Health Care Provider and Faith Diversity
The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and acceptance of a diversity of faith expressions.
The purpose of this paper is to complete a comparative analysis of two faith philosophies towards providing health care, one being the Christian perspective. For the second faith, choose a faith that is unfamiliar to you. Examples of faiths to choose from: Sikh, Baha’i, Buddhism, Shintoism, etc.
In a minimum of 1,500-2,000 words, provide a comparative analysis of the different belief systems, reinforcing major themes with insights gained from your research.
In your comparative analysis, address all of the worldview questions in detail for Christianity and your selected faith. Refer to chapter 2 of the Called to Care for the list of questions. Be sure to address the implications of these beliefs for health care.
• What is prime reality?
• What is the nature of the world around us?
• What is a human being?
• What happens to a person at death?
• Why is it possible to know anything at all?
• How do we know what is right and wrong?
• What is the meaning of human history?
In addition answer the following questions that address the practical and healthcare implications based on the research:
1. What are critical common components to all religions/beliefs in regards to healing, such as prayer, meditation, belief, etc.? Explain.
2. What is important to patients of the faiths when cared for by health care providers whose spiritual beliefs differ from their own?
Foundations of Christian Spirituality in Health Care
There has been an increase of interest in the role of spirituality in health care, as well as in the workplace and other fields in general. This interest has been met with a variety of responses, including an uneasiness that has historical roots. There is generally a perceived tension between science and religion/spirituality. This estrangement between the worlds of science and religion is in some ways is not truly reflective of some inherent incompatibility between science and religion per se, but rather a reflection of underlying worldview tensions. The rediscovery of spirituality and its implications for health care provides recognition that the estrangement between the two worlds has not served patients’ best interests. If this is the case, then part of the task of serving patients well will require some basic worldview training in order to not only understand patients’ own backgrounds more clearly, but to also promote the fruitful interaction of science and religion in the health care setting more generally.
Spirituality and Worldview
The theoretical and practical foundations of any discipline or field take place within the wider framework of what is known as a worldview. A worldview is a term that describes a complete way of viewing the world around you. For example, consider religion and/or culture. For many people their religion or culture colors the way in which they view their entire reality; nothing is untouched by it and everything is within its scope. Yet one need not be religious to have a worldview; atheism or agnosticism are also worldviews. Thus, all of one’s fundamental beliefs, practices, and relationships are seen through the lens of a worldview. The foundations of medicine and health care in general bring with it a myriad of assumptions about the very sorts of questions answered in a person’s worldview. Consider carefully the seven questions in Called to Care textbook in order to begin grasping more clearly the concept of a worldview.
A Challenging Ethos
A fundamental thesis of this course is that two sorts of underlying philosophies or beliefs about the nature of knowledge, namely, scientism and relativism, are at the heart of this perceived tension between science and religion. Moreover, scientism and relativism help explain to some degree why this tension has not served the best interests of patients, and is even at odds with the fundamental goals of medicine and care.
Scientism is the belief that the best or only way to have any knowledge of reality is by means of the sciences. At first glance this might sound like a noncontroversial or even commonsensical claim. However, think about this carefully. One way to state this is to say that if something is not known “scientifically” then it is not known at all. In other words, the only way to hold true beliefs about anything is to know them “scientifically.” Relativism on the other hand is the view that there is no such thing as “truth” in the commonsensical sense of that concept. Every and any claim about the nature of reality is simply relative to either an individual or a society/culture. Thus, according to this way of thinking, it might be true here in the United States equality is a good thing, but in some Middle Eastern countries it is simply not a concern. Yet there is no ultimate “truth” of the matter, it is simply a matter of individual or popular opinion. In some way, “truth” is just what an individual or a culture decides that it is, and therefore not truly discovered, but invented.
