Dr. A. Missagh Ghadirian — McGill Courses
Dr. Ghadirian is presently teaching a course in Spirituality and Ethics in Medicine at McGill University, Faculty of Medicine.
Spirituality and Ethics in Medicine: a new approach to compassionate care
OVERVIEW
Compassionate care of the sick and suffering is an important part of the physician-patient relationship. In our multicultural society where diversity of religious traditions is common, many patients’ attitudes toward physicians and treatment are influenced by their personal and religious beliefs. They expect to be understood not only with respect to their illness but also with respect to their spiritual and cultural values on health and healing.
The study of the role of spirituality in medicine has been rapidly expanding in the majority of North American faculties of medicine. At the McGill Faculty of Medicine this course has been conducted since 2002. Students who have participated in this elective course found it enriching and very informative as they hadn’t had an opportunity to study in depth this aspect of medicine during medical school. Students who had no religious affiliation or were secular or atheist also found the course helpful in order to have a better understanding of the concept of spirituality in relation to compassionate care. Some said that they learned how to relate to patients who will come to them with diverse religious beliefs and spiritual concerns. What many of these students are interested to know is the contribution of religions to the progress of medicine in history.
Participants in this course are 4th year medical students, approaching the final stage of their undergraduate medical education. The students who select this course are eager to explore and understand the relevance of the relationship between medical science and spirituality. Will cultural and spiritual beliefs and practices enhance recovery from illness or will they impede the healing process? How can one relate to patients of different faiths who come to physicians with a number of religious/spiritual needs and expectations? How to take spiritual history during patient evaluation? Do certain religious tradition conflict with medical ethics? These are some of the issues which are explored and discussed.
The program of this selective course is highly interactive. Besides presentation by guest speakers and the course director, at each session two or more students make a presentation on a topic they choose related to the main theme of the course, followed by group discussion which is very interesting. There are also video presentations, analysis and discussion as well as case studies. Students are also expected to do research in the literature and to write a short essay on a chosen topic related to the role of spirituality and ethics in medicine.
Suggested literature on Spirituality and Medicine
Available online:
Astrow, A.B., Sulmasy, D.P.: Spirituality and the Patient-Physician Relationship JAMA. 291:2884, 2004.
Breitbart, W. et al. “Depression, hopelessness, and desire for death in terminally ill patients with cancer”, JAMA 2000; 284 pp. 2907-2911.
Breitbart, W. et al. “Reframing hope: meaning-centered care for patients near the end of life”, J. Pall. Med. 2003; 6(6). pp. 979-988.
Chibnall, J.T., Duckro, P.N. Does exposure to issues of spirituality predict medical students’ attitudes towards spirituality in medicine? Academic Medicine. 7:6:661, June 2000. Assn of American Medical Colleges, US.
Csikszentmihalyi, Mihaly. If We Are So Rich, Why Aren’t We Happy? American Psychologist. Vol. 54 (10) October 1999, pp. 821-827.
Daalman, T.P., VandeCreek L.: Placing religion and spirituality in end-of-life care. JAMA, 284: 19:2514-2517, Nov. 2000.
Flannelly, K. et al. “A systematic review of religion and spirituality in three palliative care journals, 1990-1999”, J. Pall. Care. 2004; 20(1) p. 50-56.
Fortin, A.H., Barnett K.G., Medical School Curricula in Spirituality and Medicine. JAMA.291: 2883, 2004.
Fosarelli, P. (2008). Medicine, spirituality and patient care. JAMA: Journal of the American Medical Association. 300(7) 836-838.
Ghadirian, A-M.: Is spirituality relevant to the practice of medicine? J. Medicine and Law. (27) 229-239, 2008 (available only in web curriculum)
Ghadirian, A-M.: Alzheimer’s Disease: An Eclipse before Sunset (2016).
Ghadirian, A-M.: Materialism: Moral and Social Consequences, 2nd edition, Oxford: George Ronald, 2017.
Grabovac, A.D., Ganesan, S.: Spirituality and religion in Canadian psychiatric residency training. Can J. Psychiatry, 48 (3) 171-175, 2003.
