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The Depersonalization of Medicine, and the Promises of Spiritual Care

  • Symposium: Hostility to Hospitality
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Abstract

In this article, I discuss the main ideas, strengths and limitations of Hostility to Hospitality: Spirituality and Professional Socialization with Medicine, a book written by Michael J. Balboni and Tracy Balboni. I identify the key strength of this work as the in-depth, well-researched description of the relationship between medicine and religion/spirituality and its influence on the Western, healthcare system. I discuss the main points made by the authors and suggest this book as a must-read for anyone who wants to improve the ethos of the modern medical system. However, I also advise readers critically assess the clinical suggestions made in the book, recommending that chaplains be consulted to improve how the Balbonis' ideas are put into practice in the healthcare system.

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Notes

  1. Michael J. Balboni and Tracy A. Balboni, Hostility to Hospitality: Spirituality and Professional Socialization within Medicine (New York: Oxford University Press, 2018), p. 1.

  2. See MJ Balboni, Puchalski, CM, and Peteet, JR. 2014. The Relationship between Medicine, Spirituality and Religion: Three Models for Integration. Journal of Religion and Health, 53(5):1586–1598. doi:https://doi.org/10.1007/s10943-014-9901-8; HY Vanderpool and JS Levin. 1990. Religion and Medicine: How Are They Related? Journal of Religion and Health,29(1):9–20; and HG Koenig. 2001. Religion, Spirituality, and Medicine: How Are They Related and What Does It Mean? Mayo Clinic Proceedings, 76(12):1189–1191. doi:https://doi.org/10.4065/76.12.1189

  3. Balboni, Puchalski, and Peteet, p. 1586.

  4. Balboni and Balboni, p. 8.

  5. T. Balboni T, M. Balboni, ME Paulk, et al. 2011. Support of cancer patients’ spiritual needs and associations with medical care costs at the end of life. Cancer, 117(23):5383–5391. doi:https://doi.org/10.1002/cncr.26221

  6. See AB Astrow, A. Wexler, K. Texeira, MK He, DP Sulmasy. 2007. Is Failure to Meet Spiritual Needs Associated With Cancer Patients’ Perceptions of Quality of Care and Their Satisfaction With Care? JCO, 25(36):5753–5757. doi:https://doi.org/10.1200/JCO.2007.12.4362; TA Balboni, LC Vanderwerker, SD Block, et al. 2007. Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol., 25(5):555–560. doi:https://doi.org/10.1200/JCO.2006.07.9046; and MJ Pearce, AD Coan, JE Herndon, HG Koenig, and AP Abernethy. 2012. Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Support Care Cancer, 20(10):2269–2276. doi:https://doi.org/10.1007/s00520-011-1335-1

  7. See M. Best, P. Butow, and I. Olver. 2016. Doctors discussing religion and spirituality: A systematic literature review. Palliative Medicine, 30(4):327–337. doi:https://doi.org/10.1177/0269216315600912; MR Ellis, P. Thomlinson, C. Gemmill, and W. Harris. 2013. The spiritual needs and resources of hospitalized primary care patients. J Relig Health, 52(4):1306–1318. doi:https://doi.org/10.1007/s10943-012-9575-z; and JA Williams, D. Meltzer, V. Arora, G. Chung, and FA. Curlin. 2011. Attention to Inpatients’ Religious and Spiritual Concerns: Predictors and Association with Patient Satisfaction. J Gen Intern Med., 26(11):1265–1271. doi:https://doi.org/10.1007/s11606-011-1781-y

  8. Balboni and Balboni, p. 69.

  9. See Astrow et al.; HG Koenig. 1998. Religious attitudes and practices of hospitalized medically ill older adults. Int J Geriatr Psychiatry, 13(4):213–224; and A. Moadel, C. Morgan, A. Fatone, et al. 1999. Seeking meaning and hope: self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psychooncology, 8(5):378–385.

    Brady MJ, Peterman AH, Fitchett G, Mo M, Cella D. A case for including spirituality in quality of life measurement in oncology. Psychooncology. 1999;8(5):417–428.

  10. MJ Brady, AH Peterman, G. Fitchett, M. Mo, and D. Cella. 1999. A case for including spirituality in quality of life measurement in oncology. Psychooncology, 8(5):417–428.

