Harold Y. Vanderpool

Is religion therapeutically significant for hypertension

Epidemiologic studies of the effects of religion on blood pressure suggest that religious commitment is inversely associated with blood pressure and that several religious denominations or groups have relatively low rates of hypertension-related morbidity and mortality. In this review, we examine the implication that certain characteristics and functions of religion account for this association, and we posit 12 possible explanations for this finding. We propose that a salutary effect of religion on blood pressure can be explained by some combination of the following correlates or sequelae of religion: the promotion of health-related behavior; hereditary predispositions in particular groups; the healthful psychosocial effects of religious practice; and, the beneficial psychodynamics of belief systems, religious rites, and faith. Since past epidemiologic studies may have been methodologically limited or flawed, possible explanations for the findings of these studies also include epistemological confusion, measurement problems, and analytical errors. Finally, for the sake of completeness, two more speculative hypotheses are identified: superempirical and supernatural influences or pathways.

The International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes Chapter 1: Key ethical requirements and progress toward the definition of an international regulatory framework

Abstract:  The outstanding results recently obtained in islet xenotransplantation suggest that porcine islet clinical trials may soon be scientifically appropriate. Before the initiation of such clinical studies, however, it is essential that a series of key ethical and regulatory conditions are satisfied. As far as ethics is concerned, the fundamental requirements have been previously reported in a position paper of the Ethics Committee of the International Xenotransplantation Association. These include aspects related to the selection of adequately informed, appropriate recipients; animal breeding and welfare; safety issues and the need for a favorable risk/benefit assessment based on strong efficacy data in relevant xenotransplantation studies in the primate. As most diabetic patients are not at risk of short‐term mortality without islet transplantation, only a small subset of patients could currently be considered for any type of islet transplant. However, there are potential advantages to xenotransplantation that could result in a favorable benefit‐over‐harm determination for islet xenotransplantation in this subpopulation and ultimately in a broader population of diabetic patients. With regard to regulatory aspects, the key concepts underlying the development of the regulatory models in existence in the United States, Europe and New Zealand are discussed. Each of these models provides an example of a well‐defined regulatory approach to ensure the initiation of well‐regulated and ethically acceptable clinical islet xenotransplantation trials. At this stage, it becomes apparent that only a well‐coordinated international effort such as that initiated by the World Health Organization, aimed at harmonizing xenotransplantation procedures according to the highest ethical and regulatory standards on a global scale, will enable the initiation of clinical xenotransplantation trials under the best auspices for its success and minimize any risk of failure.

Mind, Body, and Spirit: Family Physicians’ Beliefs, Attitudes, and Practices Regarding the Integration of Patient Spirituality into Medical Care

ABSTRACTThis study used a qualitative approach to explore family physicians’ beliefs, attitudes, and practices regarding the integration of patient spirituality into clinical care. Participants included family medicine residents completing training in the Southwest USA. The qualitative approach drew upon phenomenology and elements of grounded-theory. In-depth interviews were conducted with each participant. Interviews were recorded, transcribed and coded using grounded-theory techniques. Four main themes regarding physicians’ attitudes, beliefs, and practices were apparent from the analyses; (1) nature of spiritual assessment in practice, (2) experience connecting spirituality and medicine, (3) personal barriers to clinical practice, and (4) reflected strengths of an integrated approach. There was an almost unanimous conviction among respondents that openness to discussing spirituality contributes to better health and physician–patient relationships and addressing spiritual issues requires sensitivity, patience, tolerance for ambiguity, dealing with time constraints, and sensitivity to ones “own spiritual place.” The residents’ voices in this study reflect an awareness of religious diversity, a sensitivity to the degree to which their beliefs differ from those of their patients, and a deep respect for the individual beliefs of their patients. Implications for practice and education are discussed.

Religious Coping and Mental Health Outcomes: An Exploratory Study of Socioeconomically Disadvantaged Patients

OBJECTIVE This study was designed to investigate the association between religious coping and mental health in a socioeconomically disadvantaged population. METHODS Participants were selected as they presented for mental healthcare at a community health center for patients with little, if any, financial resources or insurance. A total of 123 patients participated in this study. Multiple regression analysis was used to identify religious coping predictors for mental health outcomes. RESULTS Positive religious coping (PRC) was significantly associated with and predictive of better mental health (P < .01). Conversely, negative religious coping (NRC) was found to be significantly associated with poorer mental health scores (P = .031) with gender, income, and ethnicity controlled for in the model. The relationship between NRC and inferior mental health outcomes was more robust than the relationship between PRC and improved mental health scores. CONCLUSIONS This study illustrates the important association between PRC and NRC and mental health outcomes among economically disadvantaged patients. Interpretation of these findings and clinical implications are offered.

Is religion therapeutically significant

How are religion and medicine related? Each seeks to cope with many of the mysteries, tragedies, and critical beginning and end points of life; each is concerned with human well-being. Yet what respective roles do they play in the mysteries and tragedies of human existence and in the maintenance and secur ing of well-being? My concern here is to explore in a fresh way some of the interfaces between medicine and religion and in the process to suggest that the roles of religion are more extensive than is commonly assumed. I have in mind two exploratory theses.How are religion and medicine related? Each seeks to cope with many of the mysteries, tragedies, and critical beginning and end points of life; each is concerned with human well-being. Yet what respective roles do they play in the mysteries and tragedies of human existence and in the maintenance and securing of well-being? My concern here is to explore in a fresh way some of the interfaces between medicine and religion and in the process to suggest that the roles of religion are more extensive than is commonly assumed. I have in mind two exploratory theses.

Religion and medicine: How are they related?

