By Stacey Kusterbeck
Almost a decade ago, Cynthia Geppert, MD, PhD, DPS, adjunct professor of bioethics at the Alden March Bioethics Institute (AMBI) at Albany Medical College, noticed that few graduate bioethics programs included a course addressing religion and spirituality. The notable exception were programs affiliated with a specific religious tradition, such as Catholic or Jewish bioethics.
This realization led to Geppert co-developing a religion and bioethics course in 2018. “We sensed that there weren’t too many courses like ours in bioethics programs. But we struggled to find any published data,” says Daniel T. Kim, PhD, MPH, an assistant professor at AMBI.
Some of the earliest ethicists were theologians and religious scholars. In recent years, the bioethics field has become more secularized, distancing itself from religious roots as it evolved into a distinct area of study and professionalization. “Bioethics and religion and spirituality have a complicated history and relationship. The relationship is contested, with scholars arguing for and against the role of religion and spirituality in the field, and often taking polarized positions,” says Geppert.
This controversy is relevant largely in academic settings, however. In clinical settings, ethicists routinely consult on questions about religion and spirituality. Many ethics consults involve patients wrestling with questions of meaning and worth, for example. “Moreover, many of our most fraught bioethics policy issues, such as medical aid in dying and abortion, also have religious and spiritual implications,” says Geppert.
For Geppert and colleagues, this disconnect raised some questions: Are bioethicists being trained adequately to address religious and spiritual concerns? And, if not, what more should be done to prepare them? The researchers conducted a literature review, surveyed bioethics programs, and analyzed course content.1 Some key findings:
- Some publications addressed religion and spirituality in undergraduate medical education. However, few papers addressed religion and spirituality specifically in the field of bioethics.
- There were few religion and spirituality course offerings in bioethics programs.
- Courses in bioethics programs covered public health, clinical care, empirical research, diverse religious perspectives, and theoretical considerations.
“These domains reflect much of what’s discussed in the literature and at conferences,” observes Kim. Courses focused on the need to understand diverse positions on bioethical controversies and the need to manage cases involving religiously based refusals of care (such as Jehovah’s Witnesses refusing a blood transfusion).
In Kim’s view, limiting course content to these areas is missing the bigger picture: “The significance of religion and spirituality in healthcare is far deeper and broader than simply a problem to be accommodated or challenged.”
Ethicists can address this by specifically inviting people to share their religious and spiritual concerns. “Patients, families, or clinicians may fear that concerns about religion and spirituality will be dismissed or even ridiculed. Ethicists can consider these concerns in their assessment, and offer support and referral to chaplains as appropriate,” says Geppert.
To do this effectively, ethicists need strong relationships with the spiritual care department and hospital chaplains. Just as chaplains consult ethicists when there are value conflicts, most ethicists are not experts in theology and, therefore, may need to consult chaplains. “Collaboration on complex ethics cases involving religious and spiritual concerns should be encouraged, to improve the institution’s responsiveness to patient needs,” suggests Kim.
Reference
- Kim DT, Ostrowski TJ, Geppert CMA. Why study religion and spirituality in bioethics? Results of a survey of courses in graduate bioethics programs in the USA. J Relig Health. 2024; Dec 30. doi: 10.1007/s10943-024-02201-6. [Online ahead of print].
Almost a decade ago, Cynthia Geppert, MD, PhD, DPS, adjunct professor of bioethics at the Alden March Bioethics Institute at Albany Medical College, noticed that few graduate bioethics programs included a course addressing religion and spirituality. This realization led to Geppert co-developing a religion and bioethics course in 2018.
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