Spirituality and medicine

Today in medical ethics we discussed religion and spirituality and its role in the healing process. Initially, I believed that my job as a physician would be to present the facts, educate and let the patient find his/her own way in regards to spirituality, almost like a separation between church and state. I am slowy becoming convinced that physicians should have a role in the spirituality of their patients especially during end of life care. I'm currently trying to determine what exactly that role should be in my own practice. Should a physician pray with his patients? Should a physician ask questions during the new patient interview about an individuals religious beliefs? How would you feel if a doctor asked about your faith? In Utah, we almost expect everyone shares our beliefs and think the doctor would know, for example, that we would want a blessing if the situation arose. But nearly everywhere else, that is not the case. I feel that as a patient going to a doctor who asked about my religious beliefs that if he sought understanding, then I would appreciate the inquiry about my faith and what I would want done during an end of life scenario. Some of my collegues disagreed believing that it is personal and should stay personal. I guess it is really up to the patient. Which brings up the issue of when it should be asked, during the new patient visit or after the patient has been diagnosed with cancer? Both have potential pitfalls. Who would be thinking straight after being told they were diagnosed with a life threatening illness and would want a talk about spirituality and religion? Not me. The other issue is time. A doctors schedule is already packed and visits already shortened, would talking about spiritual things take away from other essential interactions of the doctor/patient?
Another interesting thing is to look at what is the difference between spirtuality and religion? Are they different or the same? Do you have any spiritual beliefs outside of your religion? I feel like my religion is inexplicably tied to my spirituality. Again, several of my collegues don't feel the same way, and thats ok.

In other exciting news, I spent four hours this morning calculating the risk of breast cancer for individuals at a breast cancer awareness conference in West Des Moines. Some of those survivors were the most optimistic people I have ever met.