Unpacking these issues in their entirety is beyond the scope of this paper, but prominent concerns are outlined here. Some of these questions have been broached by others. For some, answers have been proposed. But for the most part these are questions that still need resolving. They are offered to help frame the ongoing conversation on partnerships between the faith-based and medical sectors.
Federal funding of religion-health research, congregation-based public health interventions, and especially large-scale faith-based initiatives and partnerships remains a subject of debate, despite efforts to delineate precisely what is and is not permitted and concomitant judicial vetting during the Clinton, Bush, and Obama administrations Levin, The charitable choice doctrine and federal funding of faith-based programs—which predates by decades the creation of a White House office—create administrative, legal, and ethical challenges that persist, despite efforts to clarify what is and is not acceptable Kennedy and Bielefeld, The public visibility and contentiousness of these disputes have died down, but key questions remain:.
Who defines what is and is not acceptable behavior—of a religiously partisan nature—on the part of funding recipients? How are assurances regulated and enforced regarding: Potential misuse of federal funds by faith-based organizations in ways that violate church-state separation? Potential federal violations of the religious freedom of faith-based organizations?
Faith-based institutions and organizations have a long history of medical and health-directed work, as this review describes. Relationships have been developed and nurtured that can be drawn upon to meet strategic population-health needs Bennett and Hale, This much is widely appreciated Gunderson and Cochrane, How can the public health sector work with faith-based organizations to reduce health disparities? What opportunities are there for DHHS agencies e. How can state and local governments partner with religious denominations and congregations for community health development?
Are there existing models that outline how such partnerships can come together and function harmoniously? Especially in clinical settings, professionally trained practitioners in medical, healthcare, and faith-based occupations are in regular contact and interaction in the care of patients.
Sometimes these relationships are ongoing; sometimes they are transient.
Their dynamics, in turn, may be reinforced by institutional guidelines and by unstated parameters related to professional jurisdiction, tacit decision-making authority, and other turf-related issues Post et al. Which sector or profession has decision-making authority? Does it matter? Are there particular clinical endpoints cure, recovery, discharge that take precedence over others well-being, patient satisfaction, pain-free status and that are the domain of respective professions?
How are misperceptions of the mission of the other sector handled? How are vision or values conflicts negotiated? How are turf conflicts adjudicated? Is there a role for clinical pastoral professionals in the training of medical care professionals, and vice versa? How can medical practitioners best be made aware of faith-based resources that may impact on health care or health status, for better or worse? Should practitioners even concern themselves with such things, much less patient spirituality and beliefs, even if evidence suggests a positive impact on mental or physical health?
Aside from ethical concerns implicit in issues touched on above related to faith-based organizations, federal sponsorship, institutional partnerships, and health-directed programming, ethical challenges also exist in the clinical encounter between religion and medicine. Conflicts may arise, for example, related to spiritual assessment, referral to pastoral care providers, end-of-life decision-making, prayer with patients, and delivery of spiritual care Puchalski and Ferrell, Spiritual beliefs of physicians add another factor of complexity to difficult clinical decisions that may be perceived as morally compromising Curlin et al.
A sampling of questions that arise, clinical as well as institutional:. Is it ever appropriate for medical caregivers to pray with patients? Under what conditions? Who decides? Who initiates it? How do denomination-sponsored healthcare institutions respond to federal mandates that violate their values?
Research on religion and health has been of several types, including clinical, population-based, biomedical, behavioral, and evaluative. Of these, the latter has received the least attention, yet is the most critical for program planning in prevention. Questions that arise here are simple, yet, to now, underexplored. So much energy has been expended on vetting legal issues—such as the constitutionality of federal faith-based initiatives—that more fundamental and just as important questions regarding efficacy and applications have been relatively ignored Johnson, For example:.
What works and what does not work? Is there evidence that faith-based interventions measurably improve population-health outcomes and not just near-term impacts? How can medical care institutions and public health agencies more effectively make use of faith-based resources, both human and organizational? How should the health-directed work of faith-based organizations inform policy deliberations about public-private partnerships regarding distribution of scarce public resources related to healthcare?
What are the barriers to evidence-based evaluations being used formatively by government decision-makers? To restate the take-home point from earlier in this paper: The intersections of the faith-based and medical sectors are multifaceted and of long standing. The idea that religion and of medicine can partner in ways to promote well-being and relieve suffering is a very old one.
The Bible, for one, and other sacred Jewish and Christian texts have far more to say about health, healing, healthcare, medicine, and even the human body and pathophysiology than most people may be aware see Preuss, The intersection of religion and medicine is not a novel concept, nor one that implicitly connotes whatever disreputable images may be conjured by activities of religious fundamentalists or new-agers, images that many within the mainstream of scientific medicine may find distasteful.
Religious people, organizations, and institutions have worked hand in hand with medical and healthcare practitioners, organizations, and institutions for hundreds of years, especially since the mid 20th century, creating fields of academic study, professional practice, community intervention, and human caregiving that buttress the work of those laboring to advance the cause of preventive medicine and public health.
Former U. There is historical precedent for such an alliance, and, informed by science and scholarship, it is in our best interest for this to continue and to flourish. The Transparency document associated with this article can be found in the online version. National Center for Biotechnology Information , U. Journal List Prev Med Rep v. Prev Med Rep.
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Published online Jul Jeff Levin. Author information Article notes Copyright and License information Disclaimer. Jeff Levin: ude. This article has been cited by other articles in PMC.
Associated Data Supplementary Materials Transparency document. Abstract Interconnections between the faith-based and medical sectors are multifaceted and have existed for centuries, including partnerships that have evolved over the past several decades in the U. Religion and medicine: The history of encounter The history of the encounter between religion and medicine is marked by contention and controversy. Contemporary intersections of the faith-based and medical sectors As noted, the intersections of religion and medicine, especially institutionally, are multifaceted.
