Be Aware of the Interface Between Spirituality and the Practice of Medicine, and Never Interrupt the Chaplain



Be Aware of the Interface Between Spirituality and the Practice of Medicine, and Never Interrupt the Chaplain


Angela C. Wooditch MD

Joseph F. Talarico DO



Here is the editor’s favorite true anecdote concerning spirituality in medicine: A patient was just going under anesthesia, when he waved the mask off his face, and asked to see the Catholic chaplain, as he had just heard God asking him to be blessed before surgery. The priest was paged, but unfortunately was still several miles from the hospital. A considerable delay ensued. As luck would have it, the eminent chief of surgery (Dr. John Cameron) was operating in the next room. His opinion was sought by the surgical residents as to whether the operating room (OR) schedule for that day could tolerate this disruption. Dr. Cameron (to his eternal credit) told the house staff to wait for the chaplain as long as necessary, be thoroughly blessed, and then send the father to his room to bless him and his operation as well!

Avoiding anesthesia errors is important because it promotes patient safety and physical well-being. As physicians, we have been trained to focus on the physical aspects of our patients’ health, and we continually strive to improve their bodily condition. However, that is not the only component to our patients’ general state of health. Multiple surveys have suggested that most patients have a spiritual life that is often equally as important as their physical well-being. In a 1998 study of alternative medicine, 35% of patients reported using prayer in relation to health problems. The same study found that 82% of Americans believe in the healing power of prayer. Physicians often fail to consider the patient’s spirituality and its relationship to their general sense of well-being. Possible reasons for this failure are a lack of awareness of the importance of spirituality in many patients’ lives, discomfort with religious beliefs of others, and the prominence of more scientific concepts in medical education.

In a meta-analysis of studies relating to spirituality, religion, and physical health, a correlation was found between patients with a religious/faith affiliation and better health outcomes, greater longevity, and improved coping skills. These patients also had a lower incidence of depression, anxiety, and suicide. Depression has been associated with poorer outcomes in surgical interventions, including cardiac, gynecologic, and orthopedic procedures.
It could be concluded that if patients are allowed to practice their religion and express their faith preoperatively, a lower incidence of depression and, therefore, better surgical outcomes would result.


WHAT CAN WE DO?

It can be argued that the practice of medicine is not only the science of healing but also an art. In practicing the art of medicine, the physician must be cognizant of the importance of taking into account the patient’s emotional well-being. This consideration is the essence of providing good customer service, a concept that is all too often neglected when practicing the science of medicine. This concept does not involve the indulgence of the patient’s every demand, but we do have a responsibility to listen to our patients and honor requests within reason. This responsibility is paramount particularly when the request has a known association with better outcomes. Many patients express their desire to be prayed over preoperatively by a clergyman of their faith. Accommodating this request commonly results in delaying the start of surgery. Regardless of the inconvenience, this may impose on the surgical, anesthesiology, and OR staff, the patient’s emotional well-being is of primary importance, and the patient’s comfort level on entering the OR must be considered. This will enhance our ability as anesthesiologists to relax a patient and develop a healthy doctor-patient relationship. Also, if there is a true connection between the practice of faith and better outcomes, the time spent could make a difference in the patient’s healing. Ultimately, patients have rights, and one of those rights is to be free to practice one’s religion without restraint, regardless of whether those beliefs coincide with those of the physicians and the OR staff. As physicians, we are obligated to respect these rights and make any reasonable accommodation to preserve them.


THE POWER OF PRAYER: PRIVATE VERSUS INTERCESSORY PRAYER

There are few studies directly investigating prayer and outcomes in patient populations undergoing surgical interventions. Most of the studies attempting a randomized controlled design are focused on intercessory prayer (IP) for cardiac patients. IP is when one asks God, the universe, or some other higher power to intervene on behalf of an individual. Prior to the Study of the Therapeutic Effects of intercessory Prayer (STEP) trial published in 2006, there were four studies investigating IP in cardiac patients. The results were mixed. Two studies revealed a beneficial effect of prayer in coronary care unit (CCU) patients and two (one of CCU patients and the other of patients undergoing cardiac catheterization) showed no difference. The STEP trial studied approximately 1,800 patients in six U.S. hospitals undergoing coronary artery bypass grafting (CABG) surgery. There were three study groups: the first received prayer after being informed that they may or may
not receive prayer, the second did not receive prayer after being informed that they may or may not receive prayer, and the third group received IP after they were informed that they would receive prayer. The study concluded that IP had no effect on error-free recovery, and the certainty of receiving prayer was associated with a higher incidence of complications.

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Jul 1, 2016 | Posted by in ANESTHESIA | Comments Off on Be Aware of the Interface Between Spirituality and the Practice of Medicine, and Never Interrupt the Chaplain

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