Advances in Medical Education

 

Spirituality, Religiosity, and Other Things


In a way doctors are the new priests, because so many people do not belong to an organized religion or have a spiritual leader that they go to on regular bases. The only "well being sort of person" they may see is their doctor, or maybe their dentist or psychiatrist. The only person that fulfills that listening role, the role of confidante-because there you have confidentiality, is the physician or psychiatrist. They assume that role in a world where the role of the religion is disappearing. Do dentists count as confidantes? I mean you cannot really talk because your mouth is pried open .It is funny, because so much of the doctor's role is based on the physical, and I have to wonder if our whole idea of spirituality is disappearing at the same time We cannot take care of our souls, so we try and take care of our bodies. Instead of having shamans, we now have personal trainers. If we do not ever die, then we don't have to worry about heaven or hell, sort of whole redirection from the spiritual to the physical. It seems apt that doctors, and pharmacists would become the new priests. Look what we have got now, we are over-medicated. People who took drugs first with a recreational purpose have now moved on to taking drugs for coping, for therapy devices. It became so acceptable to take a pill first for having fun, and for feeling better, and then just for getting through the day. On the one hand, I feel like we have socialized ourselves to accept this. On the other hand, I think the quality of our lives- in terms of environment, human interactions, the pace of life, have become so unbearable that we have to jump-start evolution by medicating our selves to keep up with the world that we are living in now.

Usually spirituality and religiosity are used as interchangeable terms, but the underlying concepts are different. It is well established to divide religiosity into 3 sub-constructs: intrinsic, extrinsic, and quasi religiosity(1-4), while the construct spirituality was divided into the following sub-constructs: cognitive orientation towards spirituality, experiential-phenomenological dimension of spirituality, existential well-being, paranormal beliefs, and religiousness(5). Intrinsic religiosity identifies religion as an end in itself. Strong personal convictions, beliefs, and values are what matter, while the social aspects of motifs of religion are not important. In contrasts the motifs of extrinsic religiosity are based on social or external values or beliefs; religion is used to gain social standing or endorsement(1-4). Spirituality can be viewed as opposite to religion, or as a vital aspect of religiosity. 7 aspects of spirituality have been recently differentiated, which entail more personal , more individualistic views, namely, "prayer, trust in God and shelter", "insight, awareness and wisdom" ,"transcendence conviction", "compassion, generosity, and patience", "conscious interactions, "gratitude, reverence and respect", and "equanimity"(6).

There is an outstanding difference between spirituality and religiosity convictions between Muslims and Western Europe, while differentiation is inappropriate for Muslims; it is of conceptual importance for others. This is in congruence with the observation that in Islam "there is no distinction between religion and spirituality". For a Muslim, "Allah's unity must be maintained spiritually, intellectually, and practically in all facets of life", and thus illness is regarded as part of life and a test from Allah. Moreover, "illness is one of the forms of experience by which humans arrive at knowledge of Allah" as cited by Rassool. However, in Western Europe the Reconnaissance has significantly affected the trust in institutional religion and God, changed ethical norms, and thus, we have to notice a decline of interest in religiosity and even praying. While the relation to Allah is vital in Arabic countries, we have to notice the disturbance of this vertical connection in Western countries.

For Muslim patients the "spiritual causes" of disease may be regarded much more as "given by Allah"(namely, Albaqarah 2:155-156): "We will most certainly try you with somewhat of fear and hunger and loss of property and lives and fruits; and give good news to the patient. Who, when a misfortune befalls them, say: Surely we are Allah's and to Him we shall surely return."; Sahih Bukhari Book71,No.665:Narrated Abu Huraira: "The prophet said, 'No' Adha (namely, no contagious disease conveyed to others without Allah's permission); nor (any evil omen in the month of ) Safar: nor Hama. [restless wandering ghost]." and a matter of less faith and trust (namely; Sahih Bukhari Book71,630): "Narrated 'Aisha (the wife of the prophet ) that she asked Allah's Apostle about plague, and Allah's Apostle informed her saying," plague was a punishment which Allah used to send on whom He wished, but Allah made it a blessing for the believers." Or as a trial (namely, Al-Hagg 22; 53): "So that He may make what the Shaitan casts a trial for those in whose hearts is diseases and those whose hearts are hard". However most of the Western Europe patients would reject this point of view. The significant differences in the spirituality and religiosity convictions and attitudes of Arabic and Western Europe people can be explained of course with cultural differences, but also with distinct religious perspectives. Faith in Allah (Shahadah) and regular worship (salat) are 2 of the 5 major concepts of the Islamic faith and Muslims will cling to them. Both concepts are highly relevant for Christian too, but due to the changing of social and religious structure of Western society, you may state that you have no interest in religiosity at all, or may set up an individual 'religious patchwork', using various existing esoteric and religious resources, to provide meaning, sense and hope, and there is no social disqualification(7).

