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The relationship between medicine's internal morality and religion.

In the face of managed care and market economies infringing on the practice of medicine, reducing its autonomy and determining the moral guidelines for medical practice, many physicians are calling out for a return to what is perceived as a traditional medical ethic. Many religiously motivated critics of certain modern developments in medicine have made similar appeals. These calls are best understood as an attempt to define medicine as a practice that is necessarily ethical in nature, a practice the moral basis of which is internal to that practice. This article examines and assesses this definition of medicine in reference to Aristotle's division of human undertakings into three distinct categories: theory, poieisis (i.e., production), and praxis. It is concluded that medicine can be understood as a praxis (as opposed to a theory or production, both of which are morally neutral), because the practice of medicine, and all of its constitutive acts, can only be explained and assessed in reference to health, which is itself a final good and hence of moral value. Such an understanding would immunize medicine against usurpation by the free market. However, by the same token it would also dissociate medicine from all other moralities external to it, including those grounded in faith and religion.

Christianity↗

Religion and attitudes towards nature in Britain.

Religious institutions have been identified as important conduits in shaping social attitudes toward nature and the environment. Using Lynn White's historical thesis that Judeo-Christianity has cherished the domination of nature ('dominion' belief) by humans as our frame of reference, this article examines the impact of religion, specifically Abrahamic and Judeo-Christian beliefs, on environmental attitudes in Britain. Based on the 1993 British Social Attitudes Survey, a nationally representative sample of the adult population in Britain, the multivariate results of this paper suggest that: (a) there is no significant difference between Christians and non-Christians concerning environmental attitudes; (b) Roman Catholics are the most sceptic toward nature among Christian denominations; and (c) irrespective of religious identification, the two most notable and consistent factors in determining pro-dominion attitudes in Britain are educational attainment and particularly levels of scientific knowledge about the natural environment.

Adult↗

Stress resilience, locus of control, and religion in children of Holocaust victims.

Two hundred eight children of Holocaust survivors who were born after their parents' Holocaust experience (children of survivors; COS) and 70 children of parents who left Europe after Hitler's rise to power in 1933 but managed to escape or avoid the Holocaust (children of escapees; COE) were recruited from various Jewish organizations. Research was conducted using questionnaires that were returned by mail. Measures of stress resilience (Kobasa, 1982; Kobasa & Puccetti, 1983), locus of control (Nowicki-Strickland, 1973), and religion (Jewish identity) were administered to all participants. The COS were found to have less resistance to stress and to identify less with feelings of being Jewish. The appropriateness of using COE as a control group and the difficulty of incorporating the unique experiences of the parents into a research study about the intergenerational transmission of coping style is discussed.

Adult↗

Apostles and Zionists: the influence of religion on demographic change in rural Zimbabwe.

Religion has acted as a brake on demographic transition in a number of historical and contemporary populations. In a study in two rural areas of Zimbabwe, we found substantial differences in recent demographic trends between Mission and Independent or "Spirit-type" churches. Birth rates are higher in some Spirit-type churches and, until recently, infant mortality was also higher. Recent increases in mortality were seen within Mission churches but not in Spirit-type churches. Missiological and ethnographic data indicate that differences in religious teaching on healthcare-seeking and sexual behaviour and differences in church regulation could explain this contrast in demographic patterns. More restrictive norms on alcohol consumption and extra-marital relationships in Spirit-type churches may limit the spread of HIV and thereby reduce its impact on mortality. These contrasting trends will influence the future religious and demographic profile of rural populations in Zimbabwe.

History, 20th Century↗

Intermarriage and the risk of divorce in the Netherlands: the effects of differences in religion and in nationality, 1974-94.

A textbook hypothesis about divorce is that heterogamous marriages are more likely to end in divorce than homogamous marriages. We analyse vital statistics on the population of the Netherlands, which provide a unique and powerful opportunity to test this hypothesis. All marriages formed between 1974 and 1984 (nearly 1 million marriages) are traced in the divorce records and multivariate logistic regression models are used to analyse the effects on divorce of heterogamy in religion and national origin. Our analyses confirm the hypothesis for marriages that cross the Protestant-Catholic or the Jewish-Gentile boundary. Heterogamy effects are weaker for marriages involving Protestants or unaffiliated persons. Marriages between Dutch and other nationalities have a higher risk of divorce, the more so the greater the cultural differences between the two groups. Overall, the evidence supports the view that, in the Netherlands, new group boundaries are more difficult to cross than old group boundaries.

Adult↗

Religion, relationships and mental health in midlife women following acute myocardial infarction.

