In recent years, there has been more recognition in the medical field, particularly medical education and physician training, of the importance of spirituality and spiritual issues in the care of patients.
At a time when that medical care has become more fragmented than ever and doctors have much less time to spend with an individual patient, because of the financial rigors of modern day practice, the demands of employers, and the realities of medical insurance companies, recognizing the spiritual needs of patients is more important than ever.
In traditional western medical practice, most attention is focused on the objective medical symptoms and physical findings a patient may have. And the effects of the patient’s mind and emotions on the onset, course, and experience of the disease are often put on the “back burner” or given no recognition at all. Even more likely, the patient’s spiritual beliefs, practices, and questions are never explored. But the patient’s physical, emotional, and spiritual sides are all related and can affect each other and the course of a disease. In fact, the main difference between a disease and an illness is that a disease comprises the physical symptoms and bodily changes, while an illness involves those symptoms and changes plus the way the patient perceives and responds to them and the manner in which the patient’s interaction with others and with the surrounding environment is altered. Treatment of the whole patient with attention to the physical, emotional, and spiritual needs frequently results in a better outcome, even if the disease cannot be cured.
So why stress the importance of spiritual needs? Most patients, when questioned, would like their physician to ask about their spiritual beliefs and needs, but are hesitant to bring them up themselves, frequently because they think the physician would not be interested and usually because the physician doesn’t ask. However, understanding patients’ spirituality gives great insight into who they are and how they might understand and cope with a disease. While there are many definitions and conceptions of spirituality, many would agree that it relates to a person’s central core, what gives meaning to someone’s life, and how one relates to the sacred in our surroundings. One doesn’t necessarily have to believe in God or even be religious to be a spiritual person. But being spiritual helps us to connect to the universe and to others in ways that recognize our humanity and give us a sense of purpose and a potential for growth.
Because of the power, influence, and personal meaning of spiritual beliefs and practices, it is no surprise that there is much anecdotal evidence and also some scientific studies that have documented how one’s spirituality can positively affect the course of a disease, response to medical therapy, and the quality of life one has while living with an illness, as well as, in the case of a terminal disease, the quality of one’s death. How one views an illness and accepts and copes with it can be strongly influenced by spiritual beliefs. A spiritual outlook can often generate hope, even under difficult physical and emotional circumstances. And spiritual distress and pain can be equally as troubling as physical pain and should be addressed as part of the treatment. Fortunately, the importance of these issues has been increasingly recognized in medicine, and most medical schools now have spirituality as part of the curriculum and are teaching medical students how to do a spiritual history. Hopefully, this will have an effect of making physicians more aware of and willing to discuss a patient’s spirituality and address spiritual needs when necessary.
I look forward to discussing spirituality and healthcare further in future editions of Jewish Sacred Aging.
Donald M. Friedman, M.D.