Hinshaw, D.B. “Spiritual needs of the dying patient” J. Am. Coll. Surg. 2002; 195 p. 565-568.
Hodges, S.: Mental health, depressions, and dimensions of spirituality and religion. [Article] Journal of Adult Development. 9(2): 109-115, 2002 Apr.
Kaut, K.P.: Religion, spirituality and existentialism – Near the end of life. Am. Behavioral Scientist, 45(2): 220-234, 2002.
Kissman K., Maurer L.: East meets West – Therapeutic aspects of spirituality in health, mental health and addiction recovery. International Social Work. 45(1): 35-43, Jan. 2002.
Koenig, H.G.: Religion, spirituality and medicine: How are they related and what does it mean? Mayo Clinic Proceedings, 76(12): 1189-1191, 2001.
Koenig, H.G.: Taking a Spiritual History. JAMA. 291:2881, 2004.
Koenig HG: Religion, spirituality and health: a review and update. Advances in mind-body medicine. 2015;29(3): 19-26.
Latimer, E.J.: Ethical care at the end of life, CMAJ, June 30, 1998 (158) 13: 1741-1747.
Lo, B. Ruston, D., Kates L.W.: Discussing religion and spiritual issues at the end of life – A practical guide for physicians. JAMA, 287(6): 749-754, 2002.
Mansfield, C.J., Mitchell. J., King D.E.: The doctor as God’s mechanic? Beliefs in the southeastern United States. Social Science & Medicine, 54: 399-409, 2002.
Marrow, R: Dying, mourning, and spirituality: A psychological perspective. Death Studies, 23: 495-519, 1999.
McSherry, W., Draper, P., Kendrick, D.: The construct validity of rating scale designed to assess spirituality and spiritual care. International Journal of Nursing Studies. Vol. 39 (7): 723-734, Sep. 2002.
Miller W.R.: Researching the spiritual dimensions of alcohol and other drug problems. [Review] Addiction. 93(7): 979-990, 1998 Jul.
Modjarrad, K: Medicine and Spirituality JAMA. 291: 2880, 2004.
Mouch, C.A. and Sonnega, A.J. Spirituality and recovery from cardiac surgery: a review. J. Relig Health (2012) 51:1042-1060.
Mueller, P.S., Plevak, D., Rummans, T.A.: Religious involvement, spirituality and medicine: Implications for clinical practice. Mayo Clinic Proceedings 76: 1225-1235, 2001.
O’Hara, D.P.: Is there a role for prayer and spirituality in health care? Medical Clinics of North America, 86: (1): 143, 2002.
Ortiz, L.P.A., Langer, N.: Assessment of spirituality and religion in later life: Acknowledging clients’ needs and personal resources. Journal of Gerontological Social Work. Vol. 37 (2): 5-21, 2002.
Phillips, L. L., Paukert, A.L., Stanley, M.A. & Kunik, M.E. (2009). Incorporating religion and spirituality to improve care for anxiety and depression in older adults. Geriatrics, 64(8), 15-18.
Puchalski, C.M.: Spirituality and health: The art of compassionate medicine, Hospital Physician, pp. 30-36, March 2001.
Puchalski, C.M.: Spirituality and end-of-life care: A time for listening and caring. Journal of Palliative Medicine, 5(2): 289-294, 2002.
Rhi, B.Y.: Culture, spirituality, and mental health, Psychiatric Clinics of North America, 24 (3): 1-9, 2001.
Seybold, K.S., Hill, P.C.: The role of religion and spirituality in mental and physical health. [Article] Current Directions in Psychological Science. 10 (1): 21-24, Feb. 2001.
Sims, A.: The cure of souls: psychiatric dilemmas. Int. Reviews of Psychiatry. 11:97-102, 1999.
Slife, B.D., Hope, C., Nebeker, R.S.: Examining the relationship between religious spirituality and psychological science. [Article] Journal of Humanistic Psychology. 39 (2) 51-85, 1999.
Stotland, N.L.: When religion collides with medicine. Am. J. Psychiatry, 156 (2): 304, Feb. 1999.
