Richard Sloan, director of behavioral medicine at Columbia-Presbyterian Medical Center, ignited the debate about the role of religion in medicine in 1999. By far the most outspoken critic, he is now writing a book on the topic. He talked with NEWSWEEK's Claudia Kalb:
> KALB: What got you interested in religion and health?
SLOAN: I became skeptical of the many reports in the popular media about the benefits of religious experience for health.
How would you rate the existing research?
Weak. The strongest area is the epidemiologic studies linking attendance at religious services to mortality. A great deal of [the studies] have methodological flaws serious enough to question the conclusions that they draw.
Do you think this research should be done at all?
Yes, but I'm not sure that we can learn very much that applies to clinical practice.
Should medical students be required to take a religion-and-health course?
Medical students need to be able to treat their patients as people and not lumps of tissue. That means learning about what makes them a person, what's important in their lives--and that may include religion and spirituality. And it may not. Absolutely, a course is required to help medical students understand their patients, but by no means [should] it be restricted to religion and spirituality.
Should doctors take spiritual histories of patients?
I see every reason to ask about religion and spirituality as part of this broad attempt to understand the patient but not as a dedicated inquiry, no.
Is it ever acceptable for doctors to pray with patients?
I don't think so. It muddies the waters. It confuses the relationship. It may encourage patients to think a prayer is going to somehow improve their well-being. It certainly will improve their spiritual well-being but there's no evidence it's going to improve their health. If you pray for recovery and you don't recover, do you then abandon your faith? It's bad theologically as well as medically.
Is it OK for doctors to ask patients if they'd like to pray?
I think it's a really bad idea.
What do you think is driving the interest in merging religion and health?
There are cyclical increases and decreases in religiosity in American society. There is pervasive dissatisfaction with the way in which medicine is practiced in the United States. And there is a concerted effort on the part of some within the field to promote this.
What are your biggest concerns?
Manipulation of religious freedom. Restriction of religious freedom. Invasion of privacy. And causing harm. It's bad enough to be sick, it's worse still to be gravely ill, but to add to that the burden of remorse and guilt for some supposed failure of religious devotion is unconscionable.
Are you a religious person?
I don't answer that question largely because religion is an intensely private, personal matter.