Spirituality and Your Health



     As a young medical student in the 1960s, I do not recall any of my teachers ever discussing the issue of spirituality and its effect on patient welfare. It seemed to me then and for several decades after my training that physicians tended to avoid the subject of religion and spirituality altogether. In fact, there seemed to be an element of hostility when the medical profession was confronted with patients who depended as much or more on their belief system than on their own physician.

     Fortunately there were some physicians who understood the importance of spirituality in medical practice and had the strength of their convictions to openly state their opinion. In 1910, Dr. William Osler, a famous and highly respected physician stated that "The subject (spirituality) is of intense interest to me. I feel that our attitude as a profession should not be hostile." There were others who also felt this way, but they were clearly in the minority. Sadly, it was not until the last few years that the issue of addressing spirituality in the practice of medicine reached academic medical centers where students of medicine are taken through the rigors of becoming a doctor. 		 

     A person's spiritual feelings can be separated from a person's religious background and training. There are many in our society, who, while professing little interest in organized religion, are none the less quite spiritual in their approach to handling many of life's ups and downs. When serious illness strikes, there are few atheists in hospital beds and many who dig deep into their spiritual core to find inner peace and support.

     The medical profession is slowly, but surely, embracing the concept that physicians need to be attentive to a patient's religious or spiritual needs, as well as learn how to intertwine these needs into the overall approach to medical treatment. Medical organizations and boards of accreditation now require that spiritual needs of patients be considered and openly addressed.

     But now that the issue of spirituality is being discussed and attended to by the medical profession, is there any proof a patient's use of religion or spirituality improves outcome? The best answer to this question is we are not sure. One reviewer noted that 75% of 325 studies indicated that religion improves health and well being. The Handbook of Religion and Health published in 2001, reviewed 1200 articles with similar findings. The major problem with all these studies is most lack a proper scientific research approach and therefore cannot be accepted as evidence based medicine by the medical profession.

     While there are many intriguing studies on the effects of spirituality and religion on medical outcome, there are no definitive answers that meet the rigid criteria needed to convince scientists or skeptics. I have taken the position, however, that if a patient believes that their spiritual tools can help then that is all the proof one needs. If that "help" is one of bringing inner peace and strength as well as acceptance of one's illness, then I believe that is a positive result. A well-known writer on the subject once stated, "If you are a believer you don't need proof and if you're a skeptic you won't accept proof."

     Spirituality and faith seems to work by giving the patient a sense of hope and control. Hope and control can reduce stress and create a sense of inner peace, as well as evoke beneficial changes in the body, such as, decreasing blood pressure, breathing and metabolism rates, and improving the body's immune response. What we also know from large surveys is that 80% of Americans believe spiritual faith or prayer can help patients recover from illness or injury and more than 60% think that doctors should talk to their patients about faith and even pray with those who request it.

     How then can doctors' best address this controversial subject which lacks absolute scientific proof yet remains an important tool for patients to use in times of medical crisis? Guidelines to answer this question are emerging. Physicians should take a spiritual history from adult patients in order to determine whether spiritual beliefs are used by the patient to cope with illness as well as to determine if these beliefs would in any way influence medical decisions. By obtaining this information, physicians will be able to provide support for religious beliefs when they do not conflict with necessary medical treatment.

     I have noted that most of my patients have welcomed discussion of spiritual issues and that a dialogue on this subject enhances overall communication with my patient. The medical profession has come a long way in being encouraged to discuss spirituality with patients since the day I entered medical training. We still, however, have a long way to go. Infusing spirituality into medical care may not be the only answer in obtaining a cure, it may, however, be part of the answer.




Building Patient/Doctor Trust, Lighting Print, ISBN 0-9772351-0-6