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Cancer Care Chronicles
July 16, 2020

Spirituality in Medical Training—An Agnostic’s Prayer

Author Affiliations
  • 1Stanford University School of Medicine, Stanford, California
JAMA Oncol. 2020;6(10):1533-1534. doi:10.1001/jamaoncol.2020.2063

Spirituality is a largely neglected topic in medical training, and on the rare occasions when it is considered acceptable during patient care, spirituality is regarded as a benign but futile hope at best, and an inappropriate imposition on patients at worst. It is too personal, too easy to get wrong, especially in comparison to the impersonal nature of procedures established and validated through the scientific method. Engaging with spirituality in the secular world of medicine is fraught with peril, even under the gentlest of circumstances. Leave it to the chaplains.

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2 Comments for this article
The spiritual dimension of cancer
Al Pfadt, PhD | Prostate cancer patient
What a delightful surprise to read this meditation on spirituality in JAMA. Indeed, as the author notes, spirituality often seems out of place in a discussion of cancer in a medical journal. However, as a research scientist with metastatic prostate cancer, I understand from my review of the professional literature as well as from my personal experience just how important it is to consider the spiritual dimension of cancer. Mr Bair‘s commentary illustrates so clearly how spirituality transcends any particular religious traditions, although the two terms are often lumped together when the topic is discussed.
Thanks for publishing this
contribution on how care providers can reach out to patients in a respectful and helpful manner if each is prepared to accept the other as humans struggling to make sense of a profound reality.
Spirituality vs Psychiatric Categories
BRUCE QUINN, MD PhD | Physician
Great article. One aspect that helps me is that spirituality covers an array of different means of functioning well and living well, whereas psychiatric diagnoses are naturally focused more on disease than on health. In psychiatry, we have appropriate criteria like depression, PTSD, OCD, attention deficit, and so on. This is like a series of checkboxes for disorders, and hopefully, you don't have any of them.

In spirituality, there are concepts like "sense of meaning in life," "sense of value in relationships to others," and "centeredness." I hesitate to add "self-actualized" but it's
lurking there too. (Then, of course, one can continue with more specifically religious concepts like prayer or specific religious beliefs and precepts under the broad umbrella of spirituality.)

Thus, when one restricts one's lines of sight to a medical psychiatric vocabulary, a lot is left out very much part of one's response to disease, morbidity, disability, or mortality.