Does Spirituality Have a Place in Healthcare?

The role of spirituality in facing a health crisis varies from patient to patient. For healthcare providers, who rely on medical science, it can be a contentious subject. We posed the question of spirituality to a group of cancer patients who were interviewed for the Center for Communication in Medicine’s video Voices From the Lived World of Illness.

We hear Adrienne admit, “When I was a nurse, I’d look at a cancer patient who was dying and assumed they had this immediate connection to God because they got their diagnosis and then they got their spiritual connection to God—the two just came together. I kind of envied them that. I didn’t want to have the disease but it would be kind of cool.”

Pete casually adds, “I really don’t remember having any spiritual connection my whole life. Having been diagnosed with cancer hasn’t changed that a bit.”

Then, Pat tells us, “A significant portion of my life right now is dealing with spiritual issues that I consider very important and I think I’m trying very hard to focus on the blessings.”

The patient’s perspectives were aired on The Health Show, a public radio program recorded at WAMC in Albany, NY. Psychologist Dr. Bernard Bandman and I, as producers, were invited to play clips from the video and share our views about this issue. Dr. Bandman explained, “Spirituality and religion can play a significant role for some patients… 3 patients had 3 different experiences. For one patient, who doesn’t remember having a spiritual connection, cancer didn’t change that. One found dealing with spiritual issues helped her to focus on the blessings. For another, she discovered a diagnosis didn’t bring a spiritual connection to God.”

Dr. Bandman continued, “Spirituality and religion should be identified as a resource but not imposed on a patient in early discussions with their doctor and not just at the end of life. That’s why we invite clergy to participate at our community forums– to hear what patients are saying and to speak to their role with patients and families in the course of illness.”

I was recently listening to a recording of The Health Show interview and it reminded me of an experience as a medical humanist at the Bennington cancer center. I was tasked with introducing a spirituality survey to patients but I really wasn’t sure how it would be received. Plus, I was concerned that the survey was in questionnaire form and not designed for a thoughtful conversation about a topic that could trigger strong reactions.

The first survey question was “Do you believe in God?” A patient, before writing his answer, confessed, “I read this question and I feel that if I would have prayed more and been more religious that I wouldn’t have gotten cancer.” It was not in my job description to address this concern but what came to mind were words from a poem by WH Auden, which began with “To pray is to pay attention to a landscape.” The patient looked at me and said, “So, maybe I’ve prayed more than I think… thank you.”

I documented his response in my medical humanist’s note, which was shared with the cancer care team. When I asked his doctor about talking with the patient about his concerns, I could sense a hesitancy in addressing the relationship of prayer to his cancer diagnosis. Instead, the doctor suggested a consult with the hospital Chaplain. A referral was made and the patient told me at the next appointment that he felt relieved to hear that his lack of praying didn’t cause him to get sick.

Soon thereafter, the cancer center medical director decided to discontinue using the spiritualty survey. I suspect it placed doctors in the awkward position of talking about a subject not based upon their medical training. Yet, I’ve witnessed many patients who have relied on their spiritual beliefs for strength and comfort.

So, is there a place for spirituality in healthcare? Through my work I have come to learn that understanding a patient’s belief system can be useful in identifying what could be a supportive resource during uncertain times. I’ve also observed that discussing this topic can offer insight into a patient’s rationale for their decisions about care, especially if religion and culture might be an influence. I’m interested in hearing what readers think about healthcare providers exploring the role of spiritual belief systems in planning of care. Please use the comment section to share your thoughts.