The current context of health care and medicine in the West is defined by an ethos (the prevailing attitudes and beliefs of a culture) of scientism and relativism. This ethos has exacerbated the perceived philosophical and cultural tension between science and religion. The result has been a general relativizing and caricaturing of religion, and the elevation of “science” as the default epistemology for all things “rational” or even true.
While scientism may seem commonsensical or rational at first glance, a closer examination reveals glaring weaknesses. It should be noted right from the outset that “scientism” is not equivalent to “science.” This is because “scientism” is a philosophy about the nature and limits of science as well as the extent of human knowledge. Scientism is a philosophical thesis that claims that science is the only methodology to gain knowledge; every other claim to knowledge is either mere opinion or false.
One of the most pressing dilemmas’s for scientism is science’s inability to make moral or ethical judgments. To understand why consider the nature of scientific claims and their distinction from moral or ethical judgments. We can describe general scientific claims simply as the attempt to make descriptions of “fact”. But when we make moral or ethical judgments, we do not simply make statements of fact (though that is part of it), but we are evaluating those fact claims. Thus when making a moral judgment we are evaluating whether some fact is good or bad. Thus consider the distinction between the following statements:
(1) 90% of Americans believe that racism is wrong
(2) Racism is wrong
Statement (1) is a statement of fact in the sense that it is meant to describe the way things actually are, or what is the case. Statement (2) however, makes a judgment; it makes a normative claim in the sense that it is making a claim about what ought to be the case. Statement (2) is not simply reporting or describing the facts, it is saying that it is not the way it is supposed to be. In recognizing these differences a crucial distinction has surfaced between (1) scientific claims and (2) moral and ethical claims. Scientific claims are limited to statements of description; they are solely claims about what is the case. Moral and ethical statements are prescriptive and are evaluative claims about what ought to be the case. This has been described as the “fact-value” distinction to designate the difference between facts and values, values being a prescription of the way things ought to be, the moral evaluation of facts. This distinction has also be described as the “is” (fact) vs. “ought” (value) distinction.
Thus, because science deals with mere facts, it is not in a position to tell us anything about what ought to be the case. Science is relevant to moral and ethical claims in interesting ways, but prescriptive statements about what morally ought to be the case are simply beyond the bounds of science. To try to derive what ought to be the case only from what is the case is a logical fallacy. If one were to look at the world and the way things are, and then claim that it simply follows that it is the way it ought to be does not match our experience of morality. There are many events that are the case and describe what is (genocide, war, hatred, murder), but whether or not they ought to be that way is a further question that science is not in a position to answer. Thus to try to derive an ought from an is, refers to what is called the fallacy of deriving of ought from an is. Much more could be said of the inadequacy of scientism, but it ought to be noted that moral, ethical and religious claims all involve normative claims about the way the world ought to be.One practical effect within health care has been the subtle but pervasive view that religion is a harmless tangent to medicine and health care at best, and a superstitious and destructive distraction at worst. Recently there has been a resurgence and appreciation of “spirituality” within medicine in more holistic approaches to health care. For example, the Center for Spirituality, Theology and Health at Duke University was established in 1998 for the purpose of
conducting research, training others to conduct research, and promoting scholarly field-building activities related to religion, spirituality, and health. The Center serves as a clearinghouse for information on this topic, and seeks to support and encourage dialogue between researchers, clinicians, theologians, clergy, and others interested in the intersection. (Center for Spirituality, 2014, para. 1)
While a welcome corrective, it is easy to inadvertently buy into weaker forms of scientism and fail to appreciate the particularity of each religion by reducing all religion to a generic “spirituality.” For example, Burkhardt (1999) attempts to defend a generic definition of the term “spirituality” (p. 71), but Shelly and Miller (2006) point out the inadequacy of such a strategy. It is not fair or respectful to paint all religions or worldviews with the same brush under the heading of spirituality and ignore the differences.
Thus, in the interest of philosophical clarity, religious sensitivity, and genuine care, this section will introduce fundamental concepts and challenge the contemporary ethos to make room for genuine religious dialogue.
