Is There a Moral Difference Between Pseudoscientific and Religious Healing Practices?
Abraham Graber, PhD, The Ohio State University, Columbus, OH, and Allison Maguire, The University of Texas at San Antonio, San Antonio, TX
Healing practices are a central component of nearly every culture and religion. The range of religious healing rituals is quite broad. For example, the Ua Neeb Khu is a Hmong healing ritual, built on an animist religious foundation, that involves a shaman traveling between the physical and spiritual world to entice a patient’s soul to return. Likely closer to home, the Mi Shebeirach is a Jewish prayer for healing, often led by the Rabbi and song by the congregation. A Rabbi leading the congregation in a prayer for healing, or a shaman performing the Ua Neeb Khu, both seem like paradigmatic cases of morally permissible behavior.
Intuitively, these kind of religious healing practices stand in contrast with pseudoscientific complementary or alternative medicine (CAM). Consider, for example, quantum healing hypnosis therapy (QHHT). QHHT practitioners hold that “the Subconscious has the ability to identify any physical problem it detects within the body to a practitioner and explain the causes for its presence, be it from the current life or a past life.” QHHT practitioners thus hypnotize their patients to put them in direct contact with their subconscious. Once a physical problem has been detected, it can putatively be cured via the “Subconscious."
In contrast with the Mi Shebeirach and the Ua Neeb Khu, QHHT is intuitively deeply morally problematic. Not only does QHHT fail to address biomedical pathologies, there is no plausible mechanism by which QHHT could be effective. This snake-oil is, however, far from cheap. A single QHHT session is in the ballpark of $300 for 4 hours; or approximately $75 per hour. The financial cost of QHHT is, however, only a fraction of the harm done. Patients convinced of the therapeutic value of CAM interventions may forego biomedical treatment. The patient who, at the exclusion of biomedical treatment, relies on QHHT to cure her cancer, AIDs, or diabetes will suffer far more than mere financial harm.
The literature includes a number of extant explanations of why practices like QHHT are unethical. In each case, the ineffectiveness of the intervention (or lack of evidence regarding effectiveness) constitutes the core of the criticism. Thus, some CAM therapies have been criticized on the grounds that practitioners may violate patients’ autonomy by claiming, without substantiating empirical evidence, to be able to provide therapeutic benefits; some CAM therapies have been criticized on the grounds that, because many CAM therapies are of questionable therapeutic efficacy, practitioners fail to fulfill their obligation of beneficence; and some CAM therapies have been criticized on the grounds that it is unjust to allocate resources to therapeutically ineffective interventions. Though each of these criticisms draws on a distinct ethical principle (autonomy, beneficence, and justice respectively), each criticism bottoms out in the primary concern that various CAM interventions do not work (or have not been shown to work).
Extant criticisms of pseudoscientific healing practices like QHHT are based on the fact that pseudoscientific healing practices are not effective. These criticisms will, consequently, apply equally well to any traditional healing practice that does not cure biomedical pathology, e.g., the Mi Shebeirach and the Ua Neeb Khu. Our best explanations of the impermissibility of pseudoscientific CAM like QHHT thus appears to entail that religious healing practices like the Mi Shebeirach and the Ua Neeb Khu are similarly impermissible. This is, however, an untenable result. While not all religious healing rituals are morally permissible, many clearly are. A more nuanced criticism of pseudoscientific CAM is thus needed.
Building on the internal morality of medicine, we aim to provide an account of the impermissibility of pseudoscientific CAM that does not overgeneralize. The difference, at heart, is that pseudoscientific CAM and religious healing practices rely on distinct notions of healing. Pseudoscientific CAM claims to provide biomedical healing, which it does not. By contrast, (many) religious healing traditions claim to provide a different kind of healing. Many religious healing traditions are thus effective at accomplishing their ends, in a way that pseudoscientific CAM is not.
Intuitively, these kind of religious healing practices stand in contrast with pseudoscientific complementary or alternative medicine (CAM). Consider, for example, quantum healing hypnosis therapy (QHHT). QHHT practitioners hold that “the Subconscious has the ability to identify any physical problem it detects within the body to a practitioner and explain the causes for its presence, be it from the current life or a past life.” QHHT practitioners thus hypnotize their patients to put them in direct contact with their subconscious. Once a physical problem has been detected, it can putatively be cured via the “Subconscious."
In contrast with the Mi Shebeirach and the Ua Neeb Khu, QHHT is intuitively deeply morally problematic. Not only does QHHT fail to address biomedical pathologies, there is no plausible mechanism by which QHHT could be effective. This snake-oil is, however, far from cheap. A single QHHT session is in the ballpark of $300 for 4 hours; or approximately $75 per hour. The financial cost of QHHT is, however, only a fraction of the harm done. Patients convinced of the therapeutic value of CAM interventions may forego biomedical treatment. The patient who, at the exclusion of biomedical treatment, relies on QHHT to cure her cancer, AIDs, or diabetes will suffer far more than mere financial harm.
The literature includes a number of extant explanations of why practices like QHHT are unethical. In each case, the ineffectiveness of the intervention (or lack of evidence regarding effectiveness) constitutes the core of the criticism. Thus, some CAM therapies have been criticized on the grounds that practitioners may violate patients’ autonomy by claiming, without substantiating empirical evidence, to be able to provide therapeutic benefits; some CAM therapies have been criticized on the grounds that, because many CAM therapies are of questionable therapeutic efficacy, practitioners fail to fulfill their obligation of beneficence; and some CAM therapies have been criticized on the grounds that it is unjust to allocate resources to therapeutically ineffective interventions. Though each of these criticisms draws on a distinct ethical principle (autonomy, beneficence, and justice respectively), each criticism bottoms out in the primary concern that various CAM interventions do not work (or have not been shown to work).
Extant criticisms of pseudoscientific healing practices like QHHT are based on the fact that pseudoscientific healing practices are not effective. These criticisms will, consequently, apply equally well to any traditional healing practice that does not cure biomedical pathology, e.g., the Mi Shebeirach and the Ua Neeb Khu. Our best explanations of the impermissibility of pseudoscientific CAM like QHHT thus appears to entail that religious healing practices like the Mi Shebeirach and the Ua Neeb Khu are similarly impermissible. This is, however, an untenable result. While not all religious healing rituals are morally permissible, many clearly are. A more nuanced criticism of pseudoscientific CAM is thus needed.
Building on the internal morality of medicine, we aim to provide an account of the impermissibility of pseudoscientific CAM that does not overgeneralize. The difference, at heart, is that pseudoscientific CAM and religious healing practices rely on distinct notions of healing. Pseudoscientific CAM claims to provide biomedical healing, which it does not. By contrast, (many) religious healing traditions claim to provide a different kind of healing. Many religious healing traditions are thus effective at accomplishing their ends, in a way that pseudoscientific CAM is not.