Essays on Palliative Care: Each week a new essay will be offered for consideration by physicians at Ochsner Medical. To follow the series, go to the Education tab each week for further information. In the weeks to come:
Essay on Spirituality and Religion Relationship Explained: So many are confused whether there is a potential a relationship between religion and spirituality. The short essay presents one possible way of understanding the relationship.
Anandarajah, G, Hight E. Spirituality and Medical Practice: Using the HOPE Questions as a Practical Tool for Spiritual Assessment. Am Fam Physician. 2001 Jan 1;63(1):81-89. http://www.aafp.org/afp/2001/0101/p81.html
A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patient's spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process.
Bryan CS, Babelay AM. Building character: a model for reflective practice. Acad Med. 2009 Sep;84(9):1283-1288. doi: 10.1097/ACM.0b013e3181b6a79c.
Recent work in philosophy underscores the importance of character ethics (virtue ethics) as a complement to ethical systems based on duty or results. Recent work in psychology suggests that virtues and character strengths can be analyzed and taught. This article proposes a four-step method of reflective practice for building character that includes (1) the details of a situation; (2) the relevant virtues; (3) the relevant principles, values, and ethical frameworks; and (4) the range of acceptable courses of action.
Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry. 1993 Dec;50(12):975-990. Review.
Previous research has confirmed four dimensions of temperamentthat are independently heritable, manifest early in life, and involve preconceptual biases in perceptual memory and habit formation. This article describes three dimensions of character that mature in adulthood and presents a psychobiological model of the structure and development of personality that accounts for dimensions of both temperament and character.
Curlin FA, Hall DE. Strangers or friends? A proposal for a new spirituality-in-medicine ethic. J Gen Intern Med. 2005 Apr;20(4):370-374.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1490093/
The authors argue that dialogue about religion between patient and physician should be approached as a form of philosophical discourse about ultimate human concerns. They further argue that such moral discourse is often essential to the patient-physician relationship.
Davidson RJ. Spirituality and medicine: science and practice. Ann Fam Med. 2008 Sep-Oct;6(5):388-389. doi: 10.1370/afm.900.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532774/
This editorial identifies key questions about assessing a physician’s sensitivity to patient spirituality that have major implications for how healthcare clinicians are trained.
Ehman JW, Ott BB, Short TH, Ciampa RC, Hansen-Flaschen J. Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med. 1999 Aug 9-23;159(15):1803-6.http://archinte.jamanetwork.com/article.aspx?articleid=1105624
The objective of this study was to determine if patients would object to the inclusion of the following question in a routine medical history: "Do you have spiritual or religious beliefs that would influence your medical decisions if you become gravely ill?" The results—based on responses from 177 ambulatory adult patients visiting a pulmonary practice at a university teaching hospital in 1997—showed that many but not all of the patients would welcome such a carefully worded inquiry about their beliefs.
Koenig HG. Religion, spirituality, and medicine: how are they related and what does it mean? Mayo Clin Proc. 2001 Dec;76(12):1189-1191.
This editorial reviews the controversy over addressing religious and/or spiritual issues within a medical setting and calls for clinical trials to examine not only the effects of spiritual interventions on health outcomes, but also to assess the effects on the patient-physician relationship, compliance with treatment, use of health services, disease outcomes, and quality of life.
McKee DD, Chappel JN. Spirituality and medical practice. J Fam Pract. 1992 Aug;35(2):201, 205-208.
This paper distinguishes between spiritual and religious issues and reviews the history of these issues in medicine as well as the growing medical literature in this area. The article also provides practical guidelines for the practicing physician.
Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality, and medicine: implications for clinical practice. Mayo Clin Proc. 2001 Dec;76(12):1225-1235.
This article provides a review of published studies, metaanalyses, systematic reviews, and subject reviews that examine the association between religious involvement/spirituality and physical health, mental health, health-related quality of life, and other health outcomes.
Religion among the millennials: Less religiously active than older americans, but fairly traditional in other ways. Pew Research Center. A Pew Forum on Religion & Public Life Report. 2010. http://www.pewforum.org/Age/Religion-Among-the-Millennials.aspx
This report—one of a series of studies that examine the values, attitudes, and experiences of America’s next generation—provides data on the religious affiliation, worship attendance, other religious practices, and religious attitudes and beliefs of young adults aged 18 to 29.
Salt S. Is Spirituality Good for Your Health? Cleveland Plain Dealer. Cleveland.com. April 03, 2012. http://blog.cleveland.com/healing/2012/04/is_spirituality_good_for_your.html
Religion and spirituality have often been viewed in medicine as largely irrelevant, even conflicting with care. That impression is changing according to Dr. Harold Koenig, Director of the Center for Spirituality, Theology and Health at Duke University. He has studied the links between health and spirituality for nearly 30 years.
Sevensky, RL. The Religious Foundations of Health Care: A Conceptual Approach. J Med Ethics. 1983;9:165-169. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1059326/pdf/jmedeth00010-0037.pdf
The relationship of religion and health is often misunderstood owing to a tendency to concentrate on the medical model and to ignore the wider context of health care.
Oxford Textbook of Spirituality in Healthcare by Mark R Cobb, Christina M Puchalski
This is one of the most comprehensive books on spirituality and healthcare. The relationship between spirituality and healthcare is historical, intellectual and practical, and it has now emerged as a significant field in health research, healthcare policy, and clinical practice and training. Understanding health and well-being requires addressing spiritual and existential issues, and healthcare is therefore challenged to respond to the ways spirituality is experienced and expressed in illness, suffering, healing, and loss.