The Foundations of Christian Spirituality in Healthcare
In stark contrast to this ethos is the Christian tradition and the resources it provides for a rich conception of “care.” Contra scientism and relativism, the foundations of Christian spirituality in health care includes two attitudes/theses: (1) an acknowledgement of science as a subset of “knowledge” in general, and a deep appreciation for science as a collective human enterprise that reflects the knowability and order of creation; and (2) the goodness and worth of this creation (in so far as it reflects God’s “creative intention”) with human beings bearing special “dignity” and intrinsic worth, reflected in the well-known bioethical principle of “respect for persons” (National Commission, 1979).
The foundations of Christian spirituality in health care assume genuine knowledge of God and His purposes. Central to this foundation are the Biblical Christian narrative and the person of Jesus Christ. In order to appreciate and do justice to this center, the ethos of scientism and postmodernism must be first challenged and dispelled.
This first topic of this course is devoted to understanding the concept of “worldview” in detail and to begin to challenge the philosophies of “relativism” and “scientism.” It will also begin to lay the foundations of a broadly holistic understanding of the relationship between spirituality and health care in general, and a Christian worldview for health care in general.
Burkhardt, M. (1989). Spirituality: An analysis of the concept holistic nursing practice.
Center for Spirituality, Theology and Health. (2014). Retrieved from http://www.spiritualityandhealth.duke.edu/
National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. Retrieved from http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html
Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2nd ed.). Downers Grove, IL.:IVP Academic.
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Theological Anthropology and the Phenomenology of Disease and Illness
While health care utilizes some of the most advanced technology and is dependent upon scientific advancement, the goals of health care and medicine are fundamentally different from that of science. Science’s fundamental goal is the acquisition of knowledge through research and experimentation, the fundamental goal of health care and medicine is healing and care that results in physical, emotional, and spiritual well-being.
Dissecting the Concept of “Care”
The concept of “care” that undergirds and is assumed by the healing professions presupposes a certain conception of the subject (as opposed to a mere object) towards which care is directed. The oft-debated topic of personhood is not merely an accretion of American culture wars, but has been a topic of philosophical and religious debate for millennia (“Personal Identity,” 2014).
What Does It Mean to Be a Human Being?
While there has been an explosion of scientific knowledge regarding homo sapiens such as the example the Human Genome Project (“All About the Human Genome Project,” 2000), the question of human personhood and dignity remains an irreducibly philosophical and theological question. Implicit in a naïve scientism is not only a form of epistemic reductionism (reducing all knowledge to only that which “science” can tell us), but also a general metaphysical or anthropological reductionism (reducing human beings or human nature to nothing but their physical components or that which can be measured by science).
Anthropological axiology (the basis upon which human beings are assigned value in relation to other kinds of beings) contra relativism, cannot be simply dependent upon culture or personal preference but rooted in the nature of what it means to be a human being. Contra scientism, the value and dignity of human beings stands over and above that of other species and cannot be simply reduced to a person’s abilities or function, or the person’s physical constituents.
While it has a been a perennial challenge for secularism to find a basis upon which to assign human beings intrinsic worth and dignity, the concept of human “dignity” and intrinsic value (including its implied ethical principles such as respect for persons, etc.) is inherent Biblical teaching and Christian tradition. An appreciation and grasp of this question is fundamental for understanding the contemporary religious context and the goals and virtues of medicine.
A related and central concept in contemporary biomedical ethics is the concept of moral status. Briefly, the concept of moral status concerns which sorts of beings or entities have rights (in the sense that a moral agent has obligations toward this being or entity). Human rights, for example, are considered to be a prime example of descriptions of obligations a moral agent has to any human being. Furthermore, human beings are taken to have these obligations due to them simply in virtue of being human beings. Another way to describe the concept of a beings moral status is to talk about its value or worth. Thus, to talk about a beings moral status is to talk about a beings value, as well as why it has that value.
