More patients and doctors are contemplating the benefits of an age-old complementary and alternative medicine practice—spirituality. Interest in adding a spiritual dimension to healthcare may stem from a number of factors. Many patients have long lamented the absence of a personal level of care from their doctors. In addition, the aging US population demands a growing emphasis on end-of-life care. Even doctors are reacting to the increasingly depersonalized medical approach of today, and a growing number of them believe that attending to the spiritual lives of their patients is an important part of the doctor-patient relationship. This changing attitude can be seen in our medical schools: more than 50 US medical schools now offer elective courses in spirituality.

Scientists have been taking a closer look at spirituality as well. A dozen studies by Duke University Medical Center show that certain religious activities seem to improve health. For example, one study found a strong connection between lower blood pressure and prayer, Bible reading, and attending church (note: religious TV and radio shows did not have that affect). A recent study in Kansas City indicated that people may benefit from having others pray for them, even when the prayers are said without their knowledge. The study involved two groups of heart patients. Neither group knew if anyone was praying for them; people unrelated to the study participants said prayers for one group but not the other. At the end of the study, the group that had people praying for them had experienced fewer medical complications. Other research has indicated that practices such as saying repetitive prayers and spending time in meditation may have positive physiological, neurological, and psychological effects. This supports findings that people who have spiritual practices are better able to cope with stress.

Many practitioners believe that spiritual practices help with medical treatment (thereby reducing health care costs) and enhance quality of life. But some hesitate to prescribe spirituality as an extension of medicine, questioning whether it is appropriate for doctors to be involved in a non-medical arena. Others wonder if religion can be considered equivalent to other lifestyle factors, such as regular exercise and a healthy diet, and therefore falls under a doctor's scope of advice. Still others are concerned that if doctors encourage religious practices they may cause harm by implying that poor health is a result of lesser spiritual worthiness. They believe it would be wrong to convey the message that being close to God means having better health.

Doctors and patients will continue to struggle with the issues around incorporating spirituality into health care as more research is done on the subject. For now, there's no definitive scientific proof that prayer is a necessary part of healthcare, although, from the evidence that's in, it certainly doesn't seem to hurt.

Neurological: having to do with the nervous system's structure and function

Physiological: having to do with the body's chemical and physical function

Psychological: having to do with the mind's function and how it relates to behavior

Timeless Healing: The Power and Biology of Belief by Herbert Benson and Marg Stark (Fireside 1997)

Healing Words: The Power of Prayer and the Practice of Medicine by Larry Dossey (Harper Mass Market Paperbacks 1997)

Reinventing Medicine: Beyond Mind-Body to a New Era of Healing by Larry Dossey (Harper Collins 1999)

American Medical Association. "What is the role of spirituality in medicine?" American Medical News. April 12, 1999. Available at: http//www.ama-assn.org/sci-pubs/msjama/articles.

National Institutes of Health, National Center for Complementary and Alternative Medicine. "Health Care Industry Supports Spirituality in Medicine," CAM Newsletter. January 1998. Available at: http://altmed.od.nih.gov.

Sloan RP, Bagiella E, Powell T. Religion, spirituality and medicine. Lancet. 1999;353:664-667.

Spirituality & Health Web site. "Prayer Helps Heart Patients Who Don't Know They're Being Prayed For." Accessed on Oct. 26, 1999. Available at: http//www.spiritualityhealth.com/news.

Spirituality & Health Web site. "Want Lower Blood Pressure? Get Out to Church, Says a New Study." Accessed on Aug. 11, 1998. Available at: http//www.spiritualityhealth.com/news.