Doctor în teologie Ileana Stănculeasa 1,2
1Grup de suport – Clinica NeoLife București România, 2Consilier spiritual voluntar
Primit: 6.07.2022 • Acceptat pentru publicare: 15.07.2022
Abstract
Introduction: In recent years medicine has undergone a real humanistic revolution, which that has embraced three distinct trends: bioethics – a consequence of the fear of losing the person’s humanity, palliative care – a consequence of the observation of the abandonment of a large number of patients at the end of life, and the biopsychosocial model as a need to integrate the social and psychological dimensions of patients into clinical practice. These have opened the medical door to spirituality.
In the case of serious illnesses, patients may need to address existential issues related to the meaning of life and death. That is why the patient needs to be seen as a whole person, and the health care professionals caring for them need to know and accept that the spiritual dimension is part of our lives.
Objective: When illness progresses, existential questions may amplify patient suffering. They are about how long he has to live, the meaning of his life, the meaning of hope in a miracle, or about who will be there for him, whether he will suffer more, or who will care for his loved ones after…
At the same time, a number of desires are in his head: he would like to have the power to decide about his life, to keep his dignity until the end, to keep his serenity, to be supported by those close to him. Spiritual counselling may help the patient to find answers to these questions, to fulfil these desires, to move from spiritual suffering to spiritual well-being, manifested by a realistic hope, not just a wish or an illusion, by finding meaning in suffering and in personal life, etc.
Material and methods: Spiritual anamnesis leading to spiritual assessment is used to establish the diagnosis of spiritual distress. Both form the basis of the spiritual counselling needed for each individual patient. The first model of a spiritual history is that of Dr Christina Puchalski, an acronym consisting of four questions to the patient (FICA), aimed at finding out basic information about the patient’s spirituality. Once the diagnosis of spiritual distress has been established, the spiritual counsellor developes a plan to help the patient to overcome the spiritual crisis. Essential elements to establish a true relationship are presence, listening, attention.
This type of caring, done with dedication, with compassion, with unconditional love is spiritual by definition. Being spiritual persons ourselves, full of love and compassion, understanding, tenderness, gentleness, means, first of all, living our spirituality for the benefit of the suffering, but also for ourselves, because spirituality, of divine essence, has the power to transform life for the better. It is a life-fulfilling challenge, which only happens when you are close to the suffering one.
Result: A breast cancer patient who, after surgery, chemotherapy and radiotherapy, did receive spiritual counselling successfully carried two pregnancies to term, delivering two perfectly healthy baby girls, and now leads a normal life.
Conclusion: The importance of spiritual counselling in medicine can no longer be ignored. Given the place and importance of spirituality in the life of a person in palliative care, we need to consider how our actions can bring spirituality into this by definition ‘scientific’ medical space. Ultimately, however, it is not a question of how to introduce spirituality into palliative medicine, but of becoming aware that the end of a life is in itself a spiritual act, just as caring for someone at the end of their life means talking to them, listening to them, being there for them. Everything we do with our whole being is a spiritual act.
Keywords: palliative care, spirituality and medicine, spiritual suffering, spiritual counsellor, case study