The UK's selection of some of its legislators by their religious beliefs (the 26 Lords Spiritual - senior Bishops - in the House of Lords) puts it in the same club as Iran. Bringing this incredible practice into the spotlight are the frankly bizarre utterances of the Archbishop of York who, in supporting a motion by the crossbench peer Baroness Hollins, explained how the NHS should be bound to take care of the spiritual health of people, not just their mental and physical health.
The Archbishop of York, who thinks that exorcism has relevance to the debate on the Health Bill
...when he first became a vicar in south London, he was
invited to a home where there was "a presence ", a phrase he said he did
not understand at the time. At the home, he said, he found a young girl who had been
unable to move for nearly three weeks and would shout out in the middle
of the night. He was told the family had been to a witches' coven where a
goat had been sacrificed. The young girl was petrified she would be
next. Visits from a GP, psychiatrist and psychologist did little to
help, he said, but then he said a prayer, anointed the girl and lit a
candle on his visit. Shortly after, he received a phone call saying the girl was no longer terrified and was talking again. "That was not mental or physical illness; there was something in her spirit that needed to be set free" he told his peers.
The Archbishop's utterances are not much more bizarre than the motion by Baroness Hollins, who is a psychiatrist. Psychiatrists seem to get themselves into all sorts of problems with matters spiritual. The new Recommendations for Psychiatrists on Spirituality and Religion (PDF Link) is authored by Professor Christopher Cook (Chair of the Royal College of Psychiatrists Spirituality and Psychiatry Special Interest Group) who believes that mental disorder can be caused by demonic possession (published and presumably endorsed by the Christian Medical Fellowship). Here's the astonished response to his beliefs by me and by the medical ethicist Iain Brassington at the BMJ Medical Ethics Blog. Baroness Hollins's motion is equally bizarre, but with supporters like the Archbishop, you don't need me to tell you that. Time for the UK to exorcise the Lords Spiritual from its legislature.
...that he wants to promote a debate on the practice of
vaccination in general. He has also urged British Muslims not to give
their children vaccines such as that for measles, mumps, and rubella
(MMR), because they contain substances that make them un-Islamic. He
alleged that almost all vaccines contain “haraam” (forbidden)
derivatives of animal or human tissue and that Muslim parents were
better off letting children’s immune systems develop on their own.
Other medical practices are apparently not to be encouraged by Muslim doctors, such as giving condoms to unmarried persons, and the organisation sees its mandates as "joining actively the Pro-life campaign in Britain" and "Joining the campaign against
the adding of Fluoride to our drinking water" (see http://www.islamicmedicine.org/imaUK.doc).
The article notes that the British Medical Association and GMC have learned of Muslim students who are refusing to learn about alcohol related illness or sexually transmitted disease as it offends their religious beliefs and that "A
small number
were also reported to be refusing to
treat patients of the opposite sex."
I guess that would at least shorten ward rounds by about half. Makes the Christian Medical Fellowship look almost moderate in its views. (OK, not really).
Rules designed to restrict abortion choice look set to be introduced by the coalition Government in the UK. The rules, proposed as an amendment to the Health and Social Care Bill by Labour MP Frank Field and Conservative MP Nadine Dorries (both devout Christians), will remove the role of abortion providers such as BPAS and Marie Stopes in providing pre-abortion advice. Ms. Dorries and Mr. Field state that there is a financial conflict of interest of abortion providers in providing pre-abortion counselling. It is of course a ridiculous idea, effectively accusing medics and nurses working for such organisations of failing to obtain informed consent (the cornerstone of medical ethics) for abortion procedures. There is not one study or piece of evidence to support their claim. Imagine if you are thinking of having your gallbladder removed due to gallstones. The very idea that a surgeon could not tell you about the procedure or alternative options because he/she has a financial stake in carrying out the operation (is paid by the NHS to carry out such operations) is a ludicrous one. But that is the logic of Ms. Dorries.
The amendment is supported by the secretive 'Right to Know' campaign, which rebuts all questions about its funding. It is widely suspected that it is financed by US evangelical conservative Christian groups (see interview with Dr. Evan Harris here), and is part of the 'chipping away' strategy that Ms. Dorries is adopting at UK abortion law.
Whilst this is only tinkering (reducing the gestation limit at which abortion is available was roundly rejected by MPs in 2008), Ms. Dorries has admitted to being advised by Dr. Peter Saunders, who is CEO of the Christian Medical Fellowship (which appears to be an increasingly extreme organisation peddling increasingly wacky ideas). A look at the powerpoint slides of Dr. Saunders here lays bare the 'chipping away' strategy. Ms. Dorries has indeed concentrated on the potential reduction in numbers of abortions her amendment might produce (she states up to 60,000) a year). More pragmatic commentators have stated that numbers will probably not be reduced a great deal, but that referral to the 'independent' counsellors will cause delays in abortion meaning later term abortions, which will be a matter of regret not only to Christian and secular organisations, but particularly for patients.
