Saturday, January 21, 2012

Spirituality and Healthcare: By Who's Ethic?

I recently heard a very interesting lecture at the hospital where I work presented by Dr. Ryan Nash on "The Temptation of Spiritual Medicine: An Argument for Informed Respect.” He addressed the role of spirituality in medical care from a number of vantage points.  He made it clear that any spiritual care should be based upon the patient’s own values. One should also not expect the patient’s ethic to always be in line with standard medical practice. An example he gave was the efforts by medicine to make care as pain-free as possible. Most would probably agree, but a Buddhist patient who is hospitalized, even with a terminal condition, may not wish sedation and narcotic to numb him, thereby removing him from being able to be present to experience the last stage of life.

Dr. Nash also pointed out that people may live by different ethics and values. In referencing Herve’ Juvin’s book The Coming of the Bodyhe made note of what Juvin calls a post-modern culture which holds a tripartite ethic of “health, safety, and pleasure.” This in contrast to the humanist ethic of “liberty, equality, and fraternity.”  Juvin claims that we humans are not the same as we were 100 years ago, as evidenced by a narcissistic era in which the body is sacrosanct.

Which is the higher ethic for you? I find the rallying cry of "liberty, equality, and fraternity" to be a much nobler cause, but Juvin raises an important question (as does Dr. Nash).  When we look at healthcare today, by and large, people seem to be demanding health and safety, and most of us want to avoid any pain that would rob us of pleasure.

Of course, “liberty, equality, and fraternity” was the ideal for our founding fathers in the forging of a new nation of democracy in America. In a later conversation with Dr. Nash, he pointed out that even then, there was debate over who was to be included in “fraternity,” and that “equality” did not mean “egalitarian” as we usually understand the word today. Still, the ideals of “health, safety, and pleasure” were far from anything on the minds of our ancestors as a new nation was being forged.

It was fascinating food for thought for me. I agree that as healthcare providers, we must take the patient’s values into consideration in any care, medical or spiritual, that is provided. We should also be vigilant that we not assume that the values we hold are necessarily the same ones our patient holds.  


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