Psychiatrist Argues Doctors Shouldn't Prescribe Religion

NEW YORK—A medical journal article that questioned the benefit of religion for patients and advised doctors not to talk about the subject with their patients, won lots of media attention. But it failed to persuade Mary Clarke.

Clarke, a former nurse, recalled when her husband was first diagnosed with cancer. Doctors reckoned he had one month to live. “They told me six months at the very most — if he was lucky,” said Clarke, who asked to be identified by her maiden name.

With such a grim diagnosis she entered a surgeon's office in despair. He surprised her with a new prescription: “Prayer helps.”

“Those words gave me such hope,” she recounted. Month after month her husband returned to Letterkenney General Hospital in County Dunegal, Ireland, where doctors began to dub him “the miracle man.” Then it became year after year.

“We spent three healthy and active years together,” Clarke said. “And I say thanks to a surgeon who reminded us of the power of prayer.”

Despite stories like Clarke's, an article published Feb. 20 in the British journal The Lancet strongly advises against any mention of faith by doctors. “Religion, Spirituality and Medicine” is coauthored by Dr. Richard Sloan, professor of psychiatry at Columbia University. Sloan said the article is a review of previous studies from other medical professionals.

The article said, “Health professionals, even in these days of consumer advocacy, influence patients by virtue of their medical expertise. When doctors promote a nonmedical agenda, they abuse their status as professionals.”

Sloan told the Register that if religious or spiritual factors were shown convincingly to be related to health outcomes, they would join other factors such as socioeconomic status and marital status, which are already significantly associated with health.

“For example, the decision to marry: People live longer and healthier,” he said. “But we regard that area of people's lives as personal and private, even if it has implications for people's health. The same is true of religion.”

Sloan added that there is a difference between taking into consideration all aspects of the person and taking them on as “objects of intervention.”

“If patients are very religious, then it is important for physicians to understand that,” the psychiatrist advised. “What's questionable is whether doctors should make recommendations on the basis of that evidence.”

But physician assistant Richard DiBella of St. Raphael's Hospital in New Haven, Conn., doesn't think such issues are necessarily part of a “non-medical agenda.”

“[Doctors] are not just physical body technicians,” DiBella asserted. “If the patient is operating under a system of beliefs, then supporting that, offering encouragement, can only help the patient. It's not a misuse of professionalism.”

Patients appreciate it, too, he said. “I have found that patients respond very favorably to having their spiritually acknowledged. It creates a bond between us for one thing.

“Faith is a very important part of getting well. We are body and spirit. You have to pay attention to that.”

More Medical Schools Addressing Religion

Sloan noted that his and his coauthors’ research was prompted by numerous media reports that examine the “hundreds and hundreds” of papers discussing whether religious practices influence health. His report comes at a time when more than 50 medical schools are including courses on religion and spirituality in their curricula. Sloan said the data about the benefits of linking faith and medicine raised ethical concerns, and he pointed to the possible harm to patients who might link serious illness and moral failure.

Dr. David Larson, president of the National Institute for Healthcare Research, agreed that many of Sloan's concerns should be addressed. But he said the question rarely is about “forcing” religion on patients or “making people feel more guilty.”

He said that courses on religion and spirituality are being added to medical school curricula “due to the data, but not the data that he is talking about.”

“About 5% to 10% of patients are already guilty and so you are not making them guilty. You're not addressing it if you don't deal with it and that is our concern.

‘If the patient is operating under a system of beliefs, then supporting that, offering encouragement can only help the patient. It's not a misuse of professionalism.’

“They might need some sort of chaplain or clergy person to work through that distress. Medical problems bring on a sense of alienation, rejection and ‘Why has God done this to me?’ It happens and it's not because it's being [brought up] by medical doctors, it's because [patients] feel this way already.”

Heather McGrath said that as a registered nurse in Long Beach, Calif., and Washington, D.C., she has seen religion as a great benefit to patients. It was not a matter of “bedside conversions,” she said, but a strength of spirit in her patients.

“I saw hope,” she stressed. “I saw them reach out more and want to get better. The one thing about hope, is that every person has the right to hope. And our job is, in little ways, to include that in a [patient's] care.”

Mental Health

Larson said that while Sloan is “well-intentioned” and his study is driven by ethical concerns, “he actually is only reviewing one area.”

He said there had been much mental health research on the benefits of religion that had not been reviewed, including addiction research. “We actually did a consensus report that not only looks on the mental health but on the physical health and the addiction area even in neuroscience,” he said. “He just looks at the one area when there are other areas of research that need to be looked at as well.”

Dr. Gladys Sweeney agrees. The director of the Washington, D.C.-area Catholic Institute for Psychological Sciences said that when it comes to the practice of psychology, “the fact is that for some patients their spiritual life is a very important aspect. And for those clients, it becomes part of their psychology.”

To intentionally ignore such an important part of the client, she said, is to practice “bad psychology.”

She added, “A psychologist would not be departing from his channel of expertise by addressing spiritual issues that are so connected to the psychology, especially to a client that wants to use those resources.

“The therapist should not be a spiritual director. That is not his expertise, but to ignore it and to say that spiritual issues are outside the psychology of an individual — that is not true. He is saying that spiritual issues are apart,” she said.

Seeing the link between body and soul, the Catholic Church teaches that the sacrament of the anointing of the sick can at times lead to physical healing. Regarding the sacrament, the Catechism of the Catholic Church states: “This assistance from the Lord by the power of his spirit is meant to lead the sick person to healing of the soul, but also of the body if such is God's will” (No. 1520).

In clinical experience, Sweeney said she had seen a very definite link between religion and health: “What I see from my clients, is even a greater sense of peace even in the face of the worst catastrophes of their lives. They can deal with it a lot better because they have hope.

“They can deal with trauma better because they understand sometimes the meaning of suffering. And so I definitely see that they do heal faster.”

Geraldine Hemmings is an assistant editor of the Register.

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