By Richard Sloan
Should the medical care you receive from your doctor depend upon the quality of the available treatments? Or should it depend upon the doctor’s religious beliefs? According to a report in the current issue of the New England Journal of Medicine, for about one-fifth of physicians in the US, it’s the latter. Results of a survey of 1,820 physicians representing different regions of the country and different medical specialties revealed that many believe not only that their religious views should determine which medical treatments they will offer but, more distressing still, that they are under no particular obligation to disclose this bias to their patients.
We’ve grown accustomed to the intrusion of religion into many previously secular areas of our lives, for example, scientific research and partisan politics. But in both these domains, the impact is somewhat remote. We don’t really feel the effects of those influences immediately or intimately. We don’t really understand how science works and how our lives depend upon it. Only about half of us vote. But we all get sick and almost all of us see doctors.
In this intrusion of religion into medicine, the patient is the loser. Linking religion and medicine represents bad medicine and bad science.
It’s bad medicine, as the recent article makes plain, because it deprives patients of legitimate medical care. An organization called the Association of American Physicians and Surgeons objects to vaccination for chickenpox on moral grounds because the vaccine was derived from aborted fetal tissue. According to a bill recently introduced before the Wisconsin legislature, a doctor could use this as the basis of a claim of conscientious objection and refuse not only to administer the vaccine to a child but to tell the child’s parents about it. West Virginians for Vaccination Exemption reports that 14 current vaccines, including those for hepatitis, measles, polio, and rabies, derive from aborted fetal tissue.
Conscientious objection to these vaccines holds the well-being of the larger society hostage to the moral views of a small fraction of doctors by risking the unleashing of epidemic diseases we conquered decades ago. To allow religious values to interfere with the care patients receive was assailed by epidemiologist Petr Skrabanek as “a social movement dressed up in scientific language.”
This behavior among physicians also represents bad science. Despite hundreds of studies examining associations between religious practices and health, the evidence of such a connection is at best weak and inconclusive. No one would take seriously your belief that you’re a great fisherman because you showed up with a big bass at the end of the day if it became clear that it took you all day to catch it, that you used a drag net instead of a rod and reel, and that in addition to the bass, the net dragged in 7 tree limbs, 32 snakes, 53 food containers, and 115 fish under the legal limit.
To have a valid claim, you have to follow the rules and this is no less true of science than it is of fishing. If you drag for a finding that supports a scientific conclusion you want to make, for example, that religion is good for your health, you can’t declare to have proven your point if you also collected much more evidence that didn’t support your claim.
Unfortunately, in studies of religion and health, this data dredging happens all the time. It means that the claim that there’s a beneficial health effect of religious devotion is about as valid as the fisherman’s assertion. Fishing may be rife with tall tales but that shouldn’t be the case for science.
Being a medical professional means assuming certain responsibilities and foremost among them is acting in the interests of your patients. Ethicists have pointed out that because doctors have state licenses giving them exclusive rights to practice medicine, they have an obligation to deliver medical care to all those who seek it. That means understanding the best scientific evidence about what factors contribute to health and which ones don’t, and practicing medicine accordingly. It means not allowing your personal values, religious or otherwise, to interfere with the best interests of your patient. If as a doctor, you find that you can’t do this, there is a clear alternative: find another profession.
Richard Sloan, Ph.D., professor of Behavioral Medicine at Columbia University Medical Center, is an internationally known commentator on the subject of prayer and medicine. Dr. Sloan believes there are no scientific methods to accurately measure the value of faith/prayer. With Dr. Emilia Bagiella, he challenged the “health effects” of religious activity in articles in the Lancet, the New England Journal of Medicine, and the Annals of Behavioral Medicine, raising methodological failures and ethical problems. His new book is Blind Faith: The Unholy Alliance of Religion and Medicine. His research at Columbia focuses on psychological risk factors that contribute to the risk of heart disease. Dr. Sloan has been interviewed widely by media around the world.
