Journal of General Internal Medicine

, Volume 20, Issue 4, pp 370–374

Strangers or friends?

A proposal for a new spirituality-in-medicine ethic


We argue that debate regarding whether and how physicians should engage religious concerns has proceeded under inadequate terms. The prevailing paradigm approaches dialogue regarding religion as a form of therapeutic technique, engaged by one stranger, the physician, upon another stranger, the patient. This stranger-technique framework focuses the debate on questions of physicians’ competence, threats to patients’ autonomy, and neutrality regarding religion, and in so doing, it too greatly circumscribes the scope of physician-patient dialogue. In contrast, we argue that dialogue regarding religion is better approached as a form of philosophical discourse about ultimate human concerns. Such moral discourse is often essential to the patient-physician relationship, and rather than shrinking from such discourse, physicians might engage patients regarding religious concerns guided by an ethic of moral friendship that seeks the patient’s good through wisdom, candor, and respect.

Key words

medical philosophy physician-patient relations ethics religion and medicine spirituality 


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Copyright information

© Society of General Internal Medicine 2005

Authors and Affiliations

  1. 1.Section of General Internal Medicine, Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Department of SurgeryUniversity of PittsburghPittsburghUSA
  3. 3.Duke University Medical CenterDurhamUSA

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