Reconsidering spirituality and medicine.

Increasing awareness of possible links between religion and health has led to greater attention to spirituality and medicine in medical education; both trends have culminated in vigorous debate about the place of spirituality and related values in medical care. The author argues that due to basic ambiguities of the term "spirituality" as well as prevailing biases of both patients and practitioners, this debate risks valorizing theistic religious views, a trend that would be to the detriment of physicians, residents, and students who happen to be non-believers or adherents of minority faiths. It is maintained that philosophical value theory, a broad inquiry into value and meaning that is carefully neutral as regards religious matters, provides the greatest possible protection of both secular and non-secular world views. A notion of "separation of church and medicine," similar in some ways to the well-known political model, is proposed. Because so many issues of meaning and value may be relevant to health, vigilance is required to properly delineate the purview of medicine. The author concludes by proposing that a medicine that neither exalts nor demeans religious belief but rather situates the latter among the countless values persons may hold should be the goal.