Saturday, March 9, 2013

Part 3! The Finale!

There are so many examples of times where religious/personal beliefs have to be taken into consideration, typically in life or death scenarios. A patient’s right to make these decisions always trumps the professionals desire to help. But what about those scenarios that happen right in the doctor’s office? Telling someone they are pregnant and they react badly, or having to explain to someone the side effects of a drug that could be life altering are both situations where the patient’s beliefs need to be taken into account. The professional cannot simply assume that abortion is a solution or that the side effects of a drug are worth sacrificing a way of life.
It is perfectly acceptable to be without faith, to not understand why people believe the way they do, or to not be able to relate your beliefs to others. It is part of our rights in America. But as a professional, I believe part of our job is to communicate the needs of the patient in a way that does the best good, or that does the least harm. It is our obligation to our community to take into account their beliefs on a level that does not discriminate.
From patient to medical professional, my experience (small town experience anyway) has shown the communication is so much better if each can be open about their own faith. To be able to talk about what is going on and level about what you “believe” leaves less of a gap for science to scare the public. One of the best experiences I have had was from a patient point of view.
After a near fatal car crash, my faith was all but crushed. Yet, my doctor,  physical therapist, specialist, and my orthopedist always took into account my belief that my life was meant to be saved and treated it as such. I was able to ask questions about how they felt about the technology that was now a part of me that I didn't consider “god given.” It was those discussions that encouraged me to want to become a medical professional. To rely on my faith to get me through the good and bad, to help me communicate our need for advancement in the medical field, and to help understand my patient’s need on a better level.

This video is Tony Robbins talking about being emotionally involved in what you do (STRONG paraphrasing)! He ends with "explore your web, the [stuff] that's controlling you, so you can give and appreciate what drives other people." It made me think of my Physical Therapists who reminded me of that everyday. I see a direct relationship in being emotionally involved as a medical professional and being aware of the patients beliefs/faith/religion/EMOTION!

My physical therapist loved this old Zen master quote, “A strategy of detachment may not serve you well in the long run. There are indeed rewards for those who care for the dying, but you must be present to win them."

Part 2!

So today is about the patient and medical professional! I left off yesterday with a question about how the medical professional should go about bringing religion/faith into their everyday patient communication. Actually many medical schools require a medical student to take some sort of course revolved around “spiritual history.” It simply gives the student the means and education to assess how or whether or not they should invite religion into their communication with the patient. More recently, Medical Universities are offering “spirituality in medicine” classes. For example, University of Washington (Medicine) offers course for the purpose of providing an opportunity for interactive learning about relationships between spirituality, ethics and health care. Here are some of the goals of the class:
  • To heighten student awareness of ways in which their own faith system provides resources for encounters with illness, suffering and death.
  • To foster student understanding, respect and appreciation for the individuality and diversity of patients' beliefs, values, spirituality and culture regarding illness, its meaning, cause, treatment, and outcome.
  • To strengthen students in their commitment to relationship-centered medicine that emphasizes care of the suffering person rather than attention simply to the pathophysiology of disease, and recognizes the physician as a dynamic component of that relationship.
  • To facilitate students in recognizing the role of the hospital chaplain and the patient's clergy as partners in the health care team in providing care for the patient.
  • To encourage students in developing and maintaining a program of physical, emotional and spiritual self-care which includes attention to the purpose and meaning of their lives and work.
The emphasis on listening to the patient and learning of the patient's beliefs and values as well as the signs and symptoms of illness is timely. Both play a critical part in the medical professional-patient relationship.
During my shadowing of Dr. Adams (Shelbyville, TN), I noticed a whole slew of various persons come through her office. Although they were treated individually, one of her nurse practitioners kept mentioning, “Same thing, just a different day. You would think by now I could do my job with my eyes closed.” This does nothing to convince me that the professionals are doing all they can to relate to the patient as a person, rather than just simply another problem to fix.  These are the types of problems our demand for speed causes.
A lot of simplistic problems work against the patient’s need, not all of them being avoidable. The office visit grows shorter as medical professionals are pushed into statistic of who better based on how many patients one sees. USA Today terms the physician as the "gatekeeper" in terms of referral to specialists, diagnostic procedures, or hospitalization decisions. This is all projected on the physician from an economy basis. However, an economy boost should not come at the sacrifice of respect for persons, the fundamental moral obligation in the profession of medicine.
From the patient point of view, these problems are only complicated by a slew of rising ethical questions concerning the medical field’s process of coming up with new technologies or medicine to help the patient. Not only is there a lack of communication in the office but there are a mass of medical journals being morally questioned. Without the patient being able to ask their own doctor about the conflict, what else can they do but look into the bias of the publicity world?
Glenn McGee touches on so many areas of the medical world that are being questioned with good reason. A great advancement such as Polyheme  is being squandered under the moral criticism of the company that created it. Seasonale helps the female body from experiencing what can be a very chronic issue with menstruation. Yet, both of the products are feared because of the media and the medical profession’s inability to communicate a code of moral obligation whether it be their own faith or their respect for the patients faith. McGee goes from clinical trials to genomic baby production, and I see one outlying case question: where are the morals being taken into consideration? For me, all that starts in the medical professional’s office. Talking about it helps, truth be told!

Friday, March 8, 2013

Part 1!

Benedict gives Obama some life lessons -- literally!

The above link is a good place to start with Religion in Medicine. What does it mean? Who does this concern? Why is it important to tackle such a personal topic?
Pope Benedict simply lets the President know his opinion on where he is allowing the science/medicine to venture. Most of the article is irrelevant but I was fascinated that this was a topic under religion in Bioethics.
So, I began to think about what kind of professional I want to be described as? How much of that description is directly related to my faith? The link simply reminded me of how important it is to at least be aware of the religiosity in such a influential field.

So my first objective is to explain the regulations and code of ethics pertaining to Faith/Religion in Medicine. Then, I want to address two sides of how religion affects Medicine, from the patient and from the professional. This blog is dedicated to providing the reasoning behind why it is so important to be aware (religious or not) of the role religion/faith plays in medicine.

Modern medicine raises an anomaly of grey area. Should we or not lengthen life through artificial means?Is it acceptable to shorten life or dull the exposure of life through the use of pain medications? What is the expanse on how far a person can go to render a disease? This is but a fraction of the myriad of questions that have religious and spiritual significance to a large host of our society. These decisions deserve a sensitive yet direct approach. How can one's faith be taken into account if it is not acknowledged? And at what point does a professional know that faith is playing a role in the patients decision?

Below I have included the guidelines a medical professional must abide by when dealing with the religious aspect of their duty.

Four guidelines are offered for physicians regarding religious issues:

  • physicians may enter such a dialogue, but they are not obligated to do so.
  • the dialogue must be at the invitation of the patient, not imposed by the physician.
  • physicians must be open and nonjudgmental in claiming that their beliefs are personally helpful, without claiming ultimate truth
  • the guiding principle should be "do no harm," the purpose of the dialogue should be burden-lifting, not burden-producing. [1]
So for now, I leave you with this question: How can a professional assess when faith is pertinent to the patient if they are not allowed to bring it up? Or course, as you may assume, their are guidelines for that as well! 

 1. Foster DW. Religion and Medicine: The Physician's Perspective. Health/Medicine and the Faith Traditions. Marty, M.E., Vaux, K.L., editors, Philadelphia, Fortress Press, 1982, pp. 245-270.