Contemplative spaces in social work practice.

Exploring contemplative practices and spirituality in social work has developed a new impetus as the understanding of the importance of those variables in patient care has increased. Social work brings its historical attention to the whole person and the many ways the social worker and patient understand their respective roles in assisting in the process of healing and coping with loss. It is essential that social workers attend to their own understanding of the space for contemplative practice in their lives. This article sets the context for this important work and provides an example of a program designed to increase the social worker's awareness and practice skills that reflect the particular dynamics of engaging spirituality in the clinical relationship.

Ethical quandaries in spiritual healing and herbal medicine: a critical analysis of the morality of traditional medicine advertising in southern African urban societies.

This paper critically examines the morality of advertising by practitioners in spiritual healing and herbal medicine heretofore referred to as traditional medicine, in southern African urban societies. While the subject of traditional medicine has been heavily contested in medical studies in the last few decades, the monumental studies on the subject have emphasised the place of traditional medicine in basic health services. Insignificant attention has been devoted to examine the ethical problems associated with traditional medicine advertising. Critical look at the worthiness of some advertising strategies used by practitioners in traditional medicine in launching their products and services on market thus has been largely ignored. Yet, though advertising is key to helping traditional medicine practitioners' products and services known by prospective customers, this research registers a number of morally negative effects that seem to outweigh the merits that the activity brings to prospective customers. The paper adopts southern African urban societies, and in particular Mozambique, South Africa and Zimbabwe as particular references. The choice of the trio is not accidental, but based on the fact that these countries have in the last few decades been flooded with traditional medicine practitioners/traditional healers from within the continent and from abroad. Most of these practitioners use immoral advertising strategies in communicating to the public the products and services they offer. It is against this background that this paper examines the morality of advertising strategies deployed by practitioners in launching their products and services. To examine the moral worthiness of the advertising strategies used by traditional medical practitioners, I used qualitative analysis of street adverts as well as electronic and print media. From the results obtained through thematic content analysis, the paper concludes that most of the practitioners in traditional medicine lack both business and medical ethics. That said, the paper urges practitioners to seriously consider the morality of their adverts as in most cases they (adverts) do more harm than good. Further to that, the piece recommends the governments of the affected countries to put in place stringent measures to address this mounting problem.

Who pays for providing spiritual care in healthcare settings? The ethical dilemma of taxpayers funding holistic healthcare and the first amendment requirement for separation of church and state.

All US governmental, public, and private healthcare facilities and their staff fall under some form of regulatory requirement to provide opportunities for spiritual health assessment and care as a component of holistic healthcare. As often the case with regulations, these facilities face the predicament of funding un-reimbursable care. However, chaplains and nurses who provide most patient spiritual care are paid using funds the facility obtains from patients, private, and public sources. Furthermore, Veteran healthcare services, under the United States Department of Veterans Affairs (VA), are provided with taxpayer funds from local, state, and federal governments. With the recent legal action by the Freedom From Religion Foundation, Inc. (FFRF) against the Veterans Administration, the ethical dilemma surfaces between taxpayers funding holistic healthcare and the first amendment requirement for separation of church and state.

Ethical considerations in the integration of religion and psychotherapy: three perspectives.

The authors maintain that the integration of religion in psychotherapy is, at best, problematic and requires a respect for boundaries, but that the integration of a nonreligious but spiritual psychotherapy consisting of the three elements identified above (attention to the person, not the disease, considering one's work as vocation, and the pursuit of empathic understanding) is a therapeutic necessity and an ethical duty. The authors speak with distinct voices in the three major sections of the article but come to remarkably similar conclusions: (1) the ability to inquire into the religious and spiritual life of patients is an important element of psychotherapeutic competency; (2) information about the religious and spiritual lives of patients often reveals extremely important information; (3) the inquiry process must communicate respect and curiosity for this dimension of the patient's life even (and perhaps especially) when the content is at variance from that of the therapist; and (4) there is significant potential for therapeutic abuse when the therapist communicates in a manner reflecting a personal agenda that abandons the principle of psychotherapeutic neutrality. One area of potential disagreement came as the authors considered the possibility of different combinations of faith disciplines and therapy in designated religious settings that all parties recognize as such. One author (G.P.M.) believes that such combinations in these settings may be ethically permissible. The other two authors are concerned about such combinations because of the powerful but covert factor of transference in healing relationships. The authors eventually decided that this question was beyond the scope of the article and limited themselves to discussions about psychotherapy in secular settings. They each advocate the systematic inclusion of spiritual assessment as a core competency for psychotherapy education. In a way similar to the exploration of any deeply personal dimension of human experience, integrating spiritual and religious dimensions of our patients' lives into their treatment requires consummate professionalism, the highest quality of knowledge, skills, and attitudes, and thorough grounding in a sophisticated biopsychosocial model.

Práctica médica y sufrimiento espiritual (1ª parte) / No disponible

En el último decenio se ha visto en la literatura médica una profusión de artículos sobre la relación entre Religión o Vida Espiritual y Salud. Se ha determinado que no hay una relación causal entre estos dos aspectos de la vida humana, pero que existe evidencia científica sugestiva de una directa asociación de ambas: salud y espiritualidad están misteriosamente entrelazadas en la vida del individuo. El debate y la investigación continúan, como continúa la experiencia por parte del enfermo de un 'sufrimiento espiritual' y la muchas veces vacilante actitud del médico de ofrecimiento de un 'soporte espiritual', pues no está seguro de que éste sea su papel. En esta primera parte se revisa la literatura científica reciente sobre el tema con el objeto de ofrecer una reflexión sobre esta realidad asistencial. La lectura crítica de estos artículos permite concluir que el médico debe ser más consciente del papel de la vida espiritual en la salud, particularmente en dos momentos: el primero durante su formación académica, sin descuidar la vertiente humanística de esta profesión; el segundo en cada acto médico, pues la atención de cada enfermo no pide la resolución de un problema, sino la sanación de un ser que sufre no únicamente en su realidad material (AU)

Over the past decade a large number of articles have appeared in the medical literature sharing a particular concern: what is the connection between spirituality and health? There seems to be one, but its nature is unknown. Research goes on, and in the meantime, our lack of knowledge takes its toll: on the one hand the patient experiences not just pain but also a kind of discomfort that has been termed 'spiritual suffering'; on the other hand the physician is willing to alleviate suffering but unsure of his or her role as a spiritual healer. After reviewing some of the most significant recently published studies, we wish to offer in this first part of a series a reflection that could be of some help to the practitioner. Our conclusion is that doctors should be more aware of the link between spiritual life and health, with consequences at two different stages: First, during their years of training in medical school, giving more attention to humanistic aspects of their formation. Second, in each of the medical acts, since when dealing with a patient we are not just trying to solve a problem, but to alleviate pain in a human being who transcends the purely material (AU)