September/October 2008 The importance of faith I normally don't write to editors of magazines. However, after reading the article "Healing and Saving:  Can Religion and Medicine Get Along?" by David Goodman (July/August 2007), I felt I needed to respond to this article. I am one who is responding with some experience in medicine, for I am a family physician who has been in practice 15 years post residency, and I currently hold the position of President of the Medical Staff of my local hospital. I am also deeply rooted in my faith in Jesus Christ and committed to providing care to those in need.  I find that my faith has had a positive impact on how I practice medicine and in no way has there been a conflict between my faith and the medicine I practice. Furthermore, the care of the sick has been carried out in the name of Christ throughout history. In my own life, it is in faith that I find the very reason to practice medicine in the first place. Hence, I take offense when people like Guadalupe Benitez make statements such as, "If you are going to provide services for one person, you have to provide them for all. If you can't accept that, maybe you shouldn't be in the medical field." Mr. Goodman placed this statement at the end of his article. Hence, he himself likely supports this statement. This statement implies that a physician's religious beliefs should have no influence in his or her practice of medicine.  Ms. Benitez not only does not understand that in today's world of medicine everyone does not get the same service (which I know is not always fair-and that is another issue to discuss at a different time), but she also does not understand that those who do provide the care to those in need are themselves individuals with rights and freedom of thought. As for myself, I would not want to go to a physician who did not consider how God has uniquely made me, for I may not benefit from the same treatment plan as someone else may. Individuals, both patients and physicians, are uniquely created by God and require specific treatment measures. Furthermore, these treatment measures need to be provided in the light of the practitioner's own religious beliefs.  More specifically, with regards to faith in my own practice, I find that many people's problems stem from a poor relationship with God, and that when the timing is appropriate, not only will I treat the patient's disease process, but lead them to an understanding of how much God loves them and values them and that their lives can be made whole in Christ.  Finally, not only does religion play a large role in medicine's origins, help mold how medicine is practiced, provide the necessary backdrop on how to treat each patient as individuals, but religion provides the very reason to provide these services to those in need. People are individually valued by God and therefore I can value each patient I see individually and provide the correct service for that patient, and that service will be modified by my faith. Contrary to the above article's bias, I know that I should be in medicine and that my faith has been integral to how I practice medicine. I will state that not only can religion and medicine coexist, medicine cannot even exist without religion.  Thank you for reading this editorial response of mine and if you feel it is appropriate, you can publish this letter, for I believe there are many in the field that would support what I have said. Luke A. Elliott, MD Grosse Pointe Park, MI   A telling response Just wanted to write you in response to Vicki Martin's response in "Letter's From You" in the September/October issue of Unique Opportunities. I enjoyed your recent article, by the way. The fact that Dr. Martin is so adamant on her views about abortion is saddening. I would hope that most physicians practicing nowadays have enough sense and obligation to their patients that they can set aside their personal views when it comes to treating each individual person. Although many do not agree with abortion, IV drug use, smoking, or even drinking, we still do our best to treat these individuals who make these choices and attempt to do so without prejudice. By not referring someone for a legal procedure based on one's personal belief makes me wonder if she has at some point purposely withheld medical information to someone in order to maintain her own belief, thereby treating herself and not the patient. And, on a more spiteful note, I doubt that losing her subscription matters much being that she appears so closed minded. Pedro Ramos San Diego, CA

Add End-of-life Care to the Debate Thank you for exploring the often ignored problem of health-care providers failing to provide full information, services, or even referrals to their patients if the patient seeks care which conflicts with the provider’s personal, moral, or religious views. (“Can Religion and Medicine Get Along?” by David Goodman, July/August 2007) Your article did not discuss how this problem arises in end-of-life care. In the same study conducted by Dr. Curlin, which was discussed in the article, researchers found that a significant percent of physicians refuse to provide palliative sedation or make a referral for this care, on “conscience” grounds. (Curlin et. al., “Religion, Conscience, and Controversial Clinical Practices,” 356 New Eng. J. Med. 593 (2007)). Palliative sedation is the use of medication to induce sedation to relieve a dying patient’s severe distress that cannot be controlled despite other aggressive measures. (Z. Schuman et al, “Implementing Institutional Change:  An Institutional Case Study of Palliative Sedation,” 8 J. Palliative Med. 666 (2005)). This practice is well accepted by mainstream medicine. ( See also, B. Lo, “Palliative Sedation in Dying Patients,” 294 JAMA 1810-16(2005)); (Rousseau, “Terminal Sedation In The Care Of Dying Patients,” 156 Archives of Internal Medicine 1785 (1996)). When a dying patient is suffering terribly in the final stages of terminal illness and chooses sedation, that option ought to be available, regardless of the provider’s personal, moral, or religious views. At a minimum, a provider unwilling to provide palliative sedation should be required to make a referral to a physician who is willing to do so, and facilitate prompt transfer of care, so that the patient’s needs are met. Kathryn L. Tucker Director of Legal Affairs Compassion & Choices, Affiliate Professor of Law Lewis & Clark School of Law, Portland, OR ED. NOTE:  Watch for an article on palliative care in UO’s Mar/Apr 2008 issue.   A Different Opinion Dear Ms. Mollie Hudson, I saw your editorial in the July/August edition of Unique Opportunities, and I greatly disagree. A physician is one who should save life—not destroy it. He should have no part in it whatsoever, including referring a patient for an abortion. If you don’t like it, that’s your opinion. You have no right to insist (mandate) that physicians be a party to murder! Be sure to unsubscribe my name to your publication. Vicki Martin, MD Birmingham, AL ED. NOTE:  I did make the point in my letter that this was my opinion. That is the nice thing about opinions—everybody is entitled to one. M. Hudson   UO welcomes your responses. Letters must be signed for verification but names may be withheld for publication. E-mail your comments to tellus@uoworks.com.