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P&S Journal

P&S Journal: Winter 1996, Vol.16, No.1
Religion in Medicine

By Lynne Christensen

What does religion have to do with medical care? Perhaps more than is commonly addressed in therapeutic encounters between health care providers and patients.

Dr. K.J. Lee, a 1965 graduate of P&S, has a special interest in the role religious beliefs play in health care. Dr. Lee's interest is so strong he gave P&S a $52,000 gift to create the K.J. Lee Family Fellowship Fund in the Richard and Hinda Rosenthal Center for Alternative/Complementary Medicine, specifically to encourage researchers to explore the role of religion in healing.

"The grant is in memory of my mother," says Dr. Lee, "who believed that in addition to technological knowledge, there is a higher being guiding us in the healing process." His wish is that the grant be used to expose medical students to the importance of religious beliefs in patient care or to investigate and define the influence of religious beliefs in scientific terms the academic community can accept. Dr. Lee, associate clinical professor of otolaryngology at Yale, has published 15 textbooks, one of which is in its sixth edition and is considered the most-read text in otolaryngology in two decades. He is secretary-treasurer of the American Academy of Otolaryngology.

The first recipient of a Lee grant is Dr. Maria Sullivan, senior resident in psychiatry, who is studying the impact of religious beliefs on end-of-life care decisions. The central question being evaluated is whether religious beliefs cause patients to interpret "Do Not Resuscitate" status as equivalent to suicide and thus morally wrong so they would refuse DNR status or suffer emotional distress as a result of choosing it.

Dr. Sullivan became interested in the subject of religion and healing partly as a result of time spent in Ireland studying cultural factors influencing mental health. She found that many patients there imbue their illness with religious or moral meaning. "One thing that impressed me," she says, "is that for many Irish people the capacity to suffer in silence is considered a moral virtue. Illness is viewed as an expression of moral strength; redemptive suffering is a Catholic tradition."

Dr. Philip Muskin and Dr. Maria Sullivan: Do religious beliefs affect end-of-life care decisions?

She also discovered that the shared religious background of doctor and patient in Ireland improved the therapeutic encounter. During her residency, Dr. Sullivan has found that many patients have spiritual concerns not addressed by most American doctors.

The Lee grant supports a pilot study of 50 patients receiving treatment for cancer. On-

cology patients who meet established criteria will be asked to participate, regardless of the type, severity, or stage of cancer they have. The research team consists of Dr. Sullivan; Dr. Philip Muskin, associate professor of clinical psychiatry; Dr. Karen Antman, professor of medicine and director of medical oncology; and Mary Arnold.

Participants are interviewed for about 30 minutes to determine level of religious beliefs, denial of illness, and attitudes about DNR. The following survey instruments were chosen: Folstein Mini-Mental State Exam; demographic survey; intrinsic and extrinsic religiosity measure; religious coping scale; denial of illness scale; intrinsic religious motivation scale; quality of life index; patients' reported recognition/understanding of DNR; and Likert-type series of questions addressing beliefs about DNR.

The study is not specific to any religion. "We are not attempting to investigate the dimensions of any particular religion, but rather how individual patients' own moral reasoning affects their decisions about medical care," says Dr. Sullivan.

Plans call for a larger follow-up study to look at the differences in attitudes about end-of-life medical decisions among Jews, Catholics, and Protestants.

The researchers see their work as setting the stage for further research on the role of religion in health care. "Religious belief and practice clearly affect health and illness, but it is an area that hasn't been studied," says Dr. Muskin.

DR. K.J. Lee

copyright ©, Columbia-Presbyterian Medical Center

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