Spirituality in Health Care

 

Family Medicine is relationship-based, and we are skilled at integration (versus the analysis of specialists). Relationships with patients, continuity, and life crises make spiritual issues common in Family Medicine.

 

 

What is Spirituality?

Everyone has their own worldview, and Canada is a multi-faith country, including those that have no faith.

 

operational definitions of spirituality:

  • how people make sens of life - meaning and purpose
  • how they situate themselves with others - love and relatedness
  • how they let go of bad things - forgiveness

 

 

How can Illness Affect Spirituality?

Illness causes a disruption of

  • relationships with family and friends
  • relatio nship with self and personal life cycle
  • worldview/religious view
  • sense of order and control
  • sense of belonging to the human commuinity
    • patients with chronic illness often feel aleination or exile
    • HCPs can sometimes cause feelings of guilt/blame
    • "bad things don't happen to good people"

 

 

Reasons to Bring Spirituality into Care

  • almost every encounter is shaded by patients' fear of death
  • anxiety and depression have spiritual origins of meaning and purpose
  • what is your vision of the role of a clinician?
    • technician?
    • advisor?
    • contract or covenant?

Spirituality can bring...

  • healing - alleviating suffering
  • guiding - assist in ethical decision making
  • nurturing - enabling potential despite disability or illness
  • reconciling - repair of broken relationship with worldview, self, others, or God
  • sustaining - helping the suffering to endure

prayer between a physician and a patient can be a very powerful force, but be cautious when setting that up so that informed choice is maintained. The power differential can be tricky

 

Do Patients Want to Talk about Spirituality?

find better info, but until then...

 

US Data (USA Weekend, April 5-7 1996)

  • 79% believe faith can help one recover
  • 63% believe doctors should talk with patients about spirituality
  • only 10% of doctors do so

 

 

Barriers to Discussing Spirituality

  • spirituality is one of the few taboo subjects
  • perceived clash between science and faith
  • psychiatry has been traditionally hostile to faith
    • Messianic delusions
  • there is no training of doctors in spiritual care
  • proselytizing
  • doctor's spirituality (or lack of awareness)

Tricky Cultural Factors

  • we are happy nihilists
    • spend time avoiding meaning and angst about death
    • fluctuate between boredom and anxiety, treated with shopping, sex, alcohol, drugs, etc
  • believers can be labeled fanatics and terrorists
  • you cannot impose your own values (a value in itself)
  • everything is relative
  • freedom is the ultimate value - an end unto itself...
  • fierce individual freedom worship of self
    • forget the story of your background, or have it taken away
  • fear of the mysterious, including birth and death

 

Ways of Opening the Discussion

  • how do you make sense of this?
  • where do you find strength or hope?
  • is there a faith community that is important to you?
  • wea ll do things that are wrong - how does forgiveness work for you?
  • have you ever had an experience of undeserved approval (grace?)

 

 

Helpful Tips

  • people who grew up with faith can stop practicing but still keep mentalities that can come back to haunt them
  • the power differential can intimidate patients - be cautious asking patients if you want them to pray for you

 

 

Spirituality Success stories

  • Alcoholics Anonymous
  • human rights - if it is survival of the fittest, why care for the oppressed?
  • justice
  • truth and reconcilation commission in South Africa

 

Spirituality and Religious Care in Nova Scotia

contacts:

Neale Bonnet - head of spiritual care at CDHA - 473-2311

Jody Clarke - professor at Atlantic School of THeology - 425-5315