Negotiating Religious Beliefs in a Medical Setting (original) (raw)
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When Religious Language Blocks Discussion About Health Care Decision Making
HEC Forum, 2019
There is a curious asymmetry in cases where the use of religious language involves a breakdown in communication and leads to a seemingly intractable dispute. Why does the use of religious language in such cases almost always arise on the side of patients and their families, rather than on the side of clinicians or others who work in healthcare settings? I suggest that the intractable disputes arise when patients and their families use religious language to frame their problem and the possibilities of solution. Unlike clinicians, they are not bilingual and thus lack the capacity to understand and negotiate differences in terms that are responsive to those who work in healthcare settings. After considering a representative case, I explore whether an ethics consultant or chaplain can function as a translator and suggest that, at best, such efforts at mediation depend on contingent aspects of a case and will only be partially successful. To appreciate limits on the role for bilingual translators, I consider a futility dispute where a parent using religious language demands that everything be done for a permanently unconscious child. I challenge the traditional interpretation that says the parent values "mere duration of biological life irrespective of quality." From a religious perspective, human life is never "merely biological." This effort to slot the dispute into standard philosophical schemas misses what is crucial in the dispute. I suggest that a better interpretation views the dispute at a meta-level as one about whether withholding and withdrawing care is morally distinguishable from killing. Curiously, this interpretation makes the advocate of futile care into an ally of those "quality of life" advocates who also challenge this distinction. The crux of their dispute now rests on the normative ethics of killing. While I think my interpretation comes much closer to the views of many who demand 'futile care,' I suggest that it still falls short because of the way it reconstructs the religious concerns in nonreligious terms. I close by considering an analogy between the language of suffering and the language of faith, suggesting that both require a much richer understanding of the narratives that orient the lives of patients and their families.
Why Religious Discourse Has a Place in Medical Ethics: An Example from Jewish Medical Ethics
This article will lay out the different rhetorical strategies that exist in religious discourse on topics related to medical ethics. In demonstrating that religious ethicists use different rhetorical strategies, depending on their goals and audiences, this essay attempts to show how recognition of the different strategies is a first step to finding practical tools to assist in dialogue between individuals and groups in multicultural settings. By understanding how to account for these different rhetorical strategies when considering arguments from different religious groups and in negotiating norms and values in the public square, public discourse related to medical ethics can be enriched, and, importantly, ways to avoid or at least ameliorate ethical conflict or tension between people and groups in a multicultural environment may be found.
Responding to Religious Patients: Why Physicians Have No Business Doing Theology
Journal of Medical Ethics, 2019
A survey of the recent literature suggests that physicians should engage religious patients on religious grounds when the patient cites religious considerations for a medical decision. We offer two arguments that physicians ought to avoid engaging patients in this manner. The first is the Public Reason Argument: we explain why physicians are relevantly akin to public officials. This suggests that it is not the physician's proper role to engage in religious deliberation. This is because the public character of a physician's role binds her to public reason, which precludes the use of religious considerations. The second argument is the Fiduciary Argument: we show that the patient-physician relationship is a fiduciary relationship, which suggests that the patient has the clinical expectation that physicians limit themselves to medical considerations. Since engaging in religious deliberations lies outside this set of considerations, such engagement undermines trust and therefore damages the patient-physician relationship.
Bioethics
This paper considers what concept of accommodation is necessary to identify and address discrimination, disadvantages and disparities in such a way that the plurality of religious people with their beliefs, values and practices may be justly accommodated in healthcare. It evaluates threats to the possibility of such accommodation pertaining by considering what beliefs and practices might increase the risk of unjust discrimination against and disadvantage for religious people, whether as individuals or as groups; and the risk of disparities between the care provided to religious people. The claim is that there is an important cluster of risks that are political in kind and emergent within philosophical bioethics. While not amounting (yet) to a trend, they are sufficiently threatening to a just civic life for patients and healthcare staff as to warrant scrutiny. After an Introductory Section 1, Section 2 evaluates a criticism of 'accommodation' and the apparently additional health-related requirements that those of religious faith demand, when compared with other people. It does so by comparing Lori Beaman's idea of agonism with that of a distinct and somewhat complementary approach in Jonathan Chaplin's political philosophy, before examining the role of established religion in setting the conditions for the accommodation of religion and belief in healthcare. Section 3 examines risks to such accommodation by engaging critically with three health-related instantiations of political philosophy that differ radically from both Beaman and Chaplin. A concluding Section 4 focusses on appropriate modes of communicating about religious and other beliefs in healthcare.
