Praying in the Hospital June 19, 2008

Praying in the Hospital

Somehow this story slipped by me last week.

Manoj Jain — a doctor from Memphis — wrote a piece for The Washington Post where he discussed his discomfort with praying with a patient.

… Although I am comfortable asking patients about their faith when I question them about their profession and their family or social support structure, I feel awkward, even squeamish, about praying with my patients. That may be because I was never taught how to pray with my patients in medical school, nor did I see my mentors praying with patients. Also, I am of the Jain faith, an Eastern religion based on the principle of nonviolence and the practice of meditation, and most of my patients are of the Christian or Jewish faith. In addition, at times I have seen religious beliefs compromise a patient’s health: One young patient of mine died in my intensive care unit because she refused blood transfusions based on her religious beliefs.

It gets a little more complicated when you’re dealing with a doctor of a particular faith:

I asked my [Christian] neurosurgeon friend how he prays with patients who are Jewish, Muslim or Hindu. Does he end with the phrase about “our Lord, Jesus Christ”? He paused and then told me that it depends on the patient. I suspect that there is a selection bias and that he is more likely to offer prayers to Christian patients than others. He admits he feels uncomfortable offering a prayer in another faith or using the words “Allah,” “Om” or “Shalom” because for him the prayer would not feel authentic.

In the end, this is what prompts my discomfort with praying with patients. If a doctor is using prayer because he feels it will help to heal a patient and not just to improve the doctor-patient relationship, then I believe it is unfair, even discriminatory, for a doctor to offer a Christian prayer with a Christian patient and not offer another prayer to patients of other faiths.

However, Jain is not saying doctors should dismiss the role of faith in healing. He correctly agrees that encouraging a patient’s spirituality sometimes plays a part in helping them get better, but there’s a difference between spirituality and religion:

I think I could pray (using a generic prayer) or do a meditation exercise at a critical moment with my patient. At times, if this is uncomfortable or if there is not enough time, I could simply encourage the spiritual part of patients’ lives.

This is what I did with my patient suffering from end-stage congestive heart failure. I touched his Bible and said, “Many patients find this very helpful. I am glad you are using it.”

“Couldn’t make it without it, Doc,” he replied with a tone of hope and optimism.

So put yourself in a doctor’s shoes for a moment. (And to those of you who are doctors: feel free to chime in.)

According to the piece, 40-60 percent of patients want their doctors to pray with them.

Your job is to help them get better.

Do you indulge them and pray along?

Incidentally, Jain was also a co-investigator on the largest study to date on the effect of intercessory prayer, finding “that being prayed for did not improve outcomes, and it seemed to have a negative effect when patients knew they were the subject of prayers from afar.”

(via The Dallas Morning News)

[tags]atheist, atheism[/tags]

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  • Bad

    I got a little confused until I realized that his name and his religion were the same.

    This is a very, very hard call. Of course, some hospitals have spiritual counselors for precisely this purpose. And I believe that doctors should be, above all else, honest with their patients about who they are and what they are doing.

    Think about it this way. If a patient really, really believed that Christ could help them through an illness, would they want an atheist doctor faking it through prayers? Shouldn’t they get a chance to object to that if might feel it would compromise their own prayers? Wouldn’t they want to know, so that they could get authentic prayers from a Christian doctor if that’s what they felt they needed? Patients have a right to make these and any choices regarding any part of what they feel is their treatment. And I think ultimately them knowing the truth and getting to make their own decisions is better than essentially lying to them.

  • Siamang

    I’d rather the doctor take that time to better explain my condition. Doctors don’t do that enough.

    Why is a doctor called on to be a spiritual cohort anyway? Isn’t that a priest’s job? I don’t go to a priest for medical advice.

    You know what makes me feel better when sick? Good old chicken soup. But I don’t make my doctor whip me up a batch. Also, you know what else? A good belly laugh. But I don’t require a doctor to tell me a joke. Maybe if I found out I had six months to live, I might want to take a trip somewhere. But I don’t expect the doctor to be my travel agent.

  • Erik

    Siamang, that was a great response.

    I haven’t put much time in hospitals, so I don’t really know when and where prayer comes into play for many patients. I never would have pictured the doctors praying with the patients… What would really get to me is if a doctor forced a patient to pray with him/her.

  • David D.G.

    I agree with Siamang’s post. Well put.

    Honestly, I find it difficult to even treat this situation the least bit seriously. I’m sure that it is a very serious matter to these people, and an atheist doctor ought to take his patients’ frame of mind into consideration in taking care of them. Nevertheless, pandering to a patient’s superstitious beliefs seems both ridiculous and even potentially counterproductive, whether those beliefs involve Jesus, Allah, Buddha, Krishna, astrology, crystals, or the Lucky Charms leprechaun. The doctor should be dealing with the medical situation and guiding the patient through it in a reality-based fashion, not reinforcing woo-based beliefs, no matter how widely practiced.

