Providing care for patients more often than not requires treating more than the medical problem. Many medical schools now teach using a bio-psycho-social model, recognizing how one aspect can influence the other. The spiritual component can be seen as a subset of the model or perhaps a separate dimension on its own. Spirituality does not equate to religion. The former is more individualized and can even be at odds with one’s religion or lack thereof.
Bearing the same name, the title of this article comes from a book by Glenda Hodges Ph.D., J.D., M. Div and Harold Betton M.D., Ph.D. The doctors speak about their personal and professional experiences of blending faith and science. The book also has example of medical miracles and personal testimonies. Yet apart from anecdotal evidence, where does spirituality fit in the daily practice of a physician?
In 2008, The Annals of Family Medicine devoted some articles to the “science and practice” of spirituality and medicine. The editorial in the issue remarked that “the medical profession has become increasingly open to considering…these issues for good medical care, a hopeful sign of a more complete interdependence between clinician and patient, and within the patient, between the mind and body.”
Why talk about this topic in a JSNMA issue devoted to Minority Medicine? Historically, medically under served minorities have grown up in and fostered spiritual ideals as part of their identity. Being aware of this and including this in the holistic approach of medicine to these patients will improve communication and health outcomes. Spiritual persons tend to have optimistic outlooks therefore having more resilience and a social support network beyond the nuclear family.
The physician’s role is to first do no harm however this harm is not always physical. Consider the Jewish or Seventh-Day Adventist Christian patient who would refuse a porcine replacement heart valve because of their adherence to Levitical law. Learning more about patient’s beliefs can help to create treatment plans that wont harm them spirituality which for some patients is the same or even more important than harming them physically. This requires honest and open communication using the bio-psycho-social model of patient care.
What is essential is to accept the patient’s spirituality as a valid part of their persona. Include a spiritual history when interviewing patients. Approaching the topic in a nonjudgmental and compassionate way will improve communication between physician and patient and only serve to better the relationship and health care outcomes.
This article first appeared in the Summer 2010 JSNMA, Volume 15, Number 4
Filed Under: Global Health
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