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Praying With Patients

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by Brad Farris, MD …

by Brad Farris, MD
presented at COS, Annual meeting 2008

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  • 1. When and How to Pray with Patients Bradley K. Farris, M.D. Professor, Ophthalmology Adjunct Professor, Neurology & Neurosurgery University of Oklahoma School of Medicine Dean McGee Eye Institute
  • 2. Disclaimer
    • I am a Christian
    • I view the world and its contents through the eyes of a Christian
    • I am a Neuro-Ophthalmologist
      • I see patients with difficult visual/neurological problems
    • I have offered prayer to every new patient in my clinic for the past 20 years
  • 3. The Tripartite Being
    • Man consists of:
      • Body
        • That which we are physically attempting to heal
        • Our anatomy/neuro-anatomy/physiology
      • Soul
        • That which we are emotionally attempting to comfort
        • Our mind/emotions/will
      • Spirit
        • That which is within us, and many believe, is guiding us
  • 4. Law, Ethics, and Morality
    • Law
      • Behavior mandated government which must be obeyed
      • Laws change from time to time
    • Ethics
      • Behavior mandated by society which should be obeyed
      • Ethics change from time to time
    • Morality
      • Behavior mandated by God
      • Morals never change with time
  • 5. Why Offer Prayer with a Patient?
    • If a physician is a Christian:
      • He/She presumes to believe their “textbook”
      • James 5:13-16
        • “ Is any among you suffering? Let him pray. Is anyone cheerful? Let him sing praises. Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord; and the prayer offered in faith will restore the one who is sick, and the Lord will raise him up…The effective prayer of a righteous man can accomplish much.”
  • 6. Why Offer Prayer with a Patient?
    • If the Physician is non-Christian believer:
      • His/Her faith may believe similar to that of Christians
        • The power of healing prayer
  • 7. Why Not Offer Prayer?
    • There is concern that the patient may not appreciate or want the offer
      • The fear of rejection is a powerful motivator
    • There is fear of retaliation by the patient
      • Filing complaints/lawsuits
  • 8. Who Benefits from the Prayer?
    • The Patient
      • Those of faith
      • Those of borderline faith
      • Those seeking answers about faith
    • The Patient’s Family
      • Healing and comforting are their priorities
    • The Physician
      • The gratitude shown by patients is overwhelming
    • The Medical Support Staff
      • They see an intimacy of caring
  • 9. Short Term Benefits to Prayer
    • You demonstrate your sincerity in your care
    • A deeper relationship is established
      • Patient loyalty
      • Patient trust
      • Family loyalty and support
      • Physician-patient connection begins that can help overcome emotional obstacles to a healthier lifestyle
  • 10. Long Term Benefits to Prayer
    • Patient compliance is improved
    • Family more eager to be involved in care
    • Hope is established beyond medical/surgical assurances or disappointments
    • An opening is initiated to begin addressing other issues in their life that may require spiritual counseling
  • 11. Pitfalls in Offering Prayer
    • Physician Initiated:
      • Implied Coercion
      • Patient discomfort
    • Patient Initiated (not uncommon):
      • Differing beliefs
      • Physician discomfort
  • 12. When to Offer Prayer
    • Never
    • Always
    • Sometimes
  • 13. When to Offer Prayer
    • Never
      • Easy if physician is agnostic or atheist
      • Relatively easy if physician is a “non-practicing believer” of a certain faith
      • Difficult to come to terms with if the physician is a believer in the power of prayer in their respective faith
        • Why would they not want to utilize this potential power in their medical practice?
  • 14. When to Offer Prayer
    • Sometimes:
      • Presumption that the physician is a believer
        • When the patient is of same belief:
          • May be unknown without asking (wearing cross)
          • Spiritual assessment can be helpful
        • When the patient is in a medical crisis:
          • Patient’s perception or physician reality?