    Whether the doctor should use the situation as a “teachable moment” to introduce the patient to reality-based thinking on a larger scale is, undoubtedly, an extremely delicate issue and probably left for case-by-case judgment (and probably to be done only rarely even then, since it can be mistaken for proselytizing of a sort itself). But at the very least, the doctor has a responsibility to base his patient’s care in reality, not to reinforce fantasy, especially when the doctor actually knows it is fantasy.

    ~David D.G.

  • Siamang

    Whether the doctor should use the situation as a “teachable moment” to introduce the patient to reality-based thinking on a larger scale is, undoubtedly, an extremely delicate issue and probably left for case-by-case judgment

    I think this should only be the case if the patient is thinking of pursuing quack remedies.

  • Darryl

    How awkward though. When your patient asks you to pray with them, and you don’t want to, what can you say that won’t offend them?

  • Polly

    I hate being asked to pray at the dinner table when at my mother’s house. How much more awkward to pray with a dying stranger.

    I don’t know what I’d do, but if a patient needed someone / anyone with whom to utter some words to their invisible buddy – in order to get through the next round of chemo, radiation, or whatever brand of treatment – and I were the only one available, I suppose – if they didn’t ask, I wouldn’t tell – I’d just pray with them.

    But, it really depends on how dire the circumstances.

    Drawing conclusions about systemic discrimination based on religion is probably fruitless since each incident is so unique. What if the Xian doctor prays with the xian cancer patient but not the Muslim hernia patient, is that prejudice?

  • Tracy

    I’ve prayed with patients before. Doesn’t bother me a bit. It doesn’t make me feel like a hypocrite or uncomfortable. I am an atheist but I don’t tell them that! I think a positive attitude has a lot to do with a patient’s ability to heal themselves. I don’t want to mess up their “mojo”.

  • Stephanie

    Well, a chaplain certainly helped raise my mother’s spirits when she was in the hospital dying of lung cancer. The chaplain got he wrong room and came in while my brother and I were visiting mom. When she breezed in and asked us all to pray, she got an earful first from me then my brother. Mom was laughing about the chaplain’s horrified retreat for weeks.

  • I spent three years volunteering in a hospice. At one point, a patient asked me to read her some Bible verses. Although I am an atheist, I know the Bible better than most Christians. As a moral being, I have some serious ethical issues with large portions of the Bible. However, I was being asked to read Bible verses. This wasn’t about me. She wanted to hear the words of her Bible. I didn’t pick and choose my favorite examples of bad dogma. I asked her what she wanted to hear and I read it. This seemed to give her some peace and it also gave me a good feeling for being able to do something which brought some peace to someone else’s life.

    For myself, I’ve been through some serious health challenges. At one point, a Christian volunteer popped into my hospital room and offered to pray with me. I resented the intrusion on many levels. For one thing, I was a captive audience. I could not leave without being unleashed from a variety of tubes & monitors. Because I was reasonably conscious at the moment, I could (and did) refuse the intrusion.

    I do not want anyone to pray for me under any circumstances. ‘Praying’ in the Christian context assumes that there is something wrong with me, starting with original sin. While I don’t believe I’m perfect, I do not believe there is something fundamentally wrong with me. That attitude leads to pity. If I’m ill or going through a difficult time, I want compassion, not pity.

  • sabrina

    I’m am an ICU nurse and we have chaplains for praying. If a patient needs spiritual counseling or a “pray buddy” I just call the chaplain, we have one on duty 24 hours a day. I would imagine my patients would rather me spend my time double checking their medications, monitoring their vitals, and rounding with the doctor than mumbling some inane prayer. Patients normally don’t ask for you to pray with them unless you bring it up. I work with some Christian nurses and if a patient has a bible in the room, or one of those bible c.d.’s playing on their radio, the nurse might say something about God, and sometimes they’ll pray together. I don’t mention the subject and the patient doesn’t either.

  • Ian

    I was recently in the hospital, and my doctor surprised me when he said that his whole church was praying for me. It actually made me a bit scared, as it gave me the message that a highly trained doctor, a man of science, was praying to a supernatural being that I get better. It blew away that illusion that he was the competent doctor, knew exactly what was wrong, and how to fix me. It made me think, “Is my condition so serious that not even a doctor can help me?” Fortunately, he didn’t offer to pray with me then.

    I think doctors should be aware of what religion (if any) their patients are, so that they can reduce the likelihood of offending and/or scaring them with the wrong comment.

  • I’ve had clients ask me to pray with them on several occasions, and I’m just a lawyer handling business and real estate disputes. But I’ve had some very devout clients who seem to only be able to vent strong emotions through some sort of expression of piety.

    When they’ve invited me to pray with them, my response is “this kind of prayer isn’t really my tradition.” (A very devout client under great stress does not need to suddenly learn that her lawyer is an atheist.) Once I had someone insist on going forward with the prayer anyway — it was right before the first day of trial, and she grabbed my hands in the courthouse hallway and made a rambling speech imploring Jesus to come to her aid and to help me and the judge show the jury “the truth.”

    There were no jurors around, so I just let her do her thing and didn’t protest.

    We reached a settlement with the other side later that day, by the way. Jesus didn’t have nearly as much to do with it so much as the judge’s rulings on preliminary motions about what evidence would be considered by the jury.

