Defend this component Sulmasy’s “”Biopsychosocial-Spiritual” model of

Defend this component Sulmasy’s “”Biopsychosocial-Spiritual” model of healthcare Healing the Whole Person On this model, healing is not, as it is often characterized, a “making whole.” Rather, healing, in its most basic sense, means the restoration of right relationships. What genuinely holistic health care means then is a system of health care that attends to all of the disturbed relationships of the ill person as a whole, restoring those that can be restored, even if the person is not thereby completely restored to perfect wholeness. A holistic approach to healing means that the correction of the physiological disturbances and the restoration of the milieu interior is only the beginning of the task. Holistic healing requires attention to the psychological, social, and spiritual disturbances as well. As Teilhard de Chardin (1960) puts it, besides the milieu interior, there is also a milieu divine. Furthermore, this means that at the end of life, when the milieu interior can no longer be restored, healing is still possible, and the healing professions still have a role. Broadly construed. spiritual issues arise J L naturally in the dying process. In a sense, these are the obvious questions-about meaning, value, and relationship (Sulmasy, 1999b, 2000, 2001b). No matter what the patient’s spiritual history, dying raises for the patient questions about the value and meaning of his or her life, suffering, and death. Questions of value are often subsumed under the term. “Dignity.”, Questions of meaning are often subsumed under the word “hope.” Questions of relationship are often expressed in the need for “forgiveness.” To die believing that one’s life and death have been of no value is the ultimate indignity. To die believing that there is no meaning to life, suffering, or death is abject hopelessness. To die alone and unforgiven is utter alienation. For the clinician to ignore these questions at the time of greatest intensity may be to abandon the patient in the hour of greatest need. So, the appropriate care of dying persons requires attention to the restoration of all the intrapersonal and extra personal relationships that can still be addressed, even when the patient is dying. Considering the relationship between mind and body in its broadest sense, symptomatic treatment restores the human person by relieving him or her of the experiences of pain, nausea, dyspnea, fatigue, anxiety, and depression. Considering the relationship between the human person at the end of life and the environment, this means, for example, that the facilitation of reconciliation with family and friends is genuine healing within the biopsychosocial-spiritual model. For the dying individual to experience love, to be understood as valuable even when no longer economically productive, and to accept the role of teacher by providing valuable lessons to those who will survive. are all experiences of healing. Finally, to come to grips with the transcendent term of each of these questions about existence, meaning, value, and relationship is also an opportunity for healing for dying individuals. If the human person is essentially a being in relationship, then even the person who has chosen to believe that there is no such thing as transcendence has made his or her choice in relationship to that question, which is put before each person. Each person must live and die according to the answer each gives to the question of whether life or death has a meaning that transcends both life and death. On this model. the facilitation of a dying person’s grappling with this question is an act of healing. Clinicians, at a minimum, have an obligation to ensure that a spiritual assessment is performed for each ~patient. Those clinicians who are uncomfortable doing this may ensure that other members of the health care team perform this important function. It is also important to recognize the value of referral and that an assessment of spiritual needs does not imply that the physician or nurse must provide spiritual services in lieu of a chaplain or other clergy. Finally, it is important to understand that patients who refuse spiritual assessment or intervention should be free to do so without any pressure or any detrimental effect on the rest of their care.

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