I am a theoretical physicist and currently Director of 
August 25, 2005
The ethical dilemma of faith healing - 2
There were some very thought provoking comments (some of them sent privately) in response to my posting on the ethics of faith healing. In one of the comments, Erin made a very telling observation that I've been thinking about and which prompted me to revisit the topic.
Those of us who do not believe in a god who intervenes in daily life tend to think of faith healing (if it works at all) as purely a placebo effect whose success depends on people believing that there is something real going on. As I said before, I have a real problem with how to deal with this.
On the one hand, the rationalist/skeptic in me wants to actively debunk all faith healers as, at worst, cynical con artists who are preying on the gullible for monetary gain or for fame and glory, or at best as self-deluding people who genuinely believe that they have some sort of gift. Even if a few people are of the latter kind, allowing them to propagate the belief that faith can heal allows the charlatans amongst them a greater chance of swindling others.
On the other hand, the humanist in me wants to keep out of the issue since I don't want to jeopardize the chances of a "cure" for a few people, even if it is placebo induced.
In these types of discussions, we tend to contrast the placebo effect (which is based on an illusion) with the effects produce by modern medicine, which is assumed to be based on science and is thus real. But Erin points out that the medicine-as-science versus placebo-as-quackery distinction isn't as clear-cut as one might imagine.
On the third floor of Allen building (where my office is) is the Dittrick Medical History Museum. It consists of just two rooms but contains enough devices and descriptions of past treatments to make me glad that we live in the current age. If one goes back in medical history, one finds all kinds of treatments that were once fully endorsed by the medical establishment and are now discredited. Some of them (such as bleeding using leeches) are pretty bizarre. The museum is free and open 10:00 am-4:30 pm Monday through Friday, and well worth a quick visit.
So what are we to make of these past treatments? Based on current science, we have no reason now to think that they should work, so any success they had must have been due to the placebo effect. But since the medical establishment believed in those treatments then, they must also have been considered science at that time. One assumes that the physicians of that time recommended these treatments with complete sincerity and achieved some "cures". What distinguishes them from the sincere faith healers of the current times?
Can we maintain the distinction between science and the placebo? Some argue that we cannot. I have heard it said that: "The history of medicine is the history of the placebo." This may be a little strong but it has enough truth in it to be disquieting. What if current medical treatments are also placebos? It could be that a few generations from now, people will marvel that bodies were once cut open with sharp knives or that strong chemicals were introduced into the bloodstream, all in the name of medicine-as-science.
One way to get around the problem is to think that past generations of medical scientists were simply wrong and that we are fortunate to happen to live in an era when science has come into its own, producing real cures, and that our current successful treatments are permanent. Some science triumphalists extend this argument across the board, arguing that current scientific knowledge, unlike that of its predecessors, is right in its essentials and that all that awaits us in the future are minor improvements, tinkering at the boundaries.
I am always a little wary of assuming that we live in a special time in history, whether it is a high point (as asserted by the science triumphalists) or an especially low point (as asserted by those Christian fundamentalists who think the country has gone to the dogs and want to return it to a previous era by putting religious symbols in the public sphere and overthrowing evolutionary theory). While changes have undoubtedly occurred and in some cases for the better, we may not be too different from our predecessors in our ability to distinguish good science from bad, or science from non-science.
One thing that has definitely improved is our research protocol methods. At least with double-blind clinical trials, we can have some confidence that some of the medical treatments we use are truly beneficial. But that still does not solve our problem of the ethics of faith healing and whether we should try and debunk them, whether the practitioners are sincere or not.
That's the trouble with true ethical dilemmas. There is no obvious right answer.
POST SCRIPT 1
Tom Tomorrow spells out how supporters of the Iraq war avoid reality.
POST SCRIPT 2
As usual, Jon Stewart of The Daily Show has the best take on Pat Robertson's latest idiocy and the coverage of it (via onegoodmove).
Comments
I think that while our research protocol methods are better than in the past, as consumers, we can't necessarily assume that the medical treatments offered/recommended to us are really in our best interest. Especially when it's a matter of quality of life rather than a matter of life or death. The influence of big pharma is a big reason for my skepticism.
