Don't leave medicine out of faith, ethicist says

She says denying treatment can put children at risk

Deseret News/November 4, 2000
By Carrie A. Moore

Religious beliefs that prescribe withholding traditional medical treatment from those who could benefit from it must be questioned, particularly when the health of children is at stake, says a local ethicist.

Margaret Battin, a professor of philosophy and adjunct professor of medicine at the University of Utah, discussed the ethical implications for leaders and members of religious groups whose practices "run afoul of what we would expect to be the norm in mainstream medicine." Her presentation was part of the school's second annual medical ethics conference held Wednesday, where participants discussed medicine, ethics and faith.

Battin noted the beliefs of several religious groups, including Jehovah's Witnesses, Christian Scientists and members of Faith Assembly and the Holiness churches of Appalachia, each of which has specific theological tenets that restrict some or all types of traditional medical care.

"The conflict between medicine and religious practice involves real risks" for adherents who become sick or injured, she said. For example, Christian Science teaches that its members should call in a "practitioner" or healer, who prays for the afflicted person in place of medical intervention.

Such healers exercise their faith for the ailing person, and most Christian Science families can relate personal stories of how they or family members were healed by the intervention, she said. Insurance companies have also recognized the reality of faith-based healing and reimburse Christian Science practitioners with the same level of financial compensation that medical personnel receive for treating the same type of illness or injury.

Yet Battin, who has just finished a new book titled "Praying for a Cure," said there is "a great deal of disagreement over how death rates in the Christian Science population compare with the non-Christian Science populace." The conflict comes into play not over whether adult Christian Scientists have a right to choose prayer over medical intervention but when ailing children enter the picture. At that point, many people, including medical personnel, begin to question whether parents have a right to withhold medical treatment that has been proven effective, she said. "It then becomes a public policy issue" because children don't have the understanding or maturity to make such decisions for themselves. "Yet we allow adults to decide for them. I think that's much too simplistic."

The debate becomes whether the child should be medically treated and what legal mechanisms can be employed to make that happen. Yet "what we don't look at clearly is the role of religious groups in getting their members to take these kinds of risks."

As in most organizational structures, religious groups have "professionals," who are considered the leaders and the experts, and the laity, or those who follow. Paternalism is a characteristic of religions, just as it is with businesses, and leaders have an ethical responsibility to determine whether their control over those they serve is in the group's best interest.

Battin said despite the fact that religion is grounded in faith and a higher authority, it is possible to critique religious practices, "though it's not easy" because religion defies the scientific method.

One way to evaluate ethical behavior in such a setting is to look at whether leaders of the religious group are actively seeking to provide their ill or injured members "with the most direct and straightforward and loyal attempt to fill this need" when their advice is sought over medical issues. "The best way of seeking a cure may mean choosing conventional medicine rather than religious help."

Elaine Englehardt, a professor of ethics at UVSC, said medical personnel often struggle with the religious prohibitions against conventional treatment. "My son has been employed at LDS Hospital for the past two years, and he has seen five people die as a result of not being treated. I think it's a very staggering concept for a young person to understand why that happens."

Even so, answers are not clear-cut because there are often long-term implications for both ailing people and their family members if medicine is used in place of o or even in addition to o prayer. Family relationships can be strained or even broken and in extreme cases, members can be completely exiled from the religious group, Battin said.