A few notes from the December 2, 2016 Symposium sponsored by the Harvard Initiative on Health, Religion and Spirituality*:
- Regular attendance at religious services seems to have a protective effect. -Tyler Vanderweele (learn more at: Li, S., Stamfer, M., Williams, D.R. and VanderWeele, T.J. (2016). Association of religious service attendance with mortality among women. JAMA Internal Medicine, 176:777-785.)
- The effect of religion on health is a notoriously difficult area to study and get reliable data. Cross-sectional data is useless. That said, the confidence interval in the new research on religious service attendance by Vanderweele et al makes it extremely unlikely that the findings are random or accidental.
- “Presence is not about doing; it’s about being.”
- 84% of the world’s population report a religious affiliation, though religious service attendance as such is decreasing in the US (43% in 1999 vs. 36% in 2014 per Gallop Poll).
- Health professionals should use extreme caution before advising their patients to increase religious service attendance; it is not that simple, but more likely related to the underlying reasons that folks actually attend services.
- A person who has longterm regular service attendance who stops attending may be at increased risk for depression and the effects of depression on health; this might suggest that religious attendees with them (or their religious leaders, defined broadly) would do well to be attuned to such absences and reach out.
- “To ignore the questions that illness raises in our patients makes us derelict in our duties as health care providers.” (Daniel Sulmasy, MD, PhD, Georgetown University)
- “We are spiritual beings on a human journey; how does the health care system speak the language of frailty and finitude?” (noted by a hospital chaplain in the audience)
- Spiritual care in the health care system must also include the staff and providers. Compassionate care with patients requires providers to have an integrated awareness of their own inner selves and issues. There’s a lot of burnout in the healthcare professions, a large number of “wounded healers.” It’s said, for example, that 40% of family physicians in practice right now would quit–if they could.
- Let’s learn from “narrative medicine;” every patient is a “culture of one.”
- Clergy desperately need to understand the health care system better so they can more wisely advise their congregants who ask their advice about medical ethics, such as “do not resuscitate” and the spiritual / emotional implications of dying in hospice vs. dying during intensive revival efforts in the ICU; clergy mean well but they need more integration with hospital chaplains to understand the system and ethics of care in illness and end-of-life conversations.
- On the ethics of “palliative care triumphalism,” see the works of physician-lawyer, Dr. David Barnard, particularly his chapter on this topic in Lynn A. Jansen (ed), Death in the Clinic (2005).
- Hospital chaplains are needed, not just in hospice care but across the health care spectrum (see above). To be effective and reliable providers, chaplains must not only complete rigorous CPE requirements but also (1) have theological training and (2) be paid a living wage as chaplains by an employer who strongly believes that what they do is important in advancing health and strengthening health care services.
(*not all symposium attendees agreed on all of these points)