Introduction
Religious beliefs are a crucial sociocultural factor that plays a role in the doctor-patient relationship. With religion being historically heavily intertwined with the medical field since 3000 BC, the interconnections of the two in the modern day are crucial in understanding where we stand today. It is important to assess the direct and indirect influences of religion in the relationship, but also the role of third parties in order to fully contextualize the current state of religion in healthcare.
History of Religion’s Role in the Doctor-Patient Relationship
In ancient times, healers were often viewed as intermediaries to divine forces, blending medicine with spiritual and religious beliefs. As early as 3000 BC, Mesopotamian religious leaders treated the injured at temples through both traditional medical treatment and prayers with religious offerings (“The history of religion and healthcare”). During the Middle Ages, the Christian Church played a significant role in the development of hospitals and medical training (“The history of religion and healthcare”). However, the rise of modern medicine and scientific inquiry led to a separation between religion and the practice of medicine. This rise has been fairly recent: in fact, religion and medicine have been separated only within the past 200-300 years, which is less than 5% of recorded history (Koenig 392). Therefore, navigating the intricacies of spirituality within the doctor-patient relationship today is fairly novel and has value in being studied.
The Explicit Presence of Religion in the Doctor-Patient Relationship
At times, religion may play a large role in the conversation between doctor and patient. A direct example of faith in the doctor-patient dyad is Mary Warren, a patient experiencing stress due to her manufacturing job. She states when she visited a nurse during a mentally troubling time, “She was asking me who could I talk to, and I said, ‘Well, I don’t know.’ So they asked me what church did I go to, did I have a pastor… So I had start[ed] to attend a church… getting involved in church really gave me a different outlook on life” (11). Through the interaction, Warren was able to not only directly connect with the provider through the introduction of spirituality but also found mental health support within faith through the relationship. Religion can be discussed as a coping and support mechanism between doctor and patient. Additionally, conversing about faith can identify health constraints that doctors must keep in mind, such as how Jehovah’s Witnesses cannot take blood transfusions.
The Implicit Presence of Religion in the Doctor-Patient Relationship
However, it is important to note that this is not a universal experience: 48% of doctors in a study stated that they would never discuss religion and/or spirituality with their patients (Notini et al). This begs the question: does spirituality also have an indirect sphere of influence in the doctor-patient relationship?
While religion may not be explicitly discussed within the doctor-patient relationship, a doctor’s religious values can permeate how they approach their patients. For example, James Morgan is a medical professional who explains how his Christian values and experiences in church taught him that “everybody’s got a story, everybody’s got a heartache, and some are a lot worse than others, but everybody deserves a chance at changing their life around” (28). Later in the interview, Morgan describes times in the clinic when patients would get angry, saying “I kind of felt like, ‘Well, there’s something else going on there than just a bad attitude kind of person. It’s usually something that they’re going through or they’ve had a rough life’” (20). Although he does not explicitly make this connection, it can be inferred that his values of patience and empathy stem from his religious beliefs and influence how he treats his patients in difficult times. This is shown on the national level: A survey of 2,000 randomly sampled physicians found that 55% agree that their religious beliefs influence how they practice medicine, showing the subtle yet present role of religion in the doctor-patient relationship (Curlin et al).
Religious Third Parties in the Doctor-Patient Relationship
However, the doctor-patient relationship is not a dyad: rather, religious third parties may intervene. These third parties serve as intermediaries, enhancing cultural and religious competence by bridging the gap between diverse beliefs and healthcare decisions.
In the book Black Man in a White Coat, Dr. Tweedy defines cultural competence as an approach to “find the commonalities and respect the differences between us and our patients. In that way, we can understand what they value, [and] how best to communicate with them” (274). Religious competence is a specific subset of cultural competence and is exercised by Norma Armwood, a bridge counselor who works as an intermediary to assist HIV-positive patients. She says, “People have their own beliefs, and I can’t pressure anyone… but whatever their beliefs is and some of them don’t believe in God, and I still encourage them, whatever you have faith in, then that’s what you need to turn to or who you need to turn to” (31). It is figures such as Armwood who are more specialized than physicians, due to their high level of training and experience, to discuss spiritual topics in a proper way that exercises religious competence. For example, hospital chaplains, such as Brian Cornell who was also interviewed by the Southern Oral History Program, provide spiritual guidance to patients and families in medical settings. The majority of physicians who have experienced working with chaplains report that they were satisfied with their services and prefer referring religious questions to them, showcasing the importance of religious third parties (Cadge). Chaplains and bridge counselors are just a few examples of third parties that can support patients’ spiritual needs.
Conclusion
The intersection of religion and the doctor-patient relationship is multifaceted, with its existence interwoven throughout history. Experts in the field state that more research needs to be done on both the physicians’ and patients’ interactions with religious third parties (Cadge). Nonetheless, I argue that embracing a multidisciplinary approach through team-based care allows for comprehensive care that respects diverse beliefs and values, which goes beyond the limited capabilities of the doctor-patient dyad. Open communication about spiritual needs allows doctors to better serve religious patients. By emphasizing proper communication and religious competence within healthcare teams, we can better meet the needs of patients and communities.
Work Cited
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Cadge, Wendy. “Study Shows Most Physicians Satisfied with Hospital Chaplain Services.” BrandeisNOW, www.brandeis.edu/now/2009/october/cadge-release.html. Accessed 29 Apr. 2024.
Cornell, Brian. “Y-0014.” Southern Oral History Program Collection #4007, 28 June 2018. Southern Historical Collection, https://dc.lib.unc.edu/cdm/compoundobject/collection/sohp/id/27945/rec/75.
Koenig, HG. “Religion and medicine I: historical background and reasons for separation.” International Journal of Psychiatry in Medicine vol. 30,4 (2000): 385-98. doi:10.2190/2RWB-3AE1-M1E5-TVHK
Morgan, James. “Y-0115.” Southern Oral History Program Collection #4007, 17 July 2019. Southern Historical Collection, https://dc.lib.unc.edu/cdm/compoundobject/collection/sohp/id/28693/rec/201.
- Notini, Lauren, and Justin Oakley. “When (if Ever) may Doctors Discuss Religion with their Patients?” Bioethics, vol. 37, no. 1, 2023, pp. 72-80.
“Recognizing Religious Beliefs in Healthcare.” HealthStream, www.healthstream.com/resource/blog/recognizing-religious-beliefs-in-healthcare. Accessed 28 Apr. 2024.
“The History of Religion and Healthcare – from Ancient Times to Now.” Doctorpedia, 6 Feb. 2023, https://www.doctorpedia.com/channels/the-history-of-religion-and-healthcare/#:~:text=Religion%20and%20medicine%20combined%20once,the%20construction%20of%20dedicated%20hospitals.
Tweedy, Damon. Black Man in a White Coat: A Doctor’s Reflections on Race and Medicine. Picador, 2016.
Warren, Mary. “Y-0136.” Southern Oral History Program Collection #4007, 25 June 2019. Southern Historical Collection, https://dc.lib.unc.edu/cdm/compoundobject/collection/sohp/id/28458/rec/7004.