Religion and Spirituality in Advance Care Planning
Abstract
Purpose of study: To evaluate the effect of spirituality and religion on Advance Care Planning.
Methods: Five studies are analyzed to determine knowledge of ACP by religious leaders, the influence of caregivers’ religious affiliation, and the influence of the patient’s religious affiliation on ACP.
Results: Of the sample, three studies concluded that religiosity poses a significant influence on ACP. One study shows that patients’ religious affiliation leads to a reduced ACP while another study shows that health care providers’ religious affiliation does not influence ACP. One study indicated that religion is not a primary influencer of ACP.
Conclusion- Religious affiliation does not influence the healthcare principle of autonomy. However, religious people are likely to be more averse to ACP. Healthcare workers should therefore possess knowledge about the preferences of various religious denominations to be able to effectively advise patients. Further research is however required to explore other factors that influence ACP.
Keywords: Advance Care Planning, religion and spirituality, autonomy.
Introduction
Advanced care planning refers to a process that allows an individual to express his or her values and preferences regarding medical care in the event of a critical health condition. ACP ensures that patients receive their preferred care. The high percentages of religious people globally suggest a need for a consideration of how spirituality and religious needs impact ACP. There exists a wide range of factors that play a part in the place of death including religion and spirituality. Addressing spiritual issues in healthcare settings is therefore essential in healthcare practice.
Summaries of Studies
During the planning process of Advanced Care Planning (ACP), the integration of religious and spiritual aspects plays a fundamental role. In a research conducted by Pereira-Salgado, Mader, O’Callaghan, Boyd, & Staples (2017) to determine how religion affects followers’ approaches to end of life care and Advanced Care Planning (ACP) and their implications for healthcare, it was found that religious people who constitute a majority of the population in most societies today hold religious-based preferences in the end-of-life care matters prompting caregivers to possess some degree of religious knowledge. Different religions however hold different opinions about life length and end of life values. In a study aimed at evaluating the extent to which self-identified religious importance and religious affiliation affect ACP via beliefs related to human control over the end of life and life length values, it was found that patients who hold great importance to spirituality and religion exhibited a lower likelihood of ACP (Garrido, Idler, Leventhal, & Carr 2012).
Regarding the role of religion and spirituality among surrogate decision-makers for hospitalized older adults, research shows that religion is a key factor in the making of end of life decisions. a research conducted by Geros-Willfond, Ivy, Montz, K., Bohan, & Torke (2016) suggested that clinicians have an obligation to consider religious beliefs in making healthcare decisions. To explore how the religious preference of healthcare providers influences their involvement in ACP, (Bowman, St. Cyr, & Stolfi, (2018) found out that religion does not influence the healthcare provider’s willingness to facilitate ACP discussions. As such, the religious affiliation of healthcare providers does not significantly influence their interest in undertaking ACP or even endorsing ACPs that are contrary to their religious beliefs. In another research aimed at determining whether religiosity influences the rate of ACP by older African Americans, the whites were found to engage in ACP compared to the African Americans and religiosity did not close the Gap (
Integration and Analysis
Studies therefore show that religiosity and Christianity is a major determinant of ACP. A majority of people today follow some form of religion that stipulates certain values particularly in relation to end of life care and life length. For example, Christianity which is the largest religion in the world believes that God is the giver and controller of life. While the medical caregiver’s main focus to improve the patient’s quality of life, respect for patient’s autonomy is a key principle that caregivers observe. As such, the caregiver’s spiritual orientation does not influence the patient’s perception of ACP. Even though these studies provide insight into the role of spirituality and religiosity in ACP, there exists a wide range of factors that influence health-related decisions among patients. As such, further research is necessary to determine the complementary factors to religion that are likely to influence ACP.
Conclusion
Studies show a majority of people’s decisions about healthcare are influenced by their religious orientation. In respect to the patient’s autonomy, healthcare providers consider their patient’s spiritual beliefs and therefore do not actively influence the patient’s ACP decisions. As a result, persons with strong religious beliefs about God’s control over the end of life develop resistance over some forms of ACP. Healthcare providers should therefore possess knowledge about various religious beliefs in advising patients about ACP. However, their practice should be guided by professionalism and should therefore not let their personal religious affiliations to act as a barrier in engaging in ACP. Research on alternative factors that influence ACP among patients should however be explored to bridge the existing research gap.
References
Bowman, M., St. Cyr, S., & Stolfi, A. (2018). Health-Care Provider Personal Religious Preferences and Their Perspectives on Advance Care Planning with Patients. American Journal of Hospice and Palliative Medicine®, 35(12), 1565-1571. Retrieved May 18, 2020, from https://journals.sagepub.com/doi/abs/10.1177/1049909118785891
Garrido, M. M., Idler, E. L., Leventhal, H., & Carr, D. (2012). Pathways from religion to advance care planning: Beliefs about control over length of life and end-of-life values. The Gerontologist, 53(5), 801-816. Retrieved May 14, 2020, from https://search-proquest-com.tp-library.idm.oclc.org/docview/1433900465?accountid=47385
Geros-Willfond, K. N., Ivy, S. S., Montz, K., Bohan, S. E., & Torke, A. M. (2016). Religion and spirituality in surrogate decision making for hospitalized older adults. Journal of religion and health, 55(3), 765-777. Retrieved May 18, 2020, from https://link.springer.com/article/10.1007/s10943-015-0111-9
Koss, C. S. (2018). Does religiosity account for lower rates of advance care planning by older African Americans? The Journals of Gerontology: Series B, 73(4), 687-695. Retrieved May 18, 2020, from https://academic.oup.com/psychsocgerontology/article/73/4/687/2965389
Pereira-Salgado, A., Mader, P., O’Callaghan, C., Boyd, L., & Staples, M. (2017). Religious leaders’ perceptions of advance care planning: a secondary analysis of interviews with Buddhist, Christian, Hindu, Islamic, Jewish, Sikh, and Bahá’í leaders. BMC Palliative Care, 16(1), 79. Retrieved May 14, 2020, from https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-017-0239-3#citeas