Praying for patients? God help us.

Via the Press Association, the BBC has been reporting the motion to be discussed by the BMA conference that would explicitly seek to allow doctors to offer to pray for their patients.  The full text of the motion is available via the Christian Medical Fellowship’s website.

Right.  Go and make a cup of tea.  We could be here a while.

Back?  Good.

Here we go.  Let’s deal with the BBC’s reportage first, before we get to the substantive issues – and let’s start at the end, with a part of the quotation from Joyce Robins, the co-director of patient concern:

Offering to say a prayer is a warm and kind thought. Most patients will accept it as such. It is no more offensive than being offered a sleeping pill. You can say thanks but that sort of thing isn’t my cup of tea.

I want to raise this now because its good to get the offence point out of their way.  In normal circumstances, having someone offer prayer is not something that right-minded peiople would consider offensive.  To take offence at this would be idiotic.  And, in fact, I doubt that anyone ever has been offended by such a move: we might think it daft, or empty, or whatever – but the sentiment behind it is clearly praiseworthy.  (There’s an echo here of the “Political Correctness Gone Mad” scare stories about Christmas being banned in various town centres for fear of offending Muslims.  Not only has this never happened, but anyone who was seriously upset by a banal good wish for the Solstice Saturnalia Christmas clearly doesn’t have the first idea about minimally decent human interaction.)

We shouldn’t be harping on about the offence canard, because its not even a remotely plausible objection to offers of prayer.  And there are many, many more much better objections to be had.

One objection has to do with the incongruity of medics taking god on the ward round with them.  I know that there are many medics who, if not religious in a tubthumping way, are believers.  Having been raised both CofE and sickeningly middle-class, I’ve met a fair few of them.  But I’ve never really been able to square a supposedly naturalistic and evidence-led discipline like medicine with the evidence-free la-la land of god.  A doctor’s profession involves medium-sized solid objects like people and parasites, and the training presumably takes account of the undesirability of introducing to explanations of the world stuff you don’t need and of continuing to believe in things for which there’s no evidence (and, no, a face on a piece of toast, or the fortuitous arrangement of aubergine seeds to look like the word “Allah”, if you squint a bit and use your imagination, do not count as evidence).  Belief in deities simply does not fit with the methodological approach upon which the practice of medicine seems to rely.  Faith without evidence is a vice.

Admittedly, though, this doesn’t address the issue at hand, because there’s a difference between having a supernaturalistic belief, and offering to pray for patients.  The former is odd; the latter is pernicious.

For one thing, a medic who offers to pray for patients seems to be admitting that he doesn’t trust his training to do the job of curing, but that if he has a quiet word with his invisible best mate – a best mate who, incidentally, presently seems to favour whatever germ it is that’s making you excrete blood right now – things could be different.  Well, nuts to that.  I want my doctor to know his way around the medicine cabinet.  I want him to go to the evidence – and if the evidence is that I’m going to lose this fight, I want him to be honest with me.  Either the medicine’ll work, or it won’t.  Praying simply is not a catalyst – much less is it a substitute.

Ahhh, the defence might be, but prayer isn’t about cure; it’s about a particular kind of care for the patient.  That is what it’s good for.

No.

First up, this doesn’t begin to explain why doctors need the right to offer to pray.  If they think that they can’t care adequately without praying, then let them pray all they want.  But offering to pray is something else entirely: in essence, it’s tantamount to wandering up and down the ward wearing a white coat with the slogan “LOOK AT ME, CARING FOR YOU” embroidered in sequins across the back.  If you care, that’s great.  But caring is a quiet, dignified attitude.  It’s not something that needs patient approval, and it’s not something that has – or ought – to be trumpeted publicly, because public trumpeting is not care at all: it’s vulgar self-congratulation.

Besides: the implication of a public offer of prayer as part of the caring relationship is that atheist doctors – or those believers who have a bit of dignity – don’t care as much for their patients, because they aren’t offering to pray.  That’s clearly nonsense, and mendacious, anti-collegial and well-poisoning nonsense at that.

