What role should religion and spirituality play in patient care?

Religion’s influence on patient care is expressed in prayer requests, in clinician-chaplain collaborations, and through health care organizations’ religious accommodations for patients and staff.

Whether and how religion and spirituality training are critical components of students’ and clinicians’ development of cultural humility is one important set of questions explored in the July issue of the AMA Journal of Ethics® (@JournalofEthics).

Take a moment to consider this question: The night before a scheduled bypass surgery, a patient asks her surgeon to pray with her. How should the surgeon respond?

• Say yes, but only if he shares her religion.
• Say yes, even if he does not identify with her religion.
• Say no, and call the chaplain.
• Say no, but offer to remain with the patient while she prays.
• Say no, and do nothing else.

Give your answer and find responses to this question in this month’s issue, which explores religion and spirituality in health care practice.

Articles include:

“How Should Clinicians Respond to Requests from Patients to Participate in Prayer?” Over the past 20 years, physicians have shifted from viewing a patient’s request for prayer as a violation of professional boundaries to a question deserving nuanced understanding of the patient’s needs and the clinician’s boundaries. A patient’s request for prayer can reflect religious distress, anxiety about her clinical circumstances, or a desire to better connect with her physician.

“Best Practices for Partnering with Ethnic Minority-Serving Religious Organizations on Health Promotion and Prevention.” Faith-based organizations serve as effective sites for community-based health promotion, but there is a lack of research on this work in ethnic minority-serving religious institutions such as mosques, temples and Sikh gurdwaras. This article shares best practices, challenges and special considerations in engaging these sites through two projects working with Asian-American and Muslim-American communities.

“Training Physicians as Healers.” Spirituality is increasingly recognized as an essential element of patient care and health. It is often during illness that patients experience deep spiritual and existential suffering. With clinicians’ care and compassion, patients are able to find solace and healing through their spiritual beliefs and values. This article chronicles a history of spirituality and health education, including the development of consensus-based clinical guidelines and competencies in health professions education that have influenced curricular development.

“Should Clinicians Challenge Faith-Based Institutional Values Conflicting with Their Own?” Catholic health care organizations generally prohibit their employees from prescribing contraceptives for the purpose of birth control. This restriction might go against a clinician’s own beliefs and the explicit wishes of a patient. In this case with commentary, a physician is being asked by a patient to code oral contraception as treatment for acne, a noncontraceptive benefit of birth-control pills, although both parties know the patient’s primary desire is to prevent pregnancy. We examine the legal and moral arguments surrounding contraceptive provision in this case and offer guidance for how the physician and patient might work to find a tenable solution.

In the journal’s July podcast, Rabbi Susan Harris, director of chaplaincy at Boston Children’s Hospital, discusses how chaplains communicate about values in clinical settings. Listen to previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other services.

Meanwhile, the AMA Journal of Ethics Discussion Forum will explore how to respond when patients' and physicians' religious values conflict. The discussion runs July 23–30. Learn from experts on the topic and ask your questions.

The Conley Art of Medicine and Conley Ethics Essay contests for medical students, residents, and fellows are now open through Sept. 25. Each has a $5,000 prize for the winning art entry.

The journal’s editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians. Submit a manuscript for publication. The journal also invites original photographs, graphics, cartoons, drawings and paintings that explore the ethical dimensions of health or health care.

The AMA Journal of Ethics call for papers is now open. The journal invites original submissions for peer review consideration on themes that will be explored in 2019 issues.

A call for theme issue editors is also now open through Oct. 1, 2018. The journal invites medical students, residents and fellows (MDs or DOs) in United States-based programs to apply to serve as theme issue editors for monthly issues to be published from December 2019 through November 2020.

Upcoming issues of the AMA Journal of Ethics will focus on ethics, policy, and the roles of physicians in care of the dying, and ethics in precision health. Sign up to receive email alerts when new issues are published.