What GPs mean by 'spirituality' and how they apply this concept with patients: a qualitative study

Alistair Appleby; John Swinton; Philip Wilson

doi:10.3399/bjgpopen18X101469

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What GPs mean by 'spirituality' and how they apply this concept with patients
Nat MJ Wright

Published on: 27 April 2018

Published on: (27 April 2018)

What GPs mean by 'spirituality' and how they apply this concept with patients
Nat MJ Wright, clinical research director, Spectrum Community Interest Company
I found this an interesting study in a very under-researched area. I did have concerns about the reports of doctors offering to pray with patients. At worst this is surely an abuse of trust — an imposition of one's own belief system upon a patient likely to be vulnerable on account of ill-health. Further, it introduces an 'intervention' which, by definition is metaphysical and therefore unable to be validated (or falsified) by the scientific method. Thus it cannot ever be called evidence based.

At best praying with patients surely leads to an unhealthy blurring of the boundaries of the doctor–patient relationship. Doctors are mandated through the GMC Good Medical Practice guidance to avoid a 'close personal relationship' with their patients. Regardless of whether there is or isn't a deity, surely there are few actions that are more intimate than praying with patients. In my opinion such an act leads to an unhealthy blurring of the boundaries. In no way do I wish to denigrate the act of prayer — rather doctors who have such a need should find a role with their chosen faith group outside their practice area. Faith groups have a long, chequered and painful history of harm caused to vulnerable people when they (either consciously or unconsciously) assert superiority of their 'code of practice' above those mandated by society. If enlightened democracies saw fit hundreds of years ago to separate church and state...
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I found this an interesting study in a very under-researched area. I did have concerns about the reports of doctors offering to pray with patients. At worst this is surely an abuse of trust — an imposition of one's own belief system upon a patient likely to be vulnerable on account of ill-health. Further, it introduces an 'intervention' which, by definition is metaphysical and therefore unable to be validated (or falsified) by the scientific method. Thus it cannot ever be called evidence based.

At best praying with patients surely leads to an unhealthy blurring of the boundaries of the doctor–patient relationship. Doctors are mandated through the GMC Good Medical Practice guidance to avoid a 'close personal relationship' with their patients. Regardless of whether there is or isn't a deity, surely there are few actions that are more intimate than praying with patients. In my opinion such an act leads to an unhealthy blurring of the boundaries. In no way do I wish to denigrate the act of prayer — rather doctors who have such a need should find a role with their chosen faith group outside their practice area. Faith groups have a long, chequered and painful history of harm caused to vulnerable people when they (either consciously or unconsciously) assert superiority of their 'code of practice' above those mandated by society. If enlightened democracies saw fit hundreds of years ago to separate church and state to minimise risk to its citizens through abuse of 'spiritual' power then surely there needs to be a separation in the consulting room. To adopt any other position in a society underpinned by the values of secular pluralism is a dangerous slippery slope. Why? Because next week I'm going to see my GP with shoulder pain. I require an evidence based treatment — not faith healing, dowsing, tarot, or any other non-evidence based metaphysical intervention that would differ in different consulting rooms according to the attitudes and beliefs of the 'delivering' GP.

Boundaries in life are important!
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Competing Interests: None declared.