Wednesday, 30 September 2015

Spiritual history-taking: worthy of consideration?

"Science and Charity", Pablo Picasso (1897)

It occurred to me just now that medical history-taking lacks an important component: the spiritual life. A proper spiritual history does not only ask about the patient's religion, but it seeks to answer these questions:
  • Does the patient use religion or spirituality to help cope with illness, or is it a stressor—and how?
  • Is the patient a member of a supportive spiritual community?
  • Does the patient have any troubling spiritual questions or concerns?
  • Does the patient have any spiritual beliefs that might influence medical care? 

I mean, why not? First, Indonesia is a [supposedly] religious country, so religion and spirituality are near and dear to the hearts of Indonesians. Secondly, a human being is both a physical creature and a spiritual creature. Religion is a human virtue born of a response to God's grace. Yes, of course this virtue is systematic, because virtue leads to order (i.e. orderly passions, orderly life, orderly worship and belief in God). Thirdly, I think we shouldn't make assumptions about a person's spiritual life based on his/her ID card religion. No two Muslims are the same, no two Christians are the same, no two Buddhists are the same, no two Hindus are the same. Consequently, two people holding the same faith might still define and approach their illnesses differently, and physicians should recognise this in order to give better care.

A spiritual history, however, requires a physician who is, at the very least, welcome to the notion of God, and who understands how important God is in many people's lives. Meaning, if the physician is an atheist, he must not dismiss the idea of a Higher Being as ridiculous or unfounded or counter-productive to treatment. In fact, he must use the patient's belief/religion/spirituality as an adjunct to treatment. I think, if used correctly, the spiritual history will add a fresh new dimension to the doctor-patient relationship and to medicine in general.

I'm not intending this post to be very long, so right now I'll just leave it there and think more about it.


  1. (One of my favorite tricks to play on people is to say I'll show them the first Picasso, and show them this painting. I love their confusion.) That aside, I think your ideas about taking a spiritual history are excellent. I wish I had as much time to talk with every patient and ask all these questions; hopefully in the future as a private attending, I will. I know our palliative care doctors do ask these questions, and they think they are important.

    1. I'm glad you stopped by, your blog is such an inspiration! I don't know if those questions above were your original thoughts or something you got from class? Not sure who to credit. Anyway, spiritual history is indeed more relevant to palliative care than any other disciplines. But I'm thinking that maybe psychiatry should employ it too? In my program they're developing psycho-religiosity branch. I should look more into it...


Any thoughts...?