A QUIET REFORMATION is afoot in medical circles, one that is perhaps symptomatic of a turn in the culture toward "alternative" cures. At the forefront is the National Institute for Healthcare Research in Rockville, Md., which investigates what it calls "the interface between spirituality and health." Spearheaded by Dr. David Larson, the institute aims to mend a divide that was once a partnership: that between religion and medicine.
This divide was long in the making. Time was when priest and medicine man were synonymous, and faith healers were a dime a dozen. Far from being antagonists, religion and medicine were companions in the quest for health and wholeness. This was so because religion and medicine are, in a sense, of a piece: Medicine seeks to assuage suffering. And religion strives to assign meaning to suffering, blunting our sense of the finitude of death.
The Scientific Revolution severed religion from medicine by regarding the former as inimical to the pursuit of scientific truth. This severance hastened the final divorce between religion, newly charged to care for the soul and various of life's intangibles, and medicine, assigned to care for the body (and, following Freud, the mind). Advances in scientific knowledge shrank religion's purview as the gulf between religion and science widened.
Today, that gulf is narrowing. The salutary effects of religious belief on health are gradually becoming accepted by doctors, on the strength of research. But skepticism still abounds toward remedies that smack of the supernatural -- and it is this skepticism that Larson and a cadre of like-minded doctors are seeking to attack.
Medical dogmas are being shaken by studies that attest to the beneficial effects of prayer on healing. These studies suggest that matters of the spirit are the foremost factor in enabling patients to recover from depression following a life-threatening illness, and that depth of religious commitment enhances the prevention and treatment of substance abuse. Researchers at Dartmouth report that patients buttressed by faith and social support are 12 times more likely to survive open-heart surgery. And a Duke study indicates that patients who attend religious services at least once a week have stronger immune systems.
Such findings may also confirm our intuitions: Researchers at Yale report that AIDS patients who believe in a forgiving and comforting God are less likely -- no surprise here -- to fear death. And other researchers indicate that regular church attendance, as distinct from the solitary spirituality of personal experience, conduces to health.
Still, the field has the air of a work in progress, and its methodology remains problematic. For instance, although an association exists between religious belief and good health, it is not known for certain whether religion promotes better health or vice versa. Furthermore, any measure of the effects of religious belief on health is complicated by the intermingling of psychological, social, and behavioral factors: The irreducibly religious element in attending a worship service, for example, must be separated from its healthful social effects.
Despite such concerns, Larson is goading secular-minded doctors to open their minds to the role of religion in healing. Interest in the subject has been quickened by a series of conferences, and the John Templeton Foundation -- a philanthropic organization devoted to religious and scientific "progress" -- has funded research in an area still foreign to many physicians. This foreignness is evidence of the various divides that Larson's group aims to span.
One divide lies between health-care professionals and clergy. Though four out of ten Americans consult with clergy in times of distress, psychologists routinely overlook the clergy's role in contributing to mental health. Another is the disparity between the religious convictions of many patients and the skepticism of most physicians. Larson and his allies fault doctors for paying insufficient attention to the spiritual aspects of patients' lives and for ignoring religion's part in health.
An obvious remedy is for physicians or psychologists to remand their patients to priests or pastors. But a 1996 Time/CNN poll indicates that 64 percent of Americans want doctors to pray with them should they request it -- which suggests that the public wishes to narrow the divide between physician and clergyman. "They do not want to check the religious aspects of their lives and their spiritual needs at the door when they are admitted to a hospital," says Dr. Dale Matthews, author of The Faith Factor: Proof of the Healing Power of Prayer. "They would like to incorporate their spiritual beliefs into their medical care."
Whatever reduces the anonymity and emotional aridity of a hospital stay surely deserves consideration. Yet certain doctors have actually moved beyond acknowledging to appropriating the role to be played by clergy in medicine. These physicians, deferring to patients' wishes for a more "patient-centered" focus, are dispensing prayer with Prozac. And in so doing, they may be repairing the divide between religion and medicine at the price of blurring rightful boundaries. Matthews claims that "every physician should be somewhat of a priest. We can train doctors to handle spiritual problems." But of course, no one expects a pastor to be a physician.
For medicine as a field, the rapprochement between religion and medicine may be partly beneficial and partly negative. Beneficial, because it may increase faith in medicine by opening up the profession to possibilities previously ignored. Negative, because doctors may confer undeserved seriousness on faux spiritual cures, thereby making the profession less rigorous and more vulnerable to the appeals of charlatans.
Moreover, medicine may slight religion by paying heed to it. For centuries, healing was a function of religion. Now, religion risks becoming, for some physicians, a function of healing. Though fewer than two-thirds of doctors profess belief in God, a good many of the unbelievers express confidence in the power of prayer to banish illness and maintain health. The net result among doctors may be to make religion a handmaiden of medicine, a method of "coping" whose value lies not in its truth but in its utility as an health aid.
To this charge, both physician and patient must plead guilty. Says Matthews, "The choice of one's religion should be based on personal and family considerations and theologic concerns, not out of hope that one religion offers a greater likelihood of obtaining health benefits than another." The problem, however, may not be whether one religion offers greater benefits than another (studies suggest that a depth of religious commitment matters more than the particular religious affiliation that inspires it). Rather, the prime risk is that religion will be mobilized as merely another tool, thus slighting its autonomy and dignity as an end in itself.
Sworn to pursue the interests of patients, doctors may subscribe to prayer's salutary physiological effects and at the same time doubt the existence of God -- much like the patient who "prays" so as possibly to lower his blood pressure, but not to draw nigh to divinity. Thus the bind in which unbelieving physicians are caught: To pray with a religiously committed patient is subversive of the very enterprise of prayer, yet it may also be faithful -- if prayer conduces to health -- to the mandates of the medical profession.
In any case, the role of physician as pastor must remain tentative pending an answer to the question posed by Larson and his institute in their Scientific Research on Spirituality and Health: "Does the spiritual 'goodness-of-fit' between the health care professional and the patient make a difference in the effects of religious interventions on health outcomes; that is, are better clinical outcomes achieved when practitioners and patients share the same religious belief systems?"
The question remains open. Doctors uncomfortable with the pastoral role can direct patients to clergy. Yet one principal argument for training doctors to minister spiritually to patients has been the claim that clergy are in short supply. And managed care limits the ability of patients to shop for a doctor better in tune with their own religious convictions.
In the end, like it or not, physicians committed to optimal health for patients may find themselves ministering to them. If religious commitment enhances survival rates, health-care professionals can scarcely afford to ignore it. And surely religious faith can withstand being made a means when the end is the preservation of life itself. This is, as Larson notes, the good news for medicine about the Good News. So the proper response for men of the cloth toward clerical clinicians perhaps should be: More power to them.
Christopher Stump is a reporter for THE WEEKLY STANDARD.