Medicine and spirituality have been closely linked throughout human history. As long as humans have experienced illness we’ve questioned: “Why has this illness happened to me?” or “Why is this happening to the people I love?”
Some of the oldest written texts try to account for this relationship. The Epic of Gilgamesh shows Gilgamesh searching for a plant without sickness and death. In the famous story of Job, Bildad says his illness and suffering must be the result of an offense to God. The way to get better — physically, spiritually, and socially — was by asking God’s forgiveness.
The ancient Greeks also often saw illness as the result of offending the gods. Better health and well-being depended on calming displeased gods. But the traditional “father of medicine,” Hippocrates (circa 460-370 BCE) earned this moniker arguing that illness did not have a Divine source.
Each of the world’s three most popular monotheisms, Christianity, Islam, and Judaism, have a long history of explaining how sickness and disease happen, and how medicine should be incorporated into faithful practice.
Many healthcare professionals also struggle to respect the religious and spiritual beliefs of patients and family, while also trying to preserve their own conceptions of what good patient care should look like.
This struggle is seen very clearly when a patient or a family member requests that a life-sustaining intervention (such as dialysis or ventilator support) continue as they wait for God to perform a miracle.
In my work as a clinical ethicist, I’ve talked with patients and families from all three monotheistic religions about this hope. I, myself, have tried to answer this question: How should medicine respond to patients and families who hope for a miracle?
I often begin by looking into what a miracle might be for this family or patient. The hope for a miracle is a complex hope, and I have found that patients and their families hope for these kind of medical miracles in different ways.
Some have a great deal of community support. Their religious authorities say that praying for a miracle is the right thing to do. For these people, trying to understand illness doesn’t pose a great challenge because they have a great deal of support from their religious communities.
Others think their community requires they continue life-support and hope for a miracle, but it turns out not to be true. Their idea of what a miracle must be often changes after talking with their trusted religious authorities.
And I have met others who have been completely shaken by their illness or the illness of the person they love. While they still hope for a miracle, when they try to answer the big “Why?” question, they are no longer certain of what the answer is.
Sometimes just talking about these issues can foster agreement between healthcare professionals and patients. Other times, I try to foster trust between the team and the person hoping for a miracle. This will often lead to a resolution.
However, where there is a true impasse, and no amount of mediation and conversation leads to agreement, the American Thoracic Society (and other organizations) suggest a process-based solution. The purpose of these processes is to maximize the possibility that a fair and equitable solution will happen.
Even with these national policies, in our society, there are no easy answers when the hope for a miracle appears to conflict with a healthcare professional’s idea of what good medicine should be. The relationships between life, death, medicine, and the Divine have been linked throughout human history, and this intimate and complex relationship will likely continue forever.
Want to learn more about Faith and Healing: Patients, Miracle Language and a Space for Faith in Medicine? Register to attend the Center for Medical Ethics and Health Policy’s Conversation Series event, which takes place on April 11 at noon.