Prescriptions and Proscriptions

A history of the important contributions of religious and theological scholars to the birth and growth of the field of medical ethics. Religious values influence medical decision-making in the clinical setting and across the life course for many controversial issues, such as abortion and euthanasia. However, conclusions regarding those procedures or courses of action that are proscribed (forbidden or discouraged) or prescribed (mandated or recommended) by respective religious codes (e.g., halachah, or Jewish law) often differ across and among Protestant, Catholic, and Jewish bioethicists and those of other faith traditions. The work of leading scholars in this field is discussed, with special reference to difficult medical decisions at the beginning and end of life.

Policies and Programs

Chapter 8 details the long-standing history in the United States of official position statements by religious institutions and organizations regarding medical and healthcare issues, legislation, and policies that impact the health and well-being of the broader population. This history is highlighted by the recent national debate on healthcare reform, which was influenced by advocacy reports for or against features of proposed legislation issued by denominations and faith-based organizations across the religious spectrum. This chapter also provides perspectives on the contentious subject of federal faith-based initiatives since the passage of legislation authorizing charitable choice, under President Bill Clinton, which led to establishment of a White House faith-based office in the subsequent three administrations. Programmatic and policy successes of this initiative are described, especially in the areas of community and global health, an example being PEPFAR, the most successful program ever established to address AIDS in the developing world.

Challenges and Choices

Chapter 9 outlines the many ongoing challenges to establish and maintain alliances and partnerships between the faith-based and medical sectors. These include serious questions that remain to be addressed regarding legal and constitutional issues, the politics of policy development, jurisdictional and turf disputes across sectors, professional and training requirements, ethical concerns of many types, and the special challenges of research and evaluation. Prospects for the future of such partnerships are critically assessed, and agendas for future programmatic and scholarly work are offered. The takeaway point for the book is stated and discussed, namely that the intersections of the faith-based and medical sectors are multifaceted and of long standing.

Teaching and Training

Chapter 6 features descriptions of the most established academic institutes, centers, and programs for medical education and research on religion, faith, and spirituality in healthcare and healing. Beginning with the first program, established at Baylor in Houston, in the 1950s, these efforts continue through the present day. Current academic programs are described at leading universities including Duke, Emory, Harvard, Chicago, George Washington, and elsewhere. The specialized emphases and ongoing contributions of these respective programs and their directors, including Harold Koenig, are described in depth. The chapter also relates the key role of Dave Larson and John Templeton in institutionalizing content on religion and spirituality within undergraduate and graduate medical education in the United States.

Scientists and Scholars

Chapter 5 summarizes the extensive body of empirical research studies that identify health impacts of religious practice, identity, and beliefs. These include thousands of epidemiologic, clinical, social, and behavioral studies, as well as investigations from other fields, notably health services research, the biomedical sciences, and psychiatry and clinical psychology. Population-health studies are emphasized, and the latest findings are summarized on the impact of religion, for better or worse, on medical and psychiatric outcomes and rates of morbidity, mortality, and disability, both in the United States and globally, and across religious affiliation. The work of Jeff Levin and his colleagues is highlighted here. Also summarized and critiqued are the controversial clinical trials of healing prayer that have received so much attention since the late 1980s

Conflict and Cooperation

Chapter 1 traces the history of the encounter between religion and medicine from the therapeutic cults of the ancients, East and West, to the healing ministry of Christ and to the work and writings of myriad later figures. These include medieval physician-philosophers such as Moses Maimonides, John Wesley and the fathers of the natural hygiene movement, and pioneers of contemporary discourse on religion’s influences on health and healing. This history also involves important figures from Christianity, Judaism, and Islam and from Asian religions and new religious movements. Unpacking this history entails weighing competing narratives about the relations between the institutions of religion and medicine, which at times have been characterized by conflict and at other times by cooperation.

Congregations and Communities

Chapter 4 tells the story of how congregational health promotion and disease prevention programs evolved decades ago. Pioneered by the work of Granger Westberg in the 1970s and earlier efforts in community medicine in apartheid-era South Africa, later programs included collaborations with academic public health professionals, such as work in North Carolina churches focused on eliminating health disparities among African Americans. These programs, targeting underserved populations, have grown into a major feature of public health outreach in the United States, involving partnerships between faith-based and healthcare organizations. This chapter also outlines faith-based community programs involving healthcare and human services professionals that provide outreach to specialized populations. These include primary care clinics, faith community nursing, patient education, hospices, and other programs targeting older adults, mothers and children, the homeless and hungry, the unemployed, substance abusers and the physically and cognitively challenged, and others. Interfaith efforts are highlighted, as well as projects involving community organizing for social change.

Missions and Ministries

Chapter 3 discusses the history and scope of Christian (and other) missions that provide medical, surgical, nursing, and dental care and environmental health development through extensive programs of global outreach on six continents. These include partnerships with nongovernmental organizations, government agencies, academic institutions, and secular foundations and philanthropies. The chapter also lays out a historical timeline for the emergence of the pastoral care field, with an emphasis on healthcare chaplaincy. From pioneers such as Richard Cabot and Anton Boisen, in the 1920s and 1930s, through establishment of key organizations and institutions like the Association of Professional Chaplains, the Association for Clinical Pastoral Education, and the HealthCare Chaplaincy Network, this history is traced with an emphasis on clinical, educational, and scholarly developments that have shaped the profession to the present day. Newer professional innovations such as faith-based psychotherapy are also discussed.

Healers and Healthcare

Chapter 2 narrates the history of religious healers from the time of the ancients through developments in Asia and the Greco-Roman world and in the early church. The chapter also describes the origins of hospitals as religiously sponsored institutions of care for the sick. These institutions emerged globally, across faith traditions—in the pagan world, in Christianity, in Islam, in the global East—and they remain today largely an expression of religious outreach. This can be observed in the United States, for example, in the countless religiously branded hospitals, medical centers, and healthcare facilities in most communities that go by names such as Catholic, Lutheran, Baptist, Methodist, Presbyterian, Adventist, Episcopal, Jewish, and so on.