I've been struggling with the issue of the placebo effect myself, especially since I've been dabbling in alternative medicine recently. I got moderate relief from fairly serious fatigue (for which my doctor found no "organic" explanation) with not one but two very expensive antidepressants (many thanks to my husband's insurance company). BUT I've been experiencing much more dramatic results from a OTC transdermal progesterone cream (which is pretty inexpensive).
People in my life are quick to ask whether the cream is just all about placebo effect. But if my mind was open to the placebo effect, why didn't I see more improvement with the first anti-depressant, or the second (which was prescribed largely to counter the side effects of the first).
While drug companies do test that prove that drugs do what they say they will do, finding the the right treatment for any particular person seems to me to be largely a process of trial and error.
And while we may suspect that the faith healer is just out for some quick cash, we know that pharmaceutical companies are in business to make money for their stockholders.
I don't really have any answers and I can't even say that I'm clear on all the relevant issues and facts at this point. Just thought I'd stir the pot. :-)
If you're ever in Minneapolis with some time on your hands, I strongly recommend the Museum of Questionable Medical Devices. The name says it all.
I agree with you about science triumphalism - it seems awfully similar to Biblical literalism. People believe that "the Bible" is literally true, but this often only applies to the form of the Bible that happens to be sitting on the believer's bookshelf - that is, a collection of writings translated and selected through many historical accidents. The originals, and other similar writings that were not included in "the Bible", may have significant differences from the version that is most readily available to us today. Moreover, most of us are not very familiar with what the differences are, so we have no reason other than convenience for choosing one over another. It's hard to believe that God would inspire scripture that would only become precisely true after translation thousands of years later, and that would then lose its truth when translated again in the far future, but that is exactly what this sort of literalism requires. (Well, except for the part about there being a far future at all.)
To my mind religion is the deal of individual, and it should be free of pressure and sterotypes. God is in the soul and our faith and our gods are different only in books and publications.
"If you're ever in Minneapolis with some time on your hands, I strongly recommend the Museum of Questionable Medical Devices. The name says it all."
+1
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Basic Principles of Complementary and Alternative Therapies
JUST AS MAINSTREAM MEDICINE has a fairly consistent approach to illness, so does al-ternative medicine. Most prevalent in alternative medicine are the six naturopathic principles. In one form or another, these principles are revisited again and again throughout Section Two of this text. The following principles are described by Dr. Catherine Downey and excerpted from her chapter on naturopathic medicine.
1. The Healing Power of Nature (Vis medicatix naturae)
The body has the inherent ability to establish, maintain and restore health. The healing process is ordered and intelligent: nature heals through the response of the life force. The physician's role is to facilitate and augment this process, to act to identify and remove obstacles to health and recovery, and to support the creation of a healthy internal and external environment. In short, give the body the appropriate tools and it will heal itself.
2. Treat the Whole Person (The multifactorial nature of health and disease)
Health and disease are conditions of the whole organism, involving a complex interaction of physical, spiritual, mental, emotional, genetic, environmental, and social factors. The physician must treat the whole person by taking all of these factors into account. The harmonious functioning of all aspects of the individual is essential to recovery from and prevention of disease and requires a personalized and comprehensive approach to diagnosis and treatment.
3. First Do No Harm (Primum no nocere)
Illness is a purposeful process of the organism. The process of healing includes the generation of symptoms, which are, in fact, an expression of the life force attempting to heal itself. Therapeutic actions should be complementary to and synergistic with this healing process. The physician's actions can support or antagonize the actions of the vis mediatrix naturae; therefore methods designed to suppress symptoms without removing underlying causes are considered harmful and are avoided or minimized. Therapeutic actions are applied in an ordered fashion congruent with the internal order of the organism.
4. Identify and Treat the Cause (Tolle causam)
Illness does not occur without cause. Underlying causes of disease must be discovered and removed or treated before a person can recover completely from illness. Symptoms are expressions of the body's attempt to heal, but they are not the cause of disease; therefore naturopathic medicine addresses itself promptly to the underlying causes of disease, rather than symptoms. Causes may occur on many levels, including physical, mental-emotional, and spiritual. The physician must evaluate fundamental underlying causes on all levels, directing treatment at root cause rather than at symptomatic expression.
