Spirituality: the emperor's new clothes?

Tags:

• Christianity
• existentialism
• Holistic Health
• Humans
• Judaism
• NEEDS assessment
• Nurse's Role
• Nursing Assessment
• Pastoral Care
• Patient Rights
• Philosophy
• Religion and Medicine
• Religion and Psychology
• Semantics
• spirituality

Notes:

• Background: This paper explores the concept of ‘spirituality’ with reference to the Patients’ Charter that stipulates that a person’s religious, spiritual and cultural needs should be respected at all times. Aims and Objectives The aim is to offer a critical analysis of what the word ‘spirituality’ may mean when used in the Patients’ Charter and to explore the implications of this for clinical practice. Design: A critical discussion based on a literature review, examining in particular methodological presuppositions. Methods: The meaning of ‘spirituality’ in the Judaeo-Christian biblical traditions is explored. Some of the heuristic assumptions in contemporary research on ‘spirituality’ are examined. Philosophical (i.e. non-scientific) and scientific questions to do with ‘spirituality’ are disentangled. Results and Conclusions: The paper concludes that: (i) ‘Spirituality’ is an elastic term not capable of universal definition as each person’s spirituality is an individual matter for them and (ii) tools that are being developed for identifying a person’s spirituality run the risk of making wrong presuppositions about what comprises spirituality. Relevance to Clinical Practice: It is unlikely that tools can be developed that are widely applicable for identifying and assessing spirituality.

Prayer, Science, and the Moral Life of Medicine

The Work of Andrew Weil and Deepak Chopra-Two Holistic Health/New Age Gurus: A Critique of the Holistic Health/New Age Movements

Notes:

• Despite the popular roots of the holistic health/New Age movements, a growing number of biomedical physicians have become proponents of holistic health as well as New Age healing. Over the past two decades, Andrew Weil and Deepak Chopra, two biomedically trained physicians, have emerged as the visible and financially successful spokespersons of the movement. This article provides brief biographical sketches of Weil and Chopra and compares and contrasts their respective views on health, illness, healing, and health care. It also considers the response of various biomedical parties to these holistic health/New Age gurus who have attempted to integrate biomedicine and various alternative healing and metaphysical systems. Finally, this article argues that Weil and Chopra both epitomize the limitations of the holistic health/New Age movements, albeit in different ways.

The Placebo Effect and the Molecules of Hope.

Tags:

• CHURCH membership
• Clergy
• Physicians
• PLACEBOS (Medicine)
• WIT & humor

Experiments on Distant Intercessory Prayer: God, Science, and the Lesson of Massah

Notes:

• EXPERIMENTAL studies on the health effects of distant intercession (prayer) ignore important facets of construct validity, philosophy of science, and theology while focusing on issues like randomization and double-blinding. These tendencies reflect a desire on the part of researchers to remove nature as a causal factor when intercession seems efficacious. We argue that close attention to construct validity of cause-and-effect variables invalidates distant intercessory prayer as a scientific construct. Further, the application of statistical techniques to metaphysical causal phenomena is critiqued. We conclude that research on the effects of religion and spirituality on health should avoid attempting to validate God through scientific methods.

About Intercessory Prayer: The Scientific Study of Miracles

Meditation as Medicine: A Critique

Evidence-based practice in British complementary and alternative medicine: double standards?

Are modern health worries, environmental concerns, or paranormal beliefs associated with perceptions of the effectiveness of complementary and alternative medicine?

Divine intervention? A Cochrane review on intercessory prayer gone beyond science and reason

Tags:

• Faith Healing
• Humans
• Randomized Controlled Trials as Topic
• Religion and Medicine
• Review Literature as Topic
• Science

The witches’ brew of spirituality and medicine

Notes:

• Recent proposals to join spirituality and medicine are facile and ill defined. The notion that physicians have the time or training to make assessments and recommendations about spirituality is misguided. Whenever a physician demonstrates personal caring for a patient, the healing process is likely enhanced, and in that sense, physicians often promote the spirituality of the patient. However, recent proposals to extend the physician’s task to that of assessing religion and directing the patient toward approved forms of spirituality are inappropriate. The languages of religion and science are radically different. The cultural body-mind split will not be solved by such simplistic solutions as having physicians endorse spirituality, which will result only in denigration of both medicine and religion. Physicians are encouraged to rely on clinically trained ministers for assistance in understanding the patient’s state of mind or spirit and its possible effects on the course of illness and health.

