Will Technology Enhance or Deplete Relationships?

If you’ve been to the doctor’s office lately, you probably only had the good fortune to look into your doctor’s eyes for a few seconds in a brief respite between her feverish note-taking on a swivel screen. In the past decade, all medical practitioners in the United States have been forced to switch from paper charts to electronic medical records (EMRs), a technology designed primarily for the purposes of billing. EMRs give little added value to clinicians, and they don’t help patients very much either; they increase medical professionals’ workload, while decreasing their face-to-face time with patients. These systems have been imposed with little care for their impact on the practice of healthcare.

I work in a hospital in East Africa, and the EMRs we use there are much like those used in the Baltimore hospital where I completed my residency, only less functional. In the country where I serve, politicians run campaigns promising “a laptop for every child in school” when many of these same children do not have running water at home. There is a painful irony in this mindless celebration of technology. Tamara Winter describes this phenomenon as “mimetic misdirection,” a stubborn belief that the accoutrements of successful development (highways, flashy buildings, digital technology) will be the means by which a country will be uplifted. Suckered by the promise of progress, administrators in hospitals where electricity is unreliable and computers are scarce have bought the lie that an EMR is better than a paper system, and have installed a “solution” that creates more problems than it solves.

Photograph by Chris Liverani

And doctors like me find themselves with less time to look into their patients’ eyes.

This adoption of technologies that have a tendency to render life less humane reflects something that has been happening in the West for several hundred years: a change in our relationship to technology and to each other, a jettisoning of many aspects of what has been understood, until very recently, to be virtuous and sane living. Gerald McKenny calls it the Baconian Project, turning Francis Bacon’s noble desire to use technology to relieve suffering into an imperative that any technology that can be used to relieve suffering should be used. The moral implications of this shift are not as simple as they might first appear to be. From transgender surgery to the opioid epidemic, questions about what uses of technology might rightly be considered just and prudent have become increasingly fraught.

That Hideous Strength

C. S. Lewis saw this crisis between technology and humanity coming. In That Hideous Strength (1945), the final instalment of his science fiction series, Lewis vividly portrays the West’s dangerous affair with technology. In it, a villainous organization led by a disembodied head kept alive through technology seeks to remake humankind. In a final attempt to battle the forces that plan to annihilate humanity, the protagonists awaken the magician Merlin from a 1500-year slumber. Seeing the corruption in England, and hearing that it has spread throughout the West, Merlin asks if perhaps there might be other lands where people, even if they were not Christians, still live within the laws and limits of nature, honoring the Creator and his image in humanity. The main character, Ransom, replies:

The poison was brewed in these West lands but it has spat itself everywhere by now. However far you went you would find the machines, the crowded cities, the empty thrones, the false writings, the barren beds: men maddened with false promises and soured with true miseries, worshipping the iron works of their own hands, cut off from Earth their mother and from the Father in Heaven.

This human condition – the fallen human condition – is not limited, of course, to recent developments in human history, but Lewis argues that we are experiencing a new epoch of distortion in which technology increasingly calls into question our relationship to the earth, each other, and God. Lewis fleshes out this notion in the lecture series The Abolition of Man (1943), in which he suggests that far from making us superhuman, technology and its promise of limitlessness seem be chipping away at our sense of humanness. Our appetites for speed and control have been given free rein by technology, the fruits of which we see in a warming world, nuclear stalemate, and a profound sense of alienation from our families, our communities, and our own bodies. As Paul Kingsnorth puts it: “Every culture that lasts, I suspect, understands that living within limits – limits set by natural law, by cultural tradition, by ecological boundaries – is a cultural necessity and a spiritual imperative. There seems to be only one culture in history that has held none of this to be true, and it happens to be the one we’re living in.”

If it’s true that these dystopian implications are coming to pass, what are we to do about it? How do we counter the “hideous strength” of technology? How do we remain human?

Learning from African Wisdom

Laurenti Magesa, a Tanzanian priest and scholar, has an answer that I think is worth considering. In his book What Is Not Sacred? (2014) he, too, notes that our age of “individuating revelry” obsessed with technological progress has marred our relationships with the earth, nonhuman creatures, other people, and ourselves. Magesa’s hypothesis, however, is that awareness of something like natural law has endured in African cultures to this day, despite its abandonment in the West. Thus, there may be some hope for altering the perilous course of Western society if we listen to the traditional wisdom of Africa.

Of course, the obvious must be said: Africa is a continent, not a country. One must always be extremely cautious in generalizing about “Africans.” Magesa is aware that this claim could be interpreted as yet another iteration of the Rousseauian notion of the Noble Savage. He anticipates these criticisms and responds to them at the outset by ensuring that the generalities he uses when speaking of the cultural and religious practices he calls “African” are drawn from concrete people and places. His observations are drawn from scholarship from across the continent and the robust tradition of pan-Africanism emerging over the last century. Just as one can find cultural differences between the English, the French, and the Poles and still make generalizations about the people of Europe while understanding the limits of those generalizations, Magesa argues that there are some commonalities, along with many differences, among African cultural practices which can be identified and explored. And to readers concerned over the valorization of “indigenous spirituality” in a Christian context, Magesa observes that if Western Christians affirm that they can and should learn from Athens, then there is no reason not to expand this humble stance to African indigenous spirituality and ethics as well. With these provisos in mind, Magesa makes the following observations.