This paper provides a comprehensive and dynamic profile of religion-medicine interrelationships. This profile is drawn from the respective characteristics of religion and medicine, as well as from historic and contemporary literature regarding their interconnections. Six symbiotic functions are identified and discussed with respect to their bearing on clinical practice, medical education, and research.This paper provides a comprehensive and dynamic profile of religion-medicine interrelationships. This profile is drawn from the respective characteristics of religion and medicine, as well as from historic and contemporary literature regarding their interconnections. Six symbiotic functions are identified and discussed with respect to their bearing on clinical practice, medical education, and research.

Chapter 7: Informed consent and xenotransplantation clinical trials

Abstract:  This essay explores the meaning and implications of informed consent in xenotransplantation clinical trials from both ethically justifiable and international perspectives. In international and national codes and guidelines involving human subject research and in the laws of many nations, the informed consent of research subjects is obligatory. Its moral foundations include and also extend beyond respect for individual persons as autonomous agents in Western nations. Axioms regarding the value of human life and duties to protect innocent and vulnerable persons from harm, duress, and deceit underlie Western individualism and are broadly shared in many non‐Western cultures. Accents on family and/or community consent in China and other nations are compatible with individual consent as long as family and community consent supplement, rather than replace, individual consent. Reflecting its moral foundations, informed consent in medical research is rightly characterized as “voluntary” or “freely given” informed consent because it encompasses researchers’ disclosure and subjects’ comprehension of all the relevant information about the protocol that reasonable persons would want to know in order to freely and affirmatively enroll in the research. The interplay between these conceptual foundations of informed consent and the realities of xenotransplantation research defines what the nature and functions of consent should be in xenotransplantation clinical trials. Because these trials involve a complex body of medical information, numerous procedures, numerous risks (associated with failure rates, immunosuppression, xenogeneic infections, and so on) and the subject’s obligation to abide by extensive national and international precautionary guidelines, informed consent should be enacted as an organized, sequential, thoughtfully paced, jargon‐free process of communication. The features and functions of consent forms or consent documents should accord with this process. Rather than being virtually equated with informed consent, consent documents should be utilized as templates of relevant, essential, and understandable information that contribute to comprehension and voluntary enrollment. In xenotransplantation clinical research, the consenting process must cover a large number of topics, including treatment choices, participation information, study procedures, information about risks associated with immunosuppression, xenogeneic infections, discomforts, and other matters. In addition, due to infectious risks, subjects are obliged to 10 post‐protocol responsibilities. Two of the three unique moral issues regarding informed consent in xenotransplantation trials involve what to do to minimize post‐protocol infectious risks and what to do about international and national guidelines that affirm the subject’s right to withdraw from participation in medical research at any time. The third moral issue centers on issues involving the enrollment of children and mentally incapacitated adults. The other chapters in this consensus statement demonstrate that, morally and logically, favorable harm‐benefit determinations precede considerations of informed consent. When these harm‐benefit assessments are favorable enough to warrant the onset of clinical trials, informed consent emerges as a pivotal moral precondition for these trials.

Religion and medicine: A theoretical overview.

Recent scholarly studies in history, sociology, anthropology, religion, and psychosomatic medicine, coupled with clinical experience in the care of patients, call for a reassessment of the interrelationships between religion and medicine. Six major areas of interaction between these forms of human experience are identified and outlined. Investigations into these interlinkages not only offer challenging new opportunities for discovery but also hold promise for the development of new, more effective forms of medical care and healing. This new understanding of the interconnections between medicine and religion has many implications both for health care practitioners and for professionals with specialized training in religious studies.Recent scholarly studies in history, sociology, anthropology, religion, and psychosomatic medicine, coupled with clinical experience in the care of patients, call for a reassessment of the interrelationships between religion and medicine. Six major areas of interaction between these forms of human experience are identified and outlined. Investigations into these interlinkages not only offer challenging new opportunities for discovery but also hold promise for the development of new, more effective forms of medical care and healing. This new understanding of the interconnections between medicine and religion has many implications both for health care practitioners and for professionals with specialized training in religious studies.

Payments to Participants: Beware of the Trojan Horses

tasks, is prima facie such a “rare circumstance.” Grady is right on the money in concluding that payments to research subjects appropriately demonstrate “respect and appreciation for these generous individuals” who make sacriaces to beneat others (2001). And it is especially appropriate to demonstrate that respect and appreciation to the truest heroes: those who most put their health on the line.

Commentary: A Critique of Clark's Frightening Xenotransplantation Scenario

he article by Margaret Clark’ recommends that a moratorium be placed on xenotransplantation reT search. Her call for a moratorium is predicated on an assemblage of factors, most notably, the degrees to which this research poses serious risks to the health of patients and the public, assails natural barriers between species, and is being conducted by scientists who believe that they alone should assess the risks of xenotransplantation and determine when clinical trials will begin. Clark also argues that xenotransplants denigrate and misuse animals and add to the injustice of health care systems. Xenotransplant technologies should be held at bay until the public can learn about, debate, and evaluate this assembly of issues, then possibly sanction their further development. Conceptually and ethically, Clark‘s argument is that the harms and offenses of xenotransplantation clearly outweigh any conceivable benefits. For Clark, its primary benefit is that the shortages of human allograft transplants, which “are considerably below demand,” might be eased.2 My commentary will reverse Clark’s perspective. I will indicate why the harms and offenses of xenotransplantation she sets forth are greatly overdrawn, why its foreseeable benefits are greater than she depicts, and why no moratorium is justifiable. Due to required brevity, I will not address all of the issues Clark assembles or highlight the strong sections of her article.