    Point is, I think I did the right thing by letting my client pray the way she wanted to in a time she was feeling a lot of emotional stress, even though I did not share her belief. I think a doctor should do something similar in an analagous situation.

  • Maria

    I think I could pray (using a generic prayer) or do a meditation exercise at a critical moment with my patient. At times, if this is uncomfortable or if there is not enough time, I could simply encourage the spiritual part of patients’ lives.

    I think that’s a good approach

  • Beth

    No I would not pray. However I would certainly encourage positive thought as scientific studies have shown optimism improves patient outcomes. You can word things in such a way that people can take the encouragement however they want without compromising your integrity.

  • The Unbrainwashed

    I’m sorry, but I have no sympathy with doctors like the one above. The only sympathy I have is for atheist doctors who are put in this delicate situation. My lack of empathy is for the same reason that I pause when mocking say Islam with a Christian. Dawkins mentions this type of situation in the God Delusion. Religious people always view other religions with the skeptical eye that is never present when dissecting their own. Thus, I laugh when a Hindu doctor gets uncomfortable or, even better, is indignant around Christianity. It’s the same thing with different names.

  • I find the whole notion of a doctor praying with a patient utterly astounding.

    To me it seems to be an invasion of the privacy of either party, and highly likely to interfere with the professional relationship. I’d no more expect it than I’d expect the cable technician to pray with me over the junction box.

    I have been in religious hospitals where the hospital offers patients a visit from someone (not a medical practitioner) who will pray with them and offer religious counsel (which you’re entirely free to take up or not take up), but even there, there was never any suggestion that the medical staff could be involved.

    Is this sort of weirdness common in the US?

    Fortunately, I’m in no danger of the offer of a prayer session with my GP. He’s an atheist.

  • Jen

    It would highly bother me if a doctor told me (s)he was praying for me. What the hell for? Go back and consult other doctors if you need more solutions. Now, if I were a doctor being asked to pray, I think I might do what I do when I have a dinner companion who prays before meals- sit there quietly, mentally rolling my eyes, and let them do the talking. I can’t be sure though- I have never had anyone ask me to pray with them at any job I have worked so far, and thank the good Spaghetti Monster for that.

    Now that I am thinking about it… my dentist is a Christian. He has some Christian/tooth-themed crap in his office. But he certainly never prayed in front of me.

  • Eliza

    In the hospital, “spiritual care” practitioners are available 24/7, & on relatively short notice they can call in someone whose religion matches that of the patient (or family) requesting spiritual attention. I’ve had chaplains join us in conferences with families of critically or terminally ill patients, & their presence has (so far) been quite useful, usually more for the family, but sometimes also as a sort of cultural translator, letting us know what considerations may be most important to this family or patient.

    For outpatients, I try to remember to ask patients who are going through difficult times, whether it’s due to health or something else, whether religion or spirituality is or has been a source of support for them. Clearly, people often find comfort in religion, especially in difficult times. I have done things like search online in the exam room to help a patient locate a church of their preferred denomination, or a counselor who identifies as being of the same religion.

    But: I wouldn’t pray with a patient, or pretend to pray with a patient. I think I’ve said, on the few occasions when a patient or family member directly asked me to pray with them, that I don’t pray. It seems OK to me to do the passive pretend-to-go-along-with-grace thing at the dinner table, but not OK to pretend to go along with prayer for someone who is vulnerable & seeking a type of support & reassurance that I am not going to be able to truthfully provide. (And, which I’m pretty sure I’d fake really badly, and awkwardly.)

    Most awkward thing for me is long-time patients in my primary care practice who assume I must be Christian, without ever asking. I haven’t figured out how to dispel their impression, in a way that feels like it’s not in-their-face & also which points out that I’m still the same person. (These are people for whom a red A or an FSM pin on my lapel wouldn’t serve as a hint.)

  • cipher

    Incidentally, Jain was also a co-investigator on the largest study to date on the effect of intercessory prayer, finding “that being prayed for did not improve outcomes, and it seemed to have a negative effect when patients knew they were the subject of prayers from afar.”

    I think I’ve mentioned this here before – in the nineties, Larry Dossey claimed to have done a meta-study of experiments dealing with prayer and the healing process – supposedly there was something on the order of 140 or so at the time – and he claimed that there was a positive correlation. This became the basis of his next three books. Now, this study comes along and seems to debunk that.

    Although I’m an atheist, I’m not committed to radical materialism. If it turns out that the materialists are correct, I won’t be at all surprised; however, there is an enormous body of anecdotal “evidence” to the contrary that I’m not prepared to simply dismiss summarily.

    So now I don’t know what to think.

  • valhar2000

    there is an enormous body of anecdotal “evidence” to the contrary that I’m not prepared to simply dismiss summarily.

    I do dismiss it. Any consideration I give to the supernatural is either for entertainment purposes or as an exercise in pedantry.

    One of the many reasons I do so is things like this. I’ve only recently seen that article, but I’ve heard about the ideas referenced there many times, and experienced some of them myself. People just aren’t that reliable; that’s why the scientific method had to be invented.

    By the way, I got the link from the Ecstathy blog.

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