Pre-abortion advice provided by non-mainstream organisations has been found severely wanting. As The Guardian reported this month:
A survey of 10 centres operated by Christian and anti-abortion organisations found evidence in most of them of poor practice and factually incorrect advice, while the quality of counselling differs widely. Advice ranged from scaremongering – linking abortion with breast cancer, for example – to actions apparently designed to steer women away from abortion, such as showing them baby clothes and talking about "the child"...At a Life centre in Covent Garden, London, the undercover researcher was given a leaflet entitled Abortions – How they're Done, which said incorrectly that 85% of abortions are carried out using vacuum aspiration. It stated that "the unborn child is sucked down the tube" and that "the woman should wear some protection. She has to dispose of the corpse [in the case of chemically induced abortion]."
It's good to know that the Government is, in straightened times, thinking of introducing complex, unfeasible, unceccessary, and expensive legislation for which there is no need, merely at the whim of a couple of backbench MPs. The amendments will also use up valuable time for debating the major aspects of the Bill - most notably, that GPs will be given the majority of the NHS budget to commission services, and the stealth privatisation of the NHS. I urge you to lobby your MP about this issue before the 6th Sept (when the amendment is likely to be debated), which can be done easily at this link:
The British Medical Journal has got the right take on the Christian Medical Fellowship (CMF) in its "Lobbywatch" column of 20th July 2011. It notes that the evangelical Christian GP Richard Scott, currently having problems with the GMC for proselytising during consultations, has stated in the CMF's magazine that, for him, “saving the soul was ultimately far more important than mending the body”, and that:
“Evangelism is a job for all Christians, at all times and in all places, and Christian GPs are in a unique position to reach the lost in their local area. Sharing the gospel with patients is not an abuse of trust because God himself gives us the authority and salvation is their greatest need.”
The CMF continues its attempt to legitimise proselytising to vulnerable patients by importing the notorious US 'Saline Course' which aims to equip doctors with the skills needed for "drawing patients in a natural way one step closer to God".
From the website of the cryptically named International Health Services which runs the Saline Course. "International Health Services teaches Christian medical professionals how to share Christ's love at the time of need, patient by patient"
GPs who consider our spiritual needs a higher priority than our medical treatment may think their authority comes from God, but their medical licensing comes from a higher power: the General Medical Council. Let's hope it protects us from doctors who see their patients as vehicles for their wacky beliefs.
The argumentum ad Hitlerum or reductio ad nazium is a form of argument that was given its dog latin appellation in 1953 by the political philosopher Leo Strauss. It is an informal fallacy, suggesting that X is bad because it has been associated with Y, with Y being something Hitler or the third Reich did or espoused. It is easily shown to be a fallacy because X might be playing competitive sport, something which the Nazis promoted as a way of proving the superiority of the Aryan race. It does not follow that playing competitive sport is bad.
The Nazi holocaust began in 1939 with the killing of 6,000 disabled children and 70,000 patients in geriatric and psychiatric institutions. Leo Alexander, a psychiatrist who gave evidence at Nuremberg in 1949 said that ‘its beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the attitude, basic in the euthanasia movement that there is such a thing as a life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans.
Firstly, the killing of disabled children and geriatric/mentally disordered patients is not assisted suicide. It is involuntary euthanasia, more commonly known as murder. Does Leo Alexander’s claim that this extermination was born from the notion that there is such a thing as a life not worthy to be lived make assisted suicide wrong? No, once again, the shift in attitude by physicians that Alexander mentions was not a precursor to assisted suicide. It was a precursor to murder and systematic extermination of classes of persons on an unimaginable scale.
A Nazi propaganda slide depicting portraits of mentally ill people. From the Holocaust Education and Research Archive Team www.holocaustresearchproject.org
Dr. Saunders denies having made the argument in the face of replies to his blogpost. For example, in reply to one post: “Wow, I read this assuming credibility until you likened it to Nazi Germany”, Dr. Saunders states “The article simply lists twenty facts the programme did not tell us about assisted suicide and euthanasia in Europe - of which the 20th is undoubtedly one…what you conclude from it is up to you.” This defence is given short shrift by another commenter on the blog: “Dr Saunders - you definitely have undermined the credibility of your argument by bringing up Nazi Germany… and in response to your assertion that you're factually correct, you could write an endless list of irrelevant facts if you wanted, but that wouldn't make your argument more convincing.”
In a debate about the Republican contract, US congressman John Lewis first read out Martin Niemoller's speech about the Nazi takeover ('They came first for the Communists, and I didn't speak up because I wasn't a Communist. Then they came for the Jews…'), then said, with gravity: 'Read the Republican contract. They are coming for the children. They are coming for the poor. They are coming for the sick, the elderly, and the disabled.’