On Faith, Health and Tensions An Overview from an inter-governmental perspective
The Heythrop Journal, 2014
Faith groups are major providers of health care and health-related services around the world. Faith-based providers of healthcare will often maintain that their approach to health is built on a holistic perspective, employs holistic approaches, and that the care extended to patients is also provided in order to offer a support system to help the family cope during the patient's illness and in their bereavement. In so doing, many faith-based and faith-inspired health care givers will reference an approach intended to address the needs of patients, their families, and their communities, which is carried out with a view of the whole of the person: body, mind and spirit; individual, familial and communal. In line with the World Health Organization's definition of palliative care, 2 faith-based or faith-inspired health care tends to be built on approaches which blend different forms of care and intervention-including the spiritual-while also seeking to make use of available community resources. Faith communities can exert powerful leverage to reduce vulnerability to ill-health, since the major world religions express a commitment to respecting the dignity of every person, regardless of age, gender, sexual identity, ethnicity, social position, or political affiliation.Areas of convergence exist, therefore, between the core values informing faithbased responses to health and the rights-based understanding of health that now dominates the health policies employed at governmental and intergovernmental level. The rights-based approach to health, as the name implies, is founded upon respect for and promotion of the fundamental human rights of persons as they are expressed in the Universal Declaration of Human Rights. A rights-based approach to health would therefore seek to promote respect for persons, gender equality, informed consent, confidentiality and so on. In an article published in The Seattle Times in February 2012, Monica Harrington, Deborah Oyer and Kathy Reim write that 'nearly 18 percent of all hospitals and 20 percent of all hospital beds in health systems nationwide are owned or controlled by the Catholic Church'. 'In some isolated areas' they continue, 'the only hospitals available are Catholic-run'. This is a reality in the United States of America, a country whose total net Overseas Development Assistance disbursements (aid provided overseas) was $30.7 billion in 2012. 3 In other words, this is a donor country, not classified as least developed, underdeveloped, or poor. A growing body of evidence points to the significant role of faith communities in health delivery worldwide. It is estimated that faith-based organizations (FBOs) 4 provide an average of 30 to 40 percent of basic health care in the world. 5 This figure tends to be much higher in contexts of conflict and humanitarian emergencies (e.g., Sierra Leone, the Democratic Republic of Congo and Syria) where organizations such as IMA World Health inform us that bs _bs_ banner 1070 AZZA KARAM almost 70 per cent of the basic health care can be provided by FBOs (particularly Christian ones, which
Cristina Gavrilovici Christian and Secular Dimensions of the Doctor-Patient Relationship
2016
Abstract: Trust in the doctor-patient relationship is an indispensable structural element for the medical profession. The discourse concerning trust and its importance in the healthcare context, although quite old, elicits increasingly more interest in research, especially for empirical approaches. The importance of trust in the doctor and in the medical profession can be demonstrated by starting from the Christian meaning of illness and medicine; generally, the patristic sources see medicine and physicians as God’s gifts. The perception of Christian physicians as dedicated, unselfish and compassionate preservers or restorers of health, always committed to the good of their patients is well known. The model of the Christian physician is a Hippocratic model, of one who seeks the sick so that he may bring relief to them and strengthen them. When illness occurs, Christianity affirms an ethical duty to struggle against sickness, which if unaddressed can lead to death. The moral requirem...