Little is known about coping in women following an acute myocardial infarction (AMI). In midlife, women have worse outcomes than men following AMI. Innovative interventions need to be developed that respond to these women's unique recovery needs. In this correlational, descriptive study, 59 women aged 35-64 who had experienced AMI reported low satisfaction with life and decreased mental health; 49% were experiencing depression. However, they also reported that religion, family, and friends provided strength and comfort at the time of their AMI. Greater activation of simple, family-oriented, coping resources during recovery may be key. It is recommended that mental health nurses be essential members of the recovery planning team.

Adaptation, Psychological↗

Is religion or culture the key feature in changes in substance use after leaving school? Young Punjabis and a comparison group in Glasgow.

AIMS: To establish levels of use of tobacco, alcohol and illegal drugs among 18-20 year old men and women of Asian (Punjabi) and non-Asian origin compared with levels four years earlier and consider the role of religion and culture in abstinent behaviour. DESIGN: Structured self-complete questionnaire used with 94% of pupils with South Asian names recorded by the Greater Glasgow education department in 1991 and a proportionate random sample of pupils in the same years who did not have South Asian names. Followed up in 1996 in an interviewer-led structured questionnaire in their own homes. SETTING: Greater Glasgow, largest city in the west of Scotland. PARTICIPANTS: Eight hundred and twenty-four overwhelmingly British-born 14-15 year olds in 1992, 492 followed up aged 18-20 years in 1996. MEASUREMENTS: Self-report measures of ever having tried alcohol, tobacco and drugs and the quantities consumed at age 14-15 and 18-20. Indication of reasons for abstinence from substance use at age 18-20. FINDINGS: Asians were much more abstinent from all these substances at both ages (p < 0.001), except for smoking at 18-20. However, religiously specific patterns of abstinence were particularly strong for alcohol (Muslim odds ratio 7- to 9-fold lower at 14-15, 16- to 25-fold lower at 18-20) and smoking (Sikh/Hindu odds ratio 10-fold lower than Muslims, 20-fold than Christians at 18-20), though there is a shared Asian tendency for women to observe these patterns more than men at 18-20. CONCLUSIONS: At age 14-15 abstinence was high in the largely British-born generation of Asians mainly for cultural reasons common to religious groups. Four years later culturally determined abstinence has atrophied, and abstinence reflects the specific influence of ascetic religious traditions, though some cultural influence remains in that women are more affected. Intergenerational changes are similar. The erosion of constraints on smoking presents a threat to health.

Adolescent↗

Religion among disabled and nondisabled persons I: cross-sectional patterns in health practices, social activities, and well-being.

What is the relationship between religious involvement and functional disability among elderly people? Is being disabled different for those who frequently attend religious services? Does religious involvement have an effect on subsequent change in disability? Deriving our hypotheses from traditional theories in the sociology of religion, these questions are explored in these two related articles. Both employ data from the New Haven site of the Established Populations for the Epidemiologic Study of the Elderly (N = 2812). In the first, cross-sectional correlates of religious involvement and disability are examined at the baseline of the study, including multiple indicators of health practices, social activities, and subjective well-being. We test for interactions between religious attendance and disability. Findings are (a) that religious involvement in 1982 is tied to a broad array of behavioral and psychosocial resources, (b) that these resources are associated primarily with attendance at services, and not with subjective feelings of religiousness, and (c) that some of these associations are especially pronounced among disabled respondents.

Aged↗

The influence of race, religion, occupation and other social factors on cigarette smoking in New Zealand.

97% of the New Zealand population 15 years and over (2.1 million persons) responded to a question on cigarette smoking in the 1976 population census. 38% of New Zealand men and 30% of women other than Maoris or Pacific Islanders were cigarette smokers. 56% of Maori men and 59% of Maori women smoked regularly; the corresponding figures for Pacific Islanders, a relatively recent migrant population, were 46% and 24%. In all age groups more Maoris smoked than non-Maoris. More than two-thirds of Maori women aged 20-24 were smokers. Cigarette consumption rates were high; the men and over one third of the women smokers smoked more than 20 cigarette a day. Smoking was higher then expected among Roman Catholics and among those who objected to stating their religion. Those who were divorced or separated had smoking rates 38% to 56% higher than expected. Smoking was inversely related to the level of education attained. Those in the professions were least likely to be smokers (average 27%) whereas at least half those in labouring or unskilled occupations were smokers.

Adolescent↗

The Melbourne colorectal cancer study: incidence findings by age, sex, site, migrants and religion.

