It was launched with a $2.4 million grant from the John Templeton Foundation to develop training programs in spirituality for medical students, interns and residents.
So far, 122 U.S. medical schools have developed programs. Dr. Marilyn Baetz, a psychiatrist at the University of Saskatchewan, recently received the $30,000 award for the program that she developed.
Pulchaski believes that health care practitioners have an "ethical obligation to treat the whole person and to respond to all their needs." They need to be willing to address the spiritual needs she defines as more than just religion. It includes formal religion but also encompasses the "moral standards or world view of the patient." Health care practitioners must provide "a patient centred environment where all issues can be raised including spirituality."
Physicians, when taking a history, should take a spiritual history based on the concepts embodied in the acronym FICA — Faith, Importance, Community and Address in Care.
Under ``faith,'' the doctor should ask if patients are spiritual or religious and if they have spiritual beliefs that help them to cope. If they answer no, they should be asked what gives their life meaning. Doctors sometimes get answers such as family, career or nature.
Secular patients and atheists also have "world views" and those must also be taken into consideration. The final question relates to how patients would like their health care provider to address these issues in their care.
Baetz's work in Saskatchewan has found that patients have a much higher level of spiritual or religious belief than doctors. Seventy-one per cent of patients in a national survey stated they believed in God compared to only 54 per cent of psychiatrists. In addition, 70 per cent of patients stated that religious or spiritual values are important to them. In a national mental health survey conducted in 2001, 43 per cent of patients used prayer as an adjunct to doctors' help.
Baetz's psychiatric training program will teach residents to appreciate the spiritual/religious/cultural backgrounds that patients bring with them and the impact that may have on their mental health. It will also develop skills in students to help them assess patients' spirituality in a respectful and non-judgmental way. Residents will become familiar with spiritual care resources that may help their patients and the basic tenets of the beliefs of a diverse Canadian population.
While these programs are being introduced into more and more medical schools, it has not been without some resistance. This is usually caused by the misperception that the program is designed to promote one religion or to proselytize. once it is made clear that this is not the case, the opposition melts away.
The Saskatchewan program has been well received and Baetz is hoping to expand it into the family practice training.
MARVIN ROSS
SPECIAL TO THE STAR
Marvin Ross is a Hamilton-based medical writer.