How Religion Shapes The Way People Approach Medicine

More than 30 states allow religious exemptions from child abuse and neglect laws. Now, some medical schools are finding ways to teach students about religion and how it can play a role between doctors and patients.

Here & Now's Robin Young talks with Dr. Ray Barfield, professor of pediatrics and Christian philosophy at Duke Divinity School, which has a program focused on theology, medicine and culture.

"As physicians, we depend on families trusting us, but understanding that we're human," Barfield says. "It seems to me that we could at least return the favor, and show them respect as they try to figure out the world in their own messy way — including religiously messy ways."

On his own relationship with religious faith as a doctor

"I was raised in a Christian tradition, and I had a stretch of time as I began my career in bone marrow transplant where — largely because of the suffering that I was encountering — I found it impossible to believe in God. Over the course of a long period of time I actually moved back into a faith, but a faith that has a very different kind of shape."

"If you put eternal damnation against taking a flu shot, probably the flu shot's going to lose."

Dr. Ray Barfield

On people who don't trust traditional medicine, and instead turn to their religious beliefs to help someone heal

"If they believe the consequence of not following their church is that their child and themselves will be punished with eternal damnation, well if you put eternal damnation against taking a flu shot, probably the flu shot's going to lose.

"And so when I encounter families who are wrestling with these kinds of things ... most of the patients that we see are Christian, although I have plenty of Jewish patients and Muslim patients as well. And Christianity has a particularly difficult subtype of theology that comes out of a number of verses, but one verse in particular that I hear is this one: It's where Jesus says, 'If you have faith the size of a mustard seed, you can say to this mountain, pick yourself up and throw yourself into the sea.' And that's very important verse for someone who believes their child's illness — which is the mountain — can only be cured, once we've come to the limits of medicine, if they have enough faith. Because if they don't have the faith, then they can tell the mountain, 'Pick yourself up and throw yourself in the sea,' and it's not going to move.

"And the hard thing is that that means that the death of the child is dependent on the failure to have faith, because of this formula. Now here's where it gets really difficult: If a family has decided — and this is very different from families who have suspicion about medicine — if the family has decided that even in extreme circumstances where someone is clearly dying, that they want this person to be intubated and put on dialysis and to have all these interventions, they think that those interventions — if they've linked that to an expression to God of, 'Hey, we still believe you can do a miracle' — then the medical interventions become an expression of their faith, and since the faith is necessary in their formula for the miracle to happen, they have to keep moving. They have to keep doing it."

On religious beliefs being tied to overtreatment

"This is actually something that's been studied in intensive care settings. It turns out that people who have deep religious convictions and identify themselves as being robustly supported by a religious community are more likely to use [intensive care unit] care at the end of life and less likely to use hospice than people who claim to have no religious convictions. It's not that they view themselves as being a completely sort of magical force, but most of the time these families are in the middle of facing the greatest loss that they have ever experienced. And the majority of times, people are not motivated malevolently. They're motivated by love."

"As physicians, we depend on families trusting us, but understanding that we're human. It seems to me that we could at least return the favor."

Dr. Ray Barfield

On whether there should be legal protection from child abuse charges for people who withhold medical care for their children on religious grounds

"When it comes to laws that protect people who are religiously motivated, I can't imagine a blanket law that makes sense, because there's going to be some things that are downright abuse that could be legally justified by saying, 'It's part of my religion.' At the same time, the consequences of simply dismissing protection for a range of religious expressions is going to have some consequences that probably even the people who are arguing for that are not going to like."

On how much understanding medical students ought to have about religious beliefs and practices

"I think students should know about every part of a patient's story, and remaining open to mystery is something that I encourage in all my students."