Religion and the secularisation of health care.
OBJECTIVE
To assess the claim that conceptualisations of religion and spirituality should be grounded in theology, and acknowledge the global resurgence of religion.


BACKGROUND
Although there is widespread agreement in the nursing literature that 'spirituality' is a broader concept than 'religion,' and should be understood generically, this approximate consensus has occasionally been challenged. A recent paper by Barbara Pesut and colleagues argues that the generic view not only empties spirituality of powerful religious symbols and narratives, but underestimates the continuing social influence of religion, and its resurgence on a global scale. Accordingly, these authors suggest three principles for conceptualising spirituality and religion in health care, one of which is that conceptualisations should be grounded in philosophical and theological thinking, and should not ignore the global resurgence of religion.


METHODS
Critical review.


CONCLUSIONS
The Pesut principle privileges theology, disregarding other disciplines which theorize religion. Arguably, it privileges specifically Christian theology, the history of which suggests a politics of orthodoxy and an epistemology of authority and obedience. The global resurgence of religion is not, in fact, global, as the industrialised countries have experienced a marked shift towards secular-rational values; and the postindustrial phase of development is associated with self-expression values, which represent a challenge not merely to religious institutions (arguably an affirmation of 'spirituality') but to traditional elites and structures of all kinds. Finally, religion 'resurgent' is not an attractive model for health care, since many of its most obvious manifestations are incompatible with the ideology of health professionals.


CONCLUSIONS
In the secular societies of Europe, if not North America, there should be no expectation that nurses provide spiritual care. It is a requirement of the great separation between civil order and religion that the health services, as a public space, should remain thoroughly secular.
Paley
John
J
Department of Nursing and Midwifery, University of Stirling, Stirling, UK. j.h.paley@stir.ac.uk
D003695:Delivery of Health Care; D009729:Nursing; D012067:Religion