The Soul of Medicine

Dr. John Peteet, a psychiatrist at Brigham and Women's Hospital in Boston and an Associate Professor in the Department of Psychiatry at Harvard Medical School, is one of the co-editors of the recently released collection entitled The Soul of Medicine: Spiritual Perspectives and Clinical Practice. The book consists of a series of engaging essays that explore the role and influence of spirituality in clinical practice, professionalism, and medical education. The contributors to this volume approach this topic from their own spiritual perspectives—Jewish, Christian, Muslim, Buddhist, Hindu, New Age / Eclectic, secular, Jehovah’s Witnesses, and Christian Scientist. Their thought-provoking essays provide rich insights not only into the needs of patients with various world views but also into how spirituality influences the practice of medicine.

In a recent interview with Dr. Peteet, he provided more information about the background of and motivation for the book, as well as about the impact the book has had since its publication. 

Could you speak some about the background of the book? What motivated you to bring together this collection? 

As co-directors of the Harvard Medical School course, "Spirituality and Healing in Medicine" (which draws students from the Schools of Medicine, Public Health and Divinity), Mike D’Ambra and I experienced a need for a basic text that could prepare students for dealing with the spiritual and world view dimensions of clinical and ethical issues that arise in the practice of medicine.

Who is the intended audience, and what do you hope the book conveys to this audience?

We hoped that this book would provide medical students with a needed text, we have also intended it for those in the wider medical community who are interested in better understanding the relevance of religion and spirituality to medical practice. To do so, chapter authors explore the history of the relationship between medicine and spirituality; the helpful and the problematic implications of patient and clinician spiritual beliefs, practices and experiences; the implications for practice of differing, prevalent spiritual world views (including Jewish, Christian, Muslim, Buddhist, Hindu, New Age / Eclectic, secular, Jehovah’s Witnesses, and Christian Scientist); ways of understanding the  roles of clinicians and chaplains in patients’ spiritual lives, using case examples; and the current state of medical teaching and learning in this area. 

What has drawn you to this topic of spirituality/religion and medicine? Why do you feel this topic is important?

As biomedicine makes enormous contributions to the cure of disease, there is widespread concern that medicine may be losing its soul. When technology, bureaucracy, and commercialization impinge upon  the doctor patient relationship, the satisfaction of patients, and the morale of their physicians decline.  Within this context, interest continues to grow in the deeply felt moral and spiritual dimensions of medicine. Americans spend about $1.5 billion annually on books on spirituality and religion, and about 40% have sought out complementary and alternative therapies. Medline contains 5000 citations on spirituality in relation to health research. Recognizing the relevance of spirituality to patient care, national agencies and policy organizations such as the JCAHO (Joint Commission on Accreditation of Healthcare Organizations) have mandated attention to patient spirituality as part of routine clinical care. Screening tools such as the FICA are becoming increasingly well known and in 2004, 84 U.S. medical schools offered courses in spirituality and medicine. But consensus is lacking about the clinical implications of this movement toward spirituality. What, if any spiritual information should be a part of a physician’s standard assessment of a patient? How should a physician respond to a patient who refuses life-saving care on religious grounds? Should a doctor pray with a patient? These practical questions call for answers to deeper ones about the goals of medicine, the nature of healing and the physician’s role in responding to patients who experience reality in very different ways. 

What do you think is the importance of a book such as The Soul of Medicine?

I believe it helps us as clinicians, students and trainees to listen better for what is most important to our patients as well as to ourselves, and to find ways to engage these dimensions in our everyday practice of medicine. My experience is that those who have used it to help them connect with patients and colleagues on these deeper levels have found this surprisingly rewarding, both personally and professionally.

What has the impact of the book been? 

The book has been reviewed by the American Journal of Bioethics and JAMA, and led to invitations to speak in person and on a Webinar. Students in our course have also found it helpful in allowing invited speakers as chapter authors to discuss rather than reiterate their message. Having provided a basic introduction to the clinical relevance of spirituality, it has inspired several of us to undertake the next step of envisioning a course designed to (1) counterbalance the power of  the informal curriculum to influence medical students as they leave what some have called the "pre-cynical years,” by encouraging an engaged, rather than a static spirituality that will enable them to be more able to draw on the core sources of wisdom and fortitude that have sustained them and constitute resources for self care, and (2) help students pursue more deeply the question of how scientific research can further a dialogue on these important issues.

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