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If there is a God, and God can be considered all-powerful and entirely good, why is there evil in the world? For many, this is a question that lies at the root of human existence.

The question usually comes in theological terms, and really boils down to, “How are we to understand God?” But for most people suffering the effects of evil—including those suffering from diseases and injuries in themselves or in those they love—the question is more likely to be existential: “Given what I’ve always believed to be true about God, how am I to understand this evil that has befallen me?”

A similar question may arise for someone who does not believe in a deity but for whom the world appears to operate within generally coherent and reliable patterns, such as cause and effect and the predictable cycles of tides, seasons, birth and death.

Margaret Mohrmann

Philosophers and theologians debate this question—which they have termed theodicy—often by first looking at how we define evil. Usually we say evil means all the possible bad things that can happen to human beings. Those things can typically be broken down into three parts: moral evil, like murder or social injustice; natural evil, like tornadoes or cancer; or some combination of the two, such as the societal issues shown in the aftermath of Katrina or cancer linked to smoking.

Theist or not, most of us fall back on explanations similar to those put forward by theologians long ago—and all of them have significant holes in them.

One common answer is to look for how we may have deserved this “punishment,” that we somehow have fallen out of God’s favor. This is the essence of Job’s story in the Hebrew Bible. It may also be what’s going on when a suffering person tries to rationalize the present pain by connecting it with past behavior.

But this falls short, and even seems downright outrageous, when applied to certain kinds of suffering, such as the pain of a seriously ill infant. Some may argue—as it unfortunately happens—that it is then the parents who deserved to watch their child suffer. But that implies that God would countenance such a thing, and isn’t God supposed to be all good, in ways that we can understand as “good”?

A second way we try to answer the question is by saying that the suffering is meant to teach us something. Many religious traditions note the lessons pain can teach. And many patients speak of what their illness has taught them—to change their ways, for example.

But this, too, falls short in the face of certain kinds of suffering. What of the person who dies after days of agony, with no chance to learn anything? If one argues that the observers of that suffering may have learned a lot, God’s goodness is again in question. Would a truly good God allow one human to be tortured so that another might be improved?

For many, the experience of Jews and others in the Holocaust illustrates most clearly the problems inherent in accepting either desert or growth as the solution to the theodicy dilemma. What bad actions could possibly justify such a punishment? Whose growth in understanding could possibly require such a lesson? How are we to understand God or the cosmos given such egregious evil?

So this leaves a third route: We are never going to know why. For some, this conclusion comes as a relief, a letting go of the need to understand. It allows them to rely on the support of others and perhaps too of God, believing that, from the perspective of eternity, all will be well. The risk in that relief, however, is that it may bring with it a tendency to downplay—and therefore fail to deal constructively with—the reality of the present suffering.

And for others this answer may only exacerbate the sense of meaninglessness of the suffering. Answering “Why?” with “Why not?” only restates the problem.

Most of us eventually reach our own peace with the question, some with more difficulty than others. But my resolution may not be yours, and no “answer” really solves the problem. Therefore, those who attend to others in pain—whether health care or religious professionals, family members, or friends—are called on not to offer logical solutions, which are always inadequate, but instead to acknowledge the pain of the questions, hold them with the sufferer, and by presence, attention and care, be the response.

Margaret Mohrmann is associate professor of religious studies in the College of Arts & Sciences and professor of pediatrics and medical education in the School of Medicine.