Diss - Koenig, 2000, religion & medicine 1

• Historically intertwined

  Split "became final and complete" in Age of Enlightenment (17-18C)
• Patients likely to believe that religion is relevant to health
• 96% Americans believe in God (this is 24 years ago though, would need to search new figures)
• 42% of patients in North Carolina say religious faith enables them to cope w/ stress of hospital admission
• Religion provides

  Comfort and hope in cases where treatment is not working, physicians not well prepared to deal w/ patient's psychological experience of illness
• Until few hundred years ago, disease largely understood in religious/spiritual terms
• Prehistoric Egyptians (6000-5000BC)


  • Saw no distinction btwn physical and mental illness, both believed to be caused by spiritual forces (evil spirits, demon possession etc.)
• Mesopotamian medicine (3200-1025BC)


  • Supernaturalistic & naturalistic paradigms, treatments inv. spiritual practices & natural methods - plants & animal parts
• Indus Valley civilisations (2300-1700BC)


  • Hindu priest performed dance rituals, incantations & used amulets, herbal/animal products for healing
• Hippocratic medicine in Greece (350BC onwards)


  • Focus on balancing humours
• Platonic medicine


  • Science mixed w/ mystical elements
• Asclepian medicine


  • Treatments inv. astrology, magic & herbs
• Wealthy attended by private physicians, poor ppl relied on folk remedies, miraculous healing or clergy w/ medical skills (after 400AD)
• No hospitals before Christian era, first major Western hospital 370AD in Asia Minor, founded by St. Basil, bishop of Caesarea, following biblical injunction to clothe the poor and heal the sick
• First permanent hospital in China founded in 491AD by Hsiao Tzu-Liang, Buddhist prince
• Middle Ages (400-1400AD)


  • Most physicians monks or priests, care provided primarily by church, 6C mentally ill patients cared for in church-ran monasteries, for almost 1000 years church was responsible for operating hospitals & granting medical licences to physicians
• Beginning of Renaissance (after 1400) certification of doctors became state responsibility, growing separation btwn medicine & religion
• Early 1400s - institutions for mentally ill operated by clergy opened in Spain
• 1817 - Quakers in Philadelphia establish one of first mental hospitals in US, "moral treatment" successful
• Late 1600s - Daughters of Charity of St. Vincent de Paul organised Catholic nuns to serve both religious and secular hospitals, first "nurses", by 1789 there were 426 hospitals ran by Daughters of Charity in France alone
• Despite this, religious control over medicine declined during Enlightenment period bc of 18C scientific discoveries, separation nearly complete by 1802 (end of French revolution)
• Medicine & religion remain distinctly separate for 200 years, slight change towards end of 20C
• 1990 - <5 medical schools in US teach about role of religion in lives of sick patients
• 2000 - almost 70 out of 126 US med schools have required or elective courses on religion/spirituality & medicine
• Certain health professionals believe religious involvement is root of emotional disturbance, low self esteem, depression & schizophrenia
• Schizophrenic/manic patients often have distorted religious beliefs - they are God or they hear voices from divine beings, psychotic depressives may believe they have committed sin
• For years, DSM used religious examples to illustrate examples of serious mental illness
• Some religious groups distance themselves from psychology/psychiatry, believing religious activity sufficient for mental healing
• Some books encourage choosing "psychological way" or "spiritual way" but not combining both
• Religious practices used to replace medical care - e.g. diabetics discontinuing insulin use, epileptics discarding anti-seizure medication, all to prove faith
• (Lannin) "cultural beliefs" inc. religious beliefs significant predictor of late stage breast cancer diagnosis, but individual effects of religion not investigated separate from race/education/socioeconomic factors
• "religious beliefs are much more common among African Americans, the uneducated, and the poor" p.390, explore more?
• (Zollinger) breast cancer patients, found probability of staying alive during study period 60.8% for Seventh-Day Adventists & 48.3% for non-Adventists, Adventist women had earlier stage diagnosis
• Variation in encouragement of religious practices over medical care - Christian Scientists advocate treating serious illnesses with prayer alone
• (Wilson) death rate from cancer among Christian Scientists double national average, (Simpson) higher longevity in students from College of Liberal Arts & Sciences at Ukansas compared to Christian Scientist graduates of Principia College in Illinois
• Jehovah's Witnesses refuse blood transfusions, as believe that God will turn his back on anyone who accepts transfusions
• For adults refusals accepted on grounds that transfusions are invasion of privacy & violation of freedom of religious practices, but more controversial to refuse on behalf of children - JW typically lose cases in Supreme Court involving children
• Refusal to vaccinate children also has serious consequences - come back to this section for specifics
• Refusal of prenatal care - Faith Assembly Indiana have home births w/o medical assistance or prenatal care, perinatal mortality 3x higher and maternal mortality almost 100x higher among these women vs general population (Kaunitz)
• After publication of this study, Indiana General Assembly passed law requiring health professionals to report acts of withholding medical care for religious reasons, after this law was passed perinatal mortality declined by a half & maternal mortality nearly eliminated