More on Where Religion and Medicine Meet

In 2008, Science 2.0, a nonprofit blogging site for academics created to discuss science-related subject matter, posted research from Brandeis University on the current state of chaplaincy services in hospitals. The study was deemed the first of its kind to provide a systematic national overview of hospital chaplaincy and was based on the results of the American Hospital Association’s annual survey of hospitals. It revealed that “despite changes over the last fifteen years in national accreditation guidelines making the religious and spiritual care of hospitalized patients a right,” between 1980 and 2003, 54%-64% of hospitals provided chaplaincy services.

They go on to report that the results suggests that “greater attention to religion and spirituality in medicine may be the result of doctors’ and nurses’ greater attention to spirituality and religion rather than increasing numbers of hospitals with chaplains.”

Current data on the present scope of hospital chaplain services is hard to come by. I could find no recent landmark studies. But it is a good guess that the push to provide such holistic services hasn’t changed much over the years. It doesn’t appear to be coming from hospital administrators. A recent opinion piece by Dr. T. Salewa Oseni, a surgical oncologist at Massachusetts General Hospital, an assistant professor of surgery at Harvard Medical School and a specialist in cancer surgery, seems to suggest this to be the case.

“As a surgeon specializing in cancer, I often meet people at a time of crisis and fear, when they have just been diagnosed with cancer,” he writes in a recent STAT News report. “For many, their belief system is central to their coping strategy … Times of crises are reminders of humans’ need for social connection; they are often a time when people reconnect with their faith … Yet medicine has minimized the importance of faith and religion in patient well-being. They have been largely sidelined, something to be engaged with only when death approaches.”

“Too often my empathic colleagues do not ask their patients about religion or faith or spirituality,” he writes. “In doing so, they inadvertently focus on the cancer and lose focus of the patient and their emotional well-being … Americans increasingly identify as non-religious. And many of my colleagues may believe that religion or faith or spirituality is a private matter outside the purview of medicine. Yet this is not entirely true: Physicians are comfortable relegating faith and religion to palliative or hospice care. This reinforces the notion that faith, religion, and spirituality are only end-of-life issues and not also ways to foster human connections … Medical education needs to make future physicians comfortable discussing matters of faith, religion, and spirituality as part of providing culturally competent care. This can be discussed in medical school, but unless trainees see their role models doing this, it is just another fact-finding exercise to be tested on an exam.”

This shift to more fully addressing religion and spirituality’s role in medicine is why the Harvard study I cited last week is so profoundly significant, though seemingly overlooked within current health care news. It states in irrefutable terms why spirituality should be incorporated into not only care for serious illness but in matters of overall health. The study reported in the Harvard Gazette and led by researchers at Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital shows that the findings “indicate that attention to spirituality in serious illness and in health should be a vital part of future whole person-centered care.”

“This study represents the most rigorous and comprehensive systematic analysis of the modern day literature regarding health and spirituality to date,” says Tracy Balboni, lead author of the study and senior physician at the Dana-Farber/Brigham and Women’s Cancer Center and professor of radiation oncology at Harvard Medical School.

For the study, a structured, multidisciplinary 27-member group of experts called a Delphi panel “reviewed the strongest collective evidence and offered consensus implications for health and health care. They noted that for healthy people, spiritual community participation — as exemplified by religious service attendance — is associated with healthier lives, including greater longevity, less depression and suicide, and less substance use. For many patients, spirituality is important and influences key outcomes in illness, such as quality of life and medical care decisions. Consensus implications included incorporating considerations of spirituality as part of patient-centered health care and increasing awareness among clinicians and health professionals about the protective benefits of spiritual community participation,” says the Harvard Gazette report.

“Overlooking spirituality leaves patients feeling disconnected from the health care system and the clinicians trying to care for them,” says Howard Koh, a senior author of the study and professor of the Practice of Public Health Leadership at Harvard Chan School. “Integrating spirituality into care can help each person have a better chance of reaching complete well-being and their highest attainable standard of health.” The simple act of asking about a patient’s spirituality “can and should be” part of patient-centered, value-sensitive care, they add.

The authors of the study say they hope the results will stimulate more national discussion and progress on how spirituality can be incorporated into this type of value-sensitive care. Time will tell. I pray they are right.

Stephen T. Asma is an author and professor of philosophy at Columbia College Chicago, where he is a senior fellow of the Research Group in Mind, Science and Culture. In a 2018 opinion piece in The New York Times, while admitting a historical skepticism toward religion, he readily admits that there are things it gives us that science can’t.

“My claim is that religion can provide direct access to this emotional life in ways that science does not,” he writes. “Yes, science can give us emotional feelings of wonder at the majesty of nature, but there are many forms of human suffering that are beyond the reach of any scientific alleviation (relief). Different emotional stresses require different kinds of rescue … We need religion because it is a road-tested form of emotional management.”

“Religious rituals, for example, surround the bereaved person with our most important resource — other people. Even more than other mammals, humans are extremely dependent on others — not just for acquiring resources and skills, but for feeling well … Religious practice is a form of social interaction that can improve psychological health.”