Religion, Health, Medical Ethics    12/96

by Del Meyer, MD

The topics, Religion, Health, and Medical Ethics, were chosen by the editorial committee a year ago as the final focus for this year. They are so broad in scope that we can only reflect upon a few of their many changing aspects.

Recently there has been renewed interest in medical ethics. This specialized field has grown from discussions concerning the beginning and end of life issues such as abortion, euthanasia, and doctor-patient relationships to a comprehensive discipline with formalized research and training. Interest in medical ethics has developed along several lines. Ethical issues have become a central concern in many health care activities, such as allocation of research funding, priority setting, patients’ rights, and high technology medicine. In addition, the interdisciplinary nature of medicine has prompted input regarding ethical concerns from a variety of sources: health-care workers, philosophers, theologians, lawyers, policymakers, and other professional groups. The locus of the debate has progressed from doctors and patients in hospital settings to more interactions between the general public (prospective patients, relatives, research subjects, patients on medical waiting lists) and the health care system providers and those who plan and organize health care services (politicians and administrators.) It was against this backdrop that the first world congress on ethics in medicine was held in Israel in 1985. This was followed by the second congress at Beth Israel in New York in 1987 and the third at the Karolinska Institute in Stockholm in 1989. These have been recorded in a series of monographs by the Karolinska Institute as the Nobel Conference series, and provide a textbook rendition for the serious student of ethics in medicine.

.Ethics are rooted in various religious teachings. Looking at a bibliography of hundreds of volumes on ethics, one frequently sees a large number of terms such as Hebraic," "Christian," "Mosaic," "Catholic," "Jewish," "Biblical," "Theological," etc. When I did my junior medical school psychiatric clerkship at Topeka State Hospital, which was staffed by the Menninger Clinic, an analyst stated that as he became more "ethical" he was becoming less "religious." Lately there are more views being expressed by secular humanists who seek to put basic issues in clear opposing perspectives: Man is sovereign vs God is sovereign over life; Sanctity of life vs quality of life principles; The end does not justify the means vs the end justifies the means.

Health professionals have traditionally been less religious than the people they serve, but there is anecdotal evidence that this may be changing. Dr. Herbert Benson of Harvard Medical School on Good Morning America stated that doctors are discovering that religion is good for most people’s health, and even recommended prayer. At the annual meeting of the prestigious American Association for the Advancement of Science in Baltimore, researchers presented the latest evidence regarding influence of religious belief on health. Dr Dale Matthews of Georgetown University reviewed 212 studies and found three-fourths showed a positive effect of religious commitment on health while 7% concluded religion is bad for health. Benefits of religion were most prominent in dealing with drug abuse, alcoholism, depression, cancer, high blood pressure and heart disease. Preliminary results in one large study of 4,000 elderly women by Duke University Medical Center showed those who attend church are both physically healthier and less depressed. It was also of interest that people who sit at home praying alone or watching tele-evangelists are worse off than other folks. An AP press release reported that in San Francisco, a study divided 393 seriously ill heart patients into two groups. Half were prayed for and half were not and neither group knew which group they were in. The prayer recipients suffered fewer health complications. Unfortunately, the name of the institution was not given.

This obviously is outside the realm of science. As Jeffrey Levin of Eastern Virginia Medical School stated, "If God heals, it’s a matter of faith. We can’t prove it." Dr Martin Sharlemann, a Theology Professor from Concordia Seminary, pointed out that people who go to church have strong networks of friends who make sure they get proper medical care. This helps them cope better with stressful events. Religious people are less likely to smoke, drink and have other unhealthy habits. Taking part in religious rituals may lower harmful stress which in turn reduces high blood pressure, chronic pain, insomnia, anxiety, and infertility among other things according to Dr Benson. Dr Sharlemann stated that even if there were no other benefits of religion, the societal benefits would make it a worthwhile pursuit.

Melanie Kirkpatrick, the Wall Street Journal’s assistant editorial page editor reviewed the book, "The Quest for God: A Personal Pilgrimage," by Paul Johnson. She quoted Johnson’s argument, "that as this bloody century draws to a close, not only has God survived, he is flourishing." As an historian, he believes that the great evil of the 20th century was totalitarianism, in which Hitler, Stalin, Mao replaced God with the state. As a Christian, he believes the great evil of the 21st century will be the abuse of new medical technologies to "play with human life itself." Men and women will be tempted to usurp God’s role in deciding when life begins and ends.

And so we’ve come full circle to where the discipline of ethics began as we face the ethical dilemmas of the next century. As genetic engineering advances, will we be ready to order the "perfect baby" for our patients in another 30 years? We hope this journal issue provides some food for thought and exchange of ideas about this fascinating field which affects many of our professional and practice concerns.