Spirituality and Medicine: Science and Practice

Richard J. Davidson

doi:10.1370/afm.900

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An Impoverished View of Spirituality
Timothy P Daaleman, DO, MPH

Published on: 26 December 2008

Published on: (26 December 2008)
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An Impoverished View of Spirituality
Timothy P Daaleman, DO, MPH, Chapel Hill, NC
Two editorials in a recent Annals of Family Medicine are illustrative of a burgeoning research movement to explore the process and efficacy of religion and spirituality through a scientific paradigm.1, 2 In the emerging area of psychoneuroimmunology, for example, investigators at the University of Pennsylvania used single photon emission computed tomography (SPECT) to image the brains of meditating Buddhists and Franciscan...
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Two editorials in a recent Annals of Family Medicine are illustrative of a burgeoning research movement to explore the process and efficacy of religion and spirituality through a scientific paradigm.1, 2 In the emerging area of psychoneuroimmunology, for example, investigators at the University of Pennsylvania used single photon emission computed tomography (SPECT) to image the brains of meditating Buddhists and Franciscan nuns and have observed localized neural activity during this practice.3 The interpretation of these findings – that religious impulses and mystical experiences are reproducible and biologically observable events in the brain – has led to a taxonomy of new disciplines, such as neurotheology and contemplative neuroscience.4, 5
Although much of this research is provocative, the logical progression of such a perspective – a biologically based approach advocated in the editorials – is problematic when considering the interplay of spirituality and clinical care. To begin, the call for “rigorous biologic measures to determine the relation between caregiver characteristics and clinician-patient interactions and direct biologic measures that are relevant to disease outcomes,”2 by Dr. Davidson is void of context, and is value free. If spirituality is tied to the beliefs, practices, and stories of both patients and caregivers that respond to a shared human need for meaning, 6-9 ethical, normative, and theological issues are never far off.10 Consider a physician who embraces a Nazi or Satanic spirituality and undertakes contemplative training to cultivate compassion and intention. From a biological viewpoint, any such spirituality, no matter how normatively discomforting, is acceptable as long as it results in positive, measureable outcomes.
This is an impoverished framework for spirituality and patient care as well. A biologically grounded paradigm reduces and narrows the lived worlds of patients and family physicians, which has roots in family, community, and other social networks.11 During care encounters, for example, will any experience of God, or of what is held to be sacred, be simply cast as a function of neuronal activity? Such a reductionistic approach, predicated on biological measures, is at odds with a patient- driven trend to understand and frame spirituality more broadly as an integration of mind, body, and spirit, predominantly within the context of shared communities.12 The three articles in Annals are representative of this phenomenon.7-9
References
1. Stange KC. In this issue: access to care, spirituality,and relevant research. Annals of Family Medicine. 2008;6:386-387.
2. Davidson RJ. Spirituality and medicine: science and practice. Annals of Family Medicine. 2008;6:388-389.
3. Newberg A, D'Aquili EG, Rause V. Why God won't go away: brain science and the biology of belief. New York: Ballentine; 2001.
4. Begley S. Religion and the brain. Newsweek; 2001:50-57.
5. Davidson RJ, Lutz A. Buddha's brain: neuroplasticity and mediation. IEEE Signal Processing. 2008;25:171-174.
6. Shea J. Spirituality and health care, reaching toward a holistic future. Chicago: The Park Ridge Center; 2000.
7. Daaleman TP, Usher BM, Williams SW, Rawlings J, Hanson LC. An exploratory study of spiritual care at the end of life. Annals of Family Medicine. 2008;6:406-411.
8. Anandarajah G. The 3H and BMSEST models for spirituality in multicultural whole person medicine. Annals of Family Medicine. 2008;6:448 -458.
9. Katerdahl DA. Impact of spiritual symptoms and their interactions on health services and life satisfaction. Annals of Family Medicine. 2008;6:412-420.
10. McGinn BG. The letter and the spirit: spirituality as an academic discipline. Journal of the Society for the Study of Christian Spirituality. 1993;1:1-10.
11. Delvecchio Good MJ, Good B. Clinical narratives and the study of contemporary doctor-patient relationships. In: Albrecht GL, Fitzpatrick R, Scrimshaw R, etal., eds. The handbook of social studies in health and medicine. London: Sage; 2000:243-258.
12. Daaleman TP. Religion, spirituality, and the practice of medicine. Journal of the American Board of Family Practice. 2004;17:370-376.
Competing interests: None declared
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Competing Interests: None declared.