.” We are already a diverse congregation, and we affirm “one Lord, one Faith, one Baptism.”(Ephesians 4:5) We affirm the unity of all believers at the Table, despite significant theological diversity. We affirm that we must approach our study of scripture and our conversations about God with humility, recognizing that God is ultimately unknowable, and our understanding is limited and partial. This could suggest several things:

We acknowledge and embrace that people at FGCC also participate in other ministries in other congregations and community/parachurch organizations. For example, several of our youth participate in other youth ministry programs, and have done so for the last ten years at least. In addition, women and men in the church participate in bible studies sponsored by other organizations or congregations. Even the pastor attends midweek mass and goes to a catholic retreat center for prayer and spiritual direction. Since this is true, and consistent with our embracing diversity, why not live into this as a strength and discover how to make the most of it – i.e. we could gather information on other local ministries and make it available to those who attend or visit our congregation, or even publicize it on our website.

Our families have theological diversity within them – people grew up in different theological traditions and often hold on to many of those doctrinal and practical distinctions when the get married and when they come into a church. Why not embrace this idea and find ways to celebrate this diversity and teach one another how to listen and share what matters to each one?

Our mission work is ecumenical. What if we learned more about our mission partners and found ways to intentionally pray for and otherwise encourage and support them in their ministries.

Many of us have said, “We’re less concerned that someone be in our church, than that they are in church somewhere.” If we really believe that, then what might we do to live that out? How might we learn more about and share the ministry of other congregations with those we meet? If it is possible true that “Forest Grove isn’t for everyone,” then how can we prepare ourselves to offer people other good alternatives that might meet their needs and hopes for themselves and their families?