Episode Summary: Modern Medicine is Still Religious (#365)

Podcast: Religion on the Mind
Host: Dr. Dan Koch
Guest: Dr. Nathan Carlin, Professor of Medical Humanities (McGovern Medical School, Houston), author of The Secularization of How Religious Ideas Migrate into Modern Healthcare
Date: December 4, 2025

Overview

This episode dives deep into how modern medicine, despite its secular veneer, is shot through with religious ideas, authority structures, and rituals. Dr. Dan Koch and guest Dr. Nathan Carlin discuss how medicine has not so much replaced religion as continued many of its functions, especially in providing meaning, ritual, and authority within society. The discussion explores the historical entanglement of religion and medicine, the ethical and existential crises in healthcare, and provocative issues such as autonomy, secularization, and assisted dying in contemporary contexts.

Key Discussion Points & Insights

1. Doctors as "The New Priests"

• Historical Parallels: Dan introduces the idea—traced back to Freud and common in academic circles—that doctors now serve as the "clergy" or "high priests" in secular societies.

  • "And I think you talk about this a bit in your book that, like, Freud thought that therapists were kind of the new priests..." (01:57)

• Personal Genesis: Nathan traces his own interest back to a college lecture inspired by the geography of cathedrals, connecting this to the modern medical skyline.

  • "That skyline is just right on the edge of Rice's campus. And Martin's comment comes back to me, and I look at them, and I think, and those are the cathedrals of our time." (04:01)
  • Memorable quote: “It's the salvation of the body that matters now in secular society, not the soul.” (05:33)

2. From Soul to Body: Shifting Salvation

• Societal Value Shift: Discussion on how primacy has shifted from "saving the soul" to "saving the body," reflecting the rise of secular humanism and individual worth (05:58).
• Roots in Protestantism & the Reformation: Nathan links this shift to the Reformation’s emphasis on individual interpretation—a destabilizing force on traditional authority leading to today’s crisis of truth and epistemology.
  • Quote: “If anybody can read the Bible and if all interpretations are sort of valid, how do we know sort of what is right? If it’s not the Pope...where do we turn?” (07:41)
  • Dan responds: “...but you know what is a final arbiter? Fucking death. And so let's just focus on not dying, you know...” (10:05)

3. Medicine & Religion: Historical Intertwinement

• Hippocratic Oath as Ritual: Nathan explains to medical students that ancient oaths were explicitly religious, and only recently have their spiritual references been replaced with secular, “whatever I hold sacred” phrasing.

  • “In the original, it’s I swear to Apollo...now it’s, whatever it is that I hold sacred.” (12:40)

• Medical Morality Historically Rooted in Religion:

  • "The basis of medical ethics rests in religion, that medical morality rests in religion." (13:27)
  • He finds it unimaginable for such language to appear in contemporary secular settings, noting the cultural shift in the 1960s–70s and the rise of radical secularization, patient rights, and individual autonomy.

4. Tension Between Beneficence & Autonomy

• Case Study: Dax Cowart

  • Nathan recounts the pivotal case of Dax Cowart, a severely burned patient who begged to die but was kept alive by doctors—he later became an advocate for patient autonomy and the right to die.
  • “And the doctors were right that they could save him. But they were wrong that he would thank them.” (16:25)

• Dan draws a parallel to psychotherapy: Therapists, like doctors, regularly have to balance client autonomy with professional judgment—when to “know better” and when to honor a client’s wishes.

  • “So I have to sort of balance those things...That’s an example from my world.” (18:30)
  • Nathan: “It would seem to be irresponsible on your end if you didn’t probe, if you didn’t ask.” (19:54)

5. Medical Assistance in Dying (MAID) and Moral Authority

• Exploring Canada’s MAID Program: Dan summarizes The Atlantic's article "Canada is Killing Itself," examining how MAID has rapidly expanded and now accounts for 1 in 20 Canadian deaths.

  • “...for the purposes of our conversation, it is exploring Canada's Medical Assistance in Dying program, which is shortened to MAID...” (20:23)
  • Raises questions: Who should hold the power to end life? What are the religious undertones of such authority? Is medicine adopting priestly, sacramental roles?

• Nathan’s Analysis:

  • Highlights moral/ethical confusion and social cost—the intersection of insufficient social support with expanding medical power for ending life.
  • “You can see how challenging, how awful things can be.” (24:41)
  • Example of loneliness and poverty intersecting with medically assisted death: “A patient, all alone, gave final consent from a mattress on the floor of a rental apartment. Boukman recalls having to kneel next to the mattress...” (24:52)
  • Stark reality for aging populations with fragile support systems, warning of trends converging in the US and elsewhere (25:45).

6. Role Confusion and the Marketization of Death

• Dan’s Critique:

  • “Well, I mean in one way it’s like letting the fucking market decide, you know, it’s like that is literally a big part of what’s going on...” (27:25)
  • Points out the moral inadequacy of market solutions for end-of-life care, comparing the “last rites” of priests to the untrained hands of physicians delivering death.

• Anticipating Future Chaos: Both agree that trends of social support erosion, aging, and market pressures will yield more confusion, hardship, and ethical complexity in how society handles death and care.

  • “If you’re right about these trends, then we should anticipate more such chaos and less clarity...” (29:24)

Notable Quotes & Memorable Moments

• “Those [medical centers] are the cathedrals of our time.”
  (Dr. Nathan Carlin, 04:01)

• “It’s the salvation of the body that matters now in secular society, not the soul.”
  (Dr. Nathan Carlin, 05:33)

• “If anybody can read the Bible and if all interpretations are sort of valid, how do we know sort of what is right?”
  (Dr. Nathan Carlin, 07:41)

• “I swear to Apollo...now it’s, whatever it is that I hold sacred.”
  (Dr. Nathan Carlin, 12:40)

• “And the doctors were right that they could save him. But they were wrong that he would thank them.”
  (Dr. Nathan Carlin, 16:25)

• “...for the purposes of our conversation, it is exploring Canada’s Medical Assistance in Dying program, which is shortened to MAID...”
  (Dr. Dan Koch, 20:23)

• “A patient, all alone, gave final consent from a mattress on the floor of a rental apartment...”
  (Dr. Nathan Carlin, 24:52)

• “Well, I mean in one way it’s like letting the fucking market decide... It feels like so ill equipped to the task.”
  (Dr. Dan Koch, 27:25)

Timestamps for Important Segments

• [01:08] - Episode begins, guest intro
• [03:15] - Origin of Carlin’s interest: cathedrals & medical centers
• [05:00] - Modern “pilgrimages” to medical institutions
• [05:58] - Shift: Salvation of the soul to salvation of the body
• [07:41] - Historical roots: Protestantism and the crisis of authority
• [11:58] - How religion and medicine intertwined up to the modern period
• [12:40] - Hippocratic Oath’s religious roots and secularization
• [13:27] - 19th-century U.S. medical ethics and religion
• [14:08] - Bioethics, autonomy, and paradigm-shifting case studies (Dax Cowart)
• [17:50] - Autonomy v. beneficence: in medicine and psychotherapy
• [20:20] - Canada’s MAID program & assisted dying
• [24:46] - Poverty, loneliness, and end-of-life care
• [27:25] - Market failures, clergy roles, and future challenges

Tone and Language

The conversation is candid, lively, and irreverent, blending scholarly analysis with personal anecdotes, and not shying away from explicit language when emphasizing urgency or frustration. Both speakers approach the topic with intellectual curiosity and empathy, seeking to illuminate the complexity, ambiguity, and deeply human stakes that lie at the intersection of modern medicine and enduring religious ideas.

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