One of my favorite books of late has been Confessions by St. Augustine. It is a very honest book that talks about the development of the faith of a young man who struggled to accept the faith that he was raised in. Throughout the book, one can sense the inner turmoil he felt at times trying to reconcile his faith with the world around him, and the pointed questions he asks reveals a man who understands his faith in a way that helps him to be secure in it, but a man who is also aware of the nuances that come with believing in a faith that opens itself to many questions when it comes to making it relevant in the world. I think one of the reasons why I gravitate to this book these days is because I can relate to the same type of inner turmoil he has, particularly when it comes to looking at medical issues.
In full disclosure, I write this article as a Christian (I am an Anglican if you want more specifics in terms of my denominational leanings). I have a particular view about how God works in this world which may be different from the views of many of the people who read this essay. My only goal in this article is to honestly share the challenges of reconciling my faith with medicine, and the hope is that other people who have undergone this same struggle could relate to at least one particular expression of this. I also hope that for people who may not affiliate themselves with a religion, this essay could help them to understand that for people of faith in medicine, it is a daily intellectual exercise we go through as we encounter some of the challenging issues in medicine. We use our intellect to apply the medical knowledge we have learned to certain situations in order to improve patient care, while at the same time trying to reconcile the medical decision we make with the teachings of our faith, particularly when it comes to ethical decisions.
Being raised in the church, I was taught certain tenets that are important to the faith itself. Whether it regards how you see God in the world or how you are to treat other people, you are ideally guided by these particular tenets. They serve to be the standard by which you are to live your life, and early on, you are taught about what to do and what not to do in certain situations. By extension, those teachings impact how you think (or should think) about particular situations, and it was uncommon for there to be a “grey area” about certain issues (or at least I was not taught that a “grey area” was possible from a faith perspective). If there was a “grey area,” then it would be a question of how stable your faith was, and at times, I felt that the opportunities for debate would be few and far between. But to be honest, there were not many times that I had to question the tenets of my faith growing up since I did not have to deal with much in the way of ethical dilemmas.
However, as I started to take college courses in the sciences and went through medical school, I started to encounter certain ethical dilemmas in medicine that demanded that I start to think more critically about these situations. Discussion about stem cell research, genetic testing, euthanasia, and abortion among other things became more relevant to me as I heard public debates between scientific communities and communities of faith. The science would indicate one way to think about things, and my faith seemingly indicated another way to think about things, and at times, these would come into conflict. I had to learn how to grapple with the perceived contradiction and to allow myself to think about the nuances involved, nuances that were not really addressed by the tenets I learned growing up because these were never issues that were directly dealt with back in the day. With the advance of science came new questions that I had to encounter as one entering into the medical field.
It becomes much more important to be able to deal with these nuances when it comes to actively treating patients. Patients come to us for our input about their health and for our ability to treat them when a particular medical issue arises. When I encounter them, I encounter them as a physician, not as a member of the clergy, so my responsibility with regards to how I interact with my patient is defined by the Hippocratic Oath primarily. What needs to be stated, however, is that for the most part, all of the Hippocratic Oath has commonality with most faith tenets, so one could make the argument that the faith of an individual could play a role in how we encounter patients if it is in line with the oath. For the most part, there is little contradiction between the oath and the faith tenets.
However, when a potential contradiction arose, I had to learn not to run away from science or faith. It is tempting to run toward one direction in particular depending on one’s philosophical or religious leanings, but I found that the best treatment options when these issues arose came after consultation with other people. Whether they are members of the medical community or members of the clergy, valuable opinions are shared and a consensus has to be reached with the openness to thinking about nuances, no matter how uncomfortable it may be if it seemingly challenges what we believe. At the end of the day, our care of our patients should be influenced ultimately by these words from Hippocrates himself, that we should “take care that they suffer no hurt or damage” from our decisions. Thankfully, this is in line with a particular teaching from my faith, that I should love my neighbor (meaning everyone else) as myself.
At the end of the day, I have actually found a certain acceptance and comfort in these nuances. Like St. Augustine, I feel secure in my faith but unafraid to ask honest questions when these nuances in medical care come up, and I would make the argument that as I understand my faith more, I believe that there is more room for debate about these issues than is believed by the general public, particularly by communities of faith. As a doctor, I am called to care for people, not to judge them or their actions. I am not a clergyman once I enter the hospital, so I must not allow my faith to be the sole factor in making medical decisions. However, I do see a role of my faith in influencing how I care for patients from a humanistic standpoint, irrespective of the ethical dilemmas that may come up which may pit medical knowledge and religious teachings against one another. If these dilemmas do come up in the future, I can at least take comfort in the fact that my faith allows me to honestly grapple with reconciling the science and tenets together in a way that ultimately leads to the best care possible for any patient that I encounter.
Chiduzie Madubata is a cardiology fellow.
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