Abstract
This article explores the relationship of spirituality to health care and bioethics in terms of the need and efforts of people to make sense of their lives in the face of illness, injury, or impending death. Moving beyond earlier associations with specific religious traditions, spirituality has come to designate the way in which people can integrate their experiences with their sense of ultimate meaning and related values. The holistic model of health care also affirms that one should not simply treat a body in pain, but respond to the suffering of the whole person within his or her full life. A narrative emphasis in ethics also maintains that ethical decisions occur within the framework of interacting life-stories, each of which embodies a certain core vision and set of values. In each instance it is the life stories of people, their lived narratives, that provide a common thread. The telling of these stories and the discernment of the lived spirituality they contain may assist persons in the process of achieving understanding, making decisions, and finding purpose in the experience of illness, injury, or disability.
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References
For the development of the term “spirituality,” see Sandra Schneiders, Theology and Spirituality: Strangers, Rivals, or Partners,Horizons 13:2, 1986, pp. 257–264, and “Spirituality in the Academy,”Theological Studies 50:4, 1989, pp. 680–681; Walter Principe, “Towards Defining Spirituality,”Studies in Religion 12:2, 1983, pp. 130–135; and Jon Alexander, “What do Recent Writers Mean by Spirituality?,”Sprituality Today 32:3 no.3, 1980, pp. 248–252.
Schneiders, “Theology and Spirituality: Strangers, Rivals, or Partners,” pp. 261–264, and “Spirituality in the Academy,” pp. 684–687; Alexander,op. cit., pp. 249–51.
Schneiders, “Spirituality in the Academy,” p. 679.
Schneiders, “Spirituality in the Academy,” pp. 682–684; Jean-Claude Breton, “Retrouver les assises anthropologiques de la vie spirituelle,”Studies in Religion/Sciences religieuses 17:1, 1988, pp. 97–105.
Charles-André Bernard,Traité de théologie spirituelle. Paris: Cerf, 1986.
Breton,op. cit., p. 100.
Ibid., p. 101.
Ibid.
Alexander, “What Do Recent Writers Mean by Spirituality?”, p. 253.
Roger Haight defines spirituality in its most basic or general anthropological meaning as “the way a person leads his or her life,” “the way that any given person consciously directs his or her life.” He then differentiates between an authentic and inauthentic spirituality insofar as that life direction may be described as authentic or inauthentic. SeeAn Alternative Vision: An Interpretation of Liberation Theology (New York: Paulist Press, 1985, pp. 239–241. In suggesting a “universally applicable definition of spirituality,” Walter Principe also underlines a positively “lived spiritual life and reality.” He defines spirituality as follows: “the way in which a person understands and lives within his or her historical context that aspect of his or her religion, philosophy, or ethic that is viewed as the loftiest, the noblest, the most calculated to lead to the fullness of the ideal or perfection being sought.” See Principe,op. cit., p. 136.
Schneiders, “Theology and Spirituality,” p. 266. This definition is reaffirmed in “Spirituality in the Academy,” p. 684. A detailed philosophical analysis of human experience, its openness to questions of ultimate meaning and purpose, especially at times of crisis or turning points in life, the possibility of a source of being, meaning, and fulfillment, and of disclosure from the transcendent side, is presented in John E. Smith,Experience and God. New York: Oxford University Press, 1968.
Jon Alexander has claimed that spirituality has not only come to be understood in the experiential sense but also generically. He qualifies this point by acknowledging that generic spirituality does not refer to “concrete historical realities lived by individuals in particular traditions and communities. Spirituality in a generic sense is no such thing. It is an analogous conception and a heuristic tool.” Alexander,op. cit., p. 253.
Schneiders, “Theology and Spirituality,” p. 267.
Anne Carr,Transforming Grace: Christian Tradition and Women's Experience. San Francisco: Harper and Row, 1988, p. 203. Carr also defines spirituality in a wide sense as the life of the deepest self and of the whole self, affecting one's deepest thoughts, convictions, attitudes, and behaviour, encompassing all one's relationships to all of reality, and expressed in everything one does. Within this frame of reference she goes on to situate an explicitly feminist and Christian feminist spirituality; pp. 201–214.
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Ibid., pp. 265, 268.
Haight,op. cit., pp. 236–239. For one example of an attempt to extend spirituality to ecological concerns, see Thomas Berry (with Thomas Clarke),Befriending the Earth. Mystic, CT: Twenty-Third Publications, 1992.
On feminist spirituality, in addition to the study of Anne Carr cited in note 14 above, see also Judith Plaskow and Carol Christ,Weaving the Visions: New Patterns in Feminist Spirituality. San Francisco: Harper and Row, 1989. On New Age spirituality, see Mary Farrell Bechnarowski, “Literature of the New Age: A Review of Representative Sources,”Religious Studies Review 17:3, 1991, pp. 209–216. On postmodern spirituality, see David Ray Griffin, ed.,Spirtuality and Society: Postmodern Visions. Albany: State University of New York Press, 1988.
