Religion-Health Connection Claims Questioned

A team of Columbia University scientists is warning against incorporating spiritual and religious interventions into medical practice.

"We believe even in the best of studies the evidence of a relationship between religion, spirituality and health is weak and inconsistent," write Richard Sloan, PhD, and colleagues in the February 19 issue of The Lancet, a leading British medical journal.

"Much of the scientific data for claims about religion and health is highly questionable," the authors said. "It provides no empirical justification for the introduction of religious activities into clinical medicine."

The authors acknowledge that "for many people religious and spiritual activities provide comfort in the face of illness," and that codes of religious conduct that prohibit smoking, drinking alcohol, unsafe sexual activity, psychosocial stress and unhealthy dietary habits can reduce sickness and death.

But, they caution, even the best of studies that attempt to show health benefits connected with prayer, church attendance and other forms of spirituality contain serious methodological problems.

They reviewed hundreds of studies and identified several dozen which illustrated flaws that they said characterize much of the literature. The studies often involved small numbers of subjects and failed to control for other factors that could account for the findings, such as age, health status, and health behaviors. They said that other studies they examined failed to present the findings fully or failed to make appropriate statistical adjustments.

Interest in connecting religion and medicine is widespread today, the authors note. Major American newspapers and television news programs regularly reflect this interest, and a new magazine, Spirituality and Health, has begun publication under the editorship of a former editor of the Harvard Business Review.

Also, nearly 30 U.S. medical schools now include courses in religion, spirituality and health in their curricula, and a 1996 survey of 296 members of the American Academy of Family Physicians revealed that 99 percent were convinced that religious beliefs can heal, while 75 percent believed that prayers of others can promote a patient's recovery.

Other physicians argue for religious interventions in medical practice, proposing that "the wall of separation "between medicine and religion should be torn down, but Sloan and colleagues counter that:

Health professionals can abuse their status when they depart from their areas of established expertise to promote a non-medical agenda.

It is just as inappropriate for physicians to counsel religious practice for the sake of better health as it is for them to advise an unmarried patient to marry because the data show that marriage is linked with lower death rates.

The possibility exists of doing harm if a patient infers that illness is a result of insufficient faith. "No one can object to respectful support for those patients who draw upon religious faith in times of illness," write Sloan and colleagues. "However, until these ethical issues are resolved, suggestions, intentional or otherwise, that religious activity will promote health or, conversely, that illness is the result of insufficient faith, are unwarranted."