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Chapter 15¹⁵

Social Brain, Spiritual Medicine?

No one ever asks what science has to do with medicine any more than they ask what books have to do with education or what tools have to do with carpentry. Before the middle of the 19th century, there was almost nothing that physicians, however well intended, could do to actually restore health to the ill. Modern science changed that. Over the past century and a half, dramatic improvements in health outcomes have been wrought through the application of sterile surgery techniques, specialized hospital care, public health measures to prevent the spread of infectious diseases, antibiotics to treat those diseases, and myriad subsequent technologies. All of these have been undergirded by the discoveries of biomedical science.

As a result, the life expectancy in developed nations has doubled. People live not only longer but with much less disability. Diseases that formerly disfigured and killed, such as smallpox and polio, have been almost completely eradicated. Epidemics of malaria, yellow fever, measles and diphtheria have been restrained. Injuries from war or other traumatic events, which in earlier periods led predictably to death or profound disability, now can be ameliorated using sophisticated surgical reconstruction techniques, advanced prostheses, and intensive rehabilitation. Medical science already has accomplished an extraordinary amount in alleviating human illness and forestalling death, and there is good reason to expect further progress. Yet, for all that science has made possible, medicine is animated by other, less tangible, forces.

¹⁵ The lead author is Farr A. Curlin, M.D., a hospice and palliative care physician, researcher, and medical ethicist at the University of Chicago. His empirical research charts the influence of physicians' moral traditions and commitments, both religious and secular, on physicians' clinical practices. As an ethicist he addresses questions regarding whether and in what ways physicians' religious commitments ought to shape their clinical practices in our plural democracy. Curlin and colleagues have authored numerous manuscripts published in the medicine and bioethics literatures, including a New England Journal of Medicine paper titled, "Religion, Conscience and Controversial Clinical Practices." As founding Director of the Program on Medicine and Religion at the University of Chicago, Dr. Curlin is working with colleagues from the Pritzker School of Medicine and the University of Chicago Divinity School to foster inquiry into and public discourse regarding the intersections of religion and the practice of medicine.

In the world of contemporary medicine, science is front and center, and for good reason. Science provides modern medicine with extraordinary diagnostic and therapeutic capacities that can be employed to care for patients. Yet there is more to medicine than science can know. Science cannot provide visions to animate care of the sick, moral frameworks to guide the application of medical technology, or practices that nurture and extend our sociobiological capacity to care for others. For these medicine turns to religious and secular moral traditions and practices. This essay examines how religious concepts are implicit and operative in practices of medicine and in the formation of fully human physicians. By attending to these concepts, we may gain a richer understanding of the way self-conscious human practices like medicine both depend on and

extend our unique, human, biopsychosocial capacities.

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