The video lecture entitled “Ethics: Moral Status” from the Khan academy illustrates this nicely. We might begin by asking, “why is it that I have obligations to my neighbor, but not to this rock?.” Any answer one gives will describe certain characteristics or capacities that differentiate my neighbor from a rock, in virtue of which my neighbor has moral status, and the rock does not.
The video lecture distinguishes several views or theories of moral status. While they might be categorized in different ways, we will break them down into the five following view or theories commonly used by bioethicists: (1) a theory based on human properties, (2) a theory based on cognitive properties, (3) a theory based on moral agency, (4) a theory based on sentience and (5) a theory based on relationships. Each of the above theories takes a selected characteristic or set of characteristics and views it as that which confers moral status upon a being. Thus, a theory based on human properties holds that it is only and distinctively human properties that confer moral status upon a being. It follows that all and only human beings, or Homo sapiens, have full moral status. Some of the characteristics that would endow a being with moral status under this view would include things like, being conceived from human parents, or having a human genetic code. Whatever property (i.e. characteristic) the particular theory picks out is considered that which confers moral status upon a being or entity.
The theory based on cognitive properties holds that it is not any sort of biological criteria or species membership (such as the theory based on human properties holds) that endows a being with moral status. Rather, for this theory it is cognitive properties that confer moral status upon a being. In this context “cognition refers to processes or awareness such as perception, memory, understanding, and thinking…[and] does not assume that only humans have such properties, although the starting model for these properties is again the competent human adult.” Notice carefully that this is claiming that if a being does not bear or express these properties, it follows that such a being does not have moral status. The theory based on moral agency holds that “moral status derives from the capacity to act as a moral agent” in which an individual is considered a moral agent if they “are capable of making judgments about the rightness or wrongness of actions and has motives that can be judged morally” .
The theory based on sentience holds that the property of sentience is that which confers moral status on a being. Sentience in this context is “consciousness in the form of feeling, especially the capacity to feel pain and pleasure, as distinguished from consciousness as perception or thought.” According to this theory the capacity of sentience is sufficient for moral status (i.e. the ability to feel pain and pleasure confer upon a being moral status). The final theory holds that relationships between beings account for a beings moral status. Usually these are relationships that establish roles and obligations, one example being the patient-physician relationship. Of course, there are many types of relationships (family, genetic, legal, work, etc.), even ones in which one party in the relationship does not desire or value the other party. In such a case, a person who holds this theory may be forced to concede that a beings moral status may change, depending on the other party.
Consider also that the particular shape that each of these theories takes will be in the context of a broader worldview framework. Thus, the way in which Christianity and Buddhism would apply a theory based on human properties or a theory based on sentience would be very different. Furthermore, there may be worldview considerations that would not allow one to hold to one or more of the theories. It should be noted that while the video lecture covers a variety of views, it is not exhaustive (there a clearly more theories covered here) and furthermore seems to implicitly assume or be working in the framework of a particular worldview. What worldview could it be and what are some of the assumptions being made in the background?
The point is simply this: While there seems to be an innate sense of what it means to be a human being that most people have, one needs to stop and actually think about what this means. It might be assumed that healing and caring are good things because human beings are valuable and ought to be respected, but the question is whether one’s worldview provides an adequate explanation for these beliefs? Are they in some sense relative? Pay attention to how the Christian narrative answers these questions and begin to ask yourself how you would answer them.
All about the Human Genome Project. (2000). Retrieved from http://www.genome.gov/10001772
Personal identity. (2014). Stanford encyclopedia of philosophy. Retrieved from http://plato.stanford.edu/entries/identity-personal/
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Theological Anthropology and the Phenomenology of Disease and Illness
If it is in fact the case that persons are the subjects upon which medicine acts and for whom care is the highest goal of medicine, it follows that their experience is a fundamental source of data. What follows is that the goals of medicine and health care, while fundamentally empowered by science, are nonetheless different. A fundamental goal of science is knowledge of the natural world, while practical application or technology is the manipulation and power over that world. In contrast, the goal of medicine and health care is not fundamentally knowledge or mere manipulation, but care. Thus, one aspect of care is the intentional and goal-oriented use of scientific knowledge and technology for the purpose of healing and health. Science and technology are the mere means and never the fundamental goal of medicine and care.
