Religion & science: bridging the gap.

From the Terri Schiavo controversy to the stem-cell debate to the conflict over intelligent design, 2005 was rife with contentious issues that portrayed religion and science as wholly separate and competing realms of thought and experience.

Two stories challenge that characterization. In each, religious belief has prompted empirical research, and empirical research has informed religious belief. More important, the creative interplay between religion and science helped to shape consensus among partisans on opposite sides of the debate.

The first story concerns Oregon's physician-assisted suicide law, which is now before the U.S. Supreme Court. The Catholic Church fought the 1994 ballot measure that put the law on the books, and once it took effect, the church prohibited its hospitals from providing lethal medication to terminally ill patients. But it did more than oppose the law. Catholic hospitals, including Providence Health System, the largest provider in Oregon, led the way in a movement for better end-of-life care, including more effective pain and symptom management, spiritual counseling, family support, and patient involvement in care decisions. (Subsequently, a national survey of nearly four thousand hospitals reported that Catholic hospitals were far ahead of other religious, for-profit, and publicly owned hospitals in providing advanced therapies for the terminally ill).

Meanwhile, researchers at the Oregon Health Science University, who had nothing to do with the Catholic Church, were discovering, through their own surveys, that people who chose physician-assisted suicide did so out of fear of pain, loss of autonomy, loss of dignity, and worries about burdening their families. The Catholic model, which offered a medically sound approach to dealing with these concerns, appealed to many medical professionals as a better way to care for dying patients than writing prescriptions for lethal doses of barbiturates. As Dr. Linda Ganzini, a professor at the Oregon Health Science University who surveyed physicians, noted in an interview on National Public Radio: "it was the Catholic hospitals who led the charge because, for them, the best way not to have to worry about a patient requesting assisted suicide was to have very comprehensive end-of-life care. And we were surprised when we surveyed physicians how seriously they took it. And interestingly, they found care of dying patients more emotionally and intellectually satisfying than they had in previous years." Thus, whether the Oregon law stays or goes, the trend among health professionals has shifted in the direction of improving the care of the dying rather than championing physician-assisted suicide.

Then there's the story of Brian Skotko, as told by the Wall Street Journal. He has a sister with Down syndrome who represents the new face of the condition. At twenty-five, Kristin has a fistful of medals for her athletic prowess and works three part-time jobs. While co-authoring a book on the achievements of people like his sister, Skotko heard from mothers who had similarly successful children. But as the Journal notes: "Many also recounted the painful way they learned the diagnosis." Now a Harvard medical student, Skotko set out to learn more about the ways in which doctors present a diagnosis of Down syndrome. He developed a survey that drew responses from 1,250 mothers.

A majority said that their doctors had cast the news in a negative light. A physician might begin: "Unfortunately, I have some bad news to share," and then go on to a bleak prognosis. One mother was told that her child would never be able to read, write, or count change. Few doctors offered an up-to-date description of how capable a person with Down syndrome can be. Few provided referrals to parent-support groups or other resources. Some gave mothers the diagnosis over the phone rather than in person.

Finally, as the published study reported, "many of the mothers who responded to this survey ... were upset when their physicians provided detailed descriptions of pregnancy terminations without knowing whether they would like those options discussed." Of the 141 mothers who had prenatal diagnosis, "about half felt rushed or pressured into making a decision about continuing the pregnancy."

Skotko, a Catholic, is opposed to abortion (he makes an exception to save the life of the mother), but he isn't looking to get into the abortion debate. His mission is to encourage obstetricians and genetic counselors to provide parents of Down syndrome children with accurate and hopeful news about their potential and future life courses. At the same time, though, his work has inspired a partnership between two Catholic legislators who are on opposite sides of the abortion debate. Senators Ted Kennedy (D-Mass.) and Sam Brownback (R-Kans.) have sponsored a bill to provide federal dollars for more accurate information and support for pregnant women who receive a prenatal diagnosis of Down syndrome or other genetic conditions.

How much credit to give to the insights of religion and how much credit to give to the findings of science in each of these stories remains an open question. What is clear, though, is that both realms were at work in moving toward conciliation and consensus on two issues that more often divide people than bring them together.