VALHALLA — Perhaps it is best left to a pair of doctors to declare that the world of medicine is arrogant, too reverent of technology and in need of some time-tested spiritual wisdom.
Dr. Daniel Sulmasy and Dr. Alan Astrow, faculty members at New York Medical College, aren’t trying to be prophets, exactly. But they want their fellow physicians to acknowledge that they often are not prepared for the questions that arise when medicine runs out of answers, and patients are not ready to die.
“Every day, as we deal with basic medical concerns, spiritual issues come up; issues of hope, of anger, of guilt, of ‘what will happen to me?’ ” said Astrow, chief of clinical oncology at St. Vincent’s Comprehensive Cancer Center in Manhattan. “Physicians are not well-trained in how to address these issues and often don’t know what to do. The great religions of the world have thought about these very questions for thousands of years, making religion a great resource if we turn to it.”
Astrow and Sulmasy have convened an unusual series of programs this year that are designed to bring nonclinical teachings from major religions to clipboard-carrying health-care providers. Each month, two religious figures visit a hospital in the New York metropolitan area to suggest remedies of theology, philosophy and prayer.
It has not been easy to bridge two worlds that have long been separated by tensions between faith and science.
“People are beginning to recognize that technology does not give you all the answers,” said Sulmasy, a Franciscan friar and director of the Bioethics Institute at New York Medical College. “Technology does not grant immortality. The spiritual questions we face are perennial. They were with us at the beginning of time and will be with us at the end of time.”
- Source: The Journal News
On Monday evening, a Hindu leader from Washington, D.C., and the chaplain to the U.S. Senate came to the college to talk about something health-care providers are all too familiar with — denial among those with serious illness. Earlier programs dealt with the associated emotions and reactions that patients have and that doctors, nurses and specialists have to contend with: control, apathy, fear, sadness, shame, guilt and anger.
Astrow and others had precious little trouble coming up with recent examples of patients who are very sick and facing death, yet refuse to give up hope or even listen to their prognosis.
Dr. Siva Subramanian, a pediatrician and founder of several Hindu organizations, said Hinduism’s belief in reincarnation makes denial less of a factor for followers. Hindus understand that birth and death are only “two markers in the passage of life,” and they can contribute to their happiness in future lives by doing good deeds until the end of this life.
“This acts as emotionally, psychologically and spiritually comforting,” he said.
When treating non-Hindus, Subramanian said, he will try to appeal to a person’s faith when appropriate. “You have to understand the patient from the point of view of where he is,” Subramanian said.
The Rev. Barry Black, a Seventh-day Adventist minister who provides religious counsel to U.S. senators, described himself as an evangelical Christian who believes that “God intervenes supernaturally in the affairs of humankind,” a tenet he repeated several times. He said prayer always is a primary option for Christians, no matter how sick, and the “pragmatic denial” of the faithful can lead to recovery.
“When an individual is prancing around a hospital room, saying ‘God is going to heal me,’ be careful before you pour water on their parade,” said Black, an eloquent speaker who cited everyone from William James to Sigmund Freud to Rabbi Harold Kushner.
When counseling people of other faiths, Black said, he will look to their religious texts for examples of God’s intervention.
Some of the nearly 50 health-care professionals in attendance at Monday’s session nodded affirmatively at such calls for prayer in hospital rooms, while others looked skeptical or at least unsettled. One psychiatrist offered that some patients in denial actually may be suffering from depression that needs to be treated.
Sulmasy wondered whether doctors should feed a patient’s denial. “Does the physician have a moral obligation to give treatments he thinks will be more harmful than helpful because the person still has faith?” he asked.
Astrow, a Jew who cites Abraham Joshua Heschel and Martin Buber as influential thinkers on incorporating religion into daily lives, suggested that it can be easy for a doctor making his rounds to look away from denial.
“The nurses are left to deal with reality,” he said.
At the end of the program, the Rev. Susan Lunning, director of chaplaincy services at Westchester Medical Center, said that as many voters apparently considered values on Election Day, health-care providers at least must consider the faith and values of patients. “A form of denial is to not include that in our health-care system,” she said.