All posts by theurbanresident

David graduated from Princeton University with a degree in Electrical Engineering and received his medical degree from Rutgers - Robert Wood Johnson Medical School with a Masters in Public Health concentrated in health systems and policy. He completed a dual residency in Internal Medicine and Pediatrics at Christiana Care Health System in Delaware. He continues to work in Delaware as a dual Med-Peds hospitalist. He will gladly talk your ear off about health policy, the inner city, gadgets, and why Disney’s Frozen is actually a terrible movie.

Should We Pray With Patients?

The patient was abruptly, unexpectedly, and neurologically devastated, leaving his family stunned and grief stricken.  There was little else for the ICU team to offer, even as we worked to do everything physiologically possible to sustain life.  It was late at night and as we stood in the room listening to beeping monitors and the running motors of IV pumps, the family mentioned in passing that many people were praying for him.  So I asked them two simple questions: Are you Christian? Would you like me to pray for you?  They answered yes to both.  I led them in a short prayer, expressing no more in terms of medical prognosis or aspirations for therapy than had already been offered, but also asking for strength, wisdom, and a clearer understanding and experience with God himself.  The family was marginally but visibly relieved and calmed by it, and we continued on with the grueling task of caring for the patient.

As anticipated, the patient passed away several days later.  After the family left, their nurse told me, “They could not stop talking about that prayer.  They said that of the dozens of physicians they have interacted with over many years, not a single one ever offered to pray with them.  It meant a lot.”

Modern healthcare is conflicted about how to approach faith and illness.  On the one hand, rising pressure to improve patient satisfaction must recognize the importance of faith in the lives of patients; in one small family practice study, 48% percent of patients wanted a physician to pray with them (even though 68% never had a physician discuss religious beliefs with them).   On the other hand, the secularization and humanism-ization of medicine can use the ethical mandate to respect patient autonomy as an excuse not to engage in matters that could be controversial (such as faith).  Fear of “abuse of paternalistic power” in the physician-patient relationship or fear of invoking religious ritual and methodologies that are virtually impossible to hypothesis-test can create a “chilling effect” on the inquiry and expression of religious belief by healthcare workers even when no hostility or indifference is there.  It is as if medical practitioners find it hard to believe that faith not only exists, but that it could possibly matter more to patients than the field of medical therapeutics itself.

The earliest practitioners of medicine were clergy members.  In virtually every culture, ministers of medicine began as… well, ministers.  After all, what can be a more compelling reason to drive us to our knees than helplessness in the face of suffering?  Though modern medicine can explain the physiology of how we decay and die in excruciating detail, it is certainly not equipped to answer the question of why we do.  This observation alone should explain why questions of faith contend to occupy the center of a patient’s attention and not simply the periphery.

The next time you are in a small group or a prayer gathering, try to count how many times health-related concerns come up for prayer.  Illness afflicts our minds, hearts, and souls as readily as our bodies.  Healthcare workers are compelled to take hours of training in cultural sensitivity, mindfulness, and meditation; shouldn’t we be similarly compelled to attain and encourage proficiency in spiritual need assessment, willing to offer prayer when requested instead of retreating in indifference?  Shouldn’t this be true in all the “helping professions”?

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