Sulmasy D.P.: A. Biopsychosocial-Spiritual Model for the Care of Patients at the End of Life. The Gerontologist. 2002 May: 42:24-33.
Walsh, K., King, M., Jones, L., Tookman, A., Blizard, R.: Spiritual beliefs may affect outcome of bereavement: prospective study. British Medical Journal, Vol. 324: 1-5, 29 June 2002.
Yawar, A: Spirituality in medicine: What is to be done? Journal of Royal Society of Medicine. 94: 529-533, 2001.
Other literature not online (useful and optional):
Benson, H.: Timeless Healing. Fireside Book published by Simon & Schuster, New York, 1997. (Medicine’s Spiritual Crisis, p. 99, The Faith Factor and Spiritual Experience p. 149.
Cassell, E.J.: The Nature of Suffering and the Goals of Medicine. 2nd Ed. Oxford University Press, New York, 2004.
Frankl, V.E.: Man’s Search for Meaning. Pocket Books, New York, 1963.
Frankl, V.E.: The Doctor and the Soul. Bantam Books, New York, 1969.
Fromm, E.: The Art of Loving. Bantam Books, 1970.
Ghadirian, A-M.: Alcohol and Drug Abuse – A Psychosocial and Spiritual Approach to Prevention, George Ronald, Oxford, English, 91-147, 2007.
Ghadirian, A-M., Ageing – Challenges and Opportunities (section on Spiritual Dimensions). George Ronald, Oxford, England, 74-85, 1991.
Hinshaw, D.B.: “Spiritual issues at the end of life” Clin in Fam. Pract. June 2004; 6(2), pp. 423-440.
Hayes, T., Fisher B.J., Hill, R.A., Cassiday, T.J.: Life, Death and Immortality. Baha’i Publishing Trust, Wilmette, Illinois, 1994.
Kearney, M., Mount B. Spiritual care of the dying patient. In: Chochinov H., Breitbart W., eds. Handbook of psychiatry in palliative medicine. New York: Oxford University Press; 2000. p. 357-73.
Koenig, H.G.: Handbook of Religion and Mental Health. Academic Press, New York, 1998.
Koenig, H.G.: Religion and mental health: Evidence for an association. International Review of Psychiatry. Vol. 13 (2) 101, May 2001.
Koenig, H.G., McCullough M.E., Larson, D.B.: Handbook of Religion and Health, Oxford University Press, Oxford, New York, 2001.
Kübler-Ross, E: Death – The Final Stage of Growth. Prentice-Hall, Inc., Englewood Cliffs, New Jersey, 1975.
McWright: The essence of spiritual care: a phenomenological enquiry. Palliative Medicine, 16: 125-132, 2002.
Mount, B.M., Lawlor, W., Cassell E.J.: Spirituality and health: Developing a shared vocabulary. Annals RCPSC, 35: (5): 303-308, 2002.
Murchie, G: The Seven Mysteries of Life. Houghton Mifflin Co., Boston, 1978. (The Body-Mind Relations p. 258. The Change Named Death p. 520.
Osler, W.: The faith that heals, British Medical Journal, i: 1470-1472, 1910.
Puchalski, C.M., Romer, A.L.: Taking a spiritual history allows clinicians to understand patients more fully. Journal of Palliative Medicine, 3 (1): 129-137, 2000.
Puchalski, C.M.: The critical need for spirituality in our health care system. New Theology Review, November 2001, pp. 9-21.
Puchalski, C. et al. “Spirituality, religion and healing in palliative care”, Clin. Ger. Med. 2004; 20. p. 689-714.
Seeman, T.E., Dubin, L.F., Seeman, M.: Religiosity, spirituality and health. A critical review for the evidence for biological pathways. Am psychol. 16:131-147, 2003.
Sims, A: “Psyche” – Spirit as well as Mind? British Journal of Psychiatry, 165: 441-446, 1994.
Tillich, P.: The Courage to Be. Yale University Press, New Haven & London, 1952.
Warner, E.: The role of belief in healing. Can Med. Assoc. J., 128: 1107-1110, 1983.
