This guide is a collaborative effort between librarians at Bellack Library and IHP's MVCE Office. It is a launching point for health professionals to learn how religion and spirituality (RAS) can affect health care, with a focus primarily on the United States.
We've chosen to split the guide into seven main sections:
This guide aims to help raise awareness of how intertwined religion, particularly Christianity, is with health care in the United States. It is not meant to critique any group but to help foster cultural competence and to promote inclusive practices.
Throughout the guide, you will find citations referencing specific resources. You can find the entire list of references on the References tab.
We’re focusing on the European trajectory of medicine and religion in this guide, as it is what most hospitals in the United States follow. There is also an intertwined history in many other countries and groups that we’re not able to fully cover in this guide.
Retief & Cilliers (2006) explore Christianity's influence on European medicine from Graeco-Roman to Renaissance times. In early Christianity, healthcare was often seen as being controlled by God, and if there were cures to ills, they were miraculous. They argued that Christian theology and Hippocratic medicine could coexist during the early first to third centuries—they added that Christians likely "took to secular medicine very early on." But at some point, there started to be a divide, where people were beginning to place their trust more in physicians than God, and they were neglecting the "spiritual value of sickness." The fourth to sixth centuries started to have a more mystical element with the concept of healing saints and medical martyrs; in the late 5th century, a medical school was established in Jundi-Shapur, which would influence Islamic medicine. The seventh to thirteenth centuries were considered the "Golden Age of Islam" and saw massive growth in medical advancement; popular Muslim physicians included Rhazes, Avicenna, and Avenzoar. Maimonides was a popular Jewish doctor. From there, education flowed to Europe's first medical schools in Salerno, Italy and Montpellier, France. During the thirteenth to sixteenth centuries, civic hospitals began to replace monastic medicine, which started to cause a great divide. The Inquisition supported the Church's adoption of medical dogma based on Galenic and Hippocratic teaching; education was mostly hampered through banning texts, restrictions on who could attend school, and the exclusion of "heretic" teachers (particularly Jews). The Christian Church lost its hold on Europeans during the Renaissance, at least until the Age of Enlightenment.
Ferngren (2012) also provides a historical perspective on the intertwining of religion and medicine. They discuss how—following the Council of Trent—the Catholic Church based much of its medical ethics on the natural-law tradition, while Protestantism kept the church's authority based on "Scripture alone." This allowed for differing opinions on concepts like suicide. Depending on social structure, there may even be divergent views within followers of a church regarding topics such as cloning and stem-cell research. Ferngren continues to talk about how the thought process of early Christians revolving around sickness and suffering as something positive led to the creation of early hospitals and philanthropic endeavors for the sick and poor. While the Romans had infirmaries, they typically only served certain members of society, while the early hospitals were for anyone to attend, but with a focus on people experiencing poverty. This "medical philanthropy" lead to the creation of medical charities, hospitals, and health institutions. It wasn't until the 19th and 20th centuries that medicine became "professionalized" and mainly separated from religious orders.
A further example of how intertwined medicine and religion came about is the origins of nursing. Wall (2001) reviews the Catholic origins of many nurse training schools in the United States. Nuns, or sisters, were often the nurse-equivalents in early hospitals in the US, starting in the early 19th century. Wall continues, explaining how, before the creation of their nurse-training schools, the sisters focused on "works of mercy" as opposed to scientific training when it came to health; however, as the professionalization of medicine increased, the nuns began to incorporate more scientific training and lay (non-religious) members to fill out their ranks. As teaching expanded, the nuns were able to leave a lasting impression through their values and character traits for their students.
Topolski (2020) explores Judeo-Christian privilege, a subset of Christian privilege that applies to Christians and is also extended to some Jews as a "by-product of western Christian dominance" (p. 303). A key part of Topolski's argument involves promoting Semitic solidarity—what they refer to as improving Jewish-Muslim relations. Topolski contends that we need to stop treating the Holocaust as a unique event and rejecting the idea that anti-Semitism is a uniquely "Muslim problem." They suggest that fostering Semitic solidarity could serve as a means to combat racism, anti-Semitism, and Islamophobia.
Bentzen and Gokmen (2020) explore the concept of institutionalized religion across many cultures as a means of legitimizing rulers. While they are looking at how religion persists thanks to these relationships, they touch on the power dynamics in play.
