Medicine and Religion: Yes and No

Richard P. Sloan is worried about the connection of medicine and religion, as well he should be. He is Professor of Behavioral Medical (sic–I hope that word is actually “Medicine”) at Columbia University Medical Center and the New York State Psychiatric Institute and author of Blind Faith: The Unholy Alliance of Religion and Medicine.

Professor Sloan makes basically two points in his recent posting on the Newsweek/Washington Post website, “On Faith.” He thinks he is making only one: namely, that religion has no part in medicine. But in fact he is making at least two.

His article is entitled, “First, Do No Evangelizing.” This title is just a teeny, tiny bit offensive to Christian physicians who might be expected to bristle at this allusion to the Hippocratic Oath, whose first clause is, “First, do no harm.” Evangelism = harm? Ouch.

But as someone who is in favour of both evangelism and medicine, I think Professor Sloan is right about his main point: physicians must not take advantage of patients’ dependence upon them for their physical wellbeing to press spiritual matters upon them.

My late father was a family physician and surgeon. I used to think that Dad perhaps did not press his patients often enough or far enough about their spiritual needs when he was dealing with their physical troubles. Now I think he was quite properly circumspect. He was doing the will of God–making shalom where there was danger and destruction–by performing medicine well. He would have risked marring that good service by seeking to exploit it for evangelistic ends.

Don’t get me wrong: I’m all for evangelism. In fact, I’m all for good evangelism: for, literally, “good good-news-ing”! That’s why I think those in authority must be above reproach and never vulnerable to the accusation that they used their position of social authority to coerce–even with good motives and in the slightest way–religious compliance from others.

Lawyers, police officers, prison guards, chaplains, military commanders, teachers, psychologists, professors, bosses, parents–we all have to be very careful to grant each other, and especially those in our charge, the liberty that God grants us: to decide how we will respond to God’s invitations.

So Professor Sloan is right, I would say as an evangelical (and we evangelicals like evangelism quite a bit), that physicians must think through their invitations to their patients to pray, or read the Bible, or accept Jesus into one’s heart, and realize how compromised their patients’ situations really are. How can they say no, and risk offending someone on whom they are so dependent?

Professor Sloan is wrong, however, to link this concern with a very different ethical matter: physicians deciding not to offer treatment that they feel is unethical. Yes, I think Professor Sloan is right that physicians ought to inform their patients about other legal treatments available elsewhere. Those patients have the awful liberty to choose those other treatments even though a physician might believe them to be unethical.

But physicians in our pluralistic society must be allowed to demur on treatments that might be legal, but are fraught with ethical ambiguity. Professor Sloan seems to think that it is enough to say that a treatment is “perfectly legal.” I pause over the adjective “perfectly.” Hmm. It used to be “perfectly legal” to discriminate against people of colour, or of the female sex, or without money. So I’m not terribly impressed by the argument that something happens to be, today, “perfectly legal.” That hardly makes it perfect, or even right.

If we’re going to license physicians of different outlooks–and how can we not, in a pluralistic society?–then we must allow for those zones of ethical difference. And we each must allow for them: to speak in simplistic categories, conservatives must inform patients of more liberal alternatives, even while refusing to perform them themselves, while liberals must allow conservatives the right to refuse to participate in medical treatments they believe to be unethical.

There’s no point in condemning Josef Mengele–Doctor Josef Mengele, who was performing “perfectly legal” procedures in the Nazi camps–if we will not allow some of our own physicians the right of conscientious objection.

For the Hippocratic Oath doesn’t say, “First, Don’t Evangelize,” but “First, do no harm.” Physicans have to follow that dictum as best they can, whatever happens to be “perfectly legal.” And, yes, allowing them that freedom will mean that in some locales, undersupplied by physicians, some people won’t easily receive some therapies.

But the alternative is horrible: physicians obliged to do whatever the state tells them to do, whatever is “perfectly legal.” Professor Sloan should consider other, quite recent, regimes–whether in Nazi Germany, or Stalinist Russia, or Maoist China, or even early 20C America, with its compulsory sterilization and other eugenics–and consider whether he really wants the state to govern all medicine.