The big question is, can research on the effects of religion and spirituality on health validate God through scientific methods? Hemple, in his Philosophy of natural Science, has outlined basic criteria for scientific explanations. He describes explanations of phenomena that provide psychologically or spiritually valid answers (including God's will, power, or plan) as inadequate for the purpose of science. Their inadequacy derives from their failure to meet 2 essential scientific criteria: explanatory relevance and testability. Explanatory relevance refers to the requirement that an explanation for a phenomenon must constitute grounds for expecting a given result under a given set of conditions. When we offer that a rainbow will appear any time light from behind an observer is refracted through water droplets in front of the observer, the explanation has relevance to the phenomenon being observed. That is, even without having seen a rainbow, the explanation allows us to expect that under the conditions specified, one will appear. (This criterion is similar to that of "prediction" as opposed by Lambert and Brittan, who state that for an explanation to be adequate in science, it must indicate "why, given certain antecedent conditions, the event to be explained could have been expected to occur). Alternatively if we offer that rainbows are the bridge that souls cross to the after life , our explanation- now and forever, has no link to the observed phenomenon and allows us no conditions under which to expect or predict the rainbows occurrence (which of course only matters with respect to science and not with respect to spirituality, literature, culture, personal meaning ,etc)(8). The second requirement is testability, or that a given explanation must be empirically testable, in principle if not in reality.

That is, a scientific hypothesis must have certain "test implications", such that empirical findings can either support it or contradict it. The fact that you can create a research design for a given hypothesis does not ipso facto make the hypothesis scientific. Hempel offers the example of entelechies or "vital forces" as explanation for the "organic directiveness" that occurs in embryonic development. Experiments that demonstrate repair of embryonic damage can and have been done. Yet a hypothesis that this process is a function of entelechies would be neither supported nor contradicted by the experimental results because the entelechial explanation cannot make differential predictions regarding when these forces will manifest and in what manner they do their directing. The vital force is just "there" .Hempel calls such hypothesis "pseudo-hypothesis" (with respect to science, but not with respect to their intuitive, spiritual, or psychological validity)(8). Attempts to impose statistical order on such is absurd. With respect to God's intercession in the world, it is clear from many religious traditions that God is not bound by natural laws or probabilities. Rabbi Luzzatto(9) makes this clear in his explication of God's working in the world, including miracles, from a Jewish perspective:

The spiritual consists of all entities which are not physical and which can not be detected by physical means [1:5:1]. Every physical entity and process is under the charge of some type of Angel. These angels have the responsibility of maintaining each of them, as well as bringing about changes within them according to God's decree[1:5;2]….When he wills, God can change the order of creation at any time. He can bring about various miracles and wonders, as He desires and deems beneficial for creation, according to the time and circumstances {11:5:6}….The highest wisdom decreed …that these Forces [Kochos, a type of transcendental being] should be able to act upon the physical world in another manner…that conforms to their own innate laws, rather than the physical laws of nature. .It is through this mode of action that the normal laws of nature can be suspended and altered on the physical plane [III; 2:21][Italics ours].

In chapter 17 of the Book of Exodus (KJV), Moses must confront one of many potential rebellions by the Israelites, this one prompted by a lack of water. After smiting the rock and producing the water, Moses names the place Massah, the Hebrew word for "trial". "Verse 7 tells the story" And he called the name of the place Massah because they [the Israelites] tempted the Lord, saying, "is the Lord among us, or not?" Later, in the Book of Deuteronomy where many of the Jewish laws are explicated, this event carries enough weight to warrant its own command: "Ye shall not tempt Lord your God, as ye tempted him in Massah" (6:16, KJV). And much later, when Yushua is having his visions in the wilderness and wonders whether God's angels would actually bear him up in their hands if he leaped from a pinnacle of the temple, he chastises his beguiler with these words: "It is said, Thou shalt not tempt the Lord thy God" (Luke 4;12,kJV). The lesson of Massah is that God cannot be compelled by our research designs, statistics, and hypothesis to our demands "Is the Lord among us or not?" Massah makes it clear that our intercessions must be a matter of faith and trust in God, of putting our hope in God, of knowing that we are part of God no matter what the outcome in our experience of the physical world.

Massah tell us not only that God should not be tested, but more important, that God cannot be tested(10-11). As Sloan and Bagiella have a written, mixing experimental method with faith degrades both concepts. We do not need science to validate our spiritual beliefs, as we would never use faith to validate our scientific data(12).

References

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3. Maltby JB, Lewis CA. Measuring Intrinsic and Extrinsic Orientation toward Religion: Amendments for its use among religious and non religious samples. Personality and individual differences 1996; 21:937-946.
4. Maltby J, Day L, .Amending a measure of the Quest religious Orientation: Applicability of the scale's use among religious and non -religious persons. Personality and Individual Differences 1998; 25:517-522.
5. Macdonald DA.Spirtiuality and the Five Factors Model. J Pers 2000; 68:153-197.
6. Bussing A Ostermann T, Matthiessen PF. Distinct expressions of vital spirituality.The ASP questionnaire as an explorative research tool. J Relig Health 2007 (in press; online :Thursday, September 14, 2006).
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8. Hemple CG. Philosophy of Natural Science. Engliwood Cliffs, NJ: Prentice-Hall International Inc; 1990.
9. Luzzatto MC. The way of G-d.4th ed. Kaplan A, trans .Jerusalem, Israel: Feldheim Publishers; 1983.
10. Galishoff ML. God prayer, and coronary care unit outcomes: faith v works [letter]? Arch Intern Med 2000:26:1877.
11. Hammerschmidt DE. Ethical and practical problems in studying prayer [letter]. Arch Intern Med .2000:26:1874-1875.
12. Sloan RP, Bagiella E .Data with out a prayer [letter]. Arch Intern Med 2000:26:1870.