ROLE OF RELIGION
IN MEDICINE DEBATED

By Aaron Levin, Science Writer
Health Behavior News Service

“No one disputes that religion and spirituality are important in the lives of some patients and can provide comfort to them and their families,” said Richard P. Sloan, Ph.D., professor of behavioral medicine in the department of psychiatry at Columbia University. “But tying religion and spirituality to health outcomes is wrong for practical, empirical, ethical and spiritual reasons.”

Harold Koenig, MD, MHSc, associate professor of psychiatry and medicine at Duke University, disagreed, saying that spirituality ought to be more closely entwined with medicine. He pointed to studies that indicated that people who attended religious services regularly had better health outcomes than those who did not.

“ Physicians should take a spiritual history of the patient, just as they do a family history,” he said, although he agreed that studies of intercessory prayer were “worthless.”

The discussion was sponsored by the Heritage Foundation, a Washington think tank.

“ Should we spend time talking about spirituality with patients when there is not enough time to talk about things we know could change their health — like quitting smoking or eating better?” asked Sloan.

A recent upsurge of interest in complementary and alternative medicine demonstrates that modern medicine’s focus on the disease, rather than the patient, is a sign of something missing, said Christine M. Puchalski, MD, associate professor of medicine at the George Washington University and director of its Institute for Spirituality and Health.

“ Doctors must remember that their profession is really a calling, that we are here to serve people,” she said. If there was a place for spirituality in the doctor’s office, it lay in the physician’s initial commitment to compassion for the sick, she argued.

Puchalski has developed a component for medical school training to teach doctors how to take a spiritual history in under two minutes and then respond appropriately.“ That does not mean a religious history,” she emphasizes. “It is not ethical to prescribe religion or to proselytize or to assume the utility of prayer.”

Cynthia B. Cohen, Ph.D., J.D., who was trained in law and philosophy, said doctors should stay out of the spiritual realm altogether.

Attempts to use scientific practices like randomized clinical trials to demonstrate that prayer can influence medical outcomes will always fail, said Cohen, a senior research fellow at the Kennedy Institute of Ethics at Georgetown University, and a fellow at the Hastings Center.


“ There are too many uncontrollable variables,” she said. “Which prayer is use? Which religion? What is the amount or intensity of prayer? How do you eliminate prayers from people other than those in the trial? How do you measure outcomes?”

This does not mean abandoning prayer for the sick, she said. “Prayer is a corollary of one’s belief in God, not a test,” she said.

Health Behavior News Service: (202) 387-2829 or www.hbns.org.