Jason Reimer GREIG. Reconsidering Intellectual Disability: L’Arche, Medical Ethics, and Christian Friendship.Washington, DC: Georgetown University Press, 2015. pp. 293. $32.95 pb. ISBN 978-1-6261-6243-3. Reviewed by Ryan MARR, Mercy College of Health Sciences, Des Moines, IA 50309.

            With Reconsidering Intellectual Disability, Jason Reimer Greig demonstrates precisely what practical theology should look like. Presently, Greig is working on his PhD in theology at VU Free University of Amsterdam, but prior to his doctoral studies he spent eleven years with L’Arche communities as a house assistant and spiritual life coordinator. Greig’s experience of living with the mentally handicapped imbues his reflections on intellectual disability with a certain urgency and immediacy, which one would be unlikely to encounter in a scholar who had researched the topic “from afar.” To his great credit, there is nothing detached about Greig’s theology in this book. Within its pages, he sets forth a stirring challenge for Christians to offer a counterwitness to the materialist and objectifying habits of modern medicine. While Greig’s work will be of special interest to those who care for the handicapped, it is a book—in Stanley Hauerwas’ words—“that [should] be read by anyone seeking to know how to live well.”  

           The starting point for Greig’s reflection is the famous case study of Ashley X. Born in Seattle in 1997, Ashley experienced severe developmental disabilities due to static encephalopathy of unknown etiology. In early 2004, at the age of six, Ashley began to exhibit signs of early puberty, though mentally she remained at the level of an infant. Ashley’s parents, who were largely responsible for her care, were worried that Ashley’s continued growth would make it nearly impossible for them to care for her at home. Among other factors, they cited the increased risk of pressure sores, the pain of menstrual cramps, and the added difficulty for Ashley to fit comfortably in her wheelchair. In the face of these concerns, Ashley’s parents chose to initiate a series of interventions (i.e., estrogen therapy, a hysterectomy, and the surgical removal of Ashley’s breast buds) in order to prematurely halt her physical development. This assemblage of medical interventions became popularly known as the Ashley Treatment (p. 1

).             In Greig’s view, the Ashley Treatment is one particularly troubling manifestation of modern medicine’s tendency to treat disabilities and diseases as “categorical departures from normality” (p. 58, quoting Paul Atkinson). Within this framework, disability is viewed as a “personal tragedy,” and one of medicine’s primary aims becomes to restore impaired persons to normality. As Greig summarizes this outlook, “Any kind of impairment justifies medical intervention, usually under the discourse of ‘therapy’” (pp. 59-60). As an outworking of this assumption, persons with persistent impairments are often segregated from the rest of society and placed under the close supervision of therapeutic specialists. In this respect, our society adopts an approach directly at odds with the communal vision of the New Testament, wherein the weaker members of the ecclesial body are understood to be indispensable (1 Cor. 12:22ff.). Rather than relegating those with disabilities to the fringes of our communities, according to Saint Paul, we are to give greater honor to the weakest among us.

            Greig picks up this biblical vision of communal life and applies it to care for the handicapped, but without ever falling into a paternalistic mindset. He reminds his readers, first of all, that hospitality towards those with intellectual disabilities ought to be constitutive of a community that has been called into being by the Good News of Jesus Christ: “Remaining faithful to the Gospel narrative requires the church to welcome the bodies of people with profound cognitive impairments as graced creations of the living God, called into (potential) friendship with the Trinity and other persons in the Body” (p. 189). Greig casts this responsibility in covenantal terms, stressing that the goal of the Christian community is one of “being with rather than doing for” (p. 210). Or, as Jean Vanier, founder of L’Arche, puts it, this element of the Church’s witness “is not chiefly about doing things for the poor; but about listening to them, welcoming them and living with them a covenant … to help them discover the meaning and purpose of their lives” (ibid.).

            Reconsidering Intellectual Disability is a challenging work of practical theology by a promising young scholar. Greig appropriates the thought of such theological luminaries as Stanley Hauerwaus, Therese Lysaught, and Paul Wadell, applying their insights in compelling ways to the specific issue of care for the disabled. Greig’s monograph has the potential of attracting a broad interest among those who regularly engage works of theology, but his core audience is likely to be Christian ethicists. As for use in the classroom, the book would be particularly well-suited for a graduate level course in bioethics. Though not as readily apparent, the book could also serve as a fruitful source of reflection in a seminar on ecclesiology. In whatever context one ends up engaging Greig’s work, there is a great deal of wisdom to be gleaned from its argument. I, for one, hope that the book gains the interest it deserves.