An introduction to the Spirituality/Medicine Interface Project.

Faith and healing have long been intertwined and are often difficult to separate. Even in the present days of rigorous scientific experimentation and evidence-based medicine, there is no doubt that, at least in some instances, faith instrumentally affects the prognosis of illness.

Randomized, double-blind placebo-controlled clinical trials--meticulously designed, conducted and analyzed to the highest statistical standards--readily demonstrate the placebo effect and indicate that factors other than medication may affect the outcome of an illness. There is no denying that some of these factors are secondary to lifestyle changes or increased risk awareness; yet in some instances the effect of the mind on the body is difficult to explain and cannot be ignored--hence, the medical/scientific community's increasing interest in the mind-body relationship. There is indeed a need to better understand how the mind, and one's faith, can modulate the body's response to illness.

Although rigorous science permeates Western medicine, it is sobering to note that, in the US, approximately 80% of patients admit to praying in times of crises, including illness. Remarkably, as many as 90% of those who pray expect their prayers will be answered. (1) Physicians and health care professionals are entrusted with treating patients who seek their help. Therefore, regardless of their own beliefs and convictions, health care professionals should not ignore their patient's beliefs and the potential effect of these beliefs on their illness and treatment. This need is even more pressing as health care professionals are increasingly called to treat patients of different ethnicities and faiths.

The main goal of the Southern Medical Journal is to help clinicians provide better care for their patients. The Journal has a long tradition of publishing manuscripts on the interface between spirituality, religion and medicine. Together, the SMJ and SMA gratefully and proudly acknowledge receiving a grant from the Templeton Foundation to further explore this interface in a more systematic manner. This grant will be used to develop a series of three educational programs for physicians, physicians-in-training, chaplains, social workers and nurses, and also to publish additional pages on a quarterly basis, devoted entirely to the Spirituality/Medicine Interface Project. These pages will include review articles, original articles, editorials and other material relevant to the topic of discussion. We also plan to publish an annotated bibliography, where manuscripts published in other journals will be critically appraised. In addition, we will offer a section entitled "Eye on Religion" which will provide a summary of different religions to better assist the health care provider in communicating with their patients.

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It should be noted that the amount of material devoted to our usual topics will not decrease: The Spirituality/Medicine Interface Project is an additional section, and will be highlighted with a black band. While we do not wish to impose this material on non-interested readers, we feel it is our obligation--largely based on needs assessment surveys--to develop this series so that we may better serve the interests of our readers.

I am grateful to Harold Koenig, MD and Andrew Weaver, PhD for giving the physician's and the chaplain's views, respectively, on our project; to Conrad Daly, MTh for helping our readers differentiate spirituality from religiousness; and to Roger Smalligan, MD for sharing his experience with our readers. I am also indebted to those who have agreed to serve on our advisory board (See page 4). Also, by the time this manuscript is published we hope to have employed an editor for the Spirituality/Medicine Interface Project.

The main goal of the SMJ is to help its readers better manage patients under their care. We are convinced that this series on the Spirituality/Medicine Interface Project will be useful to most of our readers. As always, we welcome your comments.

Reference

1. Gallup GG, Lindsay DM. Surveying the Religious Landscape: Trends in US Beliefs. Harrisburg, PA. Morehouse Publishing, 1999.

Ronald C. Hamdy, MD, FACP, FRCP 

Editor-in-chief