An interesting brief essay on the spiritual dimension of clinical practice,
by Harold Koenig of Duke university, United States, is published in the Journal
of the American Medical Association for October 4. He starts by asserting that
“patients want to be seen and treated as whole persons, not as diseases.”
This is a valid point. Fortunately, we have dismissed as offensive that earlier
pernicious habit which doctors and nurses indulged in, of referring to a patient
as, for example, “the hemiplegia on Ward A.” People are entitled to
be regarded as spirit and substance, not specimens.
Spirit is defined as “the vital principle” and therefore a quality
that differentiates between the living and the non-living. We have no other
means of expressing life as opposed to death. Koenig points out, I think justifiably,
that many seriously ill individuals use religious beliefs to help cope with
their sickness and incapacity, with depression in particular. He asserts that
people enjoy better mental health and adapt more successfully to stress if they
hold some sort of belief which makes sense, to them, of existence. Most studies
of this problem have found that such individuals are physically healthier, lead
healthier lifestyles, and require fewer health services than others. Nevertheless,
religious practices must not be regarded as a substitute for therapeutic medicine.
Having decided that a patient holds spiritual convictions, the physician is
not entitled to prescribe any beliefs or practices because he or she considers
them conducive to health, and certainly may not impose his or her own beliefs
on the patient. It is permissible, however, to consider supporting any belief
which the patient holds and which appears to help that person to cope with illness.
Physicians, writes Koenig, have a professional obligation to comfort always,
relieve often, and cure sometimes. If the patient chooses recourse to prayer
in seeking relief from pain or anxiety, it is the physician’s function
to encourage but not dictate it.
It all boils down to the familiar notion of the holistic approach to sickness
and health. Perhaps it might be appropriate to alter the spelling to “wholism”,
which is what the concept means in practice.