title: Talking about spirituality in the clinical setting: can being professional require being personal?
abstract: Spirituality or religion often presents as a foreign element to the clinical environment, and its language and reasoning can be a source of conflict there. As a result, the use of spirituality or religion by patients and families seems to be a solicitation that is destined to be unanswered and seems to open a distance between those who speak this language and those who do not. I argue that there are two promising approaches for engaging such language and helping patients and their families to productively engage in the decision-making process. First, patient-centered interviewing techniques can be employed to explore the patient's religious or spiritual beliefs and successfully translate them into choices. Second, and more radically, I suggest that in some more recalcitrant conflicts regarding treatment plans, resolution may require that clinicians become more involved, personally engaging in discussion and disclosure of religious and spiritual worldviews. I believe that both these approaches are supported by rich models of informed consent such as the transparency model and identify considerations and circumstances that can justify such personal disclosures. I conclude by offering some considerations for curbing potential unprofessional excesses or abuses in discussing spirituality and religion with patients.
authors.affiliation: Loyola University Chicago Stritch School of Medicine, Maywood, IL 60153, USA. mkuczew@lumc.edu
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kuczewski
mesh_terms: D003657:Decision Making / Q000941:ethics*; D033061:Ethics Consultation; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D018802:Patient-Centered Care; D010817:Physician-Patient Relations / Q000941:ethics*; D017410:Practice Guidelines as Topic; D012068:Religion and Medicine; D029181:Spirituality