Scheurich Neil
Department of Psychiatry, University of Kentucky College of Medicine, Lexington 40509-1810, USA.
Acad Med. 2003 Apr;78(4):356-60. doi: 10.1097/00001888-200304000-00005.
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.
人们越来越意识到宗教与健康之间可能存在的联系，这使得医学教育更加关注精神层面与医学的关系；这两种趋势最终引发了关于精神层面及相关价值观在医疗中所处地位的激烈辩论。作者认为，由于“精神层面”一词基本含义模糊，以及患者和从业者普遍存在的偏见，这场辩论有可能使有神论宗教观点得到推崇，而这种趋势将对碰巧是非信徒或少数派宗教信徒的医生、住院医生和学生不利。有人认为，哲学价值理论，即对价值和意义进行的广泛探究，在宗教问题上保持谨慎中立，能为世俗和非世俗世界观提供最大程度的保护。文中提出了一种“教会与医学分离”的理念，在某些方面类似于著名的政治模式。由于如此多的意义和价值问题可能与健康相关，因此需要保持警惕以恰当地界定医学的范畴。作者最后提议，一种既不抬高也不贬低宗教信仰，而是将宗教信仰置于人们可能持有的无数价值观之中的医学，应该成为目标。