Alexander,op. cit., pp. 252–253; Haight, 239–241; Schneiders, “Theology and Spirituality: Strangers, Rivals, or Partners, pp. 255–257, and “Spirituality in the Academy,” pp. 682–684.
Eric Cassell, “The Nature of Suffering and the Goals of Medicine,”New England Journal of Medicine 306:11, 1982, p. 640. See alsoThe Nature of Suffering and the Goals of Medicine. New York: Oxford University Press, 1991.
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McGuire,op. cit., “ p. 86. See also Viktor Kestenbaum, ed.,The Humanity of the Ill: Phenomenological Perspectives. Knoxville: University of Tennessee Press, 1982. This volume of essays focuses upon the existential meaning of illness. It examines illness as lived experience from the standpoint of philosophical phenomenology and attempts to uncover the human meaning of illness and situate it within the larger context of the human condition.
Thomas Droge,The Faith Factor in Healing. Philadelphia: Trinity Press International, 1991, p. 7.
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Daniel Callahan, “The WHO Definition of “Health,” in Stephen Lammers and Allen Verhey,On Moral Medicine: Theological Perspectives on Moral Ethics. Grand Rapids, MI: Eerdmans, 1987 p. 168. This article was originally published inThe Hastings Center Studies 1:3, 1973, pp. 77–87.
Canadian Public Association,Caring About Health, Canadian Public Health Association Issue Paper on Federal/Provincial/Territorial Arrangements for Health Policy. Ottawa: Canadian Public Health Association, 1992, pp. 3–5. This paper was written by Michael Rachlis.
McGuire,op. cit., “ p. 90.
Carol Christ states that women's spiritual quest concerns “a woman's awakening to the depths of her soul and her position in the universe.” Essential to this task, is the process of getting in touch with and articulating one's deepest experiences in narrative form. In her words, “Women's stories have not been told. And without stories there is no articulation of experience. The expression of women's spiritual quest is integrally related to the telling of women's stories. If women's stories are not told, the depths of women's souls will not be known.” “Images of Spiritual Power in Women's Fiction” (Part One), in Charlene Spretnak, ed.,The Politics of Women's Spirituality. Garden City, NY: Doubleday, 1982, p. 327.
In the literature surveyed, only one article of substance, written by a physician, was found. The author defined spirituality in a way which could be located in an anthropological approach. John Hiatt, “Spirituality, Medicine, and Healing,”Southern Medical Journal 79:6, 1986, pp. 736–743. Relevant to the topic, however, is the writing of Eric Cassell, mentioned earlier. In addition to the article cited in note 20 above, see also, “Recognizing Suffering,”Hastings Center Report 21:3, 1991, pp. 24–31.
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The whole volume ofHolistic Nursing Practice 3:3, 1989, deals with the topic of spirituality.
Hiatt,op. cit., “ p. 737.
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Ibid., p. 46.
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Hiatt,op. cit., “ p. 736
Eric Cassell,op. cit., “ p. 31
Ibid., p. 24.
Ibid.
Ibid., p. 31.
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Howard Brody, “The Four Principles and Narrative Ethics”, in Raanan Gillon, ed.,Principles of Health Care Ethics. New York: John Wylie and Sons, 1993.
Howard Brody, “The Four Principles and Narrative Ethics”, in Raanan Gillon, ed.,Principles of Health Care Ethics. New York: John Wylie and Sons, 1993.
Steven Miles and Kathryn Hunter, “Case Stories,”Second Opinion 15, 1990, pp. 54–67.
Ibid., p. 67.
Ibid., p. 63.
Ibid.
See, for example, Howard Brody,Stories of Sickness. New Haven: Yale University Press, 1988; L. R. Churchill and T. S. Churchill, “Storytelling in Medical Arenas: The Art of Self-Determination,”Literature and Medicine 1, 1982, pp. 73–79; Arthur Kleinman,The Illness Narratives: Suffering, Healing, and the Human Condition, New York: Basic Books, 1988; S. Kay Toombs,The Meaning of Illness, Dordrecht/Boston/London: Kluwer Academic Publishers, 1993.
Courtney S. Campbell, “On James F. Childress: Answering Every Person,”Second Opinion 11, July, 1989, pp. 118–144.
Françoise Baylis et al.,A Proposal for a Strategic Research Network on “Health Care Ethics Consultation,” Social Sciences and Humanities Research Council of Canada Grant.
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Ibid., 37.
Ibid.
Ibid., p. 38.
Ibid.
Ibid., p. 40.
Additional information
Maureen Muldoon, Ph.D., is Associate Professor in the Department of Religious Studies, University of Windsor, Windsor, Ontario, and Norman King, Ph.D., is Professor in the same department.
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Muldoon, M., King, N. Spirituality, health care, and bioethics. J Relig Health 34, 329–350 (1995). https://doi.org/10.1007/BF02248742
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DOI: https://doi.org/10.1007/BF02248742