Why Doctors Should Start Taking Your Past Spiritual History

Nikhil Barot in Nautilus:

A little over a decade ago, Farr Curlin, a physician and professor of medical humanities at Duke Divinity School, became curious about the spiritual lives of his colleagues. He already knew that patients’ religious beliefs and communities matter: Both influence medical decisions and change the meaning of illness. But the influence of physicians’ religiosity on their work was relatively unknown. So he and his colleagues conducted a national survey of physicians’ religious characteristics. He found that, compared to a sample of the general U.S. population, physicians were twice as likely to cope with their own major life problems without relying on a “higher power.” Doctors were also less likely to carry their religious beliefs into other dealings in life. Curlin’s survey was the first of many to show that doctors are less inclined to bring up spiritual and religious matters with patients and their families, even though addressing these dimensions of illness can help coping with death, and even though patients frequently welcome the discussion.

“When spiritual needs are not met,” concluded Michelle Pearce, a University of Maryland clinical psychologist and her colleagues in a 2012 paper, “patients are at risk of depression and a reduced sense of spiritual meaning and peace.” Yet according to a 2013 study, despite recognizing the importance of spiritual care to patients, physicians and nurses infrequently provide it. A report published in the Journal of Clinical Oncology found that most cancer physicians, nurses, and patients believe such care would have a positive impact. The evidence suggests that physicians might do well to take a Past Spiritual History, similar to the Past Medical and Past Surgical Histories that are a routine part of patient-doctor encounters. A Past Spiritual History represents a biopsychosocial-spiritual approach to understanding illness, which may not only “enrich the dialogue between patients and health providers,” as one 2006 study concluded, but also inform what treatments are acceptable within a given patient’s system of values. “For many people, this spiritual history unfolds within the context of an explicit religious tradition,” wrote Christina Puchalski, a professor of medicine at George Washington University, and colleagues, in the Journal of Palliative Care. “For others it unfolds as a set of philosophical principles or significant experiences.”

More here.