Daniel P. Sulmasy
The New England Journal of Medicine
March 16, 2024
DOI: 10.1056/NEJMp2310498
Mind, body, and soul are inseparable. Throughout human history, healing has been regarded as a spiritual event. Illness (especially serious illness) inevitably raises questions beyond science- questions of a transcendent nature. These are questions of meaning, value, and relationship. 1 They touch on perennial and profoundly human enigmas. Why is my child sick? Do I still have value now that I am no longer a "productive" working member of society? Why does brokenness in my body remind me of the brokenness in my relationships? Or conversely, why does brokenness in relationships so profoundly affect my body?
Historically, most people have turned to religious belief and practice to help answer such questions. Yet they arise for people of all religions and of no religion. These questions can aptly be called spiritual.
Whereas spirituality may be defined as the ways people live in relation to transcendent questions of meaning, value, and relationship, a religion involves a community of belief, texts, and practices sharing a common orientation toward these spiritual questions. The decline of religious belief and practice in Europe and North America over recent decades and a perceived conflict between science and religion have led many physicians to dismiss patients' spiritual and religious concerns as not relevant to medicine. Yet religion and spirituality are associated with a number of health care outcomes. Abundant data show that patients want their physicians to help address their spiritual needs, and that patients whose spiritual needs have been met are aided in making difficult decisions (particularly at the end of life), are more satisfied with their care, and report better quality of life.2.... Spiritual questions pervade all aspects of medical care, whether addressing self-limiting, chronic, or life-threatening conditions, and whether in inpatient or outpatient settings.
Beyond the data, however, many medical ethicists recognize that the principles of beneficence and respect for patients as whole persons require physicians to do more than attend to the details of physiological and anatomical derangements. Spirituality and religion are essential to many patients' identities as persons. Patients (and their families) experience illness, healing, and death as whole persons. Ignoring the spiritual aspects of their lives and identities is not respectful, and it divorces medical practice from a fundamental mode of patient experience and coping. Promoting the good of patients requires attention to their notion of the highest good.
Here is my summary:
The article discusses the interconnectedness of mind, body, and soul in the context of healing and spirituality. It highlights how illness raises questions beyond science, touching on meaning, value, and relationships. While historically people turned to religious beliefs for answers, these spiritual questions are relevant to individuals of all faiths or no faith. The decline of religious practice in some regions has led to a dismissal of spiritual concerns in medicine, despite evidence showing the impact of spirituality on health outcomes. Patients desire their physicians to address their spiritual needs as it influences decision-making, satisfaction with care, and quality of life. Medical ethics emphasize the importance of considering patients as whole persons, including their spiritual identities. Physicians are encouraged to inquire about patients' spiritual needs respectfully, even if they do not share the same beliefs.