Don't let ideology trump science

An evaluation of the evidence in "evidence-based" integrative medicine programs

Tags:

• Complementary Therapies
• Curriculum
• Education, Medical, Undergraduate
• Evidence-Based Medicine
• Humans

Notes:

• Alternative therapies are popular, and information about them should be included in the curricula of health profession schools. During 2000 to 2003, the National Institutes of Health National Center for Complementary and Alternative Medicine awarded five-year education grants to 14 health professions schools in the United States and to the American Medical Students Association Foundation. The purpose of the grants was to integrate evidence-based information about complementary and alternative medicine (CAM) into the curriculum. The authors reviewed the educational material concerning four popular CAM therapies-herbal remedies, chiropractic, acupuncture, and homeopathy-posted on the integrative medicine Web sites of the grant recipients and compared it with the best evidence available. The curricula on the integrative medicine sites were strongly biased in favor of CAM, many of the references were to poor-quality clinical trials, and they were five to six years out of date. These “evidence-based CAM” curricula, which are used all over the country, fail to meet the generally accepted standards of evidence-based medicine. By tolerating this situation, health professions schools are not meeting their educational and ethical obligations to learners, patients, or society. Because integrative medicine programs have failed to uphold educational standards, medical and nursing schools need to assume responsibility for their oversight. The authors suggest (1) appointing faculty committees to review the educational materials and therapies provided by integrative medicine programs, (2) holding integrative medicine programs’ education about CAM to the same standard of evidence used for conventional treatments, and (3) providing ongoing oversight of integrative medicine education programs.

Are there demonstrable effects of distant intercessory prayer? A meta-analytic review

Tags:

• Behavioral Medicine
• Health Services Accessibility
• Helping Behavior

Notes:

• Background: The use of alternative treatments for illness is common in the United States. Practitioners of these interventions find them compatible with personal philosophies. Consequently, distant intercessory prayer (IP) for healing is one of the most commonly practiced alternative interventions and has recently become the topic of scientific scrutiny. Purpose: This study was designed to provide a current meta-analytic review of the effects of IP and to assess the impact of potential moderator variables. Methods: A random effects model was adopted. Outcomes across dependent measures within each study were pooled to arrive at one omnibus effect size. These were combined to generate the overall effect size. A test of homogeneity and examination of several potential moderator variables was conducted. Results: Fourteen studies were included in the meta-analysis yielding an overall effect size of g = .100 that did not differ from zero. When one controversial study was removed, the effect size reduced to g = .012. No moderator variables significantly influenced results. Conclusions: There is no scientifically discernable effect for IP as assessed in controlled studies. Given that the IP literature lacks a theoretical or theological base and has failed to produce significant findings in controlled trials, we recommend that further resources not be allocated to this line of research.

Research Into Complementary And Alternative Medicine: Problems And Potential

Spirituality and the threat to therapeutic boundaries in psychiatric practice.

Reconsidering spirituality and medicine

Tags:

• Education, Medical
• Humans
• Physician-Patient Relations
• Religion and Medicine
• Social Values
• spirituality
• United States

Notes:

• Increasing awareness of possible links between religion and health has led to greater attention to spirituality and medicine in medical education; both trends have culminated in vigorous debate about the place of spirituality and related values in medical care. The author argues that due to basic ambiguities of the term “spirituality” as well as prevailing biases of both patients and practitioners, this debate risks valorizing theistic religious views, a trend that would be to the detriment of physicians, residents, and students who happen to be non-believers or adherents of minority faiths. It is maintained that philosophical value theory, a broad inquiry into value and meaning that is carefully neutral as regards religious matters, provides the greatest possible protection of both secular and non-secular world views. A notion of “separation of church and medicine,” similar in some ways to the well-known political model, is proposed. Because so many issues of meaning and value may be relevant to health, vigilance is required to properly delineate the purview of medicine. The author concludes by proposing that a medicine that neither exalts nor demeans religious belief but rather situates the latter among the countless values persons may hold should be the goal.