Data in Experience
There is certain universality in the experience of illness. Pain, suffering, and disease are personal and have certain qualitative features that are the same for human beings qua human beings. However, numerous particularities such as language, gender, race, social status, and religion color that experience. Moreover, while science and technology do not define the goals of care, they have manifestly changed the scope, quality, and experience of care as well. In analyzing this experience of illness and disease it is helpful to think of your own personal experience of being sick, in addition to your experience of healing, or your interaction with medicine and health care providers, such as nurses, and physicians, such as your primary doctor. Your textbook, Called to Care analyzes this experience in terms of the environment or context of care. Three aspects of this environment are distinguished in Shelly & Miller (2006):
1. The seen environment.
2. The unseen environment.
3. A storied environment.
As you read through these sections, pay attention to the way in which technology has colored this experience. You will also be reading The Death of Ivan Illych, a short novel by 18th century Russian novelist Lev Tolstoy. As you read through this story, notice the universal elements of the experience of illness, disease, and ultimately death including how it was unexpected.
In this section, the phenomenon (qualitative experience or phenomenology–i.e., the felt and lived experience) of illness and disease is analyzed in order to foster the proper goals of care and serve patients well.
Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2nd ed.). Downers Grove, IL.:IVP Academic.
Tolstoy, L. N. (1886). The death of Ivan Ilych(L. Maude & A Maude, Trans.). Grand Rapids, MI: Christian Classics Ethereal Library. Retrieved from http://www.ccel.org/ccel/tolstoy/ivan.html© 2015.
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The Christian Narrative and Spiritual Diversity
The reality of religious pluralism (the view that there are many different religions with different teachings) does not logically imply any sort of religious relativism (the view that there is no such thing as truth, or that everything is a matter of opinion). There are genuine distinctions between religions and worldviews. Given this fact, it is imperative that one be tolerant of differences and engage civilly with those of different religions or worldviews. It might be tempting to think that one is being tolerant or civil by simply rolling all religions into one sort of generic “spirituality” and to claim that all religions are essentially the same. But this is simply false. Once again, there are genuine and important differences among religions; these differences are meaningful to the followers of a particular faith. To simply talk of some sort of a generic “spirituality,” while maybe properly descriptive of some, does not accurately describe most of the religious people in the world. Furthermore, this terminology often reduces religion to a mere personal or cultural preference, and it ignores the distinctions and particularity of each. The point is that such a reductionism is not respectful of patients. It should also be noted that atheism or secularism are not simply default or perfectly objective (or supposedly “scientific”) starting positions, while religious perspectives are somehow hopelessly biased. Every religion or worldview brings with it a set of assumptions about the nature of reality; whether or not a particular view should be favored depends upon whether or not it is considered true and explains well one’s experience of reality.
The Christian Narrative
While it is not possible to survey every possible religion, this survey will at least attempt to do justice to the biblical narrative and Judeo-Christian tradition.
The Bible is a collection of 66 books written over thousands of year in several different languages and in different genres (e.g., historical narrative, poetry, letters, prophecy), yet there is an overarching story, or big picture, which we will refer to as the “Christian biblical narrative.” The Christian biblical narrative is often summarized as the story of the creation, fall, redemption, and restoration of human beings (and more accurately this includes the entire created order). Concepts such as “sin,” “righteousness,” and “shalom” provide a framework by which the Christian worldview understands the concepts of “health” and “disease.”
