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Spirituality and Healing M. Basheer Ahmed, M.D.


Disclosure Information With respect to personal financial relationships, contracted research includes research funding where the institution gets the grant and manages the funds and the person is the principal or named investigator on the grant. Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship. The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest. The ACCME considers “content of CME about the products or services of that commercial interest� to include content about specific agents/devices, but not necessarily about the class of agents/devices, and not necessarily content about the whole disease class in which those agents/devices are used. With respect to financial relationships with commercial interests, when a person divests themselves of a relationship it is immediately not relevant to conflicts of interest but it must be disclosed to the learners for 12 months. The provider collects disclosure information from all Individuals in control of content. Those who refuse to disclose this information are disqualified from participating. For any person who reports a relevant financial relationship, the provider uses a peer review process to resolve the potential conflict of interest. For presentations that have the greatest potential for bias, the provider asks an independent third party reviewer to conduct a second peer review as an additional mechanism to resolve conflicts of interest. (SCS 2.1, SCS 2.2, SCS 2.3) disclose relevant financial relationships to me and to the learners who participate in my activities?

In compliance with the guidelines established by ACCME I have NO actual or potential conflict of interest in relation. I have no relevant financial interest to this program or presentation.


My Experience of Spirituality as a Child


What is Spirituality? • Strong faith and closeness to God • “When my servant asked about me, tell them I am closer to them (than their jugular vein). I listen to their prayers when they pray – let them listen to my call and believe in me. They should put their trust in me so that they may be rightly guided”(2:186) • Belief that God is a healer


Cancer, Terminal Illness and Depression

Depression Causes • • • •

Hopelessness Loss of interest Loss of desire to get better Prolong hospitalization and risk of death


Spirituality Gives • Hope • Improve coping mechanism • Reduce depression • Give strength to face the serious health problems


Prophet Mohammad (PBUH) encourages people to get treatment • O’ you the servant of Allah take medicine as Allah almighty has not created a disease without having created a cure for it except old age”. • Muslim physicians believe that all knowledge come from Allah and one must be strong believer in a positive outcome of treatment


A renowned Neuropathologist and a Nobel laureate Dr. Santgo Roman Cagol states, “I attribute 99% of my healing ability to God. The remaining 1% represents the talent, He has invested in me which He expects me to apply wisely�. (Ref: Texas Medicine Nov. 2004)


Historical Perspective • Throughout the history of mankind, spirituality and faith played a major role in healing • Greeks belief in God Asclepius as a healer • Medieval Muslim physician Incorporated spirituality and medical knowledge • As medical knowledge advance, the spirituality and religion lost its place in practice of medicine


Reemergence of Spirituality • • • •

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Several research papers have been published on spirituality and healing Koenig HG (1998), Int J Geriatr Psychiatry 13(4): 213-224. Koenig HG, Cohen HJ, Blazer DG et al. (1992), Am J Psychiatry 149(12): 1693-1700 Azhar MZ, Varma SL, Dharap AS (1994), Acta psychiatr Scand 90(1):1-3 Roberts JA, Brown D, Elkins T, Larson DB (1997), Am J Obstet Gynecol 176(1 Pt 1): 166-172. The studies found that spirituality and faith promotes healing by:

Reducing depression and anxiety Increase hope Improve coping mechanism


How Spirituality and Prayer Helps? Sense of empowerment • Patients experience more involvement in their treatment • Gives them a sense of empowerment and control • Feels at ease in coping with pain and even facing death


How Spirituality and Prayer Helps?

Placebo Effect •

Patient may have a strong feeling that prayers are helping him

•

This believe itself may stimulate the healing process


How Spirituality and Prayer Helps? Relaxation Response • The prayers and meditation may result in a relaxation response • Reduces the level of circulating stress hormones • Lower blood pressure and heart rate • Patient experiences sense of calmness


Spirituality, Religion and Healing Gallup report showed • 95% of people believe in God • 85% claimed that religion is important in their lives


Spirituality, Religion and Healing Physician’s Reluctance

• Many physicians feel uncomfortable addressing spiritual and religious issues • Lack of training • In multi cultural society, there is a wide range of belief systems • Difficult to understand the beliefs and practices of differing faith communities


Spirituality, Religion and Healing Listening to the patients leads to • Learning their believes and values, • Understanding their physical symptoms • Their distresses This is necessary to help patients


Spirituality, Religion and Healing Patients need help with:  Searching for hope, value and meaning in life  Coping with loneliness, despair and death  Making important decisions  Advance directives Living will Durable power of attorney

 Prolonging the life through artificial means  Taking narcotics to reduce pain which may shorten the life  For-go life support and accept death as natural


Students in Training Students always feel uncomfortable taking: • Psychosocial history • Sexual history • Spiritual history


Physician’s Training • They need to understand the valid reasons for psychosocial and spiritual assessment • Now medical schools develop special courses on taking spiritual history • The future doctors will be more comfortable asking relevant questions • Harvard Medical School started annual CME program for physicians on spirituality in medicine


Personal Experience as a Psychiatrist


Hospital Chaplains  Undergo specialized training-Clinical Pastoral Education  Work with patients, family and physicians  Able to deal with difficult questions such as: In vitro fertilization Pregnancy termination Blood transfusion Organ donation Removal of life support system-dialysis, ventilators and artificial nutrition  Unfortunately, we do not have any trained Muslim Chaplains who can assist patients in these areas  Muslim physicians have to take responsibility in dealing with these issues


Spirituality and Faith Healing • Differentiate between spirituality, healing and faith healing • In Indian and Pakistan subcontinent and even in USA faith healing is not uncommon • Individual healers claim that they can cure illnesses through prayers and writings of Quranic verses on piece of papers to put around the neck. • In USA, many evangelistic healers claim, curing many serious illnesses through prayers • During past 40 years, several investigators in USA studied this subject and no single evidence was found about the efficacy of faith healing • Prophet Mohammad (PBUH) says that there is cure for every illness but he never mentioned that only prayers will cure the illness


Assessment of Spirituality JCAHO is encouraging all physicians to conduct Physicians are reluctant due to time constraint, lack of interest and knowledge •

Consider spirituality as a potentially important component of every patient’s physical well being and mental health.

• • • • •

Do you consider yourself spiritual or religious? Is it important in your life? How have your beliefs influenced in your behavior during this illness? Are you part of a spiritual or religious community? How would you like me, your healthcare provider to address these issues in your healthcare? Make referrals to chaplains, spiritual directors or community resources as appropriate.

• •

Respect a patient’s privacy regarding spiritual beliefs; don’t impose your beliefs on others.


‫شِفنيِن‬ ْ‫ت فَُهَو يَ ِف‬ ُ ‫ض‬ ْ‫َوإَِذ ا َمِر ِف‬ Wa-itha maridtu fahuwa yashfeeni

"And when I am ill, it is He Who cures me” (26:80)


THANK YOU


Spirituality and Healing- Islamic perspective