Faith, Spirituality, and Medicine: Toward the Making of the Healing Practitioner
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Using prayer to effect health is perhaps the most controversial subject of research. In the NEWSWEEK Poll, 84 percent of Americans said praying for others can have a positive effect on their recovery, and 74 percent said that would be true even if they didn't know the patient.
But what does the science say? Mitchell Krucoff reported preliminary data on a national trial of patients undergoing heart catheterization or angioplasty. A group of patients who were prayed for by, among others, Roman Catholics and Sufi Muslims in the United States, Buddhist monks in Nepal and Jews at the Western Wall did no better than a second group that received standard care or a third, which was given a special program of music, therapeutic touch and guided imagery. But there was one intriguing finding: a fourth "turbocharged" group, which received both prayers and the music program, had death rates 30 percent lower than any of the other patients.
Overall, the prayer studies have not shown clear effects, and even religious proponents are skeptical that it can ever--or should ever--be tested. So many people already pray for the sick that scientists cannot establish a control group; when the prescription is prayer, patients often get it whether doctors want them to or not. This "noise"--the extra prayers of mothers, fathers, sisters, brothers, friends, church members--may taint trial results. And the studies prompt questions that no one, not even the best scientists, will ever be able to answer: Can one extra prayer mean the difference between life and death?
Can prayer be dosed, the way medicines are? Does harder praying mean better treatment by God?
A Divine Prescription for Spiritual Healing
In the minds of many, especially theologians, those questions border on the sacrilegious. Still, prayer can be an enormous source of comfort to patients and their families. Anton Imling, 54, was raised Catholic, but he rarely attended church. In , Imling was diagnosed with non-Hodgkin's lymphoma, and one day last spring he wound up in the intensive-care unit at North Shore University Hospital in Manhasset, N.
His wife, Shirley, later told him he'd been close to death. Throughout his illness, friends and family had formed prayer circles as far away as Maryland and Texas, and Imling had begun exploring his spirituality with the Rev. Jon Overvold, who works for the HealthCare Chaplaincy in New York, an organization that provides chaplains to local hospitals.
Imling believes those prayers and a "spiritual being" saved his life. He hasn't beaten the cancer and he hasn't become a zealot, but he now prays several times a week, mostly for others who are sick. Rabbis and imams have prayed with Catholics. Overvold's colleague, Sister Maureen Mitchell, recalls the parents of a sick baby saying, "Do your thing.
We're Jewish, but whatever will help. Other experts worry, however, that faith can sometimes interfere with a patient's journey through illness. Suki Tepperberg, a family physician in Dorchester, Mass. One of her patients, a Jehovah's Witness who has diabetes and hypertension, believes her illness is in God's hands and she sometimes eats destructively, harming her health. Tepperberg is worried that, while this woman could take better care of herself, "she believes God really is the ultimate decision-maker.
Interpreting disease as retribution for sin has its roots in the Bible--Miriam and King Uzziah were struck with leprosy after offending their God--and it continues to haunt many patients today. Molly Winterich, a nurse at Rainbow Babies and Children's Hospital in Cleveland, often hears parents question God, especially in the dead of the night, when fear runs rampant.
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They'll ask: "Why would God do this to an innocent child? Kenneth Pargament, a psychology professor at Bowling Green State University in Ohio, studied the religious coping methods of almost patients with diseases from gastrointestinal disorders to cancer. Those who thought God was punishing them or abandoning them were up to 30 percent more likely to die over the next two years.
He is leading the charge for a better understanding of patients' religious and spiritual beliefs in the medical setting. Do you have any religious beliefs that would influence decision-making? Do you have any spiritual needs that someone should address?
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Not asking can have devastating consequences because religion can affect the most pragmatic details of a person's life, says Dr. Stangl recalls a Muslim patient who needed medication, but was observing Ramadan and couldn't drink or eat during the day. After taking a spiritual history--routine for all hospitalized patients at UCLA--Stangl chose a once-a-day medication that could be taken after sundown. People don't want to contradict their doctors.
Today, more than 70 of the United States' medical schools--from Harvard to Stanford--offer specific courses in spirituality or incorporate the theme into the curriculum, says Dr.
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Students often shadow hospital chaplains in an effort to acquaint themselves with issues that don't show up in blood tests. Jeffrey Bishop, an M. Columbia's Sloan agrees, but says religion shouldn't be the arena for this kind of intimate doctor-patient connection. His main concern is that religion will creep into physicians' domain. Problems range from simple logistical issues, he says--physicians barely have enough time to ask how patients are feeling, let alone inquire about their faith--to ethical blunders.
Simply asking about religious beliefs or faith could be a setup for manipulation, making patients feel as if they have to be religious for the benefit of their health and bear responsibility for their illness if they're not. Just because some studies show that being married can make you live longer, Sloan argues, "we don't expect physicians to say to patients, 'I recommend that you get married'.
My answer is no. Few would disagree that doctors have to tread carefully.
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