Briefly, consider the following summary of each of the four parts of the grand Christian story (your instructor will be sure to go through the actual biblical references together with you as you explore this narrative):
According to Christianity, the Christian God is the creator of everything that exists (Gen 1-2). There is nothing that exists, which does not have God as its creator. In Christianity there is a clear distinction between God and the creation. Creation includes anything that is not God–the universe and everything in it, including human beings. Thus, the universe itself and all human beings were created. The act of creating by God was intentional. In this original act of creation, everything exists on purpose, not accidentally or purely randomly, and it is good. When God describes His act or creating, and the creation itself as “good, ” among other things, it not only means that it is valuable and that God cares for it, but that everything is “the way it’s supposed to be.” There is an “order” to creation, so to speak, and everything is it ought to be. This state of order and peace is described by the term Shalom. Yale theologian Nicholas Wolterstorff (1994) describes Shalom as, “the human being dwelling at peace in all his or her relationships: With God, with self, with fellows, with nature” (p. 251).
Sometime after the creation, there occurred an event in human history in which this order was broken. In Genesis 3 the Bible describes this event as a fundamental act of disobedience to God. The disobedience of Adam and Eve is referred to as “the fall,” because, among other things, it was their rejection of God’s rule over them and it resulted in a break in Shalom. According to the Bible, the fall had universal implications. Sin entered into the world through the fall, and with it, spiritual and physical death. This break in Shalom has affected the creation ever since; death, disease, suffering, and, most fundamentally, estrangement from God has been characteristic of human existence.
The rest of the story in the Bible after Genesis 3, is a record of humanity’s continual struggle and corruption after the fall, and God’s plan for its redemption. This plan of redemption spans the Old and New Testaments in the Bible and culminates in the life, death, and resurrection of Jesus Christ. The climax of the Christian biblical narrative is the atoning sacrificial death of Jesus Christ, by which God makes available forgiveness and salvation by grace alone, through faith alone. The death of Christ is the means by which this estrangement caused by sin and corruption is made right. Thus, two parties, which were previously estranged, are brought into unity (i.e., “at-one-ment”). For the Christian, salvation fundamentally means the restoration of a right and proper relationship with God, which not only has consequences in the afterlife, but here and now.
The final chapter of this narrative is yet to fully be realized. While God has made available a way to salvation, ultimately the end goal is the restoration of all creation to a state of Shalom. The return of Jesus, the final judgment of all people, and the restoration of all creation will inaugurate final restoration.
Worldview and the Christian Narrative
The way in which Christianity will answer the seven basic worldview questions will be in the context of the above narrative. In the same vein, a Christian view of health and health care will stem from the above narrative and God’s purposes. Of course, the pinnacle of this framework is the person of Jesus Christ. Thus, for Christianity, medicine is called to serve God’s call and purposes, and everything is done in remembrance of, and in light of, Jesus’ ultimate authority and Kingship.
Wolterstorff, N. (1994). For justice in Shalom. In W. G. Boulton, T. D. Kennedy, & A. Verhey (Eds.), From Christ to the World: Introductory Readings in Christian Ethics. Grand Rapids, MI: Eerdmans.
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Death, Dying, and Grief
Death and dying are a bitter part of the reality of life in general, and a particularly common experience for those called to health care. The nature and meaning of death is not simply biological or scientific, but rather involves deep philosophical and religious questions. Once again, medical technology has changed the scope, quality, and experience of death (or at least the dying process). It has even prompted a changing of the very definition of death.
Death in the 21st Century
One of the incredible benefits of modern science and its application in medical technology has been the ability to extend physiological life. In the 1960s, the development of CPR, ventilators, and the like allowed never before seen intervention in the process of dying, such that a “millennia-old general understanding of what it meant to be dead” (Veatch, Haddad, & English, 2010, pp. 390-391) was transformed. In the field of biomedical ethics, the very definition of what it means to be dead is a controversial topic. In continuing with a fundamental theme running throughout this course, it should be noted that while the pathophysiological and scientifically detectable signs of death are crucial in this debate, they should not be taken to be determinative or comprehensive. This debate still crucially depends on the philosophical background of one’s anthropology (i.e., view of personhood) and in the resulting interpretation of these scientific and physiological signs. The medical definition of death is not a purely or irreducibly scientific question.
