Thursday, January 28, 2010

Religion and Health: Interference or Complementarity

Following my speculations about why some people seem to imagine that they can be made very rich by a miracle, a friend sent me an article entitled Religion, Spirituality, and Medicine. This article is a "comprehensive, though not systematic, review of the empirical evidence and ethical issues" and concludes that "the evidence of an association between religion, spirituality, and health is weak and inconsistent".

Perhaps more importantly, the authors question the ethics of mixing religion and medicine, a question that would still arise even if there was stronger evidence of an association between religion and health. One could ask, which religion would a doctor recommend or agree to discuss? What would they do with someone who didn't believe in any religion? Would each medical professional require special training and what kind of special training? (The authors of the paper did not raise all these questions, but they arise from considering the problems of combining medicine with religion).

Even if people go to a doctor without any expectation that the doctor is, to a large extent, a scientist, that doctor is obliged to do things that are supported by scientific evidence and avoid things that are not so supported. The fields of science and religion are completely different and the practitioners of each field work in different ways. Is it even feasible for doctors to also become experts in religion (as if religion were just one thing!)?

If I was renting a damp room that affected my health badly, should my doctor write a letter to my landlord and ask for my conditions to be improved? Medical advice could be brought to bear on an employer who was exposing me to health risks, but this is a matter for employment laws. The doctor doesn't intervene directly. Yet we know that environmental conditions are closely connected with people's health. We know that economic circumstances are closely connected with people's health but we don't expect our doctor to recommend a pay rise. Even government health advice about healthy eating is considered to be taking things too far by some.

I accept that certain beliefs can be comforting and I certainly wouldn't suggest that people should be told what to believe and what not to believe or how to express their beliefs. If they see praying as part of their recovery from illness or as helpful in bearing an illness from which they will not recover, no one has the right to interfere. But when it comes to prescribing medication, the doctor is the expert, not the religious leader. And when it comes to praying and giving religious advice, the religious leader is the expert.

In fact, I find it exasperating that there are many churches in developing countries who don't seem to be able to make that distinction. They feel they are experts in marriage, reproduction, sexual behaviour and protecting against sexually transmitted infections (STI). They are not experts, generally they know even less than lay people and should certainly have less experience. If you can't persuade someone to give up having sex or sex outside marriage, the least you can do is tell them how to avoid becoming infected with an STI, infecting someone else with one or giving rise to an unplanned pregnancy. Otherwise, these leaders are failing to do what they can to prevent serious consequences.

If religious leaders wish to give medical advice, they had better know what they are talking about. As for advice about sexual behaviour, contraception and reducing the spread of STIs and unwanted pregnancies, many don't seem to have had a lot of success and should leave the job to someone who has the appropriate knowledge and training. In the same token, doctors should discuss religious matters with patients if they feel able to do so and if they are requested to do so but it should never be seen as a type of medical care or treatment.

If someone has a particular set of religious beliefs, presumably they hold those beliefs regardless of their health or lack of health. It seems unlikely that they just 'adopt' those beliefs in the hope that they will get well. Whether someone is religious or not, some will suffer illnesses and injuries and all will die eventually. If the 'belief' is purely conditional on their health, the person's piety would be quite questionable. So I don't see why a religious person would be interested in whether religion is in any way connected with health outcomes in the first place.


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