Today it is generally accepted that an illness should be understood on the basis of a biopsychosocial model in which the patient’s thoughts, feelings and social relationships are of significance. But life also has a fourth dimension – the spiritual and existential. In our opinion, simple, open-ended questions on personal beliefs when taking the case history as well as in other clinical contexts can result in better patient treatment.
The existential or spiritual dimension incorporates the basic values of patients, their thoughts on what gives life meaning and religious or non-religious worldview. It also includes beliefs about what happens after death. The aim of this article is to discuss whether these aspects of human life are also relevant for doctors in their encounters with patients, and to provide advice on how to handle the spiritual and existential dimension.
Numerous studies have been carried out internationally of the interaction between religious beliefs and health, and the needs of patients for the health service to follow up existential needs (1, 2). However, in Norway little research has been conducted into this field. The results of studies conducted in other countries among patients with particular beliefs cannot be generalized and transferred to other cultures and religions indiscriminately. Nevertheless, in our discussion of this topic it is natural to include studies from other Western countries whose culture and religion are similar to our own.
the authors are active members of the Norwegian Christian Medical Association.