A couple of recent court cases and the advent of recent changes to health insurance law have brought the issue of who controls the patient’s access to health care into the public mind, particularly in relation to religious freedom. Should religious organizations have to provide access to treatments of which they disapprove? How about businesses which happen to be owned by religious persons? Should religious pharmacists have to fill prescriptions for such treatments? Are Catholic hospitals bound to follow the Do No Resuscitate directives of patients who do not have access to other hospitals?
From the fourteenth century perspective, it says a great deal for the attitudes and values of our society that we can even have this conversation. Back then, Catholicism was more or less the official religion for most nations of Europe–so taken for granted that nobody had to write a document to say so. Minority religions were ignored, persecuted, despised or accepted depending on the regime in charge at any given time, and what they had to offer to that regime. And medical care was closely linked to religion, with treatments options often circumscribed by some interpretation of the Bible.
For instance, the idea that women should not be given access to pain-management drugs during childbirth because the Bible says they should give birth “in sorrow.” So if it doesn’t hurt, that’s in defiance of God. Yikes! At various times, opium for the control of pain was banned by order of the Pope, only to have the ban lifted by a later patriarch. That suggests some level of discomfort with the idea of encouraging suffering, yet at the same time, many future saints and beatified persons displayed great fortitude in the face of painful or disfiguring illness in a celebration of such holy suffering.
Illnesses were often taken as a sign of God’s disapproval, and treatments might be literally religious: patients often went on pilgrimage, made offerings at churches, hired priests to say masses or paid abbeys to pray. Bits of saints perceived as related to the ailment might be brought to effect a cure, the equivalent of “Say two ‘Hail Mary’s’ and call me in the morning.”
The physicians of the time were, in fact, often minor clergy, trained at medical schools established or managed by the Church itself and expected to comport themselves with that sort of decorum. How would you feel now if your doctor were not only affiliated with a Catholic hospital, but were actually a cleric himself who might well prescribe penance for your spiritual failings alongside a nice, healthy bleeding every couple of months?
Okay, that’s probably overstating my case. The physicians were, in some way, participants in the miracle of God’s creation, trained to understand certain aspects of His work and thus to look for the signs that God would allow a cure to take place. Or, as Ambroise Pare put it, “I stitched him, and God healed him,” suggesting that medicine and religion went together. Even if the doctor didn’t call upon a saint’s intervention, he still anticipated that God’s approval was the final ingredient to any cure.
At the same time, especially among practitioners who learned their trade through non-religious means, there was an increasing awareness of and interest in methods that really worked. Surgeons wrote manuals for one another, swapped recipes and cures and worked constantly in their own practice to improve technique and technology, without any apparent qualm that God disapproved of such efforts. Medicine finally shook off most of its religious influence after the Renaissance, especially with the advent of the Germ Theory, which found a direct cause for many previously mystifying (therefore likely heaven-imposed) illnesses.
There are still sects who believe that prayer alone is the cure–God will either heal you or not, it’s up to Him–but many more people who take a more practical approach. Given all the advances in medical science, maybe God, in fact, wants us to be healthy and pain-free. If you’re inclined to believe that God is at the root of everything, than that means he gave man not only the natural treatments that can be derived from the world around us (willowbark tea, anyone?) but also the intellect to devise even more.
Alas for the suffering people, so often, we turn that intellect to arguing against advances in medicine, to making complex systems that prevent access to healthcare, to generating labyrinthine billing methods that result in huge debt loads for patients, creating the impression that many are still advocating a right (if not a duty) to suffer. A fact that seems, well, positively medieval.