How should physicians engage with a patient’s spirituality?

The question has recently been raised again in the UK as to whether or not it is right for a General Practitioner to speak to his or her patients from the basis of the doctor’s own religious convictions. (See Christian doctor who prescribed faith in Jesus fights for his job, in the Daily Mail.)

While the temptation is to assume polarisation around this question between the religious and the non-religious, as usual in life things are not so black and white. Even as someone whose very healthcare choice is premised on the idea that prayer can bring an understanding of an all-loving God to light with healing impact, I would still be concerned about how a physician chooses to approach the subject of faith, religion and spirituality, should they do so.

Is there, for instance, a mental ethics to broaching the subject of spirituality? What if, behind a spiritual encounter – no matter how sweetly spoken and well-meaning – the thought is “You need to convert because you are damned to go to hell if you don’t believe what I believe”? Whether unspoken to an atheist or to a follower of another denomination, might not the underlying mental thrust directly contradict the animus needed by any healer to perform his practical role of caring and helping?

On the other hand, there are many physicians whose experience has led them to the conclusion that there is no choice as to whether or not to deal with the spirituality of the patient.

The only choice is whether or not the physician deals with a struggling individual’s spirituality by ignoring “the elephant in the room” or by openly addressing it, according to an Associate Professor of Clinical Medicine. In the video below – from the University of California TV series: “UCSF Mini Medical School for the Public” – Dr Mike Rabow says, at one point:

Maybe when someone comes in, and I can’t figure out what is wrong with them, maybe what’s wrong with them is not biological, maybe it is not emotional, and maybe it’s not even inter-personal, maybe it is this other domain of spirituality.

This is an hour long video, but it is an excellent summary of the spirituality and health issue surfacing in the world of medicine. For those vistors to this blog who don’t have an hour to spare, Dr Rabow offers a thoughtful and thought-provoking set of “guidelines and recommendations” on spiritual care to “physicans-in-training and practicing physicians” about 38 minutes into his talk.

In addressing these, he contrasts the difference between the tradition of competence, autonomy, and neutrality in clinical matters to the requirement for wisdom, respect and candour in dealing with a patient’s spiritual needs. At one point he looks back on his own experience, and says:

…I wasn’t even meant to be in the room ideally, and unduly influence people, as a physician. And they wanted me to sit back and be neutral as if I wasn’t there – as if I wasn’t in a relationship with somebody – to be totally, scientifically, clinically neutral. And of course, all of [the patients] said “Ugh! why would I want my physician to be cold? I don’t want them to be a medical instrument, stainless steel. I want them flesh and blood. I want them to care about me.” And this is the idea now, that we don’t think about spirituality as a medical intervention, the same way we often think about medical interventions… What I am seeking in these guidelines is in fact wisdom, not competence. I don’t need a physician to be competent in this. I need them to let their wisdom out, to be present as a human.

While spirituality and sincerely caring for another might not be classed as a medical intervention, they can form a powerful combination for healing sickness, as I have experienced in my own life, over the past three decades. While that might not be the motive of doctors who address spiritual issues with their patients it would be interesting to hear whether such results have at times occurred when physicians express their care for the patient’s spirituality in this way.

Dr Rabow’s lecture is called Complementary and Alternative Medicine: Spirituality and Health-What Does the Medical Literature Say?


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Categories: Health

Author:Tony Lobl

I write and speak on spirituality from my perspective as a Christian Science practitioner. I am also an Associate Editor for the Christian Science periodicals. I studied at the University of Surrey earning a BSc Hons Degree in Modern Mathematics before the impact of spirituality on health caught my attention and re-shaped my career.

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3 Comments on “How should physicians engage with a patient’s spirituality?”

  1. Kylie
    June 6, 2011 at 4:14 pm #

    A very thought provoking blog today – I haven’t listened to Dr Rabow’s lecture yet, but this blog has given me a lot to think about, particularly your comment about the issue of ‘how a physician chooses to approach the subject of faith, religion and spirituality’. Thank you.

  2. June 7, 2011 at 11:19 am #

    Thanks, Kylie – yes, it is worth a listen, when you have an hour. Cheers.


  1. Guest post: How should physicians engage with a patient’s spirituality? | Christian Science in Victoria - June 27, 2011

    […] June 6, 2011 | 2 Comments […]

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