On Professionals Praying With Patients

 In an off-topic response to my last post, Frank asked this question:

 

My dad has been in a discussion on another blog about whether a doctor should ask a patient if he could pray for the patient. My mom and dad are very much opposed to a doctor asking a patient if he can pray for the patient. Others think it is fine for the doctor to ask that. Are there any rules at hospitals on this subject?

 

I have two experiences that I think about with this question.  One is the story of a colleague, who spoke of a pre-op visit with a patient.  The patient commented that she hoped her surgeon was a good Christian.  He answered, “At the moment, ma’am, you’d better hope he’s a good technician.”

 

The second is the portion of my orientation of new staff that addresses our System’s policy, “Protection of Religious and Cultural Rights and Beliefs.”  I comment that my goal is that the hospital be a “spiritually safe place;” which is to say a place where each person can be the same person spiritually in the hospital that the person would be elsewhere.  I then note that I’m not the only person who pays attention to spiritual care.  I note that many professionals pray for patients; while a few besides me also pray with patients.

 

Part of that discussion is the need to really think “protection” when we think of a spiritually safe place for patients and/or families.  It might seem trivially true, but it has also been studied.  Patients are anxious, and don’t want to upset the people taking care of them.  That raises the risk that they will say what they think we want to hear.  For the hospital to be a “spiritually safe place,” we really do need to think about protecting that space.

 

That said, I find in my own work that many folks can accept as an expression of good will the thought that someone might pray for them, even if they would not pray themselves or want the other person to pray with them.  Sometimes, too, they will ask for prayer or indicate that they value prayer.  My own thought is that if they ask, and the person asked is both free to accept or decline, and also feels appropriate participating, praying with the patient, or being present while the patient prays, is okay.  Now, if you think that through, that in most circumstances suggests that the patient from his or her position of vulnerability can ask the staff; but the staff person from his or her position of power cannot ask the patient.

 

Now, there is another dynamic in play here.  In the last decade or so health care professionals other than chaplains have been thinking about how the spiritual lives of both patients and professionals affect both relationships and outcomes in health care.  Nurses have actually been including this in their professional discussions for some time.  However, physicians, psychiatrists, social workers, and counselors have also been thinking about the effects of spirituality in their work.  In most instances this isn’t a discussion of faith or miraculous healing.  Rather, it’s recognition that for many individuals spiritual beliefs influence how they live their lives and make decisions.

 

One consequence has been that physicians of faith have felt less pressure to hide.  They have been prepared to acknowledge that prayer is an important part of their lives, and that they pray for their patients, and for help carrying out procedures.  Again, for many patients this is simply a statement of good intention, and they’re not offended.  Some do indeed find it comforting.  So, consider this conversation:

 

Patient: I know things are in God’s hands, and that things will be all right.

 

Physician: Well, I will be praying for that as we go to the OR.

 

Patient: I’m glad to hear that.  Could we pray together?

 

Contrast it with this conversation:

 

Physician:  I just wanted you to know that I pray before all my surgeries.

 

Patient:  That’s good.

 

Physician: May I pray with you?

 

I think the latter conversation verges on manipulation.  Again, if we consider that the patient might well say what we want to hear (and what patient wants to offend his surgeon, however slightly, just before the procedure?), the second conversation is questionable.  But is the first?  The doctor has responded to a comment from the patient with a statement about his own practice, with no expectation of the patient.  If the patient then makes the request and the doctor feels comfortable participating, is this a bad thing?  It arguably strengthens the doctor-patient relationship.  It supports the patient’s hope and lowers stress, both of which have been shown to support health and wholeness.

 

There are some hospitals that have a culture that discourages professionals other than chaplains or clergy from praying with patients.  Those institutions feel that’s necessary to respect and protect the spiritual beliefs of the patient.  They may or may not have an explicit policy; but corporate culture can be very clear and very powerful.  In some environments chaplains feel they have to be the clearest enforcers of such policies.  They distrust the judgments of the other professionals around them, fearing that they will jump too quickly to suggest their own spiritual perspectives instead of respecting the patients’, mostly because they simply imagine that everyone will agree with them, or at least understand them.

 

In my own setting, I don’t have that fear.  New staff members do get orientation from me on the subject, including explicit directions against evangelizing or proselytizing.  They also get diversity training as part of their orientation; and I connect to this by noting that our religious and cultural beliefs are simply another category of diversity that the System expects us as employees to respect. 

 

Now, doctors don’t have that orientation.  At the same time, they are offered opportunities for diversity training, and hear regularly that respect for diversity is a central tenet of the System.  My sense is, both in my own institution and in others, physicians praying with patients are uncommon (although I can well imagine that many are praying for patients).  For those who do, if they do that in a context that’s not manipulative and that satisfies the patient, I’m comfortable.  If I were to learn that is was manipulative, that would be another thing altogether – one that I’d probably find myself in the middle of, at least in my institution.

 

Like so many things that happen in health care, prayer with a patient is one that can be done appropriately or inappropriately.  More doctors feel free to be authentic about their own faiths, and I think that’s a good thing.  If they can be authentic about their own faiths, and also respect the faiths of their patients, that’s even better.