A vivacious--and vexing--lady visited my medical office often, armed with abeguiling smile, a rapier wit, and intractable pain from arthritis. Eachvisit brought forth a languorous litany of incurable woe: She had sampledevery painkiller in the pharmacopoeia, with scant success."Is there anything that does help you?" I asked one day, in desperation.
"Faith and prayer!" she exclaimed. "And singing in the church choir!"Faith, prayer...and singing? Are these listed in the Physician's DeskReference? Should they be? Karl Marx dismissed religion as "the opiate ofthe people." Is religion, like codeine and other opiates, an effective"drug" for pain and other disorders? What's the proper dose? Are there sideeffects?
The medical effects of faith are a matter not just of faith but also ofscience. More than 300 scientific studies demonstrate the medicalvalue of religious commitment (including worship attendance, prayer,Scripture study, and active participation in a spiritual community). Thesebenefits include enhanced prevention and treatment of mental disorders(e.g., depression, suicide, and anxiety); medical and surgical illnesses(e.g., heart disease, cancer, sexually transmitted diseases); andaddictions, reduced pain and disability, and prolonged survival. Inaddition, spiritual treatment (e.g., prayer, religiously basedpsychotherapy) enhances recovery.
My answer is yes! The documented health benefits of religious beliefs andpractices and the burgeoning spiritual interests of patients compel us toaddress matters of faith with our patients. All medical professionals canlearn to recognize the medical impact of faith and to encourage, whenappropriate, the healthy use of spiritual beliefs and practices. Praying foror with patients may be a valuable, meaningful option in certain instances,depending on the beliefs and wishes of both the patient and the doctor.
Some cautions are in order regarding possible "side effects." While someclinicians may develop particular expertise in handling spiritual problems,physicians will not replace clergy: each role is unique, and both are neededin the care of the sick. Similarly, I do not suggest or sanction use offaith-based approaches instead of medical care: we need prayer and Prozac,clergy and clinicians, faith and medicine.
Participating in prayer and religious activities does not guarantee goodhealth: Both saints and sinners alike eventually get sick and die. Patientsshould not follow "doctor's orders" in matters of faith: Choosing aparticular spiritual tradition (or none at all) should not be forced, norshould it be based on the mistaken belief that one faith offers a greaterlikelihood of obtaining health benefits than another. Indeed, the verypurpose of faith is not merely to lower blood pressure or add a few momentsor months of life, but to seek truth and find God.
Despite these legitimate concerns, I do believe that physicians can--andshould--encourage patients to continue or consider authentic, autonomousreligious activity. Perhaps clinicians of the twenty-first century will joinwith clergy to develop a new synthesis of scientifically based andreligiously meaningful medical care to help persons who suffer and seek ouraid.
Shall we pray?
For the faithful, religious commitment offers many health advantages. Acohesive, comforting set of beliefs and participation in sacred rituals mayendow a sense of meaning, purpose, and hope. Faith offers a "peace thatpasseth understanding" in times of pain, grief, and disability. Healthylifestyle choices (e.g., exercise, proper diet) are more common andunhealthy behaviors (e.g., nicotine, alcohol, and drug use; suicideattempts; high-risk sexual activity) less common among religious persons.Persons of faith usually cope effectively with stress and have strong socialsupport and a high quality of life (e.g., well-being, self-esteem, job andmarital satisfaction, altruism).