During a 12-month period, age, sex, site, country of birth and religion data were obtained on all new cases of colorectal cancer (CRC) in Melbourne (population 2.8 million) yielding 1150 cases, this being the incidence study arm of a large-scale epidemiological and clinico-pathological investigation of CRC in Melbourne. The age, sex, site and subsite findings had, as expected, the characteristics of a high-risk population for CRC. Unexpectedly, rectal cancer rates were some of the highest recorded in the world. Incidence was greater in males than in females except for colon cancer between ages 35 and 58 where there was a female excess. There was an increasing male to female ratio from caecum to rectum and the crossover age to male excess had a monotonic pattern as it became younger from caecum to rectum. This site and subsite sex pattern may represent an aetiological difference and warrants further study. The data on first generation migrants supported the concept that with migration from low-risk to high-risk countries for CRC, such as Australia, there is a transition of rates towards the risk levels of the new country. Migrant rates for CRC were lower for each subsite than in the Australian born, but became closer to the Australian rate the further the distance down the bowel. Jews had rates nearly double those of the Melbourne population, a hitherto unreported finding in Australia. The possible causes of the very high rectal rates, the transition in migrant rates and the high Jewish rate will be reported in the case-control arm of the study.

Adult↗

Medicine as patriarchal religion.

This article demonstrates, by use of specific theological paradigms, how medicine functions as religion. In doing so, medicine promotes anti-feminist beliefs, symbols, social memories, and churchly structures. The essay then examines the enhancement of women's health from a feminist philosophical perspective. It argues against fetishizing in health promotion to the extent that everything comes to be regarded as therapeutic. Medicine has advanced the ideology that life itself is a disease to be cured or, at best, prevented. Alternative ethics of health promotion could revise this tendency of regular medicine to appropriate all of life into the medical domain, advocating that all sorts of simple daily activities are profoundly therapeutic in some way. Rather, health must be viewed as the constant attempt to re-create a female environment that is Self-defined on the boundary of an environment that is man-made.

Ethics, Medical↗

An exploratory study examining the influence of religion on attitudes towards organ donation among the Asian population in Luton, UK.

Currently the demand for transplant organs far outstrips the supply in the UK. This problem is even more severe for the Asian population, who have been shown to be disproportionately over-represented on transplant waiting lists in some regions of the UK. Several commentators have suggested that religious and cultural traditions may be the major determinant preventing Asians from donating organs. An exploratory qualitative study was undertaken with the aim of examining the influence of religious beliefs, amongst other things, on the extent and direction of public attitudes towards organ donation in a cross-section of the Asian population in Luton. This study indicates that, in the population studied, culture and religion play a much less prohibitive part in determining the level of organ donation than previously suggested. However, there is a desire to be aware of the religious stances so that people can make a more informed decision. The emphasis should clearly been a reconsideration of the presently inadequate approaches to organ procurement and on devising and supplementing these with more appropriate ones. An example of the failure to inform effectively the relevant populations about important developments is that only two of the 32 Muslims in the survey had heard of the 'fatwa' by the Muslim Legislative Council permitting organ donation.

Adolescent↗

Religion: a mediator of Anglo-American and Mexican attributional differences toward symptoms of schizophrenia?

This study examined the relationship of religiosity to attributions toward schizophrenia, within a cultural context. Previous research suggests that on self-report measures, Mexicans endorse holding greater moral-religious values than do their Anglo-American counterparts. Research also indicates that Mexicans, relative to Anglo-Americans, tend to hold fewer blameworthy attributions and are less likely to view patients with schizophrenia as responsible for the symptoms of the disorder. In an analog study of 88 Mexican and 88 Anglo-American college students asked to imagine that they have a brother with schizophrenia, this study assessed two competing hypotheses regarding the role of religion in shaping reactions to schizophrenia in a family member. For hypothesis 1, Baron and Kenny's mediational model (1986) was used to assess whether moral religious values may play a direct mediating role between ethnicity and controllability attributions for schizophrenia. In other words, based on observations of previous researchers, this set of analyses assessed whether ethnic differences in controllability attributions might be explained by a religious or spiritual tendency in Mexicans to view negative events, such as mental disability, as rooted in divine factors beyond the patient's personal control. In contrast, a second, competing, hypothesis was also assessed in this study: namely, that greater religiosity would be positively correlated with increasing perceptions of control over the symptoms of schizophrenia. This hypothesis stems from the premise of several investigators that religious individuals may be more likely to perceive another's adversity (such as having schizophrenia) as a punishment for prior wrongdoings or for failure to try to help oneself. Results indicate support for the latter hypothesis. Implications of the paradoxical finding, that Mexicans were both more religious and more external in their attributions, are discussed.

Attitude to Health↗

Religion, spirituality, and medicine: research findings and implications for clinical practice.