One of the most significant differences that Magesa observes is that the sharp distinction between the spiritual and material in Western thought is less pronounced in indigenous African thought. Rather, the spiritual and material are regarded as fundamentally unified. African spirituality, Magesa asserts, “is based on interactive relationships among human beings and between humans and the entire order of existence.” All the world is suffused with the sacred and we ourselves are suffused with the sacred. Thus, “all creatures deserve a degree of reverence” and human relationships with the spirits in the world can either be a blessing or a curse depending on how we relate to them. This is consonant with Lewis’ assertion that those who respect natural law “can call children delightful or old men venerable … not simply to record a psychological fact about our own parental or filial emotions at the moment, but to recognize a quality which demands a certain response from us whether we make it or not.”

The moral implications of such reverence are clear: pollution or environmental devastation are not merely bad because they might have ill effects on human beings, but because if, as Gerard Manley Hopkins writes, “the world is charged with the grandeur of God,” then our misuse of the earth is an affront to the Creator and to the vital forces with which he has imbued it. Ethical relationships with human beings are tied to nature because of the interrelated nature of all things: if we misuse the earth, it is inevitable that other people will be harmed. When we cooperate with the earth to feed each other, it is a blessing; when we push the earth beyond the limits that God gave us, it will be a curse. As Magesa says, “Afflictions … are understood to be a consequence of the human failure to act well before and toward others and the universe, a contravention of right order in the spiritual realm.” This stewardship model is far closer to the Biblical vision than contemporary scientific attitudes towards the natural world. Another African writer, Mercy Amba Oduyoye puts it this way: “We must serve nature so that nature might continue to serve humanity.”

Ethical relationships with human beings are tied to nature because of the interrelated nature of all things: if we misuse the earth, it is inevitable that other people will be harmed.

This leads to another fundamental difference between Western thought and African spirituality: relationships with others are inescapable and fundamental. While self-determination and autonomy are cornerstones of post-Enlightenment Western life, African cultures strongly emphasize the fact that we live in the shadow of our ancestors and are defined by our membership in a community or tribe. Our actions towards the communities to which we belong provide the basis for their judgment of us, and that judgment in turn determines who we are. Magesa writes, “A young pubescent person, boasting before the elders that he or she was now a man or woman, would be asked, ‘Who told you that you are a man/woman?’ … Adulthood is a social quality in this perspective, not merely a biological or a chronological one.” The rites of passage still followed by the vast majority of Africans today emphasize this communal nature of belonging in ways that are sadly lacking for Western teens.

I have seen this ethic of reverence and communality played out in my own time serving in East Africa. The most powerful example of this communitarian commitment that I’ve witnessed as a medical practitioner is the extremely strong commitment to caring for the sick. Families will often sell valuable livestock in order to buy the right medicine for their grandmother, or a village may come together to raise funds for a needed surgery for one of its people. The willingness to sacrifice one’s own needs for the sake of vulnerable members of a community is a powerful rebuke to an individualistic mindset that thinks primarily in terms of rights and property – and it’s an ethic far more consonant with the Church Fathers’ teaching about wealth and poverty. Magesa describes this as an “ethics of affection,” an ideal of mutual dependence that plays out on a small scale in countless relationships and communities across the continent. This ethic is embodied by what he describes as “eating together.” He sees this as the defining African expression of mutuality and relationship, and relates it to the practice of the early church in the Book of Acts, where believers “held all things in common” and shared in table fellowship (2:44, 4:32).

Of course, this model is not without its problems. It’s not as though Africans are less subject than others to the fall of man: no communitarian village, African or European, has ever been free of greed, lust, pride, and the whole panoply of nasties. And even if in the pre-Colonial era, solidarity and communal care were lived out (albeit imperfectly), contemporary African elites have taken up the extractive colonial machinery with gusto, as Ugandan priest Emmanuel Katongole (among many others) has shown. The day-to-day experience of many Africans is watching government ministers drive expensive vehicles to church services where a small amount of the money that they have stolen is ostentatiously donated in order to buy the silence of clergy.

Magesa does not reach a clear answer on the matter of corruption, just as he does not spell out how political communities larger than a neighborhood, clan, or tribe can balance issues of local self-governance with national or global concerns. But one book cannot do everything. Perhaps these global questions become easier to answer when we begin with Magesa’s acknowledgement of the limits in love; we cannot love “the whole world” except in abstraction, nor work for the mutual benefit of everyone in the same way that we can take care of our children or our sick neighbor. We must not fail in our duties to those close to us, even if our love ultimately does not stop there. Only by honoring the relationships that we have with others based on our common humanity and our common interchanges of trade and culture can we honor the God who created those people and places. Our local affections will have universal implications for how we use technology, farm the land, and execute trade. And in the global realm as well as the communal, love and sanity require limits.

I have forbidden the use of the EMR in my mental health clinic at the hospital, at least for now. As I scribble my notes on paper, I look to the parent, sibling, child, or friend who has accompanied the patient to the clinic. When I ask how well the medications are working, sometimes the patient will say they are fine while their companion smiles and tells me the truth. Rarely do patients come alone; some friends or family members pay a day’s wages for an hour-long bus ride to the hospital to accompany their suffering loved one. I like to think that no one in our hospital suffers alone because the cultural ethos here forbids it.

We do not reject technology: the strange miracles of the modern combustion engine and antipsychotic medication provide the opportunity for compassion and love to flourish. Yet every person will reach a point when technology or medicine cannot end their suffering or prolong their life. The African worldview places this inevitability in the context of a well-lived life among other lives, rather than curse it as the failure of science. This mounts a defense against a culture of endless acquisition and technological transgression against the natural limits God has given us. In our search for a good life, perhaps we in the West ought to look to those whose living traditions embody the communal character and the spirit of mutuality we so long for.