          • Pre-op or in ICU
        • When there is significant fear in patient:
          • Fear of brain tumor/cancer/blindness/memory loss
            • Fear is extremely common in my clinic
            • Some fears may not be recognized or admitted
        • When the physician needs help:
          • Subspecialty consultation fails
          • Why not pursue super-subspecialty consultation!
  • 15. When to Offer Prayer
    • Always
      • It can be difficult to assess the presence and depth of fear in a short time
      • It can be difficult to assess who will receive or reject an offer of prayer (>99% accept)
      • Even when accepting the offer unenthusiastically, many have a deep spiritual experience that they never forget (letters)
      • Why wouldn’t the believing physician want the help of God in every patient?
  • 16. Asking God for Help
    • When you need God:
      • Mark 11:24
        • “ Therefore I say to you, all things for which you pray and ask, believe that you have received them, and they shall be granted you.”
    • When God seems distant:
      • Romans 8:28
        • “ And we know that God causes all things to work together for good, to those who love God, to those who are called according to His purpose.”
  • 17. Personal Experiences
    • “ It never ceases to amaze me the spiritual need and comfort that people desire , and are so gracious and broken when receiving it from a physician.”
      • “ I have never had a physician do that for me.”
    • “ Even when I cannot help someone’s failing vision, they almost always are comforted by the physical and spiritual touch of a prayer.”
  • 18. Seeing and Believing
    • “ Seeing is Believing”
      • It is not believed unless seen
    • “ Believing is Seeing”
      • Hebrews 11:1
        • “ Now faith is the assurance of things hoped for, the conviction of things not seen.”
  • 19. How I offer Prayer to Patients
    • Complete History and Physical
    • Spend considerable time explaining all issues of the medical evaluation
    • Ask if the patient/family has any questions
    • Ask them again
    • Thank the patient/family for their trust in my care
    • Offer a handshake of thanks while still seated
    • Ask the patient if they would be offended if I prayed for them while informing them that I am Christian
    • Respect and be sensitive their response
  • 20. Patient Responses to Prayer
    • 20 years of experience:
      • Handful of patients responded negatively
      • Thousands of letters, phone calls positive
      • Jews/Muslims/Hindus have all been very encouraging, and have consistently asked for more prayer on return
      • If a patient responds negatively, I ask their forgiveness for possibly having offended them
        • I am “quick” to take a humble stance
        • They have always stated “no offense taken”, and seem to appreciate my sincerity.
  • 21. My Christian Prayer Model
    • Give thanks for the health/vision present
    • Ask for guidance in diagnosis/treatment
    • Ask for specific supernatural healing
    • Give thanks for any divine benefit
    • Ask that the patient’s needs be met in spirit, soul, and body (covering the bases)
    • Pray to the God of Abraham, Isaac, and Jacob, in Jesus’ name
  • 22. “ Patient Perception of Preoperative Christian Based Prayer in the Setting of Elective Outpatient Surgery”
    • Prospective study with IRB approval to review the subjective response to offered prayer
    • Two surgeons agreed to a standard Christian prayer structure pre-operatively offered to all patients
    • All patients were then sent a survey as to their opinion on the benefit of the prayer offered
  • 23. “ Patient Perception of Preoperative Christian Based Prayer in the Setting of Elective Outpatient Surgery”
    • 567 patients mailed an IRB approved survey
    • 11/2003 – 2/2005
    • 300 were collected (53%)
    • Average age 35.8
      • 361 (64%) were age 18 or older
      • Younger patients had guardian mailings
    • 1 initiated the prayer
      • 299 total in study
  • 24. “ Patient Perception of Preoperative Christian Based Prayer in the Setting of Elective Outpatient Surgery” – The Prayer
    • “ Dear God, I thank you for (name of patient) and ask you to bless (his/her) surgery. I pray that the surgery will go well without any problems or complications and that no more surgery will be needed. And I pray that You meet (name of patient)’s needs in body, soul, and spirit. In Jesus’ name. Amen.”
  • 25. “ Patient Perception of Preoperative Christian Based Prayer in the Setting of Elective Outpatient Surgery” – The Survey
    • Did your doctor offer to pray with you before your operation?
