Certain things in this world fit well together in a way people do not always truly realize — religion and medicine are two of these things.
Just how well medicine and religion intertwine was the subject of the 15th annual Lehman Medical Ethics Lecture, delivered by Dr. Farr Curlin of Duke Divinity School, at 7:30 p.m. on Tuesday, Feb. 18, in Quigley Hall Auditorium. The title of Curlin’s lecture was “What Has Religion to do With the Practice of Medicine?” and went over a study done by Curlin on this subject.
Curlin was introduced by Visiting Assistant Professor of Philosophy and Religious Studies Bradley Burroughs, ’02.
“As an alumnus of both Allegheny and Duke, it is my pleasure to welcome this meeting of my worlds and to introduce (Curlin),” Burroughs said. “Dr. Curlin has a wide array of research interests. His empirical research, as he puts it, charts the influence of physicians moral traditions and commitments, both religious and secular on their clinical practices. He addresses questions of whether and in what ways physicians’ religious commitments ought to shape their clinical practices in a plural democracy.”
Curlin began his lecture with a quote from a famous 19th and early 20th century English surgeon, Stephen Paget, from his book “Confessio Medici.”
“Every year, people enter the medical profession who were neither born doctors or have any great love of science,” Curlin read from the book. “Nor helped by name or influence, they find hard work, ill thanked, ill pay. There are times when they say, ‘what call have I to be a doctor?’ … Heaven soon let’s them know what it thinks of them. The information comes quite as a surprise to them, being the first received from any source that they were indeed called to be doctors.”
Curlin addressed the idea of a calling versus a job and the origins the word “calling” has in Christianity, even though in the modern world people often use the word without religious connotation.
“In general insofar as the practice of medicine as experienced as a job, the practice is valued instrumentally for the benefits it provides,” Curlin said. “In contrast insofar as the practice of medicine as a calling, the physician works for the fulfillment that comes from the work itself.”
Curlin then detailed how a religiously affiliated imagination in a physician might explain what they have been called to do. To consider this question, Curlin brought up a case of a 56-year-old carpenter with pancreatic cancer. In this case, the patient asks the physician why God would let this happen to him.
Curlin then used this question to explain that although physicians are trained to put personal beliefs aside, studies show that most let their personal beliefs and religion influence their practice in some way.
“For a long time, the conventional wisdom was that doctors must be much less religious than their patients,” Curlin said. “That conventional wisdom was based on studies of scientists that found that scientists tend to be much less religious than the general population, including biological scientists. … Despite that, we found that physicians are more or less as religious as members of the general population.”
Curlin used his study, which focuses on how religious most doctors are, to return to the example case, asking the audience what the doctor should do after being asked the question of, “why would God do this to me?”
Curlin brought up another chart to the audience, showing the difference in a physician’s answers and religiosity to the question in this situation, saying that those of high religiosity were three times as likely to ask about religious positions in patients than those with low religiosity. They were also three times as likely to never change the subject when religious concerns were brought up and more than three times as likely to say that they do not spend enough time discussing religious concerns with patients.
Continuing on with the same example, Curlin described the patient as being sad and falling into the category of depression of some sort after the cancer diagnosis and before asking the physician the question. Using this, Curlin discussed how religious positions in physicians affected the way they prescribed antidepressants or other mental health concerns, including the need for therapy.
“There were no religious affiliated differences between (physicians) likelihood to prescribe antidepressants, nor to the need to meet with a patient regularly for counseling,” Curlin said. “However among these physicians, those who attended religious services twice a month or more often were less likely to refer a patient to a psychiatrist, compared to those who attend less often. They were also more likely to encourage the patient to get more involved in their religious communities.”
Curlin added that physicians were also more likely to recommend getting involved in religious communities, even to patients who were not religious.
Following this, Curlin went into another situation in his example in which the patient asked the physician for physician-assisted suicide if they had a severe medical situation.
“72% of physicians (in this study) believe that it would not be appropriate to grant the request of sedation,” Curlin said.
Through controversial medical practices like physician-assisted suicide, Curlin dived into other medical controversies and the deeper questions surrounding them, especially for people with religious preferences.
“The title of this lecture is ‘What Has Religion to do with the Practice of Medicine?’” Curlin said. “Note that we don’t often get people asking what science has to do with medicine. Science is what makes medicine work. … But as medical science gives us great capacities, it does not give us a direction in which to deploy these capacities. … Science generally does not tell us which course to choose.”
Curlin described how other scientists and physicians thought about science and more specifically the limits of science being able to know of things that can be seen and not unseen. Additionally, Curlin said this has its own religious connotations in similar wording to St. Paul’s letter to the Corinthians in the Bible.
Curlin added that for Judaism, the practice of saving lives takes precedence over all but three of the commandments in the Torah, and was also regarded highly in both Christianity and Buddhism.
Curlin proposed that medicine might gain many influential resources from using religion as a tool that science could not always provide, and his idea that religion brings up questions that should be considered in a professional context.
Curlin described religion as also being able to help physicians see their work as meaningful and worthwhile, along with helping to prevent burnout in doctors.
“It’s not only that they are experiencing work as not an expression of their identity, but they’re experiencing work as at odds with their identity,” Curlin said.
According to Curlin, many religious communities struggle to form and sustain virtue in real world situations, but they help to teach people how to care for the sick.
“So it’s not as if somehow bringing religious issues from below the surface and making it the search for fitting integration of religion to medicine is going to cure medicine,” Curlin said. “But it does seem to me that religion is inexplicably intertwined with medicine. And the challenge is not to separate the personal from the professional, but to bring them together with integrity, so that medicine remains in that experience a worthy calling.”