Religion and spirituality influence people’s understanding of the world, their emotions and psychology, and even how they treat their bodies. Despite this, many medical professionals do not discuss religious beliefs with their patients.
Some think religious matters are outside their area of expertise, while others worry about saying the wrong thing or causing a disagreement. But these reasons stem from the same source: Physicians are generally uncomfortable with speaking to patients about religion.
“Patient spirituality continues to be an area that clinicians do not discuss as often as they should,” wrote the author of an article published in the AMA Journal of Ethics. “Acknowledging the moral underpinnings (spiritual or religious) that drive certain care-seeking behaviors—from end-of-life care to contraception—is critical in achieving a more holistic medical practice.”
So, how can physicians get the tools to talk about matters of faith and god? It’s all about exploring the importance of cultural and religious competence and touching on some of the ways that religion affects patients' decision-making.
Why is cultural and religious competence important?
In healthcare, culturally competent care, also called culturally relevant care, is about providing services that prioritize patients’ cultural, social, and religious needs. Data suggest that cultural competence can improve care quality and patient outcomes.
Poor cultural competence from clinicians leads to interactions that drive down patient satisfaction and can even result in unwanted health consequences, according to an article published in StatPearls.
Connecting with patients who turn to their religious beliefs during challenging times can help reduce their anxieties about medical care. It can also enable clinicians to recognize the spiritual or religious motivations behind certain behaviors.
Culturally competent healthcare supports health equity, too. When done right, every patient receives consistently high-quality treatment regardless of their cultural, ethnic, racial, or religious background.
Finally, cultural competence supports compliance. Clinics looking to gain or renew accreditation by The Joint Commission (TJC) accreditation have to demonstrate cultural competence expertise, while state and federal guidelines encourage health systems to respond to specific needs in their diverse patient populations. TJC offers articles and resources for healthcare providers to increase cultural and religious sensitivity.
How do patients’ religious beliefs affect their attitudes toward healthcare?
Here are some of the ways that different religious beliefs can affect patients’ approaches to their health and the medical system.
Concepts of health
Religious beliefs can strongly influence patients’ conceptions of their bodies, health, and the role of medical intervention. In Eastern Orthodox Christianity, for example, god is seen as the “Divine Physician,” but traditional medical interventions are acceptable.
Other belief systems also reflect this connection between religion and health. Take Hawaiian spirituality, which focuses on connections between the body, mind, and spirit. Similarly, Native American beliefs may view illness as the result of failure to live in harmony with the environment.
Christian Scientists consider illness to be a result of friction between mind and matter, a belief that can lead to general opposition to medical treatments, including vaccination and emergency surgery. People who ascribe to Voodoo or Wicca spirituality may also distrust modern medicine.
Diet and fasting
Many belief systems impose dietary restrictions that physicians should know.
Buddhism, Christian Science, Seventh-day Adventism, and Mormonism all promote abstinence from alcohol, coffee, and tobacco—substances that can be harmful to health.
Physicians can also find out whether, when, and how their patients are fasting. Muslims fast during the 30 days of Ramadan by avoiding any food or drink between sunrise and sundown. Baha’i also requires adherents to fast between sunrise and sunset during the month of Ala, which takes place March 2-20. Knowing who's not eating can inform care. Patients with diabetes who are fasting, for example, should regularly check their blood glucose levels and watch out for signs of hypoglycemia or hyperglycemia.
Mormons fast once per month if they are not sick, while Hindus fast on holy days and other special occasions. Eastern Orthodox Christians fast from meat, dairy, and oil for 40 days during Great Lent (before Easter) and Christmas Lent (before Christmas).
Medication and medical procedures
It is important to understand patients’ religious attitudes toward medication and certain procedures before breaking out the prescription pad.
Mormons, for example, may wish to avoid drugs that contain alcohol or caffeine. Rastafarians could also be concerned by the alcohol content of their medication. Buddhists might refuse mind-altering medications such as pain relievers when they are dying.
Understanding patients’ aversion to certain types of medication or intervention can inspire physicians to offer acceptable alternatives. Instead of pain relievers, non-pharmacological strategies for pain management might be best.
Children and adults following Christian Science’s teachings may not be vaccinated, and might refuse vaccinations. Jehovah’s Witnesses may reject blood transfusion or any products containing blood.
Sikhism prohibits hair removal from any part of the body, which could pose challenges for surgery that need to be addressed with the patient.
Women’s health and reproduction
Many religions have specific perspectives on women’s health and reproductive issues.
Judaism and Roman Catholicism prohibit some women from using birth control, while Jehovah’s Witnesses, Protestant Christians, and Baha’i consider the matter an individual choice.
Roman Catholicism discourages artificial insemination, and Jehovah’s Witnesses forbid the practice. For Mormons, it is only acceptable between a married, heterosexual couple.
Mormonism, Hinduism, and Islam prohibit abortion unless the mother’s life is at risk, or in cases of rape or incest. Roman Catholics and Jehovah’s Witnesses don’t allow abortion, period.
In Islam, women can’t shake hands or make any physical contact with men outside of their family. Muslim women often seek physicians of the same gender. Some Hindu women may not request special care, as they sometimes prefer the family’s primary spokesperson—the father or husband—to field questions.
Faith healing and praying for the sick
Many religions teach that prayer can help recovery. Baha’i, Protestant Christianity, Seventh-day Adventism, and Hawaiian religious beliefs all underscore the role of prayer in promoting healing. Pentecostal Christians may also express a strong belief in miraculous healing.
In a recent special edition of the AMA’s Journal of Ethics focusing on patient religion and spirituality, University of Pittsburgh Medical Center doctors noted that about half of all patients would like their physicians to join them in prayer. This can make the patient feel a stronger connection to their doctor, potentially reducing anxiety and distress.
But like with each patient, the decision to pray or not to pray is up to the physician.
To read more about this topic, check out Does religion make you healthier? on our PhysicianSense blog.