Revista de Pesquisa: Cuidado é Fundamental Online, 2017
Objetivo: Investigar como pacientes com diagnóstico de câncer concebem o apoio religioso/espiritual no contexto hospitalar. Métodos: Estudo exploratório, com abordagem qualitativa, realizado com pacientes acometidos por câncer, assistidos na Clínica Médica e Cirúrgica do Hospital Universitário Lauro Wanderley - HULW/UFPB. Resultados: Da análise dos dados qualitativos, depois das leituras atentivas das falas dos entrevistados, emergiram as seguintes categorias temáticas: Categoria 1 - Significado do apoio religioso/espiritual recebido durante hospitalização; Categoria 2 - Promotores do apoio religioso/espiritual no ambiente hospitalar; Categoria 3 - Participação em atividades religiosas/espirituais durante hospitalização. Conclusão: Os resultados revelaram que a religiosidade/espiritualidade é uma tática importante no enfrentamento da doença oncológica, considerando que os pacientes entrevistados relataram o significado positivo do apoio recebido, pois a fé proporciona uma maneira de...
Medical Education, 2002
Objectives To find out whether and how the teaching of medical ethics can influence attitudes on accepting treatment refusals. Setting and design Anonymous questionnaires were distributed to 4 groups of students at the University of Geneva who had participated (P) or not (nP) in teaching modules on medical law and ethics. One vignette described a terminally ill patient refusing mechanical ventilation, another a Jehovah's Witness refusing a life-saving blood transfusion. Participants 127 medical and 168 law students. Main outcome measures 5-point Likert scale of responses to the vignettes reaching from certain acceptance to certain non-acceptance of the treatment refusal. Results More than 80% of law students (nP) said that a good physician should accept the terminally ill patient's refusal. 84% (P) compared to 68% (nP) of medical students (P ¼ 0AE03) would accept this refusal. The acceptance of the Jehovah's Witness refusal of a life-saving transfusion was less among all students. Students from the groups (P) reported significantly more often (P < 0AE001) that they would accept (76% of medical students) or that a good physician should accept (63% of law students) the treatment refusal of the Jehovah's Witness than medical students (48%) and law students (27%) from the two other groups (nP). Conclusion (P) students showed significantly more acceptance of treatment refusals in the hypothetical case scenarios than (nP) students from the same faculty. Religion, cultural origin and school education of the parents had less influence on attitudes than participation in ethical teaching and type of student (medicine vs. law).
The subject of this article is the difficult relationship between biomedicine – with its therapeutic practices oriented toward the resolution of organic troubles of individual patients – and the profoundly semantic and social nature of the experience of illness in those who seek treatment by health institutions – mostly, but not exclusively – in non-Western contexts. Starting from a dramatic ethnographic example, the case of a Native Mexican teenager suffering from meningoencephalitis, admitted at a health center in San Mateo del Mar (Oaxaca, Mexico) and also, at the same time, ritually treated by several religious therapists for attacks against her alter-ego, I intend to show the different logics that inspire the diagnostic processes, healing practices and strategic choices of the agents involved, highlighting the difficulties of communication between them, the contrasting horizons of sense and value that orient them and the possibilities for negotiation and interaction.
Influence of religious leaders in the health-disease process
International Archives of Medicine, 2017
Introduction: Religion has helped the lower classes to raise the perspective of "divine justice" in the struggle for survival by allowing their believers to seek, in their practices, under the influence of religious leaders, the main guidelines to alleviate the suffering from the health-disease process. Objective: Unveil the limits and potentialities of religious leaders' influence on the health-disease process. Materials and Methods: Exploratory-type research, with a qualitative approach, based methodologically on the Historical Dialectical Materialism. For the data analysis, one used the discourse analysis technique proposed by Fiorin. Results: From the empirical universe, two analytical categories emerged: (1. Limits and possibilities of religious influence in relation to the health-disease process; 2. Vulnerabilities of the Unified Health System and the complementarity of religion: Interfaces of the health-disease process in postmodernity), in which religious pract...