Table 1 Intersections of the faith-based and medical sectors. Denomination-sponsored healthcare institutions Medical and public health missions Healthcare chaplaincy and pastoral care Congregation-based health promotion and disease prevention Community-based outreach to special populations Clinical and population-health research on religion and spirituality Academic spirituality and health centers Religious medical ethics Faith-based health policy advocacy Federal faith-based initiatives. Open in a separate window. Denomination-sponsored healthcare institutions Religious institutions were instrumental in establishing the first hospitals, clinics, and medical care institutions, as long ago as the first millennium of the Common Era.
Medical and public health missions For the past couple centuries, Christian missionaries have provided medical, surgical, nursing, and dental care and shepherded environmental health infrastructure and health-impacting economic development projects in the underdeveloped world Good, Healthcare chaplaincy and pastoral care The pastoral care profession, and healthcare chaplaincy in particular, has existed as a professional field for nearly a century.
Congregational health promotion and disease prevention Religious congregations are familiar loci for community-based health promotion and disease prevention HPDP programs of many types Bopp and Fallon, Community-based outreach to special populations Religious denominations and organizations have sponsored community-based organizations that coordinate outreach to special populations.
Clinical and population-health research on religion and spirituality Among the most well known, but most misconstrued, intersections of the faith-based and medical domains is the body of empirical research studies identifying religious and spiritual correlates and predictors of health and medical outcomes.
Academic spirituality and health centers As individual scientists focus their research on religion, spirituality, and health, and as programmatic research by established investigators continues to supplant a literature of one-off studies, formal academic institutes, centers, and programs have grown up at major universities and medical centers.
Faith-based health policy advocacy Concomitant to their involvement in medical ethics decision-making and their advocacy role in public policy see Heclo, , religious institutions and organizations often weigh in on medical and healthcare issues and legislation. Federal faith-based initiatives Many readers may recall the controversy surrounding establishment of a White House Office of Faith-Based and Community Initiatives, at the outset of the Bush Administration in Questions that remain The domains of religion and medicine have a history of encounter extending back a long time.
Ethical Aside from ethical concerns implicit in issues touched on above related to faith-based organizations, federal sponsorship, institutional partnerships, and health-directed programming, ethical challenges also exist in the clinical encounter between religion and medicine. A sampling of questions that arise, clinical as well as institutional: Is it ever appropriate for medical caregivers to pray with patients? Can particular religious ideations be psychopathological? Who treats? Research and evaluation Research on religion and health has been of several types, including clinical, population-based, biomedical, behavioral, and evaluative.
For example: What works and what does not work? Conclusions To restate the take-home point from earlier in this paper: The intersections of the faith-based and medical sectors are multifaceted and of long standing. Conflict of interest statement The author declares that there are no conflicts of interest.argo-karaganda.kz/scripts/cycikibot/270.php
A Deeper Look at the Christian View of Science and Faith
Transparency document Transparency document Click here to view. Footnotes The Transparency document associated with this article can be found in the online version. References Agate L. A national examination of partnerships among local health departments and faith communities in the United States. Public Health Manag. Methods for managing and analyzing electronic medical records: a formative examination of a hospital-congregation-based intervention.
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Public Health. Baptist Healing Hospital Trust; Nashville: Lay ministries with older adults. In: Clements W. Ministry with the Aging. Harper and Row; San Francisco: Religion, conscience, and controversial practices. Are prayer experiments legitimate? Explore NY ; 1 — Promoting the health of aging adults in the community. Community Health. Jessica Kingsley; Philadelphia: Psychologists and health care chaplains doing research together.
The promise of faith-based social services: perception versus reality. Pioneer medical missions in colonial Africa. Immune Defic. Palgrave Macmillan; New York: Religion and the Health of the Public: Shifting the Paradigm. The HealthCare Chaplaincy, Inc. Health Care Chaplain. Outcomes for professional health care chaplaincy: an international call to action.
Eerdmans; Grand Rapids, MI: God, Medicine, and Suffering. Religion and public policy: an introduction. Policy Hist. Waterfall Press; U. Oxford University Press; New York: Religion as a Social Determinant of Public Health. Bloch Pub. Johnson B. University of Pennsylvania; Philadelphia: Objective hope: assessing the effectiveness of faith-based organizations: a review of the literature. Paging Dr. In: Smith D. Religious Giving: For the Love of God. I lacked the quantitative data needed to say for sure. So last year, I enlisted the Barna Group, a social research firm focused on religion and public life, to conduct a survey of 1, American adults.
This study revealed that most Americans — more than three-quarters, actually — do not often have spiritual or religious conversations. More than one-fifth of respondents admit they have not had a spiritual conversation at all in the past year. A paltry 7 percent of Americans say they talk about spiritual matters regularly.
A mere 13 percent had a spiritual conversation around once a week. For those who practice Christianity, such trends are confounding. It is a religion that has always produced progeny through the combination of spiritual speech and good deeds. Nearly every New Testament author speaks about the power of spiritual speech, and Jesus final command to his disciples was to go into the world and spread his teachings. You cannot be a Christian in a vacuum. And yet even someone like me who has spent his entire life using God-talk knows how hard it has become.
Sure, I could still speak English as well as I always had. By this I mean that spiritual conversations, once a natural part of each day for me, suddenly became a struggle.
Whether I spoke to a stranger or a friend, the exchange flowed freely so long as I stuck to small talk. But conversations stalled out the moment the subject turned spiritual. Before relocating, I worked as a part-time minister at a suburban congregation outside of Atlanta. Before that, I had attended a Christian college and seminary. All my life, I used religious language daily in my home and community, rarely pausing to think about the meaning of my words. But I was not in Georgia anymore.