Spirituality and Healthcare—Common Grounds for the Secular and Religious Worlds and Its Clinical Implications
- The personal quest for understanding answers to ultimate questions about life, meaning, and the relationship to the sacred or transcendent (King and Koenig 2009).
- The ways in which a person habitually conducts their life in relationship to the question of transcendence (Sulmasy 2009).
- A dynamic and intrinsic aspect of humanity, through which persons seek ultimate meaning, purpose, and transcendence, and experience relationship to self, family, others, community, society, nature, and the significant or sacred (Puchalski et al. 2014).
- A search for meaning, purpose, and transcendence and a connection to the significant or sacred (Sajja and Puchalski 2018).
- In a study involving medical schools in Brazil (Lucchetti et al. 2012), 54% of the directors or deans believed that spirituality should be taught to students (still deemed low); however, only 10% of all schools surveyed had dedicated courses.
- Although the practice of medicine requires a secular facade, an extensive study in the United States (Curlin et al. 2005) revealed that 55% of physicians declared their religious beliefs to clearly influence their clinical practice.
- Biofield healing (a secular counterpart of spiritual healing) fits well in the integrative model of healthcare, satisfying the desires of many patients; however, it remains outside the conventional framework, mainly because of its conceptual bases (Hufford et al. 2015).
- Spiritual experiences have important effects on biological, cognitive, and psychosocial domains; however, their role in the clinical setting has generated considerable discussion within the medical community (Giordano and Engebretson 2006).
2. Secular and Religious Intersection Concerning Spirituality and Healthcare
2.1. Spiritual Wellbeing
- Concept: a state of positive feelings, behaviours, and cognitions that provides the individual with a sense of identity, wholeness, satisfaction, joy, contentment, beauty, love, respect, constructive attitudes, inner peace and harmony, and purpose and direction in life (Gomez and Fisher 2003).
- Secular examples: positive thinking activating psycho-neuro-immune-endocrine pathways and balancing neurovegetative functions through modulation of stress (Saad and de Medeiros 2017).
- Religious examples: “your faith has healed you” (some biblical excerpts such as Mark 5:34); “a cheerful heart is good medicine, but a crushed spirit dries up the bones” (Proverbs 17:22); “[to fear the LORD and shun evil] will bring health to your body” (Proverbs 3:8).
- Common ground for both: independently of metaphysical issues, a positive and causal association exists between faith and positive parameters of physical and mental health, including longevity (Saad et al. 2019).
- Clinical implications: Healthcare staff should respect spiritual values and be attentive to the patient’s needs and beliefs related to the disease experience.
2.2. Spiritual Coping
- Concept: the cognitive and behavioural efforts to find or maintain meaning, purpose, and connectedness in the face of threatening or distressing situations (Clark and Hunter 2019). In other words, the faith-related attitudes used to deal with a crisis, or to modulate the resulting emotional distress.
- Secular examples: support from rationalistic and humanistic worldviews, liberal values, and analytic thinking for a meaningful and healthy life (Uzarevic and Coleman 2020).
- Religious examples: strength from prayer, sacred rituals, and religious symbols. Religious leaders, organisations, and communities are a primary source of support, comfort, guidance, and direct healthcare (WHO 2020).
- Common ground for both: the importance of restoring individual or cultural values to face an adverse experience.
- Clinical implications: healthcare professionals need to know about negative spiritual coping (anger, sorrow, guilt, stigma, struggle), which adversely affects the course of treatment by worsening stress. If needed, secular spiritual resources can be used.
2.3. Spiritual Support
- Concept: giving professional attention to the subjective spiritual and religious worlds of patients, concerning the relationship of the sacred to their illness, hospitalisation, and recovery or possible death (VandeCreek 2010).
- Religious examples: religious minister offering doctrinal counselling and sacraments in hospital, such as anointing of the sick for a Catholic patient near death.
- Common ground for both: spiritual needs are distinct from emotional and social ones, despite the interrelationship among them. Therefore, they are outside the range of psychological interventions.
- Clinical implications: spiritual support should be considered essential care; healthcare institutions should address questions regarding the spiritual dimension and they should have clear policies to foster resource aids (Hall 2020). For hospital quality accreditation, the Joint Commission International questions in its Standard PFR.1.2 claims: The hospital provides care that is respectful of the patient’s personal values and beliefs and responds to requests related to spiritual and religious beliefs1.
2.4. Spiritual Therapies
- Concept: mystical, religious, or spiritual practices performed for the benefit of health, as defined in the Medical Subject Headings2.
