Spirituality, Religious Wisdom, and the Care of the Patient

Guilt in the Context of Illness: A Hindu/Protestant Dialogue

Introduction

Alan B. Astrow, M.D.
aastrow@maimonidesmed.org

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The conference on September 13, 2004 was held at Columbia University Medical Center, the Children's Hospital of New York and was co-hosted by Dr. Steven Z. Miller, Chief of the Pediatric Emergency Room and Director of Medical Student Education in the Department of Pediatrics.  The topic was "Guilt in the Context of Illness:  A Hindu/Protestant Dialogue" and our two speakers were S. N. Sridhar, Chair, Asian and Asian-American Studies Stony Brook University and Marilyn Mecham, Executive, Interchurch Ministries of Nebraska. 

Guilt assumes several guises in the context of patient care. Patients may be burdened with the sense that they have brought on illness through their own conduct.  Family members may feel guilty because of prior differences with an ill loved one, or by feelings that they are not doing enough to help.  Health care professionals may have to overcome a sense of guilt when they have made an error, but even when no error has occurred the professional may feel guilty simply because a treatment has not worked.  For instance, a colleague recently discussed with me the case of a young woman with breast cancer whose cancer had recurred.  My colleague admitted that his first thought on learning of the recurrence was "My God, did I do something wrong?"   His response reflects a pervasive sense in medical practice that illness occurs because someone did something wrong.   Mistakes are, in fact, sometimes made and skilled physician-ship requires that we carefully examine our own actions and constantly seek to improve our practices.   But in this particular case, as in many, the patient had been treated entirely properly, but the feeling of wrongdoing was, and is often, still there. 

While these sorts of issues would seem to fall within the domain of psychiatry and clinical psychology, the burden of this conference series is that there is a spiritual dimension to these sorts of emotions as they involve illness.   Exploring the responses of specific religious traditions is a way of accessing spiritual wisdom.   Psychiatry and religion might be seen as complementary tools to help patients, families, and health care professionals recognize our common humanity in the struggle with illness.

Marilyn P. Mecham, "Guilt in the Context of Illness- A Protestant Perspective"
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Published: February 5, 2005