Faith and Medicine: What is the Doctor's Responsibility?
Modern medicine, with its profound dependence on technology, often seems nothing short of miraculous. But even the best medicine sometimes falls short of offering a successful treatment or cure. It is in these situations that recent national surveys show many Americans think God can help.Indeed, three-quarters of Americans believe God can cure people who have been given no chance of survival by medical science. More than half of Americans regularly pray for their own health or the health of their family. Yet many physicians are unwilling, or ill-equipped, to support patients and families on this level.Many doctors see religion and spirituality as a barrier to medical care or, at most, a useful crutch when medicine has no more answers. But healing involves more than just medical diagnosis and treatment. Often patients and families see spirituality as a source of support when they are ill, or appear to be dying.A holistic approach to medicine requires physicians to understand the complex role of spirituality and religion in compassionate patient care. The best prescription: Integrate these topics throughout medical education.
This may be changing, however, as a growing number of medical schools – many with the support of the George Washington Institute of Spirituality and Health (GWish) – started offering courses about spirituality and religion during the past 20 years. These courses try to prepare students to engage in a broad range of conversations about spirituality and religion. Individual courses vary significantly, however, leading GWish to collaborate with medical schools to develop six core competencies in spiritual and health education and to design a uniform way to measure and evaluate them.While such top-down efforts are a good beginning, it’s clear that most practicing physicians have at least some level of discomfort regarding spirituality in their work, and some consider it a real source of conflict. Our bottom-up research approach – based on talking to physicians in the field – convinces us that a more nuanced, flexible approach to helping doctors and medical students navigate the spiritual shoals is needed.
First, physician educators must pay attention to the way they and their colleagues act around spirituality and religion in their work. Too many debates about spirituality in medicine are focused on what physicians should do rather than what they are actually doing now.snipSecond, doctors should pay more attention both to people’s religious traditions and to their broader senses of spirituality and meaning.snipThird, it makes sense to systematically include hospital chaplains and nurses in educational initiatives. Two-thirds of American hospitals have chaplains, and nurses have a much longer tradition of talking with patients about spirituality and religion at the bedside than do physicians. Nurses also often spend more time with patients than do physicians
UPDATE: With regard to the questionable quality and accuracy of another Christian Science Monitor article, I linked to this post and the Cadge article on a listserve I subscribe to (feminist topics). One person replied saying that I was misreading Cadge, that she was petitioning for spiritual and religious sensitivity for doctors. I replied with the below. Am I off the mark on this one? Let me know in email or comments:
I agree that doctor sensitivity to faith is absolutely necessary. But informed consent implies the doctor ethically informs of options, the patient consents according to his/her conscience. My point is that sensitivity to faith and reticence to address should not blur those roles.A March study shows that devout patients are 3 times more likely to receive futile care at than the less devout. A NYT article from August says due to lack of training on how to talk about death doctors are bad at prognosticating because they "view it as a personal failure. Most predictions are overly optimistic...and the sicker the patient, the more likely the doctor is to overestimate the length of survival." Futile care often leads to a more painful death, and great emotional challenges for the family. Rampant patient over-treatment is preventing our medical system from addressing those most in need.The CSM piece laments that "only a quarter of the physicians surveyed reported having received any formal training at the intersection of spirituality, religion, and medicine."Not to be obtuse but what is that intersection for a doctor? Does it mean that the medically sound diagnosis for pancreatic cancer is any different for a Atheist or a Muslim than it is for a Christian? And why is increased spiritual or religious sensitivity necessary for, say, palliative doctors but not OB/GYNs?How information is conveyed is a matter of sensitivity. What information is conveyed is not.