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PubMed1992

Humility in health care.

Humility, properly understood as a sense of one's limits, is one of the goods internal to the practice of health care. Humility in Christian tradition has both a relational aspect and an epistemological aspect. Each of these is evident in the practice of medicine. In its relational aspect, humility includes reverence or awe for the grace and strength of patients and their care-givers, a sense that the care-provider is not self-sufficient but needs the care-receiver, and recognition of the worth of those who are oppressed and outcast. In its epistemological aspect, humility is exhibited in respect for the meaning system of the patient and recognition of the limits of medical paradigms and their need for correction from the patient's perspective. The power wielded by the profession of medicine in contemporary society does not preclude the exercise of humility within the profession.

Christianity↗
PubMed1993

A qualified bioethic: particularity in James Gustafson and Stanley Hauerwas.

Most theoretical approaches in bioethics begin with a theory that articulates and defends basic principles or rules that are more or less systematically related and that seek to yield more or less precise conclusions with regard to specific acts, cases, or policies. Concerns about the agent and descriptions of the context of action stand on the margins of the theory. This is ironic, given the overwhelming importance and impact the training of health care professionals has upon them and upon the practice of health care as a whole, and given the fact that many advocates of the theories themselves concede that one's beliefs and how one describes a situation and weighs "facts" and values relevant to the case strongly determine one's conclusions. While morality may not lead ineluctably to religion, as Kant believed, bioethics does appear inevitably to involve particularity. I examine the work of James M. Gustafson and Stanley Hauerwas to analyze two views of the role of particularity in bioethics. I then show the relevance of their work for addressing some problems with the practicality and concreteness of current models in bioethics.

Bioethics↗
PubMed1993

Family planning: cultural and religious perspectives.

The world population explosion has caused political leaders to look upon national and regional birth control projects as vital. Support for regulation of individual fertility has been evident in all cultures, and at all times, even in those societies in which social and religious rules have favoured the abundant production of children. As the secularization of Western society and scientific enquiry gained momentum during the modern period, knowledge of reproduction increased and was applied to control human population growth. The various methods of contraception and their development through the years from the ancient ideas to the modern era are presented. Each approach to fertility control has its advantages and disadvantages. No one method is perfect for everyone, for every clinical setting, and in every culture. Higher levels of fertility have been associated with 'traditional', religious prohibitions on some forms of birth control, 'traditional' values about the importance of children and the priority of family, and 'traditional' family and gender roles reinforced by religion. The attitude of the main religious groups to contraceptive practice is discussed.

Contraception↗
PubMedDate not supplied

Taking a "leap of faith": acceptance and value of a cancer program-sponsored spiritual event.

Investigations of spiritual interventions for cancer patients are disproportionately few compared to the reported importance of religion to Americans. We report on the implementation and evaluation of a spiritual, community-based intervention developed with interdenominational community clergy. Approximately 1200 people attended a total of 3 gatherings: 2 at Roman Catholic and another at a Protestant Church. Respondents to questionnaires evaluating attendee characteristics and satisfaction (n = 209) were predominantly women (85%); 50% were patients and 45% were aged 60 years and older. Men were more likely to be currently under treatment for cancer, while women were more likely to be past patients or friends. Fewer than 2% felt anger or anxiety; attendees felt the service was very (90%) or somewhat (9.5%) helpful and expressed appreciation for cancer program clinician attendance and for hospital sponsorship of the event. Components in order of preference were prayer, music, Scripture, and litany. Logistic regression models reveal that music was most appreciated by previously treated patients, and prayer by currently treated patients. Secular healthcare systems can offer a religious service that comforts and links attendees to a broader community, including clergy and cancer program clinicians. Surveys can identify service components that appeal to differing groups and can facilitate service development.

Adolescent↗
PubMedDate not supplied

Implementing a Web-based information resource at an inner-city community church: lessons learned.

The objective of this project was to develop and implement electronic access to HIV/AIDS information resources at Glide Memorial Church in San Francisco, CA. This involved developing tailored Web-based access to the relevant information for the Glide Clinic patients. In addition, the project deployed workstations in 2 clinic areas and provided support to clinic patients as they learned to access the information resources. This article describes the experience with information retrieval in a clinic setting for underserved patients, including lessons learned, effective strategies, and anecdotes of effect on patients. Required nursing informatics competencies in this particular area are also addressed.

Attitude to Health↗
PubMed2006

The association of physicians' religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter.

CONTEXT: Controversy exists regarding whether and how physicians should address religion/spirituality (R/S) with patients. OBJECTIVE: This study examines the relationship between physicians' religious characteristics and their attitudes and self-reported behaviors regarding R/S in the clinical encounter. METHODS: A cross-sectional mailed survey of a stratified random sample of 2000 practicing U.S. physicians from all specialties. Main criterion variables were self-reported practices of R/S inquiry, dialogue regarding R/S issues, and prayer with patients. Main predictor variables were intrinsic religiosity, spirituality, and religious affiliation. RESULTS: Response rate was 63%. Almost all physicians (91%) say it is appropriate to discuss R/S issues if the patient brings them up, and 73% say that when R/S issues comes up they often or always encourage patients' own R/S beliefs and practices. Doctors are more divided about when it is appropriate for physicians to inquire regarding R/S (45% believe it is usually or always inappropriate), talk about their own religious beliefs or experiences (14% say never, 43% say only when the patient asks), and pray with patients (17% say never, 53% say only when the patient asks). Physicians who identify themselves as more religious and more spiritual, particularly those who are Protestants, are significantly more likely to endorse and report each of the different ways of addressing R/S in the clinical encounter. CONCLUSIONS: Differences in physicians' religious and spiritual characteristics are associated with differing attitudes and behaviors regarding R/S in the clinical encounter. Discussions of the appropriateness of addressing R/S matters in the clinical encounter will need to grapple with these deeply rooted differences among physicians.

Attitude of Health Personnel↗
PubMed2004

Accounting for Irish Catholic ill health in Scotland: a qualitative exploration of some links between 'religion', class and health.

This paper considers the ways in which accounts from Glasgow Catholics diverge from those of Protestants and explores the reasons why people leave jobs, including health grounds. Accounts reveal experiences distinctive to Catholics, of health-threatening stress, obstacles to career progression within (mainly) private-sector organisations, and interactional difficulties which create particular problems for (mainly) middle class men. This narrows the employment options for upwardly mobile Catholics, who may then resort to self-employment or other similarly stressful options. The paper considers whether the competence of Catholics or Catholic cultural factors are implicated in thwarting social mobility among Catholics or, alternatively, whether institutional sectarianism is involved. We conclude that, of these options, theories of institutional sectarianism provide the hypothesis which currently best fits these data. In Glasgow, people of indigenous Irish descent are recognisable from their names and Catholic background and are identified as Catholic by others. Overt historical exclusion of Catholics from middle class employment options now seems to take unrecognised forms in routine assumptions and practices which restrict Catholic employment opportunities. It is argued that younger Catholics use education to overcome the obstacles to mobility faced by older people and circumvent exclusions by recourse to middle class public-sector employment. This paper aims to link historical, structural and sectarian patterns of employment experience to accounts of health and work, and in so doing to contribute to an explanation for the relatively poor health of Catholic Glaswegians with Irish roots.

Adult↗