Proselytizing a Disenchanted Religion to Medical Students: On Why Secularized Yoga and Mindfulness Should Not be Required in Medical Education
Mark Wells, Student (MD/MA, bioethics), M.D. candidate (expected 2018), The Ohio State University College of Medicine
Ryan Nash, M.D., M.A., Director, Center for Bioethics and Medical Humanities, The Ohio State University
Since the 1990s, medical educators have strived to integrate complementary and alternative medicine (CAM) into medical school curriculums in the United States. Motivated by National Institute of Health recommendations, approximately half of American programs have implemented coursework in CAM to supplement the biomedical model of health. Curriculums vary in how this coursework is integrated into student education, from teaching students on how to integrate CAM practitioners into care plans to providing student self-care sessions. This education merits attention due to not only the effectiveness of CAM practices in promoting well-being, but also the historical religions from whence these therapies originate. As examples, the history of yogic and mindfulness practices will be examined here to elucidate whether such practices ought to be integrated into medical education, and if so, in what manner.
Each with geographical origins in the Indian subcontinent, yoga and mindfulness are historically linked to the religious practices of Hinduism and Buddhism. Yoga integrates body posturing with simple meditations in efforts to achieve harmony of body and mind. Within these practices, various spiritual forces or beings may be invoked, whether by posture or word, e.g., Kundalini yoga’s awakening of a serpentine power; mantric repetition om, referencing Brahman; etc. Practitioners introduced yoga to Europe and the Americas in the late nineteenth century, with subsequent popularization in the late twentieth century. Drawing primarily from hatha yoga, contemporary practices have been used to complement treatment of physical and mental health conditions of both medical practitioners and patients. Mindfulness derives from the Sanskrit term sati, which refers to recollection and acquisition of insight regarding the value of objects or ideas, and constitutes one element of the Buddhist noble eightfold path. Its modern medicalization can be traced to Jon Kabat-Zinn’s opening of Stress Reduction Program in the mid-twentieth century, which supported the spread of mindfulness to other hospital systems. Applications of mindfulness have included treatment of psychiatric conditions such as substance use disorder, depression, and anxiety, as well as prevention of burnout among students and clinicians.
Due to these practices’ histories, traditional religious groups such as conservative Islam, Orthodox Judaism, and Roman Catholicism object to their adherents’ participation. To understand these objections, the specific case of Orthodox Christianity will be considered regarding its grounds for prohibition in engaging these practices. While secular medicine assumes a state of disenchantment in these practice once uprooted from their respective traditions, this presupposition is not shared by Orthodox Christians, who would claim that their participation in secularized versions constitutes engagement with destructive spiritual realities. In light of these considerations, medical schools should not integrate instruction on yoga or mindfulness for patient or student practice within required studies, but instead, should focus on how contemporary physicians ought to interact with CAM practitioners.
Ryan Nash, M.D., M.A., Director, Center for Bioethics and Medical Humanities, The Ohio State University
Since the 1990s, medical educators have strived to integrate complementary and alternative medicine (CAM) into medical school curriculums in the United States. Motivated by National Institute of Health recommendations, approximately half of American programs have implemented coursework in CAM to supplement the biomedical model of health. Curriculums vary in how this coursework is integrated into student education, from teaching students on how to integrate CAM practitioners into care plans to providing student self-care sessions. This education merits attention due to not only the effectiveness of CAM practices in promoting well-being, but also the historical religions from whence these therapies originate. As examples, the history of yogic and mindfulness practices will be examined here to elucidate whether such practices ought to be integrated into medical education, and if so, in what manner.
Each with geographical origins in the Indian subcontinent, yoga and mindfulness are historically linked to the religious practices of Hinduism and Buddhism. Yoga integrates body posturing with simple meditations in efforts to achieve harmony of body and mind. Within these practices, various spiritual forces or beings may be invoked, whether by posture or word, e.g., Kundalini yoga’s awakening of a serpentine power; mantric repetition om, referencing Brahman; etc. Practitioners introduced yoga to Europe and the Americas in the late nineteenth century, with subsequent popularization in the late twentieth century. Drawing primarily from hatha yoga, contemporary practices have been used to complement treatment of physical and mental health conditions of both medical practitioners and patients. Mindfulness derives from the Sanskrit term sati, which refers to recollection and acquisition of insight regarding the value of objects or ideas, and constitutes one element of the Buddhist noble eightfold path. Its modern medicalization can be traced to Jon Kabat-Zinn’s opening of Stress Reduction Program in the mid-twentieth century, which supported the spread of mindfulness to other hospital systems. Applications of mindfulness have included treatment of psychiatric conditions such as substance use disorder, depression, and anxiety, as well as prevention of burnout among students and clinicians.
Due to these practices’ histories, traditional religious groups such as conservative Islam, Orthodox Judaism, and Roman Catholicism object to their adherents’ participation. To understand these objections, the specific case of Orthodox Christianity will be considered regarding its grounds for prohibition in engaging these practices. While secular medicine assumes a state of disenchantment in these practice once uprooted from their respective traditions, this presupposition is not shared by Orthodox Christians, who would claim that their participation in secularized versions constitutes engagement with destructive spiritual realities. In light of these considerations, medical schools should not integrate instruction on yoga or mindfulness for patient or student practice within required studies, but instead, should focus on how contemporary physicians ought to interact with CAM practitioners.