Worldview and the Meaning of Death
On a worldview level, the question of the medical definition of death is just the tip of the iceberg in terms of the broader significance and ultimate meaning of death. Whether or not there is any meaning to death and what it might be is a question of one’s worldview. Questions regarding whether or not there will be ultimate moral accountability for the way one lived life and whether there is an afterlife are key questions in this regard. The very phenomenon of the loss of (at the very least) physiological and perhaps conscious integrity and activity is a fact of life that calls for explanation.
Once again, an accurate understanding of religion and worldview is required. Furthermore, the distinctions among each religion must be appreciated and not collapsed into one another. The way in which both technology and religious background color the experience and meaning of death (both in dying and grieving) must also be appreciated. Whatever rituals or practices a religious or cultural group engages in are informed by a view regarding the nature and meaning of death that fits within an overarching worldview narrative.
Death in the Christian Worldview
Death takes on a particular meaning when seen within the Christian narrative. It is, in fact, not the greatest evil that could befall a human being and is furthermore transformed in the light of the resurrection of Jesus Christ. The Christian teaching that “God died” essentially transforms the way in which death is seen and experienced (Sanders, 2007 pp. 6-8). Death is certainly a tragedy and an evil, but it is now a conquered enemy. It is a conquered enemy because in the Christian biblical narrative, death is a perversion of God’s original design plan. And yet, the Christian God constantly redeems that which is broken.
Loss and Grief
Death is a particularly traumatic and difficult experience for both family and caregivers. Understanding the process and stages of grieving is immensely beneficial for caregivers to assess the well-being of patients and families. There are numerous resources that can be of tremendous benefit for both caregivers and family. One of the most influential is the work of American psychiatrist Elizabeth Kubler-Ross. Perhaps the most influential insight of her work was to notice certain patterns or stages in the human experience of grief, especially after the loss of a loved one in death. She called these the five stages of grief. Briefly, they include the following: (a) Denial, (b) anger, (c) bargaining, (d) depression and (e) acceptance (as cited in Verhey, 2011).
Expectations regarding an afterlife will in large part determine the manner in which patients and families welcome or spurn the prospect of death. Furthermore, the way in which a person experiences the stages of grief will be in the context of their worldview. Christian theologian Nicholas Wolterstorff’s (1987) memoir, Lament for a Son, is a personal reflection his own personal grief after losing his 25-year-old son in a mountain climbing accident. As he engages with his own grief and experience, it becomes clear that everything is ultimately seen in the light of God’s loving control and the ultimate hope of resurrection.
Sanders, F. (2007). Chalcedonian categories for the gospel narrative. In F. Sanders & K. Issler (Eds.), Jesus in Trinitarian perspective (pp. 6-8). Nashville, TN: B&H Academic.
Veatch, R. M., Haddad, A. & English, D. (2010). Case studies in biomedical ethics. New York, NY: Oxford University Press.
Verhey, A. (2011). The Christian art of dying: Learning from Jesus. Grand Rapids, MI: Eerdmans
Wolterstorff, N. (1987). Lament for a son. Grand Rapids, MI: Eerdmans.
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Spiritual Self-Care, Burnout, and Combatting Compassion Fatigue
Preventing burnout or compassion fatigue is the goal, but the reality of suffering bouts of exhaustion at some point while giving care may be inevitable. Suffering from continual fatigue and hopelessness, however, is avoidable. It is a battle that must be fought with a commitment to personal health and well-being (Chapman, 2007). Health care professionals and others who give care must be determined to seek balance and health in their own physical, emotional, and spiritual lives in order to deliver the kind of care their patients need and deserve. No one is superhuman, so all must seek help.
