Abstract
In clinical medicine there is much attention given to the biological, psychological, and social aspects of patient care. But what about the spiritual dimensions of patients' lives? According to contemporary psychology and cognitive science, religious thought and feeling arise from deep within human nature; we are born believers in many of the core features that unite many religious traditions, such as in afterlives, supernatural agents, nonmaterial human essences, and teleology (meaning and purpose in nature). 1 How could it then be that the spiritual elements of patients' lives are so often overlooked? What is, and what ought to be, the place of spirituality in clinical care?
The Soul of Medicine is a thorough and comprehensive overview of the most recent developments at the nexus of clinical medicine, medical ethics, and spirituality. The book is coedited by two leaders in the field of spiritually integrated treatment, Dr. John Peteet, associate professor of psychiatry, and Dr. Michael N. D'Ambra, associate professor of anesthesiology, both at Harvard Medical School.
The first part of the book addresses historical and clinical contexts of the relationship between spirituality and medicine. Professors Michael and Tracy Balboni address the history of the relationship of spirituality and medicine, and underscore the long-standing and intimate relationship that religion and spirituality have shared with the medical profession and it's care of the sick. They leave us with four choices central to spiritually respectful, inclusive, and effective care:
1. Should medical systems cooperate with representatives of spirituality and religion, dividing labor, or should spirituality be more completely integrated through the medical system? 2. Should spiritual practices be evaluated and promoted based on salutary effects on body and mind, or should they be embraced irrespective of their physical and mental effects? 3. Is the nature of spirituality and spiritual care intrinsically informed by religious communities, theological methods, and tradition-constituted stories and language or is it grounded in a theory of our basic humanity? 4. Should the medical profession foster and encourage the presence of particular communities in caring for the sick, or should a more pluralistic approach be employed?
It is the Balbonis' feeling that thoughtful dialogue when formulating the answers to these questions will, by it's very engagement, help shape future directions.
The next section of the book is divided into the major religious traditions (e.g., Judaism, Hinduism, Islam, Christianity, Buddhism, eclectic spirituality, Christian Science, and Jehovah's Witnesses) and poses the following questions:
1. What narrative or idea in your tradition helps to define the ultimate nature and essential concerns of human beings? 2. What resources for living well does your tradition offer? what insights about life and healing? 3. How does your tradition challenge or reinforce contemporary medical practice? 4. How do faith and culture influence each other? 5. How do you access and address spirituality in your clinical practice? 6. How do your beliefs influence your practice?
The book closes with chapters on the ethical considerations and implications for professionalism, medical education, and hospital chaplaincy. One of the greatest strengths of the book is that its chapters are often cowritten by MDs, MDivs, PhDs, and DDs, which allows a multitude of voices to approach the many contested and undecided-upon issues at the intersection of spirituality and medicine.
Out of this symphony of analyses comes nonetheless a common message: that we need more attention to issues of spirituality and medicine, because it is an essential feature of patients' lives, and that this is underappreciated in clinical practice and in medical education. Second, one hears a common message that, historically, the roots of medical professionalism link to religion and faith, so too in the oaths taken by all clinicians to safeguard the patient/healer relationship. So it may be that spirituality is a resource for physicians and other caregivers not only for their patients, but also for themselves and in understanding the nature of their profession's sacred contracts, in achieving professionalism, and in dealing with the stresses of a professional life.
The “spirituality in medicine” movement has grown and developed tremendously during the last decade, due in large part to the authors found in this slim volume. You can discover the most up to date philosophical considerations in this nascent medical movement and add greatly to your practice as you learn more about this pluralistic approach to spirituality and medicine. Although the authors suggest this book was written as a response to the need for a basic text to “prepare medical students for dealing with the spiritual, worldview, and related moral dimensions of the interaction between physician and patient,” I would recommend this book to a broad spectrum of medical clinicians as well as caregivers, patients, and theologians from both religious and secular perspectives.