spirituality and medicine:
curriculum development project

 
Is providing spiritual care ethical?

 

In an editorial in an American medical journal in 2001, Sloane and Bagiella discuss four 'substantial ethical concerns' about any form of spiritual intervention on behalf of the health professional.

Firstly, they claim it is simply not the case that all behaviours linked to good health should be prescribed by doctors - for instance the prescription of marriage would be far from being good practice. Secondly, since patients often acquiesce to the recommendations of their doctors, the suggestion of spiritual involvement may prove coercive. Third, linking good health to faith may produce real harm in patients who begin to believe that their illness is due to insufficient faith. And fourthly they claim that if religious intervention is offered only to those patients who seem receptive to it, then two classes of patients emerge, one of which is denied  intervention which proponents of spiritual interventions believe to be efficacious.

Their concerns centre on the potential for the doctor-patient relationship to be abused by doctors keen to impose their own views on patients. Similar concerns were recently addressed by the General Medical Council in producing their document Personal Beliefs and Medical Practice, which reiterates that it is inappropriate for doctors to impose their views on patients. However, it emphasises that everyone has personal beliefs and values, including those who are not members of religious or spiritual groups.

Caring for patients as whole people will include asking about, recognising and discussing spiritual issues. Whilst it is important that the doctor's views are not imposed upon the patient, it is equally true that doctors should not be dissuaded from broaching such issues with patients because of these concerns.

The basis of providing spiritual care for patients is listening and allowing patients the room to discuss their concerns and fears. Once issues have been identified, the doctor can work with other members of the multi-disciplinary team, including the chaplain, to help manage spiritual distress.

 

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The Spirituality and Medicine Curriculum Development Project is funded by the Centre for Excellence in Teaching and Learning at Barts and the London School of Medicine and Dentistry.