Flying carpets and scientific prayers. Scientific experiments claiming that distant intercessory prayer produces salubrious effects are deeply flawed

Tags:

• Faith Healing

Claims about religious involvement and health outcomes

Tags:

• Cardiovascular Diseases
• Decision Making
• Humans
• Hypertension
• Outcome Assessment (Health Care)
• Religion and Medicine
• Reproducibility of Results
• Research Design

Notes:

• Claims about religion, spirituality, and health have recently appeared with increasing frequency, in both the popular media and professional journals. These claims have asserted that there are a great many studies in the literature that have examined relations between religious involvement and health outcomes and that the majority of them have shown that religious people are healthier. We examined the validity of these claims in two ways: (a) To determine the percentage of articles in the literature that were potentially relevant to such a claim, we identified all English-language articles with published abstracts identified by a Medline search using the search term religion in the year 2000, and (b) to examine the quality of the data in articles cited as providing supportfor such a claim, we examined all articles in the area of cardiovascular disease and hypertension cited by two comprehensive reviews of the literature. Of the 266 articles published in the year 2000 and identified by the Medline search, only 17% were relevant to claims of health benefits associated with religious involvement. About half of the articles cited in the comprehensive reviews were irrelevant to these claims. Of those that actually were relevant, many either had significant methodological flaws or were misrepresented, leaving only afew articles that could truly be described as demonstrating beneficial effects of religious involvement. We conclude that there is little empirical basis for assertions that religious involvement or activity is associated with beneficial health outcomes.

Spirituality and medical practice: a look at the evidence

Tags:

• Ethics, Medical
• Evidence-Based Medicine
• Medical History Taking
• United States

Notes:

• In the general public and within medicine, interest in the possibility that religious and spiritual activity may confer health benefits is increasing, as the article by Anandarajah and Hight1 in this issue of American Family Physician clearly demonstrates. The empiric support required to convert this interest into recommendations for medical practice is weak and inconclusive at best, with most studies having numerous methodologic shortcomings.2 Even if there were methodologically solid findings demonstrating associations between religious and spiritual activities and health outcomes, problems would still exist.

Data Without a Prayer

Science, Medicine, and Intercessory Prayer

Notes:

• Among the many recent attempts to demonstrate the medical benefits of religious activity, the methodologically strongest seem to be studies of the effects of distant intercessory prayer (IP). In these studies, patients are randomly assigned to receive standard care or standard care plus the prayers or “healing intentions” of distant intercessors. Most of the scientific community has dismissed such research, but cavalier rejection of studies of IP is unwise, because IP studies appear to conform to the standards of randomized controlled trials (RCTs) and, as such, would have a significant advantage over observational investigations of associations between religious variables and health outcomes. As we demonstrate, however, studies of IP fail to meet the standards of RCTs in several critical respects. They fail to adequately measure and control exposure to prayer from others, which is likely to exceed IP and to vary widely from subject to subject, and whose magnitude is unknown. This supplemental prayer so greatly attenuates the differences between the treatment and control groups that sample sizes are too large to justify studies of IP. Further, IP studies generally do not specify the outcome variables, raising problems of multiple comparisons and Type 1 errors. Finally, these studies claim findings incompatible with current views of the physical universe and consciousness. Unless these problems are solved, studies of IP should not be conducted.

Religion, spirituality, and medicine

Notes:

• Religion and science share a complex history as well as a complex present. At various times worldwide, medical and spiritual care was dispensed by the same person. At other times, passionate (even violent) conflicts characterised the association between religion and medicine and science. As interest in alternative and complementary medicine has grown, the notion of linking religious and medical interventions has become widely popular, especially in the USA. For many people, religious and spiritual activities provide comfort in the face of illness. However, as US medical schools increasingly offer courses in religion and spirituality1 and as reports continue to indicate interest in this subject among both physicians and the general public, it is essential to examine how, if at all, medicine should address these issues. Here, in a comprehensive, though not systematic, review of the empirical evidence and ethical issues we make an initial attempt at such an examination.

Should physicians prescribe religious activities?

Tags:

• Attitude to Health
• Cultural Diversity
• Data Collection
• Health Status
• Humans
• Physician's Role
• Professional-Patient Relations
• Religion and Medicine
• spirituality
• United States

The Campaign Against CAM and the Notion of "Evidence-Based"