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An Open Letter to Medical Missionaries: Set Theory

April 24, 2017


by W. Philip Thornton, PhD  Global Impact Missions

Scenario 1. Your church has commissioned a short-term medical team to X country. The need is great, both physically and spiritually. You have just completed your treatment of one of the many you will see that day. As a final act before you send your patient on their way, you take a moment to share your faith. You explain about God's Son and His work on the cross to save us from our sins. As you come to the end of your witness, you ask if your patient would like to know this Jesus about whom you have spoken. To your delight they answer "yes." They would like to become a Christian. You take their hand and have them repeat after you the "sinner's prayer." Your patient leaves with a smile on their face. You rejoice. That night you share with the group the good news.

Scenario 2. You arrive for the first day of clinic. The line awaiting attention from your team of doctors, nurses and dentists extends out the gate and around the corner. Some have been waiting hours. The work begins even as more patients arrive. At first you think that what you saw was simply an anomaly, but as the day wears on it happens over and over again. Someone simply walks forward and cuts in line ahead of those who have been waiting patiently. To you, this seems grossly unfair. What gives anyone the right to cut in line, especially when others with more desperate needs have been waiting for hours?

The question posed in scenario #1 is this: Was the "conversion" genuine? How do we know what, if anything, has taken place spiritually in the life of this patient? Are we ok adding this person to the list of those who "became a Christian" as a result of our ministry? Scenario #2 poses a disturbing question for the North American. What gives anyone the right to cut in line ahead of another? What makes them think that they are better than those who have waited patiently for hours?

For a perspective on these two scenarios, we turn to missionary anthropologist Paul Hiebert and what he termed "set theory." North Americans are by culture a people of "bounded sets." By bounded set, things either belong to a set or they don't. From this viewpoint, we have to decide whether the patient who prayed the sinner's prayer or nodded their head to our question in scenario #1 is "in" or "out" of the kingdom. In other words, there is no in between. He either is a Christian or he is not. If he is a Christian, then he is just like all others who are in the category Christian since all members of a bounded set are essentially the same. All are simply Christians. But what if the patient in scenario #1 comes from a culture which sees life in terms of "fuzzy sets?" With fuzzy sets, a person or a thing can belong to two widely different sets at the same time. From this position, the patient who prayed the sinner's pray could genuinely consider himself a Christian AND a (whatever religion he was practicing before his encounter with the missionary doctor). In other words, with fuzzy sets one can be part or fully Christian. This explains why he may very well leave the Western doctor and immediately seek out the shaman in his village just to make sure he has "covered all the bases" both spiritually and physically.

So, is our patient now a Christian or not? It depends on one's definition for being a Christian. Mine is not an argument for "expanding" the definition of Christian, but rather a warning, especially when it comes to reporting "conversions" without a thorough understanding of their worldview. I do not deny that there is a point in time when one "becomes" a Christian. I believe this is biblical. However, for many cultures, becoming a Christian may be perceived as much more of a process rather than a point in time. Adding a notch to our spiritual gun may be not only inaccurate but also may harm the reputation of being Christian in that cultural context.

For a perspective on scenario #2, people moving to the head of the line, Hiebert calls our attention to another set theory that he calls "centered sets." In centered sets, relationship is the key. In other words, members of that culture are defined, and given certain privileges without challenge, based upon their relationship to the most important person in the culture. So, if those who "broke" line were more closely associated by blood or some other kind of relationship, then what they did would be fully expected, and accepted, by those who were more distantly related to the most import person in the society. As to the question of being Christian (the question raised in scenario #1) one's "Christian-ness" would be defined in terms of one's relationship (nearness) to Christ.

Because we (Westerners) tend to be bounded set people, we stress evangelism and conversion. In other words, we want to get people into the category of Christian. From the centered set perspective, the important question is whether one is moving toward Christ or away from Him (Christ being the center). Centered set theory avoids the dilemma we faced in scenario #1 since it emphasizes periods of training and testing as one "becomes a Christian." Conversion is not the end; it is just the beginning. With fuzzy sets, "conversion" itself is a process. The emphasis may very well be trying to find Christ in their own religions and cultures.

In using the set theory analysis, Hiebert has simply reminded us that the actions and reactions in any society, including how one "becomes" a Christian and whether or not one "is" a Christian, is strongly affected by culture. As such, he has warned us about jumping to conclusions about what has or has not happened in any particular event, as well as allowing our own interpretational reflexes to mislead us as to the rightness or wrongness of a particular behavior or point of view.
His observations also challenge us to dig deep into the culture of our target audience and try to see things from their perspective. Cultural understanding will go a long way in helping us understand both the spiritual and physical actions and attitudes of patients.

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