EDITOR’S NOTE: The Does God Exist? ministry offers $1,000 scholarships to young people who demonstrate the ability to deal with apologetic issues and who are going on to further their education. This money is not from donations made to the program but funds given in memory of Edith Lawson, Connie Parsons, and Phyllis Clayton, three women who were instrumental in the starting of this work. In 2008, $3,000 was given in scholarships, and the following is an essay by one of the winners, Brooke Walls of Bloomington, Indiana.

Plato said, “The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated .” While Plato said this many years ago, his ideas are still pertinent in today’s society. Many people believe that medicine and faith should remain separate and that there is no connection between the two. However, new research shows that faith plays a major role in the health of patients. As a result of these studies, there is a growing interest in exploring the role of physicians in patients’ spirituality. Some medical schools are even including classes on spirituality to enhance the physicians’ knowledge and awareness of their patients’ faith in the clinical setting.¹

Before the American Revolution, physicians in the United States were men who became familiar with medicine by traveling to Europe.² They were ship’s surgeons, clergy, apothecaries, or anyone who knew even a little bit about medicine and how to “treat” people, and not many had a formal education in medicine.² Around the 1900s in the United States, doctors became more prominent in a professional setting. The professionalism can be attributed to many factors, including the rise of “scientific medicine’’ as the dominant form of medicine.2 Scientific medicine began to arise in Europe with the development of the “germ theory,” and other breakthroughs in medical research about diseases.² Americans began going to Europe to study medicine and returned to begin their practices and research. As the United States began to become a more powerful country at the turn of the twentieth century, American medicine began to gain momentum.² Soon, with the development of the American Medical Association, the findings from the Flexner Report on the status of current medical schools in the United States, and funding and support from powerful people like Carnegie and Rockefeller, scientific medicine became the dominant form of medicine in the United States, and the previous other forms of medicine found themselves at a great disadvantage.² Since then, science-based medicine, now referred to as allopathic medicine, has been the dominant form of medicine practiced in the United States. With this, there was a decrease in the number of clergy-physicians; thus faith and medicine became two separate areas.

While faith and medicine have not been officially practiced together for almost one hundred years, there has recently been an indication that faith plays a vital role in the lives of patients who are experiencing life-changing events such as pregnancy, terminal illnesses, chronic diseases, unexplained illnesses, heart disease, recovery from injuries or addictions, and stress.^{1, 3} In a study conducted on patients suffering from advanced lung cancer, the caregivers of these patients, and their oncologists, the patients and their caregivers suggested that their faith in God played an important role in determining the type of medical treatment that they would seek.⁴ Their physicians felt, however that the patients’ faith should be at the bottom of the list of factors influencing their treatment decisions, perhaps because “their training is based so heavily on scientific reason that they are unable to recommend a concept that defies a reasonable explanation.”⁴ This study concluded that patients and their caregivers place a great deal of importance in their faith as they consider treatment options, and that physicians underestimate the importance that faith plays in their patients’ lives.⁴

Another study conducted on the role of religion for cancer patients found that when patients were divided in half based on their levels of pain and fatigue, those considered as having higher spirituality experienced greater quality of life than those who had comparable levels of pain and fatigue but lower levels of spirituality.⁵ This indicates that faith does play a role in the health of patients, because even though some patients had high levels of pain, those who were very spiritual had a better quality of life than those who were not as spiritual. The study also found that prayer was the most common form of coping, and breast cancer patients described God as an “ever-present support, constant companion, and confidante who helped ... their self-esteem and sense of personal control throughout their illness.”⁵

It seems from these studies that while faith does not play a role in the medical treatment of patients, faith plays a considerable role in their decisions for treatment and their acceptance of, or reaction to, the disease. If this is the case, then should not physicians have a better understanding of all of the factors that go into healing of their patients? If so, then how much of a role should physicians play in the spiritual lives of their patients? Do patients even want their doctors playing a spiritual role in their lives?

Interestingly, a study conducted at a teaching hospital at the University of Pennsylvania found that fifty-one percent of the patients defined themselves as religious, and of this fifty-one percent, ninety-four percent thought that their doctors should ask them about their beliefs if they were to become terminally ill.¹ Forty-five percent of the patients that did not claim to be religious still thought that physicians should ask them about their beliefs, and sixteen percent did not want physicians to ask about their spirituality if they became terminally ill.¹ Studies such as this one pose the question of how to incorporate a spiritual discussion in a clinical setting. Since physicians are not clergy, it may seem out-of-character for a physician to give spiritual advice to a patient, however, it seems that patients want physicians to discuss these matters with them when faced with death. There are some methods that physicians can use in order to measure the spirituality of a patient which could lead to further discussions, if appropriate. During the history taking, the patient may be asked if he or she considers himself/herself to be spiritual or religious, the importance of these beliefs, the influence of these beliefs, if the patient belongs to a spiritual community, and what the physician can do to meet any needs in this area.¹ These questions can give a physician an indication as to the level of spirituality of a patient and encourage or discourage further discussions about spirituality depending on the patient’s answers without interfering with the patient’s private life.

While some studies have indicated that patients feel it appropriate for physicians to discuss matters of spirituality in a clinical setting, physicians still struggle with the boundaries of professionalism and if they should or should not discuss matters of faith with their patients. In a study that was done on family physicians and their thoughts on spirituality in a clinical setting, sixty-eight percent of physicians from Illinois believed that strong religious beliefs had a positive affect on the mental health of elderly patients and eighty-eight percent believed it to be appropriate for physicians to pursue spiritual issues when the patient requested them.³ The doctors from the study who viewed themselves as spiritual, said that they felt medicine was their mission and their responsibility to act as “instruments of healing.”³ About half of the physicians in the study said that they discussed religious beliefs with patients regularly because they believed in the relationship between faith and health, but agreed that they did not discuss spirituality without the consent of their patients.³ However, other physicians did not feel comfortable discussing issues of faith with their patients.³ One physician described his conflict with whether or not faith should be discussed in a clinical setting: “[Discussing one’s faith with a patient risks being] an abuse of power; yet if a patient dies tonight and I haven’t shared the Good News I have ...  I’m neglecting something that’s very important. ... How do we do this ...  with both gentleness toward the patient and reverence toward God?”³

Despite the common form of practice for medicine in the United States where science dominates, it is clear from recent studies that faith plays a major factor in patients’ lives. With this in mind, it is evident that science and faith can work together to achieve better health. As the studies become better and more evidence is gathered to support this idea, the physician’s role may be redefined to include more guidance in spirituality and faith, especially for physicians working with terminally ill patients.

1. Post, Stephen G., Christina M. Puchalski, and David B. Larson. "Physicians and Patient Spirituality: Professional Boundaries, Competency, and Ethics." Annals of Internal Medicine 132 (2000): 578-83.
2. Cockerman, William C. Medical Sociology. 10th ed. Upper Saddle River: Prentice Hall, 2006, 188-96.
3. Ellis, Mark R., James D. Campbell, Ann Detwiler-Breidenbach, and Dena K. Hubbard. "What Do Family Physicians Think about Spirituality in Clinical Practice?" The Journal of Family Practice 51 (2002): 249-54.
4. Silvestri, Gerard A., Sommer Knittig, James S. Zoller, and Paul J. Nietert. "Importance of Faith on Medical Decisions Regarding Cancer Care." Journal of Clinical Oncology 21 (2003): 1379-382.
5. Weaver, Andrew J., and Kevin J. Flannerlly. "The Role of Religion/Spirituality for Cancer Patients and Caregivers." Southern Medical Journal 97 (2004): 1210-214.