Cath Lab Digest

The literature has long established that chronically ill people are likely to suffer emotionally as well as physically. To date, little has been discovered about the concept of spiritual suffering or, more specifically, spiritual distress. However, studies have suggested that attending regular religious services may lead to a longer, healthier life.¹ Only recently has spiritual distress been thought to shorten the lives of certain categories of patients. A new 2-year study of elderly hospitalized patients found that spiritual struggles, such as feeling abandoned by God, increased the risk of dying by 28%.²

This article examines the patient-professional relationship within the framework of virtue ethics and spiritual distress.

Spiritual Distress

A number of studies support the link between regularly attending worship services and longevity. A meta-analysis of studies totaling nearly 126,000 subjects found that participating in public religious practices like regular attendance at worship services increased the odds of living longer by 43%.³ For instance, African American worshippers who attended religious services more than once a week lived up to 14 years longer than those who did not.¹ However, individuals who experienced what the authors describe as spiritual distress actually died sooner.

Pargament et al² conducted a study of nearly 600 patients, all of which were at least 55 years old. The subjects were matched for physical health, cognitive ability, mental health status, physical functioning, and demographic factors such as age, education, race and ethnicity, and gender. This 2-year study found that spiritual struggles significantly increased the risk of dying earlier. Patients who reported that they felt abandoned or unloved by the divine often attributed their disease to the work of the devil and were likely to die sooner.

Professional Relationships and Virtue

Health and healthcare decisions of a moral nature are largely made from ethical rules, principles, and obligations. The Georgetown Mantra, for example, is based on the notion of ethics, which is derived from Kantian or utilitarian ethics. Aristotle and Plato ascribe more closely to what is described as virtue ethics. Although rules, principles, and obligations are important to many healthcare decisions, virtue ethicists would argue that even if a good moral decision is made, it must be made from the context of virtue. For example, a morally good clinician with the right desires and motives is more likely than others to understand what should be done, more likely to attentively perform the acts that are required, and even more likely to form and act on moral ideals. Therefore, a virtuous clinician is one who has the motivation and the desire to perform right actions, not necessarily as the rule follower, but as someone who is generous, caring, compassionate, sympathetic, or fair.