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Harriet S.MeyerMD, Contributing EditorDavidMorseMS, Journal Review EditorRobertHoganMD, adviser for new media
In this book, three academic philosophers explore "the ethics surrounding conflicting religious and medical practices by examining the specific case of health-related choices made by and for Christian Scientists."
The volume is unique in that it has a point-counterpoint format and three authors rather than two. One of the writers, DesAutels, was raised in the tradition of Christian Scientism and brings the debate to a much higher level than other articles and books in which nonphilosophers attempt to answer philosophical arguments.
In the first half of the book, DesAutels and Battin "examine certain religious practices by drawing on concepts and norms from professional ethics, rational choice theory, and philosophy of science." Their concern is "the ways in which some religious institutions influence their members to make ‘high-risk' decisions." Battin gives arguments appealing to general moral principles such as autonomy nonmaleficence, beneficence, and justice along with their application in informed consent. She challenges: "Either prove that Christian Science healing is effective or stop making the claim that it is effective." She points out that the 2800 Christian Science practitioners and 675 nurses charge fees and collect from Blue Cross and about 25 major insurance companies. She asks the church to do empirical comparative studies and provide base-rate data.
DesAutels argues that the "primary choice a Christian Scientist makes is not ultimately one of choosing between alternative health care regimes; rather, it is one of choosing between very different world views . . . more a matter of conscience than of pure rationality." By the time discomfort is felt, she has already chosen her way of life and the religious institution that promotes it. She notes that Christian Scientists are not interested in empirical studies. Furthermore, the achievement of certain mental and spiritual states cannot be "objectively" controlled and observed in the same way that physical scientists control and observe physical phenomena. Christian Scientists have already published more than 53,900 physical healings between 1900 to 1985, and 2337 of them were of medically diagnosed conditions. But Battin writes, "Testimonials of failures are not published in the church's periodicals."
In the second half of the book, May debates with DesAutels about when respect for a religious minority culture should be tempered by concerns for the fundamental rights of children. He suggests that refusal of medical treatment is better understood as a conflict between communities (Christian Science and medical) than as a conflict between individuals. May proposes a compromise: "Medical professionals should be more open to the possibility that there are at least some aspects of health that are not their sole purview. Christian Scientists should be more open to the possibility (seemingly admitted by Mary Baker Eddy) that there are aspects of health that are best dealt with by material (at least ‘mechanical') means." He admits that his compromise could occur only when physicians are willing to give Christian Scientists room to consider the results of diagnostic testing without worrying that the doctor has already contacted a public prosecutor to force the proposed medical care and when the Christian Science community stops discouraging its members from seeking medical diagnoses and in life-threatening cases seeking medical care.
DesAutels maintains that no compromise is needed. Members of the two groups should simply respect each other's disparate world views and health-related choices. The Christian Science Church is neither fundamentalist nor authoritarian. It does not threaten excommunication or damnation. However, its members do "have the intellectual and monetary means to convince others to take their views seriously." says DesAutels. Christian Scientists have recovered from some life-threatening diseases without the use of medical means. Moreover, few medical treatments of life-threatening conditions are without risks and side effects. Christian Scientists willingly report their infectious diseases to appropriate health officials and obtain vaccinations when it is required. They certainly want the best health and least suffering for their children.
Deep differences remain after these extended discussions. Battin still thinks Christian Scientists should provide base-rate data. DesAutels insists that such information is irrelevant to the practice of Christian Science and would impose the medical model of health and disease on Christian Science. May still thinks a compromise is possible in which parents are free to employ Christian Science treatment for their children's minor ailments but are expected to turn to conventional medicine for severe life-threatening conditions. He also recommends with agreement from the other two authors that fledgling members of each group should be educated more fully about the beliefs and motives of the other.
The authors agree on the following:
that people's religious beliefs should be respected
that prayer may be meaningful and important to those who engage in it
that state intrusion into religion should be minimized
that ill health (whatever that is) is undesirable
that people have the right to make their own health care decisions
that Christian Science is a long-established, cherished tradition
that Christian Science parents care deeply about their children
that children ought not be abused, injured, caused to suffer, or die
that children ought not be allowed to die when they can be saved
that legal battles over how Christian Science parents may treat their children are undesirable
that the state acts appropriately in protecting vulnerable parties from abuse
that some medical treatment is followed by "cure"
that some Christian Science treatment is followed by "cure"
that some medical treatment fails to produce "cure"
that some Christian Science treatment fails to produce "cure"
The only jolt was when these three philosophers attributed Hippocrates' "do no harm" clause to his oath, seemingly unaware that it comes from the larger corpus of his writings.
This book is interesting and well-argued and clarifies much that is often misunderstood about Christian Scientists' refusal to seek medical treatment for themselves and for their children. I think it deserves a wide reading.
Religion: Praying for a Cure: When Medical and Religious Practice Conflict. JAMA. 2000;283(22):2991–2992. doi:10.1001/jama.283.22.2991
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