A growing body of scientific research suggests connections between religion, spirituality, and both mental and physical health. The findings are particularly strong in patients with severe or chronic illnesses who are having stressful psychologic and social changes, as well as existential struggles related to meaning and purpose. Recent studies indicate that religious beliefs influence medical decisions, such as the use of chemotherapy and other life-saving treatments, and at times may conflict with medical care. This article addresses the ways physicians can use such information. Spirituality is an area that makes many physicians uncomfortable, since training in medical schools and continuing medical education programs are limited. Not only do most physicians lack the necessary training, they worry about spending additional time with patients and overstepping ethical boundaries. While these concerns are valid, each can be addressed in a sensible way. Taking a spiritual history, supporting the patient's beliefs, and orchestrating the fulfillment of spiritual needs are among the topics this article will address. The goal is to help physicians provide medical care that is sensitive to the way many patients understand and cope with medical illness.

Attitude of Health Personnel↗

Religion and unforgivable offenses.

The value of forgiveness is emphasized in many religions, but little is known about how members of distinct religious cultures differ in their views of forgiveness. We hypothesized and found that Jews would agree more than Protestants that certain offenses are unforgivable and that religious commitment would be more negatively correlated with belief in unforgivable offenses among Protestants than among Jews (Studies 1 and 2). Dispositional forgiveness tendencies did not explain these effects (Studies 1 and 2). In Study 3, Jews were more inclined than Protestants to endorse theologically derived reasons for unforgivable offenses (i.e., some offenses are too severe to forgive, only victims have the right to forgive, and forgiveness requires repentance by the perpetrator). Differential endorsement of these reasons for nonforgiveness fully mediated Jew-Protestant differences in forgiveness of a plagiarism offense and a Holocaust offense.

Adaptation, Psychological↗

Religion is natural.

Despite its considerable intellectual interest and great social relevance, religion has been neglected by contemporary developmental psychologists. But in the last few years, there has been an emerging body of research exploring children's grasp of certain universal religious ideas. Some recent findings suggest that two foundational aspects of religious belief - belief in mind-body dualism, and belief in divine agents -- come naturally to young children. This research is briefly reviewed, and some future directions are discussed.

Biological Evolution↗

Cognitive development, culture, and conversation: comments on Harris and Koenig's "truth in testimony: how children learn about science and religion".

Harris and Koenig make a compelling case for the importance of adult "testimony" and its influence on children's developing conceptions of topics in science and religion. This commentary considers how their analysis relates to constructivist and sociocultural theories and discusses several ways in which Harris and Koenig's arguments help to debunk some prevalent assumptions about research on the social context of cognitive development. Finally, a number of additional issues are raised for debate and discussion, and some critiques and suggestions for future research are discussed. The issues discussed by Harris and Koenig are crucial if we are to take seriously the importance of culture in cognitive development.

Adult↗

Religion, spirituality, and depressive symptoms in patients with HIV/AIDS.

BACKGROUND: Depression has been linked to immune function and mortality in patients with chronic illnesses. Factors such as poorer spiritual well-being has been linked to increased risk for depression and other mood disorders in patients with HIV. OBJECTIVE: We sought to determine how specific dimensions of religion, spirituality, and other factors relate to depressive symptoms in a contemporary, multi-center cohort of patients with HIV/AIDS. DESIGN: Patients were recruited from 4 medical centers in 3 cities in 2002 to 2003, and trained interviewers administered the questionnaires. The level of depressive symptoms was measured with the 10-item Center for Epidemiologic Studies Depression (CESD-10) Scale. Independent variables included socio-demographics, clinical information, 8 dimensions of health status and concerns, symptoms, social support, risk attitudes, self-esteem, spirituality, religious affiliation, religiosity, and religious coping. We examined the bivariate and multivariable associations of religiosity, spirituality, and depressive symptoms. MEASUREMENTS AND MAIN RESULTS: We collected data from 450 subjects. Their mean (SD) age was 43.8 (8.4) years; 387 (86.0%) were male; 204 (45.3%) were white; and their mean CD4 count was 420.5 (301.0). Two hundred forty-one (53.6%) fit the criteria for significant depressive symptoms (CESD-10 score > or = 10). In multivariable analyses, having greater health worries, less comfort with how one contracted HIV, more HIV-related symptoms, less social support, and lower spiritual well-being was associated with significant depressive symptoms (P<.05). CONCLUSION: A majority of patients with HIV reported having significant depressive symptoms. Poorer health status and perceptions, less social support, and lower spiritual well-being were related to significant depressive symptoms, while personal religiosity and having a religious affiliation was not associated when controlling for other factors. Helping to address the spiritual needs of patients in the medical or community setting may be one way to decrease depressive symptoms in patients with HIV/AIDS.

Adaptation, Psychological↗