Religion, spirituality, and health care: Social, ethical, and practical considerations

The public has shown increasing interest in the interplay of religion, spirituality, and health, bur many physicians are either openly skeptical or unsure how best to respond. Religion and medicine were once closely linked, but spiritual concerns have come to be seen as obstacles to scientific progress or, at best, sentimental attachments of little real value in the battle with disease. As a result, many patients and their families have been cut off from a vast storehouse of wisdom, and many physicians complain of bring isolated and overburdened with intractable human dilemmas. Although it is crucial that spirituality and religious faith not be reduced to therapeutic nostrums, an emerging literature has demonstrated a salutary impact of religious belief and practice on patient well-being. Further, if spirituality is seen as the search for transcendent meaning, then all human beings, secular or religious, grapple with spiritual questions. Serious illness can therefore be viewed as both a biologic fact and a spiritual challenge for all patients. Physicians need to learn to be open to discussing spiritual concerns with their patients; to addressing these issues in a respectful, careful and professional way; and to knowing how and when to refer patients to other members of the health care team for spiritual support. Perhaps most important, if to care for a person one must first learn to be a person, physicians may wish to cultivate and deepen their own spiritual lives.