    • Did you accept the prayer?
    • Did you want to accept the prayer?
    • Did you feel free to reject the prayer?
    • If someone other than your doctor had offered to pray with you, would you have accepted?
    • How would you classify your religious beliefs?
    • ____ Agnostic (not committed to belief or unbelief in the existence of a God)
    • ____ Atheist (disbelief in the existence of a God)
    • ____ Buddhist
    • ____ Christian
    • ____ Jewish
    • ____ Mormon
    • ____ Muslim
    • ____ Other: Please specify _____________
    • Please indicate your opinion concerning prayer offered before outpatient surgery
    • The following questions required a response as to whether they strongly agreed, agreed, were neutral, disagreed, or strongly disagreed.
    • I believe the prayer affected the surgical result in a positive way.
    • I felt uncomfortable when the surgeon offered to pray for me.
    • I felt that the prayer was being offered for my wellbeing.
    • I was offended that the prayer was Christian-oriented.
    • I felt that the prayer was solely intended to alter my opinion of the surgeon.
    • I would rather not have been offered prayer.
    • I am glad I received prayer from my physician.
    • I would like to have prayer from my doctor again.
    • I believe doctors should not address spiritual issues.
    • I believe the prayer affected my relationship with my physician in a positive way.
  • 26. “ Patient Perception of Preoperative Christian Based Prayer in the Setting of Elective Outpatient Surgery” – Results (n=299)
    • 284 Christian
      • 5 Baptist,
      • 3 Catholic
      • 4 Pentecostal
      • 2 Messianic Jews
    • 5 agnostic
    • 2 between agnostic and atheist
    • 2 atheist
    • 1 Buddhist
    • 1 Baha’I
    • 1 Jehovah’s Witness.
  • 27. “ Patient Perception of Preoperative Christian Based Prayer in the Setting of Elective Outpatient Surgery” - Results
    • 567 patients mailed an IRB approved survey
    • 300 were collected (53%)
    • 1 initiated the prayer
    • 297/299 accepted prayer (atheist/JW)
    • 12/297 patients felt they were not free to reject the prayer, yet…
      • 11/12 agreed or strongly agreed that the surgical results were affected in a positive way
      • 11/12 felt the prayer was being offered for their well-being
      • 11/12 were glad that the prayer was offered
      • 11/12 felt that the prayer offer affected their relationship with the surgeon in a positive way
    • 10/297 would not have accepted the prayer from anyone other than the surgeon
      • 6/10 were classified as Christian
    • 281/298 agreed or strongly agreed that the surgical results were affected in a positive way
      • 2/298 responses strongly disagreed that the results were affected in a positive way
  • 28. “ Patient Perception of Preoperative Christian Based Prayer in the Setting of Elective Outpatient Surgery”
    • What did we learn?
      • “ You cannot please all of the people all of the time”
      • Our goal was to heal when possible, but always offer an attempt at comforting
      • The vast majority appreciated the offer of prayer
        • 297/299 (99.3%)
  • 29. Is it Lawful to Pray with Patients?
    • Yes
    • There is no specific law prohibiting praying with patients
  • 30. Is it Ethical to Pray with Patients?
    • The Physician’s Perspective
      • The AMA Principles of Medical Ethics
        • Step #6
          • “ A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve , with whom to associate, and the environment in which to provide medical services.”
  • 31. Is it Ethical to Pray with Patients?
    • The Patient’s Perspective
      • Fundamental Elements of the Patient-Physician Relationship
        • Right #3
          • The patient has the right to courtesy, respect, dignity, responsiveness, and timely attention to his or her needs.
  • 32. Is it Moral to Pray with Patients
    • Morality is clearly a faith based issue
    • For many physicians, it may be immoral not to offer prayer to patients
    • After 20 years of practicing faith based medicine, the consequences of my actions have resulted in a robust, large, loyal patient base that is a joy to serve on a daily basis
  • 33. Thank You!
    • Questions?

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