Notes on “Medicine, Religion and Health” by Koenig

In his book “Medicine, Religion and Health” Koenig raises several important questions about the role of spirituality in the healthcare settings. First of all, he address the problem of definition of the term spirituality. As it is shown, due to the fact that spirituality in itself is a very private matter, it can be described differently by every person. Koenig brings up several definitions of different researchers and eventually offers his own. In his opinion, spirituality should be linked to religion even though it does not necessarily imply religious belief. While there may be different opinions on the precise definition of spirituality, Koenig points out that in the clinical settings these definitions are not so important. He argues that in the care of patients it would be more useful to define spirituality as broadly as possible to be able to address the spiritual needs of all patients. His concerns with separating religion and spirituality are somewhat grounded in his point about religion leading to certain behaviors or practices through the process of social expectations and norming, while spirituality does not necessarily make a person accountable to a larger group of people or standardized belief system.  So, more qualitative work must be done on understanding what spirituality might make people feel connected to in terms of an ethic when our research question is on the mechanics of how the belief leads to behaviors.  It is entirely different in clinical settings where the most important thing is how the patient defines it. 

Koenig then goes on to demonstrate, with the help of many scientific studies, the influence faith has on stress levels and then the effects of stress on our health, linking this way spiritually and health. While “religion” does not directly impact health, it can impact stress and coping, which then impacts heath.

One of the issues that Koenig raises in his book is that despite the knowledge about the spiritual needs of patients, very few health care professionals address those needs. He then proposes the ways in which doctors could make the necessary spirituality assessments and then refer their patients to such professionals as chaplains or clergy.

Finally, Koenig argues that even if the involvement of religion is to be found unrelated to the health outcomes, spirituality, should be nonetheless integrated into the patient care simply because the patients have the spiritual needs that could be met by health professionals.

The part of the book that resonates most with my professional interest is the exploration of the mind-body connection in Chapter 3. I have been extremely interested in psychosomatic causes of physical problems for more than twenty years, and I was glad to see this issue addressed within the exploration of the connection between spirituality and physical and mental health.

Being spiritual/not religious myself, I am taking the subject of definition of spirituality very personally. While the author argues that spirituality has been always linked to religion, I can only say that, in my opinion, religion has been always built on the foundation of spirituality. I see it as a way to teach spirituality to people who have not yet developed some path of their own. I would agree with the words of David J. Hufford, who defines spirituality simply as “personal relationship to the transcendent” and religion as “the institutional aspects of spirituality.”

The whole concept of spirituality, whatever meaning each of us assigns to this term, has been proved to be of extreme importance to all humans. This importance does not diminish but may  become even higher when the person is in need of medical care. Koenig emphasises the problem that even though health care professionals are aware of the spiritual needs of their patients, they do not address them properly. 

Personally, I am passionate about the idea of creating the right ways to meet the spiritual needs of people in health care. The fact that people often depend on their religious beliefs in times of difficulty to be able to cope with the loss of loved ones or loss of their own health seems to quite obviously lead to the conclusion that the whole field of spiritual care within health care system needs to develop and grow. Koenig points out that the amount of chaplains in the hospitals in not enough to care for all patients. The doctors are not educated to address the spiritual needs of patients. The system is built as if to ignore this whole concept.

In times when due to the strict budgeting of the hospitals chaplains are among the first ones to be cut off, Koenig proposes to address this issue through the religious organizations. To me it seems as a great idea. While Koenig suggests that religious organizations could create the sort of activities that would prevent people from getting into the hospitals in the first place by promoting healthy lifestyles and altruistic activities, I believe, they could also send their representatives (funded by their organizations) to serve at the hospitals. This way, the hospitals’ budgets would not be an issue, and each hospital could have a spiritual care team consisting of representatives of different religious institutions, and there would be a much higher chance for the spiritual needs of most patients to be met. There are a lot of models that incorporate this, Parish or Faith Community Nursing is one of them.