The role of spirituality in health care

Christina M. Puchalski, MD, MS

From The George Washington Institute for Spirituality and Health (GWish), The George Washington University Medical Center Departments of Medicine and Health Care Sciences, and The George Washington University, Washington, DC.

Presented at Baylor University Medical Center on February 28, 2001, as the Baylor-Charles A. Sammons Cancer Center Charlotte Johnson Barrett Lectureship.

Corresponding author: Christina M. Puchalski, MD, MS, GWish, 2300 K Street NW, Warwick Building, Room 336, Washington, DC 20037.

The technological advances of the past century tended to change the focus of medicine from a caring, service-oriented model to a technological, cure-oriented model. Technology has led to phenomenal advances in medicine and has given us the ability to prolong life. However, in the past few decades physicians have attempted to balance their care by reclaiming medicine's more spiritual roots, recognizing that until modern times spirituality was often linked with health care. Spiritual or compassionate care involves serving the whole person--the physical, emotional, social, and spiritual. Such service is inherently a spiritual activity. Rachel Naomi Remen, MD, who has developed Commonweal retreats for people with cancer, described it well:

Helping, fixing, and serving represent three different ways of seeing life. When you help, you see life as weak. When you fix, you see life as broken. When you serve, you see life as whole. Fixing and helping may be the work of the ego, and service the work of the soul (1).

Serving patients may involve spending time with them, holding their hands, and talking about what is important to them. Patients value these experiences with their physicians. In this article, I discuss elements of compassionate care, review some research on the role of spirituality in health care, highlight advantages of understanding patients' spirituality, explain ways to practice spiritual care, and summarize some national efforts to incorporate spirituality into medicine. (BUMC Proceedings 2001;14:352-357)

Subheadings:

Compassionate care: helping patients find meaning in their suffering and addressing their spirituality • Research on the role of spirituality in health care • Advantages of becoming familiar with patients' spirituality • Aspects of spiritual care • National recognition of the value of spiritual care