And for most of us, each alone is insufficient. Science, no matter how concrete and persuasive, cannot address all our insecurities. And, neither can religion, despite its profound meaning and inspirational reassurances.
GOD AT THE BEDSIDE
With so many patients drawing on their own spiritual resources, how do doctors see the connection between religion and the services they provide? It probably comes as no surprise that doctors, as a group, are generally skeptical about God's active role in the affairs of humans. While many physicians feel that they are "doing God's work," most believe they are doing so without the aid of divine intervention. This is not to suggest, however, that doctors have no appreciation for the considerable effect that religion and spirituality have on the health of their patients. A sizable and growing volume of scientific evidence supports the observation that spiritual lives tend to be longer and healthier than nonspiritual ones. Since there are many plausible scientific explanations for such an association, few physicians find cause to dispute this connection.
Disagreement comes not from the role that religion plays in the health of their patients, but from the role that religion plays in the health care of their patients. Physicians usually raise the issue of religion with their patients only when death is near and the services of a clergy member may be helpful. It is the uncommon physician who actively takes advantage of a patient's religious convictions in the course of her or his treatment and recovery. This is despite the fact that a majority of seriously ill patients, according to surveys, would welcome the addition of a spiritual component to their medical care.
Advocates supporting the routine integration of religion into patient care raise a number of points. First, if there truly is a well-founded connection between a person's religious faith and his or her health, it would be irresponsible for physicians to ignore this valuable piece of information. Everyone would quickly find fault with a physician, for example, who did not ask every one of his or her patients if they smoked, drank alcohol, took drugs, or practiced unsafe sex, all of which have a direct impact on health and safety. Why should a patient's religious beliefs and practices be viewed any differently? Second, even if there were no convincing association between religion and health, it is unreasonable, and even arrogant, to expect medical science to effectively handle all the existential issues raised by a serious illness. Ignoring such spiritual crises would be tantamount to abandoning patients at their most vulnerable moments. Asking a member of the clergy to fulfill this role is certainly appropriate, but it does not abrogate the responsibility of physicians to be there for their patients. Finally, even if an illness is not life threatening, what is the harm of praying with a patient who requests it?
Conscientious physicians do many things for their patients, even if they do not directly contribute to a health outcome. Listening to patients well beyond what is necessary to make a diagnosis, for example, is a standard part of the compassionate practice of medicine. Physicians endeavor to do this (if given the time) because it serves the patient in the end by fostering a more therapeutic patient-physician relationship, among other benefits. Why would engaging patients' spiritual lives-even just politely acknowledging their prayers-be any different?
Physicians reluctant to incorporate religion into their practices counter with a variety of concerns. First, even if they would like to provide spiritual support, they lack the expertise to do so. Medical students receive no formal training in religious or spiritual counseling, and therefore, are not competent to discuss such issues with their patients. Just as a pastor or rabbi would never consider removing a gallbladder or setting a fracture, it would be dangerously irresponsible for physicians to minister to their patients' spiritual needs. Second, these physicians are extremely reluctant to give even the impression of a legitimate connection between a patient's condition and his or her religious views. Unless done with utmost sensitivity, a policy of interjecting religion in the context of an illness risks blaming patients for their current misfortune. Patients may wrongfully assume that had they been more religiously faithful, they would have remained in good health. Even more alarming, a religiously zealous physician may send subtle signals that membership in his or her particular denomination would have benefited the patient. Finally, there is the issue of integrity. Many physicians pride themselves on being honest and forthright with all their patients, and feel uncomfortable compromising their own values or beliefs. They may find it ethically objectionable to feign a mutual interest in their patient's religious life when in fact they subscribe to a different religion or no religion at all. Religion and medicine, whose pursuits were once indistinguishable, have long since endured an uneasy relationship. Even additional research further solidifying a connection between spirituality and health will not be enough to bring the two sides back together in the unified service of patients. Many other issues must be addressed before physicians willingly invite God to join them on their hospital rounds. Despite this reticence, Americans are, and will likely remain, one of the most religious people on Earth, and we should not expect medical science alone to ever address the most vexing aspects of being sick. For all its remarkable accomplishments, modern medicine has yet to inspire enough faith to sustain our hope for the future.