- Secular examples: procedures centred on the concept of a vital bioenergy, such as Yoga, Reiki, Qi Gong, and Johrei. This includes meditation (even if this practice has religious roots).
- Religious examples: procedures centred on the soul potentialities, such as blessings from various traditions and intercessory prayer.
- Common ground for both: the activation of inner hidden resources through a facilitator (the practitioner), regardless of the mechanisms of action that explain their effects.
- Clinical implications: despite the lack of uniformity on physiological responses and low clinical relevance of effects, a humanistic, comprehensive, and integrative healthcare approach should accompany patients in their aspirations and desires with sympathy and respect. Thus, healthcare providers should define their stance regarding the validity and utility of these approaches, as patients will inquire about them (Rindfleisch 2018).
2.5. Spiritual Phenomena
- Concept: unusual experiences that deviate from the generally accepted explanations of reality, the so-called parapsychological (psi) phenomena (Cardeña 2018).
- Secular examples: scientific reports on memories of alleged past lives, with many cases of a match, near-death experiences with elements not related to hallucination, and end-of-life experiences with the embarrassing terminal lucidity (Daher et al. 2017).
- Religious examples: mystical states, such as ecstatic enlightenment, possession trance, prophesy, and mediumship (after-death communication).
- Common ground for both: the acknowledgement of the consciousness expressions complexity and the attempt to gain a deeper understanding of human condition.
- Clinical implications: clinicians should accommodate patients’ specific desires and needs related to spiritual experiences, as the outcomes may be potentially health promoting (Giordano and Engebretson 2006). However, the practitioner must check if a strange behaviour is benign or pathological, through the differentiation between healthy spiritual experiences and mental disorders with religious content (Moreira-Almeida 2013).
4. Implication and Limitations of the Present Rationalisation
- A secular hint to religiously-oriented professionals: you can hold your faith to get the strength to face the professional challenges, but keep in mind that, most of the time, clinical practice demands physicalist premises and reductionist methods; you can always follow your personal commitments by referring the patient to another colleague in sensitive cases, such as abortion or euthanasia.
- A religious hint to secularly-oriented professionals: although some religious interpretations can be harmful to healthcare, our role is to give the patients the best information and allow them to decide; the acknowledgement of religious values of a patient is a very important ingredient of cultural sensitivity, and the respect for such needs is key for a patient-centred approach.
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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The vocabulary thesaurus for indexing articles can be found in the database PubMed. www.ncbi.nlm.nih.gov/mesh.
|Expression||Secular Examples||Religious Examples||Common Ground for Both||Clinical Implications|
|Spiritual wellbeing||Positive thinking and psycho-neuro-immune-endocrine pathways||“your faith has healed you” (Mark 5:34 and other biblical excerpts)||Faith affects physiology, independently of metaphysical issues||Respect spiritual values and be attentive to patient’s feelings and beliefs|
|Spiritual Coping||Support from rationalistic and humanistic worldviews||Prayer, sacred rituals, religious symbols, and faith community||Restore individual or cultural values to face an adverse experience||Know about negative coping, which affects treatment and worsens stress|
|Spiritual Support||Discussions on non-religious beliefs related to meaning and purpose.||Religious minister offering doctrinal counselling and sacraments||Spiritual needs are distinct from emotional and social needs, despite their interrelationship||Healthcare institutions should address questions regarding the spiritual dimension|
|Spiritual Therapies||Procedures centred on the vital bioenergy: Yoga, Reiki, etc., including meditation||Procedures centred on the potentialities of the soul: blessings, intercessory prayer, etc.||Activation of inner hidden resources through a facilitator||Accompany patients in their aspirations and desires with sympathy and respect|
|Spiritual phenomena||Scientific reports: memories of past lives, near-death experience, and end-of-life experiences||Mystical states: ecstatic enlightenment, possession trance, mediumship, and prophesy||Acknowledgement of the complexity of consciousness expressions||Accommodate patients’ values, while checking for mental illness|
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Saad, M.; de Medeiros, R. Spirituality and Healthcare—Common Grounds for the Secular and Religious Worlds and Its Clinical Implications. Religions 2021, 12, 22. https://doi.org/10.3390/rel12010022
Saad M, de Medeiros R. Spirituality and Healthcare—Common Grounds for the Secular and Religious Worlds and Its Clinical Implications. Religions. 2021; 12(1):22. https://doi.org/10.3390/rel12010022Chicago/Turabian Style
Saad, Marcelo, and Roberta de Medeiros. 2021. "Spirituality and Healthcare—Common Grounds for the Secular and Religious Worlds and Its Clinical Implications" Religions 12, no. 1: 22. https://doi.org/10.3390/rel12010022