A trio of co-authors from OUWB recently published commentaries on both sides of a controversial issue in one of the premiere bioethics journals in the world.

The topic of whether to baptize a dying atheist was addressed by the cohort in two essays published in the Hastings Center Report.

“’Please baptize my son:’ The Case against Baptizing a Dying, Unconscious Atheist” was written by M2 Tate Shepherd. Co-author was Michael Redinger, M.D., associate professor, Western Michigan University Homer Stryker M.D. School of Medicine.

“The Case for Baptizing a Dying, Unconscious Atheist,” was co-authored by Abram Brummett, Ph.D., assistant professor, Department of Foundational Medical Studies, and M2 Nelson Jones.

Brummett said the commentaries are the direct result of a lecture he recently gave as part of OUWB’s Medical Humanities and Clinical Bioethics (MHCB) curriculum.

“It’s just awesome to see conversations that we have in MHCB actually leading to our students contributing at a national level to the big conversation of bioethics,” he said.

‘Unusual cases’

The topic of whether to baptize a dying man who is an atheist was based on a real case that happened in Michigan.

According to the publication in Hastings, the 23-year-old sustained a severe traumatic brain injury from a motor vehicle accident and was unconscious in an intensive care unit. The patient had elevated intracranial pressure and was at high risk of brainstem herniation. He wasn’t expected to survive long.

The patient’s mother approached the attending physician with a request that someone from the hospital’s spiritual services team baptize the patient. She explained that he hadn’t been baptized because he was an atheist. 

The physician consulted the ethics spiritual care teams for guidance on how to handle the request.

Brummett said he presented the case to OUWB medical students for their own discussion.

“I do a lecture every winter on religion and bioethics and in that lecture, I have some bread-and-butter topics that I want to make sure students are exposed to but I also sprinkle in some unusual cases, too,” he said.

Brummett said he was surprised at the level of discussion and engagement prompted by the baptism case.

“Some students felt very strongly that we shouldn’t even consider this kind of thing and others were more open to it,” he said.

The discussion continued after the lecture with both sides “making some really interesting points.”

“It got to a point where I suggested we write something up,” said Brummett. “We sent it to one of the best bioethics journals and they really liked it.”

Presenting two sides

In their essay against the baptism, Shepherd and Redinger argue that where appropriate, “efforts should be made to accommodate religious and spiritual practices in which friends and family find comfort.”

However, they wrote, “In a case like the one presented here, the requested practice would involve assuming consent on the patient’s behalf for something that he would likely have resisted and perceived as a conflict to his core values or identity, so the ethicist should recommend against the baptism and respectfully direct the family to alternative practices that preserve the patient’s dignity.”

Shepherd said he feels strongly because he plans to specialize in oncology and that he expects to frequently deal with patients toward the end of their lives.

“I have a really deep interest in promoting patient autonomy, respecting patient wishes, and protecting their dignity,” he said. “This case highlighted a lot of those issues…I hope readers take away that regardless of medical conditions, patients deserve basic dignity and that as clinicians we have an obligation to respect and protect that dignity.”

For the piece that makes a case for baptism, Brummett and Jones claim that “default positions in clinical ethics, such as following the standard decisional hierarchy, should guide decision-making unless there are compelling reasons to deviate from them.”

“They are default positions for good reasons, so epistemic uncertainty is insufficient to override them,” they wrote.

Further, the duo argued, analysis for the baptism can’t easily be “generalized to dying, unconscious patients who are committed to religious traditions in which belief and ritual aim at securing important spiritual objectives, such as salvation.”

“These patients might be concerned not only about a dignitary harm but also, and perhaps even more so, about significant spiritual harm, such as a threat to their salvation,” the team wrote. “This difference introduces an additional conversation for the substituted-judgment analysis of some patients that is not present for atheist patients who reject the very concept of spiritual harm.”

Jones said his interest is primarily in the ethical aspects of patient care and the various factors at play in a case like this.

“It’s a framework for working through complicated, difficult cases like the one that we’re discussing…people can feel like they have a place to start and work through something that’s difficult as opposed to feeling totally lost at sea,” he said.

In fact, Brummett said that’s what it’s all about: having “professional discourse” so that standard guidance can eventually be achieved.

That’s why he considers presenting the pros and cons of the topic just the beginning. For example, the topic is slated to be discussed this week at the Conference on Medicine & Religion being held in California.

And for two of the co-authors to be medical students, said Brummett, it will go a long way when looking at the next phase of their respective careers in medicine: residency.

“It tends to make our graduates stand out,” he said. “People like talking about these issues and this kind of experience gives them something unique to discuss at their interviews… and (students with this kind of publishing experience) have all matched into programs they’re very, very happy about.”

For more information, contact Andrew Dietderich, senior marketing specialist, OUWB, at adietderich@oakland.edu.

To request an interview, visit the OUWB Communications & Marketing webpage.

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