Trend Uniting Religion And Medicine Hurts Both Disciplines

The increasingly popular trend to incorporate religion and spirituality into health care is both ethically and scientifically questionable, a group of Columbia Presbyterian researchers and chaplains from The HealthCare Chaplaincy write this week in the New England Journal of Medicine. “Religion and medicine are equally important disciplines that shouldn’t be mixed. Combining them leads to weak science, watered-down religion, and a host of significant problems,” says Richard P. Sloan, Ph.D., the commentary’s lead author. Dr. Sloan directs the Behavioral Medicine Program at Columbia-Presbyterian Medical Center and is an associate professor in the Department of Psychiatry at Columbia University’s College of Physicians & Surgeons. The authors evaluated studies alleging that empirical evidence supports the link between religion and health. Most of these studies have serious methodological flaws. Even recent, well-conducted studies that show associations between attendance at religious services and health cannot demonstrate that religious activity actually causes better health outcomes, in the same way that the demonstrable association between carrying matches and lung cancer does not mean that matches cause cancer. “There is no research evidence showing that deliberately increasing church attendance influences the health or illness of individuals,” says co-author Emilia Bagiella, Ph.D., assistant professor in the Department of Biostatistics at Columbia University’s Mailman School of Public Health. The authors also evaluated a frequent claim that religious activities provide comfort to patients and that physicians can give attention to it without research evidence. “Physician recommendations concerning religious activities will often carry the same authority for many patients as medical recommendations,” noted The Reverend Larry VandeCreek, D. Min., Protestant clergy and director of pastoral research at the HealthCare Chaplaincy and a co-author of the paper. “Patients can easily view such recommendations as coercive, since religion is considered a private matter.” Chaplain Margot Hover, D. Min., Clinical Pastoral Education supervisor and chaplain at Memorial Sloan-Kettering Cancer Center and another co-author of the article, cited the conflict that religion frequently produces due to disagreements over diverse practices and beliefs among families. “Raising the profile of religion without knowing how to address the issue does not bring comfort,” she says. “Religion can be more sensitive than sex or money. Engaging patients about religious concerns requires skills for which physicians are generally not trained.” The authors cast doubt on studies suggesting that patients want religious matters incorporated into their medical care. They asserted that most studies report only a minority of patients want physicians to address their spiritual concerns and that these patients are not representative of the population as a whole. They noted that these studies usually report results from family practice settings, a specialty known for building relationships with patients, and that results might be very different if, for example, surgery patients were studied instead. Finally, when physicians make recommendations about religious activity in the service of better health, it not only represents bad science but it trivializes religion, reducing it to a mere health behavior like consuming a low-fat diet. “Religion does not need science to justify its existence or appeal,” the authors conclude. Co-authors of the article from The HealthCare Chaplaincy also include Carlo Casalone, S.J., M.D., of the HealthCare Chaplaincy; Trudi Jinpu Hirsch, Zen Buddhist and supervisory resident at Beth Israel Medical Center; Imam Yusuf H. Hasan, Muslim staff chaplain at Memorial Sloan -Kettering Cancer Center; Rabbi Ralph Kreger, Orthodox Rabbinic chaplain at Lenox Hill Hospital and the Hospital for Special Surgery; Peter Poulos, Greek Orthodox chaplain, clinical pastoral education supervisor, and director of the Department of Pastoral Care at New York Methodist Hospital in Brooklyn.