Article Tools

Apr. 29, 1999 - The days of religion existing separately from medicine are passing away, one of the many changes on the horizon for healthcare. Only in the past 400 years of Western history have they been separate, both in theory and practice. Ancient societies, and today some remote populations, look to the same place for medical and religious leadership. The shaman and the medicine man of indigenous cultures used to be the same person. Today, spiritual seekers must consult men of the cloth such as priests, pastors, or rabbis, who usually lack medical training. But now, the two groups are beginning to come together. As evidence, the author of Healing Words, physician Larry Dosser schedules prayer and meditation into his daily practice before seeing patients. Although he doesn't reveal the prayers to his patients, he believes this is a vital part of his medical practice and becoming more common in medicine.

In this week's episode of ER, Jeannie's health condition improves after receiveing both medical and alternative help. While she is taking medication for the Hepatitis-C disease, she receives prayer for her health from the minister. When she receives her new test results on the advancement of her condition, she is better. What can she credit with the improved results, the power of prayer or the pills? With the growing awareness of spirituality in today's society, this issue is becoming increasingly important. Does faith or religion have a role in medicine? Are scientific medicine and religion compatible for treating patients?

Whether or not religion has a role in medical issues, it is true that religious interests among both physicians and patients are on the rise. In 1987, a review of the medical literature collected over 200 studies containing religious terminology over the past century. More recently, surveys showed 80% of Americans believe in the power of God or prayer to improve the course of an illness, and 70% of physicians surveyed report religious inquiries for counseling of terminal illness (Levin, 792). Patients are not only more aware of spiritual issues, but they want their physicians to be aware of them as well. In other polls, 63% of people felt their physician should talk with them about spiritual issues, and 48% of hospital in-patients would like their physician to pray alongside them (Sloan, 664).

Medical educators believe religion and medicine are compatible, as many would like to see more training in spiritual issues for medical students. Educators suggest medical schools should train more compassionate physicians in addition to skilled diagnosticians and technicians. In April 1997, deans and faculty of one third of the medical schools in the U.S. attended a conference titled ŚSpirituality in Medicine: Curricular Development'. Three years ago, only three U.S. medical schools taught courses on religious and spiritual issues, while today, over 30 schools teach these courses (Levin 792-3).

Physicians and healthcare practitioners have divided opinions on whether or not spirituality has a place in medicine. One survey suggests only 10% of physicians inquire about a patient's beliefs or religious practices (Levin, 792). Evidence clearly correlates spiritual practices with health related behavior and lifestyles, providing social support and enhanced coping mechanism for patients, especially during difficult times. Larry Dosser describes prayer as learning to accept whatever prospects may come under the circumstances, without being passive. Herbert Benson, author of Timeless Healing, says faith in God has a health-promoting effect (Sloan, 664). Other physician polls reported 99% of physicians surveyed are convinced religious beliefs can heal, while 75% believed prayer could promote a patient's recovery (Sloan, 665).

Opponents of faith healing argue it is implicated in child fatalities. From 1974 to 1983, parents who relied on prayer instead of medical care when their children were sick or injured could not be charged with abuse or neglect. Child abuse programs were required to enact Śreligious exceptions' (Larkin). Others feel spirituality is not something to be advertised among physicians or practitioners. These people believe it is a personal issue, and medical students or physicians should not require spiritual training. They can go to church for spiritual training (Morgan, 584).

How did this split come about? As a society, we are becoming more mechanistic in the way we approach the human body, specifically with the non-physical aspects. The theory of evolution labels humans as advanced animals, so we developed theories of understanding the body as a complex animal or even a machine. We developed medical technologies that cannot measure the non-physical aspects of humans.

So what does this mean if medicine and religion are becoming more intertwined than in the past? First, physicians and medical care practitioners must be careful not to abuse their position as professionals. There should be no objections to physicians sharing their opinions or even their personal beliefs with patients, but there must be an understanding that it is their personal belief or even a common faith with the patient, and not professional opinion. As co-worshippers of the same faith, a physician and patient may discuss medical issues in the context of their shared faith, share the same worldview, or agree on appropriate religious practices, but when the patient does not hold the same faith, it's a different story. Then, it may not appropriate for the physician to initiate or support personal religious practices because the circumstances of disease, and the physician-patient relationship may leave patients vulnerable to new ideas. When physicians bring up the topic in conversation, it's based on the physician's point of view. Religion or spiritual issues may or may not mean very little personally to the physician (Levin, 793), however the patient will pick up on this. In a high stress situation, such as a serious or terminal disease, they may not be in their right mind to understand the difference between the physician's personal beliefs and professional recommendations. On the other hand, shared beliefs and values can be important in establishing trust in physician-patient relationships during situations of high stress for the patient. This may lead to better communication and treatment for end of life care issues that inevitably arise. Second, when patients share their own spiritual beliefs, physicians must be careful not to give advice beyond their training, even if they hold to those beliefs personally. Even though evidence suggests spiritual activity results in potential health benefits, physicians should be careful in advising these practices to improve health. Just because marriage is associated with potential health benefits for men, it would be wrong for a physician to advise his patient to marry for health reasons. There is not enough evidence to begin suggesting alternative, spiritual practices of faith and religion as adjunctive medical treatments. For now, spiritual practices are good for hope and comforting patients. Finally, there is a danger that some people may relate their health or well being to their degree of spirituality or religious commitment. An ethical problem arises when religious people believe the more devout they are the better their health should be. The results of evidence thus far do not correlate degree of commitment to a person's health. There is only a general correlation of health related behavior and lifestyle with spiritual practices. What if some religions or religious denominations begin to see improved health conditions among their members, should physicians suggest conversion? As a society increasingly interested in spiritual issues, we must prepare to face these and other questions regarding spiritual issues. Until we understand more, we may as well leave a good thing alone.

Works Cited

1. Dossey, Larry. Healing Words: The Power of Prayer and the Practice of Medicine. San Francisco: Harper San Francisco. 1995.
2. Larkin, Marilynn, "Faith Healing Implicated in Preventable Child Fatalities." The Lancet 351 (1998): 1109.
3. Levin, Jeffrey S., Larson, David B., Puchalski, Christina M., "Religion and Spirituality in Medicine: Research and Education." JAMA: Journal of the American Medical Association 278 (1997): 792-793.
4. Morgan, Peter P., "Spirituality Slowly Gaining Recognition Among North American Psychiatrists." Canadian Medical Association Journal 150 (1994): 582-585.
5. Sloan, RP., Bagiella, E., Powell, T., "Religion, Spirituality, and Medicine." The Lancet 353 (1999): 664-667.

Further Reading
Benson, Herbert, Timeless Healing: the Power and Biology of Belief. Scribner Press 1996.

Byrd, RC., "Positive Therapeutic Effects of Intercessory Prayer in a Coronary Care Unit Population." Southern Medical Journal 81 (1988): 826-829.

Wallis, C., "Faith and Healing." Time. June 24, 1996: 58-63.