I do believe if the disability is debilitating, it can lead to depression. As patients become more and more depressed, they have less and less motivation to rehabilitate and become less fully engaged in their own recovery. In cases like these, faith and spirituality can play a big role in getting hope and a sense of direction towards life. I agree with Koeing about fear of falling is a and declines in physical health. He compared fear of falling with a daily activity like attending religious services. Another take home message from the article was health care professionals should seek a basic understanding of patients’ spiritual needs, resources, and preferences which I will try to include in my practice.

 Shikha

Critical element of trust is respecting a patient as a whole person.  According to Cohen and colleagues, health care professionals are constrained to “treat the patient as a whole person”.  Respectful care begins when health care provider shows willingness to learn about patients’ needs and its resources.

I have an example to explain this, of course this patient has chronic illness but not at end of life situation. When he came to facility at the beginning we had a very rough time in understanding his behavior, but after had a chat with him as a team and talked about his needs and we divided our care within team, afterwards, we gained his trust, now he listens to us, he works towards his goals with his full potential, he is making excellent progress. Gaining his trust was not attained initially, so he was not cooperating at all. I feel the same thing well suits to spiritual care too.

The conclusion of the article provided also struck a cord with me especially “The value of providing whole-person care should lead health care professionals to offer care not only for physical needs but also for the needs of the human spirit in search of meaning.”

Five ethical guidelines were provided that dealt with the current understanding of professional ethics with illustrations of what respectful care requires of caregivers with integrity:

1. In order to provide respectful care, health care professionals should seek a basic understanding of patients’ spiritual needs, resources, and preferences.

2. Respect for the patient requires that health care professionals follow the patient’s expressed wishes regarding spiritual care. 

3. Health care professionals should neither prescribe spiritual practices nor urge patients to relinquish religious beliefs or practices. 

4. Health care professionals who care for the spiritual needs of patients should seek to understand their own spirituality. 

 5. Participation in spiritual care should be consonant with professional integrity. 

Guided by ethical reflection, health care professionals may better serve patients who desire spiritually nurturing health care. In an age of sophisticated medical care and interventions, patients still want spiritually nurturing health care. The value of providing whole-person care should lead health care professionals to meet both physical needs as well as the needs of the human spirit seeking meaning and purpose. 

On one hand, The religion might make a difference in patients with chronic disabilities and chronic medical illness especially those younger patients with huge stress after disability or chronic diseases.

On the other hand,  people with health problems and disabilities are seeking the religion and spirituality for strength and comfort to cope and handle their stress and fear from the disabilities.

So anything that helps to prevent depressions or negative emotions will affect the person’s ability and desire to function mentally, socially and physically, and the religion is quite pretty option for those are suffering from the disabilities and chronic diseases to be able to return to the normal life with a positive way.

James W. Sire: The Universe Next Door when writing about Naturalism, “As Feurbach saw it, God is a projection of human potentiality, an expression of our unrealized ideals. Religion functions perniciously, since as soon as we invent God we devote ourselves to pleasing our imaginary construction instead of working to overcome the shortcomings that led to the invention in the first place.” 

This passage made me reflect on Winslow & Winslow’s Ethical Boundaries of Spiritual Care discussion of their third guideline. Does a patient’s own understanding or perception of their religious traditions create dissonance or dysfunctional forms of coping when facing distress or illness? The authors write that “Sometimes, the ministry of a spiritual care leader who is acceptable to the patient may assist the patient in finding a more helpful grasp on his or her beliefs.” In a naturalism context, it would seem that the spiritual care leader in this case would simply be influencing the patient through their own “imaginary” projection of religion-based ethics. If that is the case, as Sire wrote above, are we missing the patient’s true “shortcomings that led to the invention in the first place”? 

 An essential ingredient in forming and maintaining a relationships of trust is the virtue of integrity. The ethical ideal of integrity is to be a whole person who has sincerity of purpose. Central to the pursuit of personal integrity is the examination of one’s own convictions, including beliefs about what ultimately gives meaning to human life. A life of integrity is marked by actions that match well considered beliefs. If spirituality may properly be defined as a quest for ultimate meaning, then the development of integrity is linked to spirituality, as both have to do with the core of personhood. The connection between spirituality and integrity leads to the fourth guideline. Nonetheless, Integrity is one of the for cores of credibility for a successful leader. 

 

However, evidence from many studies show promising results of the impact of religion in reducing depression and these were backed with theoretical considerations that relate religious involvement and support to improved quality of life through positive attitudes such as improved motivation, hope, and improved  perception of self.