Philosophical discussion on religion, morality, and medical practice

communities enfolded the care of the sick into a communal life of liturgy and prayer. This is not to say that the substantively irreligious lack proper motivation to practice medicine. It is to say that an animating vision for medicine as a good and worthy activity seems to require moral concepts that science alone does not provide. How should medical science be deployed? Medicine is not only animated by something like a religious vision; it also requires a thick moral framework for its ongoing direction. To know how best to care for patients, we need to know something about what human flourishing entails and how medicine can contribute to it. Medical science is less helpful here than one might hope. Science facilitates the sort of religious humanism that Browning encourages, because it helps us better understand the empirical world and therefore helps all moral communities refine their efforts to bring about human flourishing. Science elucidates a range of technical possibilities and provides information about what we can reasonably expect as the consequence of choosing one course over another. Yet, even the successes of medical science highlight its limits. As medical science generates technologies that can be put to ever-wider uses, it exposes disagreements about which of those uses are worthwhile. Although medicine proceeds in scientific ways in the care of patients, it does so in pursuit of goals that science cannot set. These goals come from moral traditions and cultures, religious or otherwise. In the same way that the influence of a dominant culture on medical practice is often invisible or 142 Page taken for granted precisely because of its dominance, so the influence of religious ideas on medical practice is often invisible in those areas where commitments are shared in common among different religions and other moral traditions. For example, we generally take it for granted that mending injuries, treating infections, and removing diseased organs are good things to do. That is because the moral commitments that undergird these practices are shared by virtually all moral communities, religious or otherwise. Moral commitments that are shared by all may not seem ‘moral’ at all. Yet even the idea of sickness implies a norm of and concern for health that are not fully derivable from empirical science. The influence of religion on medical practice becomes more visible where the commitments of particular traditions diverge from one another or where they diverge from the values of the dominant culture. For example, religious measures have been found consistently to strongly predict physicians’ attitudes regarding ethically controversial practices such as abortion, physician-assisted suicide, withdrawal of life-sustaining therapies, contraception, physician interaction with patients about spiritual concerns and, as we have found, physicians’ ideas about the relationship between religion and health.’ Yet overtly controversial issues merely highlight the tips of proverbial icebergs. Disputes about practices such as abortion or physician-assisted suicide concern whether the practices are intrinsically unethical. Much more commonly physicians agree about the range of legitimate clinical strategies, but they disagree about which is to be recommended in a given moment. For HOUSE_OVERSIGHT_021388