by Bill Pearson
In this exercise we will review a paper in order to
understand the assumptions that shape the
It is broadly assumed patient care is about science
and the Hippocratic tradition. People go to med
school because they “are good in science and
want to help people”.
There is a growing movement within medicine to
include spirituality. This kind of change provides
an opportunity to sound out an explanatory
As it turns out, there is more to the story…
• This presentation is not a critique of Drs. Post, Puchalski, and Larson.
• It is an evaluation of the Biomedical Mythology imbedded in their
• I understand this paper to represent a mainstream of thought in
reference to spirituality and patient care. This paper is peer reviewed
by medical professionals. It was not written to be theologically
correct. Whether the authors would have presently the information
differently if writing a theological paper is speculative and beside the
• What this paper does is provides an excellent opportunity to see how
the biomedical story shapes the “truth” the medical profession
professes. I think this is an especially helpful exercise because it is an
issue sympathetic to the Christian faith and was written by people of
faith. If we take issue with this paper theologically, then perhaps we
should question the entire enterprise.
• In this exercise we will read an excerpt and
try to understand the values behind these
statements. The blue stars indicate
statements that merit particular attention
• The key question we are asking is:
What is the Biomedical Mythology?
The authority to deal with death and disease is
through scientifically validated interventions.
Nothing else, even if it does exist, can be
known (fact-value dichotomy). We attend the
spiritual interest of patients to bring them to
the truth of scientifically valid interventions.
(Do we reverse this false dichotomy and use health care as a tool to bring people to Jesus?)
Spirituality is a good because it effects
positive health outcomes. Health is our
ultimate good. Everything serves this end. It
functions as our national religion. It receives a
tithe of 14% of our GNP. (We give .1% to
international health and development.)
(Who then are the Pharisees of American Culture?)
There is no truth without data (approximated
certainty). If it works we can measure it. If
we can measure it, then it counts.
(Is God’s reality the only spiritual reality that can produce measurable results?)
Providers are to do whatever is in the best
interest of the patient…
The right to life, liberty and the pursuit
of happiness. Individual patient
autonomy trumps everything. You
must respect the beliefs of your
(We can respect autonomy without having to respect the belief system.
As a profession there are times we disrespect autonomy, i.e. suicide)
Privatized religious or value claims are
to be understood within the patients
explanatory model (but not the
biomedical model). Spirituality is a
good, as long as it is in the image of
medicine (sterile, impersonal,
dichotomized, scientifically validated,
The almighty dollar shapes medical
practice and therefore ethics. We define
what we do as the market share instructs
us to do so.
(Oz is unveiled. Is the dollar the “divine presence”?)
In order to speak the whole truth, one must always say two
things; in which God one believes and in which idol one does
not believe, Without such a dialectic formulation, faith remains
too abstract, it is likely to be empty and, what is worse, can be
very dangerous, because it may very well allow for the
coexistence of belief and idolatry.
Moreover, I have learned that to have faith in God means to do
the will of God, to follow Jesus with the Spirit of Jesus in the
cause of God's kingdom...”
Jon Sobrino. The Principle of Mercy. pg 9. Orbis Books.
Maryknoll, NY 1992