Caring for Self
Although some people would consider caring for self a type of selfishness, it is in many ways the best way to also prepare to care for others. What good are caregivers who are so tired that they cannot determine the needs of the patient, or so sad that they feel hopeless? If caregivers are so weak that they are unhealthy physically, emotionally, or spiritually, they in essence have become patient themselves and are also in need of care. Caregivers need to see themselves as people who may also need help, and they should seek help before these needs become liabilities when caring for patients. In order to be sure they are healthy enough to serve others, caregivers must look for opportunities to make good choices for themselves. They need to eat healthy food, take breaks, get good exercise, listen to music or play and sing their own music, read, avoid unhealthy habits, and find some opportunities to laugh and cry. Everyone needs balance and the ones who are caring for others in stressful situations especially need to make sure they are pursuing balance in their own lives.
Being Physically Healthy
One of the first ways for a caregiver to increase or promote health and balance is to add a personal commitment to regular exercise. Many people feel they do not have time to add anything to their busy lives. The problem with their perception is that without wellness and balance, their lives are not as productive, nor as happy, as they could be. Busyness is creeping into people’s lives to such an extent that it is almost becoming a badge of honor to be too busy to do something. The challenge that busyness poses, however, is the diminishing of health. Without proper nutrition, proper activity, and proper rest, a body rebels with decreased immunity to common illnesses. Taking the time to walk outside for half an hour or an hour over the lunch hour would add productivity to the rest of the day because the body would have been recharged by the change of scenery and cardiovascular exercise. By the same token, a trip to the grocery store for some healthy foods would be much healthier than a quick stop at a fast food establishment or even a popular restaurant. Making a few good but initially inconvenient choices would improve one’s outlook and overall happiness.
Being Spiritually Healthy
Another area of life in which good choices are often avoided is spirituality. People feel they do not have time for spiritual things, but failing to address spiritual needs causes a spiritual version of an unhealthy body. It may not be immediately visible, but a life lived devoid of spiritual health will suffer. Although human beings were created with a mind, body, and soul, the soul receives very little attention from many people. They may be interested in having healthy bodies, but give no thought to their souls. Just as the physical body needs rest, recuperation, and healthy nutrition, the soul needs time for spiritual restoration, encouragement, and faith-building. Taking time every morning, for example, for spiritual nourishment and meditation adds health to the soul. Stopping on the weekend to rest and focus on God is essential to overall health. That is not to say that if one works on the weekend, one cannot lead a healthy spiritual life. Those who work on the weekend need to find their own “weekend” during the week and take comparable time to rest, worship, and refuel spiritually. Although spirituality includes a community aspect and interaction with others who give and receive encouragement, when schedules do not mesh, one must take the time to recharge alone with God.
Being Emotionally Healthy
As previously mentioned, human beings are made up of mind, body, and soul. An awareness of the need for protecting the mind would help many people live healthier lives overall. Just as it is essential to exercise and rest the body and the spirit, it is essential to take time for mental stimulation and time for relaxation. After running a marathon, a runner knows that it is essential to do certain things to restore balance and health to the muscles that have been overused. By the same token, health care workers who have given care for extended periods of time or experienced traumas during their workday need to allow themselves time and consideration for recovery and a restoration of emotional health. They may need a significant emotional outlet. They may need time to cry or time to laugh. They may need comfort or they may just need time and space. Each person needs to make careful choices to recover emotional health after expending the kind of energy required in health care.
Personal health care choices are essential, but by their very nature they are personal. No one can make decisions for anyone else about these matters. Each person needs to decide how to find balance, energy, and wellness in all important aspects of life. The physical, the spiritual, and the emotional all require care, especially for one who is providing care for others. Finding others who will participate in the healthy exercise of mind, body, and soul would be greatly beneficial, but ultimately everyone decides for themselves and chooses whether to be healthy and balanced.
Chapman, E. (2007). Radical loving care: Building the healing hospital in America. Nashville, TN: Vaughn Printing.
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