The Rebirth of the Clinic: An Introduction to Spirituality in Health Care

The Rebirth of the Clinic: An Introduction to Spirituality in Health Care

The Rebirth of the Clinic: An Introduction to Spirituality in Health Care

The Rebirth of the Clinic: An Introduction to Spirituality in Health Care

Synopsis

According to physician and philosopher Daniel Sulmasy postmodern thought, in which philosophical and theological universals are questioned and ethics is left up for grabs, has sickened the doctor-patient relationship. But the ill, he claims, are rebelling--they seek a medicine that treats them as persons, full of dignity, along with a renewed form of health care that does not abandon the goods of science, but also does not eschew the mystical. Medical school curricula are evidence of this emerging condition: nearly all schools require courses in spirituality and health care. But how should health care workers view this development? How should they think about soul medicine alongside scientific medicine? How might this affect their practice? Sulmasy, an internist and Franciscan friar with a Ph.D. (from Georgetown under Ed Pellegrino), introduces physicians and medical students to the basic issues in spirituality and medicine. In Part I he looks at the nature of illness and healing, sketching the history of Western heath care and Judeo-Christian thought to provide guidance for todays health care community. In Part II he examines the recent rash of empirical studies about spirituality and patient care, trying to separate the legitimate from the downright kooky. In Part III, he takes up spiritual questions that arise in the care of patients at the close of life. Here he introduces the reader to several patients and cases, reiterating his conviction that for physicians attending to the spiritual needs of their patients ought to be viewed not just as a moral option, but as a moral obligation.

Excerpt

Foucault’s clinic is dead. It was born afflicted with multiple, fatal congenital anomalies—a monster that struck terror in the hearts of many people even as it was slowly dying. Foucault’s ‘‘clinic’’ refers to the scientific, pathological approach to medicine that emerged between the Enlightenment and the establishment of university clinics in the nineteenth century. It became the dominant form of Western medicine and persisted as the model throughout the twentieth century. Previously, sick people went to hospitals run by monks and nuns, if they were poor; if they were rich, doctors came to see them in their houses. With the rise of the clinic, however, Foucault saw the meaning of medicine change. With its scientific foundations and empirical successes, the clinic became medicine’s living laboratory. Sick people came to a place where the doctors were in control. This shift in location heralded a shift in meaning. With the advent of the autopsy and anatomical pathology, diseases were analyzed by their visible effects on inner organs. Later, pathophysiology emerged as a mode of seeing diseases invisible to the untrained eye. With the birth of the clinic, Foucault saw the fundamental norms of medicine transformed. It became a practice of power; a form of control; a scientific discourse; a form of applied engineering. This revolution in medical practice brought innumerable technological advances and improvements in health, for which the world must be grateful. Despite its intelligence and giftedness, however, Foucault’s clinic harbored a fatal illness. and now it has breathed its last breath. Managed care is simply its coffin.

In truth, the clinic was nearly dead by the time Foucault gave it a name. Patients left it for dead decades ago. Now even the clinicians, the . . .

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