When Patients Are Counting on Miracles

An estimated 60 percent of people think divine intervention can save patients who are in a vegetative state. A new study looks at what happens when doctors and divinity seem to be competing as caregivers.

If the idea of a "miracle" feels out of place anywhere, it's in hospital waiting rooms. The sterile experience of getting an IV and wearing a scratchy paper gown and being surrounded by neutral landscape paintings can obscure the intense, emotional questions tangled up in sickness: Why do bodies break down the way they do? Why do some people get sick while others stay healthy? And if doctors can't save someone, can God?

A lot of people do seem to think so. In a 2008 study published in the Archives of Surgery, 57 percent of non-medical workers said they thought divine intervention could save a sick family member, even if doctors said further treatment would be useless. And 61 percent said they believed in miracles for people in a persistent vegetative state, like Terri Schiavo. This isn't necessarily a sign that people just want to hang onto their loved ones no matter what; 72 percent were comfortable with the idea of stopping treatment if a doctor says someone is going to die. If anything, believing in miracles is more of a resignation, a last-ditch hand-off to the heavens.

But doctors aren't so into the miracle thing. In the same study, only 20 percent of a large sample of trauma-care workers said they believed in medical miracles. Many people believe faith complements medicine; seeing God in physician's work can be a source of comfort. But things can get awkward for doctors who don't believe in God, a team of researchers at Johns Hopkins wrote in a paper published this month.

"For a religious patient, not even a beloved physician will win in a contest with God."

"All too often, clinicians unintentionally place themselves in direct competition with ... God," the authors, led by Johns Hopkins chaplain Rhonda Cooper, write. "The [medical] provider may be thinking, 'Well, you can believe all you want, but that miracle is not going to happen.'" That seems like a rather sarcastic thing to think to yourself in a room with a dying patient and her family, but the authors are medical professionals—they must know a God-related eye roll when they see one. But snarky doctors, consider yourselves warned: "For a religious patient, not even an esteemed or beloved physician will win in a contest with God," the authors helpfully note.

So here doctors are, suddenly somehow in a competition with God even though they just showed up for work like normal that morning, feeling awkward because they may inadvertently become disconnected from their patient "at the level of utmost concern, i.e., his or her mortality and, as a corollary, the meaning of his or her life." What's the solution?

An acronym to help them remember what to do, of course. And what else could it be but "AMEN"?

According to the researchers, this stands for "Affirm, Meet, Educate, No matter what." If Mrs. X says she's hopeful, you repeat her name and say, "Mrs. X, I am hopeful, too." If a family says they're praying for a miracle, you say, "I join you in praying." Once you've gotten that out of the way, you clear your throat and say, "Now, I want to offer some information as a medical advisor." Don't go on break right afterwards; instead, say, "No matter what happens, I will be with you every step of the way."

As cheesy as this advice may sound, this is actually a fascinating exercise in pluralism. Usually, when people disagree with each other about the nature of life and God and miracles, they can just keep living their lives—in separate houses, separate churches, separate communities. But in this case, handling disagreement well may mean the difference between a comfortable death and a prolonged treatment; families that are mad at their doctors on top of being upset about their mothers or sons or aunts or grandmas; not to mention a lot of money, if people decide to continue treatment in hopes of a divine twist. When doctors encounter people whose faith is at odds with science, navigating this intellectual tension is essential—sometimes, it's a question of life and death, but mostly, it's a matter of helping people die meaningfully.