  11. See GA Silvestri, S. Knittig, JS Zoller, PJ Nietert. 2003. Importance of faith on medical decisions regarding cancer care. J Clin Oncol., 21(7):1379–1382. doi:https://doi.org/10.1200/JCO.2003.08.036; and G. True, EJ Phipps, LE Braitman, T. Harralson, D. Harris, and W. Tester. 2005. Treatment preferences and advance care planning at end of life: the role of ethnicity and spiritual coping in cancer patients. Ann Behav Med., 30(2):174–179. doi:https://doi.org/10.1207/s15324796abm3002_10

  12. PW Skehan and DL Alexander. 1987. The Wisdom of Ben Sira: Anchor Yale Bible Commentary. Garden City, NY: Doubleday; 1987. https://www.christianbook.com/wisdom-sira-anchor-yale-bible-commentary/patrick-skehan/9780300139945/pd/139945. Accessed January 23, 2019.

  13. Balboni and Balboni, p. 89.

  14. Ibid., p. 90.

  15. Ibid., p. 91.

  16. GB Risse, Hospital Life in Enlightenment Scotland: Care and Teaching at the Royal Infirmary of Edinburgh (New York: Cambridge University Press; 1986), p. 680.

  17. JB Imber, Trusting Doctors: The Decline of Moral Authority in American Medicine (Princeton, NJ: Princeton University Press, 2008).

  18. P. Starr, The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry. 2nd ed. (New York: Basic Books; 2017).

  19. Balboni and Balboni, p. 94.

  20. K. Dobbelaere, Secularization: An Analysis at Three Levels. Vol 1. (Fragniere G, ed.) (New York: Peter Lang Publishing, 2002).

  21. DW Amundsen, Medicine, Society, and Faith in the Ancient and Medieval Worlds (Baltimore: Johns Hopkins University Press; 1996). https://www.abebooks.com/9780801863547/Medicine-Society-Faith-Ancient-Medieval-0801863546/plp. Accessed January 22, 2019.

  22. Balboni and Balboni, p. 112. See also C. Taylor. A Secular Age (Cambridge, MA: Harvard University Press, 2007).

  23. RP Sloan, Blind Faith: The Unholy Alliance of Religion and Medicine (New York: St. Martin’s Press; 2006).

  24. Balboni and Balboni, p. 225.

  25. Ibid, p. 204.

  26. Ibid., pp. 254–55.

  27. Ibid., p. 259.

  28. Ibid., p. 273.

  29. DP Sulmasy. 2009. Spirituality, religion, and clinical care. Chest.,135(6):1634–1642. doi:https://doi.org/10.1378/chest.08-2241

  30. Balboni and Balboni, p. 254.

  31. TA Balboni TA, ME Paulk, M. Balboni M, et al. 2010. Provision of Spiritual Care to Patients With Advanced Cancer: Associations With Medical Care and Quality of Life Near Death. Journal of Clinical Oncology, 28:445–452.

  32. See MR Ellis. See also L. VandeCreek. 2004. How Satisfied are Patients with the Ministry of Chaplains? Journal of Pastoral Care & Counseling: Advancing theory and professional practice through scholarly and reflective publications. 2004;58(4):335–342. doi:https://doi.org/10.1177/154230500405800406; and ML Williams, M. Wright, M. Cobb, and C. Shiels. 2004. A prospective study of the roles, responsibilities and stresses of chaplains working within a hospice. Palliat Med., 18(7):638–645. doi:https://doi.org/10.1191/0269216304pm929oa

  33. Association of Professional Chaplains. How do I become a chaplain? http://www.professionalchaplains.org/content.asp?contentid=78. Published 2018. Accessed January 23, 2019.

  34. See L. VandeCreek. 1999. Professional chaplaincy: an absent profession? J Pastoral Care. 1999;53(4):417–432; and T. Proserpio, C. Piccinelli, and CA Clerici. 2011. Pastoral care in hospitals: a literature review. Tumori, 97(5):666–671. doi:https://doi.org/10.1700/989.10729

  35. S. Nolan. 2016. “He Needs to Talk!”: A Chaplain’s Case Study of Nonreligious Spiritual Care. J Health Care Chaplain, 22(1):1–16. doi:https://doi.org/10.1080/08854726.2015.1113805

  36. B. Alper. 2018. Why America’s ‘nones’ don’t identify with a religion. Pew Research Center. August. http://www.pewresearch.org/fact-tank/2018/08/08/why-americas-nones-dont-identify-with-a-religion/. Accessed January 23, 2019.

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    Petra J. Sprik

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Sprik, P.J. The Depersonalization of Medicine, and the Promises of Spiritual Care. Soc 56, 147–152 (2019). https://doi.org/10.1007/s12115-019-00342-z

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