5. Prevention (Prevention is the best "cure")
The ultimate goal of naturopathic medicine is prevention. This is accomplished through education and promotion of lifestyle habits that create good health. The physician assesses risk factors and hereditary susceptibility to disease and makes appropriate interventions to avoid further harm and risk to the patient. The emphasis is on building health rather than on fighting disease. Because it is difficult to be healthy in an unhealthy world, it is the responsibility of both the physician and patient to create a healthier environment in which to live.
6. The Physician as Teacher (Docere)
Beyond an accurate diagnosis and appropriate prescription, the physician must work to create a health-sensitive, interpersonal relationship with the patient. A cooperative doctor-patient relationship has inherent therapeutic value. The physician's major role is to educate and encourage the patient to take responsibility for health. The physician is a catalyst for healthful change, empowering and motivating the patient to assume responsibility. It is the patient, not the doctor, who ultimately creates or accomplishes healing. The physician must strive to inspire hope as well as understanding. Physicans must also make a commitment to their personal and spiritual development in order to be good teachers.
(alternative medicine) A few clarifying points round out the complementary approach:
Alternative medicine does not suppress symptoms. It attempts to delve deeper than the symptoms and address their causes. This in turn diminishes or eliminates the symptoms.
Similar alternative treatment strategies are often applied to many unrelated disease and illnesses because the core alternative philosophy states that many illness manifestations stem from common root causes. There are no "off-label" indications for alternative medicine.
Alternative medicine is less interested in the manifestations of the disease and more interested in those elements that created the disease in the first place.
The patient is part of the healthcare team and has a strong say in planning for a future therapeutic approach. Patients are empowered to participate in the decision process and, in turn, have the responsibility to enact what they have agreed to do. In these scenarios, noncompliance is much less common.
The mind-body correlation is extremely important. Learning about the patient's social life, family life, and work life, and significant life events that predate the onset of illness can help immensely in understanding contributing factors in a patient's illness and in formulating a treatment plan. Even asking the question, "What happened to you around the time this illness began?" can be most revealing.
Many variations on this approach will be apparent through the pages of this text. The sense of facilitating a natural process or returning the patient to a natural state of balance is the common theme overall.
I sometimes wonder if physicians and scientists are threatened by the idea that God may, in fact, intervene in the natural course of human events. While I believe that it is foolish for the faithful person not to avail himself of the treatments of medical experts I also believe it is arrogant of the scientist to view God as a competitor for the healing credit.
Just my 2 cents.
Jake,
I do not think any humane person would begrudge another person being healed, whatever the source. It is just that there is no evidence that prayer ahs any effect.
Jake,
I do not think any humane person would begrudge another person being healed, whatever the source. It is just that there is no evidence that prayer ahs any effect.
+1
Paysafecard
I do accord with you guys! and very informative post!
Thanks Csaba from
Heal Blog Supporting Healthy Lifestyle
Unfortunately fear is a common theme amongst the masses. Humane people can even have a tendency to attack what they dont understand.
I am a Bristol based hypnotherapist and although hypnotherapy is complementary, with the use of MRI scans can begin to understand the true science behind it. As you have correctly pointed out what is considered medically acceptable today may not be in many years to come. The use of therapeutic hypnosis however has been used for centuries and has been fine tuned to what it is today. Many people will argue that SSRIs are placebo. I am not going to give my opinion on that either way but if they are placebo some people are still getting relief. The mind is incredibly powerful and we are only at the beginning of understanding the workings of the brain. Neurology offers exciting research and advances in brain scans means we are finally getting to see the brain in action. Hypnotherapy is psychotherapy utilizing hypnosis as a tool and I am happy to say, in the UK at least, hypnotherapy is becoming more and more regulated by official governing bodies. http://www.hypnochanges.co.uk
I tottaly agrre with Mano Singham...
Homeopathy definitely works as I have managed to remove warts from my hands when no other method worked.