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Question
Do you feel that the spiritual
attitude of health-care providers can affect the
healing process?
-- L.B.J.
Answer
Yes, I am convinced that the beliefs
of health-care providers can affect patients. However,
when choosing a physician, spiritual attitudes and
issues should not always be paramount. If you’re
having surgery, a doctor’s technical skills and
solid experience would be more important than his or
her personal beliefs. But if you have a serious,
chronic illness, or one requiring long-term care, you
might want a physician whose beliefs are congruent
with yours.
The issue of spirituality and the
physician-patient relationship is getting a fair
amount of attention in the medical community these
days. In one fascinating study at Duke University
Medical Center’s VA hospital, a doctor and nurse
recruited prayers for patients undergoing various
cardiac procedures. Those patients who opted for the
outside prayers offered by strangers had 50 percent to
100 percent fewer side effects than did the patients
who rejected the offer. A number of small studies
reviewed in the June 16, 2004, issue of the Journal
of the American Medical Association (JAMA) found
that many patients want physicians to consider their
spiritual needs; in one study, 48 percent of the
patients interviewed wanted their physicians to pray
with them.
Only a few studies have looked
specifically at physicians’ attitudes and behaviors
about spirituality in their dealings with patients. In
one study of 476 physicians cited in the JAMA review
article mentioned above, 85 percent of the doctors
felt that they should be aware of their patients’
religious or spiritual beliefs, but only 31 percent
felt that they should delve
into these questions during routine office visits.
However, more than twice as many physicians felt that
discussing spiritual questions was more appropriate
when patients are dying. A study published in the
November 2000 issue of Oncology found that
medical personnel (nurses as well as physicians) at a
New York City cancer center who described themselves
as religious were less subject than other
practitioners to emotional exhaustion or “diminished
empathy.”
Despite increasing interest in
spirituality in medical settings, the physicians who
discuss spiritual issues with patients are more the
exception than the rule. The obstacles seem to be lack
of time, lack of training (doctors aren’t taught how
to approach and explore these subjects) and difficulty
identifying patients who would welcome questions about
their spiritual lives and beliefs. This is a sensitive
area for both physicians and patients despite emerging
evidence that spirituality can play a powerful role in
healing. At the Program in Integrative Medicine that I
direct at the University of Arizona in Tucson,
physicians are trained to take “spiritual
inventories" of patients as part of their medical
history, to pray with patients when appropriate, and
to make recommendations for their spiritual needs.
By
Andrew Weil, M.D.
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