Science and Religion:Making a Good Medical Decision

Beyond the issue of physicians praying with their patients, either initiating or on request, there is the issue of the relationship between science and religion with respect to principles of patient autonomy and physician beneficence in patient care. In a survey of physicians on this matter, Farr A. Curlin, M.D. et al, writing in the Jan 10 2005 issue of the Archives of Internal Medicine come to this conclusion:

“There is no bright line that can be drawn between discussion of medicine and discussion of religion. Therefore, when conflict occurs, moral (ie, religious) counsel inheres in medical recommendations. Science tells patients what they can do, but physicians also tell patients what they should do, and the latter is always a moral exercise. If religious advocacy is a threat to patient autonomy, one must ask whether autonomy is not equally threatened by challenges to patients’ ideas of religious faithfulness, whether or not they conflict with medical evidence.

Our findings suggest that physicians always navigate a balance between respect for patient autonomy (remaining open-minded and flexible) and concern for the patient’s good (persuading the patient to adhere to recommendations). That navigation will always be guided by the physician’s sense of what "the good" is. Rather than striving for illusory neutrality, physicians should practice an ethic of candid, respectful dialogue in which they negotiate accommodations that allow them to respectfully work together with patients, despite their different ways of understanding the world.”

I would agree that the physician’s recommendations (what the patient should do) does carry a moral potential since should is not necessarily free of moral opinion. The practical issue in medical practice is unfortunately there doesn’t often appear to be enough time (or skill or motivation?) for physicians to “negotiate accommodations” and the patient is left with what seems as a paternalistic type of physician advice and the physician may be left with impression that the patient is being unrealistic and stubborn. What is the solution to the issue? Those patients who have significant decisions to make should be scheduled for more of the physician’s time. Physicians should also be aware of the potential conflict between religion or moral beliefs (physician’s and patient’s) and the science of medicine. If the physician feels insecure in the art of mediation, well.. this would be something to learn as part of continued medical education. ..Maurice.