It seems to me that there's something more complex and morally pernicious about the reductio ad nazium than it being a simple fallacy. It attempts to recruit a particular tragedy, in this case the systematic murder of thousands of patients, in (spurious) support of a particular viewpoint. The class of persons so recruited has no voice to indicate whether they object or assent to the viewpoint. As an example, I could say “All religion is bad because of the Catholic abuse scandal” (see Sam Harris here on why he’s tried to steer clear of the abuse scandal). But all religion cannot be bad because of the bad acts of some members of one religious group. By saying this, I would exploit the suffering of thousands of victims of abuse as a smokescreen for a viewpoint that I might hold for reasons totally unrelated to the abuse scandal.
In summary, to object to an issue by invoking the suffering of a group of persons (whose suffering is entirely irrelevant to the point being made and being used a smokescreen for deeper beliefs) seems to me to be a more grievous act than the mere commission of a fallacious argument.
Dr. Peter Saunders, advocating that doctors should proselytise to patients in consultations, trotted out on Radio 4 last week the rather exhausted canard that there is a huge evidence base to suggest a positive relationship between religion and health. Dr. Saunders states: “We are talking about in the vicinity of 1,200 research studies and 400 reviews in peer-reviewed medical journals. 81% show a positive correlation between faith and health; 4% a negative correlation and 15% sit on the fence.” This astonishing number of papers was mentioned by Dr. Harold Koenig in his “Handbook of Religion and Health”, and trotted out again in a (no doubt impartial) report by the Christian Medical Fellowship (CMF).
Over a thousand studies? Really? Others don’t see the statistics in quite this way. The researcher Richard Sloan (Professor of Behavioral Medicine at Columbia University Medical Center) analysed 266 papers identified as relevant to religion and health by the healthcare literature database Medline that appeared over the course of one year. However, only 42 of 266 (17%) were relevant to claims about the effects of religious involvement on health.
Sloan continues: “So proponents of a connection between religion and health are technically correct when they write that there are a great many studies on the topic. But they are wrong when they report that the vast majority demonstrate positive relationships between religious involvement and better health. In fact, the vast majority of these studies have nothing whatsoever to do with the health benefits of religious involvement”.
Let’s have a look at some of these papers supposedly demonstrating the effects of religious faith on health. Of 89 studies on cardiovascular health cited by Koenig and the Christian Medical Fellowship report, 33 were studies on denominational differences in health or compared groups whose religiosity was unknown e.g. comparing cholesterol levels in Seventh day Adventists to age-matched New York city residents. Such studies show us nothing about the effect of religious involvement and health. Eleven studies were reviews of other studies, case reports or “mere descriptions of projects”. Three were published only in abstract form and cannot therefore be critically appraised. This leaves 34 of the original 89 papers that Koenig and the CMF claim to be the basis of the relationship between religious involvement and healthcare. Sloan reviewed these and found 30 had serious methodological flaws or were “so misinterpreted or misrepresented that they cannot possibly be used as evidence for an effect of religion on health”.
That leaves 4 studies out of the original 89. Extrapolating this to the 1200 cited by Dr. Saunders, only in the region of 50 are likely to actually be about the effect of religious involvement in health, and we don’t know whether they show positive or negative effects.
The quality of many of the papers cited is also dubious in the least. In one of the 81% of 'positive' studies cited by Koenig, the CMF, and Dr. Saunders, eight ‘remote healers’ prayed for patients with high blood pressure, who did indeed have a reduction in systolic blood pressure greater than the control group. No patient details are given. The eight remote healers were four “Science of Mind Practitioners”, one was a Presbyterian Institute Minister, another was a Church of Christ Minister, one was “Director of the Seventh Sense Institute” and another was “a gifted individual whose healing abilities have been verified by both doctors and scientists”. Data was presented only for the patients of four healers who “had the highest number of returned patients”. It is a wonder that the authors managed to publish a study that drops patients from its analysis who are likely to have a negative outcome.
Whilst the Christian Medical Fellowship and Dr. Peter Saunders might consider this a study that supports the discussion of religion with patients, I would hope most doctors would look at such studies and consider that proselytising to patients on the basis of such nonsense would be a serious breach of their duty to treat patients on the basis of evidence (not to mention a breach of General Medical Council guidelines).
References
Sloan R. Blind Faith. New York: St. Martin’s Griffin.
Koenig H, McCullough M, Larson D. Handbook of Religion and Health. New York: OUP.
'Religion versus medicine' takes as its starting point that religion has a grotesque influence on medicine and health (e.g. religious war and genocide, slavery, honour killings, witch hunts, inquisitions, male and female religous genital cutting, condemnation of heterosexual and homosexual urge and behaviour, prohibition of contraception to reduce HIV transmission and population growth, systemic clerical abuse and rape of children, conscientious objection to legal methods of family planning, etc).
Title picture is the extraction of Asclepius from his mother Coronis by his father Apollo, from Alessandro Beneditti's De Re Medica (1549).
The Hippocratic oath in the shape of a cross, 12th Century Byzantine manuscript
"The truth is that medicine, professedly founded on observation, is as sensitive to outside influences, political, religious, philosophical, imaginative, as is the barometer to the changes of atmospheric density". Oliver Wendell Holmes
