Re: Addressing existential suffering

I enjoyed reading Dr Bates’s excellent article on addressing existential suffering in patients with terminal illnesses (BCMJ 2016;58:268-273). Spiritual/religious issues are important for many of our patients, not just those facing end-of-life issues. A study of 2000 physicians published in 2007[1] indicated that most psychiatrists and nonpsychiatric physicians believe that religion/spirituality helps patients cope with and endure illness and suffering by offering a positive, hopeful state of mind and/or a community that offers emotional or practical support. Over the years I have recommended that medical students, psychiatry residents, and residents in other disciplines routinely ask patients about their spiritual beliefs and how they would like them to be addressed. Dr Bates included a copy of the FICA spiritual history tool in his article. I would highly recommend that the FICA be used routinely with patients, especially those who have chronic illness and suffering. It could be used as a brief screening tool, similar to the CAGE questionnaire, which is commonly used to screen for alcohol/substance abuse. Over the years I have seen no negative effects from asking patients about spiritual issues. Instead, it usually improves rapport and contributes to a positive doctor-patient relationship. Patients can be referred to appropriate spiritual care resources as needed, but physicians should not neglect identifying important spiritual/religious issues that may be affecting a patient’s well-being.
—Stephen D. Anderson, MD, FRCP(C)
Clinical Associate Professor, UBC Faculty of Medicine, Dept. of Psychiatry


References

1.    Curlin FA, Lawrence RE, Odell S, et al. Religion, spirituality, and medicine: Psychiatrists’ and other physicians’ differing observations, interpretations, and clinical approaches. Am J Psychiatry 2007;164:1825-1831.

Stephen D. Anderson, MD, FRCP(C). Re: Addressing existential suffering. BCMJ, Vol. 58, No. 7, September, 2016, Page(s) 359 - Letters.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply