The Pastoral Role of the Physician
Bailey Sanford, MEd, Student, Duke Divinity School
The decline in religious affiliation and, in particular, participation in religious services, has been well documented, with regular attendance religious service attendance falling to an all-time low of 50% of the US population attending service at least once per month. This decline is even more marked in other parts of the world. Take, for example, the United Kingdom, where the 2005 English Church census showed the 94% of the UK population do not regularly attend religious services. It used to be the case that a parish minister would care for a family from the cradle to the grave. They would have known of discord within the family and would be called upon for counsel in times of grief and bereavement. With the decline of the influence and social role of the parish minister, some of these same responsibilities can fall upon physicians– particularly those working in primary care. Although traditional family practice doctors are less common today, they find themselves in a role similar to the parish ministers of old: they care for individuals and families from the cradle to the grave and while they are certainly in no position to provide religious absolution, they are often privy to the illicit behaviors of their patients given the confidential relationship between doctor and patient.
In the hauntingly beautiful book When Breath Becomes Air, Paul Kalanithi, writing near the end of his life, reflects on the path that he has taken and how his passions for literature, science, medicine, and religion coalesced into his career as a neurosurgeon and a writer. He muses that perhaps what he had been seeking all along was “the pastoral role” of the physician. Kalanithi never spells out precisely what he understands this “pastoral role” to be, or how he sees physicians filling this role, but his life– and the lives of countless other physicians– and patients can give us insight. As medicine has advanced to become more and more dependent upon technological advancement and algorithmic risk assessment, there seems to be less room in the medical arena for humanistic practices of caring and healing. In this essay, I hope to draw from the rich histories and traditions of both medicine and pastoral care in order to define the “pastoral role” that Kalanithi sought in a way that is applicable in the 21st century.
I argue that the modern physician ought to be fundamentally bi-vocational, serving in a medical role– providing the highest level of medical care in order to alleviate unnecessary suffering and promote health– and also in a pastoral role, bearing the responsibility for understanding the spiritual and pastoral needs of those they care for. I also argue that given a robust understanding of health and healthcare, these two roles become inextricably intertwined in the physician’s practice.Christian bioethics is the result of the interaction of medicine and the most widespread traditional religion in the world – Christianity. This report's goal is to discuss the specifics and perspectives of this area of bioethical research within the framework of Russian public health, medical science and education.
The decline in religious affiliation and, in particular, participation in religious services, has been well documented, with regular attendance religious service attendance falling to an all-time low of 50% of the US population attending service at least once per month. This decline is even more marked in other parts of the world. Take, for example, the United Kingdom, where the 2005 English Church census showed the 94% of the UK population do not regularly attend religious services. It used to be the case that a parish minister would care for a family from the cradle to the grave. They would have known of discord within the family and would be called upon for counsel in times of grief and bereavement. With the decline of the influence and social role of the parish minister, some of these same responsibilities can fall upon physicians– particularly those working in primary care. Although traditional family practice doctors are less common today, they find themselves in a role similar to the parish ministers of old: they care for individuals and families from the cradle to the grave and while they are certainly in no position to provide religious absolution, they are often privy to the illicit behaviors of their patients given the confidential relationship between doctor and patient.
In the hauntingly beautiful book When Breath Becomes Air, Paul Kalanithi, writing near the end of his life, reflects on the path that he has taken and how his passions for literature, science, medicine, and religion coalesced into his career as a neurosurgeon and a writer. He muses that perhaps what he had been seeking all along was “the pastoral role” of the physician. Kalanithi never spells out precisely what he understands this “pastoral role” to be, or how he sees physicians filling this role, but his life– and the lives of countless other physicians– and patients can give us insight. As medicine has advanced to become more and more dependent upon technological advancement and algorithmic risk assessment, there seems to be less room in the medical arena for humanistic practices of caring and healing. In this essay, I hope to draw from the rich histories and traditions of both medicine and pastoral care in order to define the “pastoral role” that Kalanithi sought in a way that is applicable in the 21st century.
I argue that the modern physician ought to be fundamentally bi-vocational, serving in a medical role– providing the highest level of medical care in order to alleviate unnecessary suffering and promote health– and also in a pastoral role, bearing the responsibility for understanding the spiritual and pastoral needs of those they care for. I also argue that given a robust understanding of health and healthcare, these two roles become inextricably intertwined in the physician’s practice.Christian bioethics is the result of the interaction of medicine and the most widespread traditional religion in the world – Christianity. This report's goal is to discuss the specifics and perspectives of this area of bioethical research within the framework of Russian public health, medical science and education.