The National Institute for Healthcare Research, a privately funded, nonprofit advocacy organization, has published extensive literature reviews suggesting that religious faith and practice are positively associated with health status. The organization's World Wide Web site encourages physicians to pay more attention to religious matters and recommends that they take a spiritual history at the time of each complete physical examination, with any concerns raised by patients addressed during follow-up visits. In addition, the National Institute on Aging and Harvard Medical School sponsor meetings on the integration of spirituality and medical practice. Nearly 30 U.S. medical schools now offer courses on religion, spirituality, and health. We believe the evidence is generally weak and unconvincing, since it is based on studies with serious methodologic flaws, conflicting findings, and data that lack clarity and specificity.
Some studies report that patients want physicians to attend to their spiritual concerns.
King and Bushwick found that 48 percent of the patients they surveyed indicated that they wanted their physicians to pray with them. On the one hand the strong evidence supporting the association is described, and then we are told that there are flaws in the original studies and that there clearly is not enough evidence to support promoting spiritual activities in medicine. The authors do bring up a valid point though in that physicians are not trained to engage in in-depth conversations with their patients about their spiritual concerns. Such discussions are not the sole domain of any one profession, but many health care facilities have chaplains or other community clergy who have received systematic post-seminary training and clinical supervision in such areas as pastoral psychology, ethics, and multicultural pastoral care and who are endorsed by their denominations. The authors advise patients who seek spiritual support to be referred to these professionals.