Moreover, there’ll likely as not be times when patients are confused and scared – perhaps they’re elderly, and they know that they don’t have long to live.  Doctor number one comes along and offers to pray.  He’s a lovely doctor.  He cares so much.  But that other doctor?  No.  She doesn’t like me.  She didn’t even offer to say a prayer for me.

Result?  A much more confused and scared patient, directly because of the napalm-spirituality of the first tambourine-botherer doctor.

Let’s keep our attention on the patients.  Imagine you’re in hospital and your doctor offers to pray for you.  We can productively ask whether the offer is a genuine one, or a pseudo-offer; and the latter seems more likely, because it’s not the kind of “offer” that you can really refuse.  You’re ill, you’re a bit vulnerable, you don’t want to upset your doctor because, right now, you’ve got better things on your mind than theology – things like the blood you’ve been excreting.  Besides – what kind of person would be so cold as to refuse a kind offer like that?  (Remember, that in your state you’re not going to notice the slightly masturbatory nature of the offer, and it’s not something about which you’d want to make a fuss right now anyway.)  So, in effect, you’ve been corralled into a kind of relationship with your physician that you never really wanted, and which you may well not have chosen.  To this extent, Robbins is wrong in the quotation above: it’d be very hard in practice to say, “Thanks but no thanks.”  An offer of prayer is not – or not just – an invasion of your privacy: it’s a gleeful trampling of your integrity.

This is not, pace the proposer of the motion, Bernadette Bertwhistle, an issue of free speech (“Freedom of speech,” she says in the BBC article, “is being curtailed too much and I don’t think that is always in the benefit of patients”), since offering to pray for someone is something that doctors should not be doing, for the reasons I’ve outlined above.  (Is it just me, or can anyone else smell burning martyr?)  Freedom of speech is not served by stamping your foot and demanding the right to pollute the patient’s mind with whatever happens most recently to have crossed yours.  Freedom of speech in the positive sense is one thing; but, just as we use the phrase “free of cancer” to mean “free from cancer”, there’s a sense in which freedom of speech has to accommodate freedom from speech.

This is a point that is touched on by the Patient Concern representative in the Beeb’s article:

[I]f Christian doctors see this as an opportunity to promote their faith to people at a time when they are particularly vulnerable, that is totally unacceptable.

Amen to that.

Just in case we forgot what all this was about, here’s the motion as reproduced on the Christian Medical Fellowship’s website.  My comments are in bold.

That this Meeting:

(i) recognises that the NHS is committed to providing spiritual care for patients;

I have no idea what this means.  What is “spiritual” care?  And why in the name of all that some people think holy is it the NHS’ business?

(ii) notes the position on inappropriate discussion of faith matters in GMC Guidance on Personal Beliefs and Medical Practice;

Notes grudgingly, I suspect…  After all, parts of this guidance are clearly against offers of prayer.

(iii) while welcoming the constructive and necessary advice in the document “Religion or belief“, is concerned that some paragraphs suggest that any discussion of spiritual matters with patients or colleagues could lead to disciplinary action;

Incidentally – I’ve had to update the links myself.  The CMF links are a bit circuitous, and ensure that you have to wade through a lot of CMF pages before you get to the documents in question.

(iv) believes that offering to pray for a patient should not be grounds for suspension;

It’s pernicious, mendacious and – presumably – a waste of time, of which there’s little enough on a busy ward.  That looks like very poor practice to me.  I’m not sure whether suspension’s the answer, but something disciplinary seems to be in order…

(v) calls on Health Departments to allow appropriate consensual discussion of spiritual matters within the NHS, when done with respect for the views and sensitivities of individuals.

But, you see, there’s nothing consensual about it.  You’d be interrupting me to talk about god.  Even opening your mouth about god means its too late for me to do anything about it.  You just don’t get it, do you?

If there really was a benevolent and omnipotent deity watching over us, he’d never have allowed the motion to have got to the conference.

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