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A Biblical basis for a whole person approach

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  A Biblical basis of a whole person approach to health care by Mike Sheldon
 

 

By adding a spiritual domain to the usual bio-psycho-social domains of health problems, are we creating a dualistic understanding of the person which is in fact less helpful than previous models? In  addressing  this issue of dualism and the separation of the physical and meta-physical worlds  the following points could form the basis of a discussion and agreement –

  1. God created both the spiritual and physical realms, and although it may be argued that the two domains are quite separate, I think the weight of Biblical evidence is that the physical world is both created by, and being continually sustained by God. Thus you can’t have one without the other, and the very existence of the physical world depends on the activity of God in the spiritual one.
  2. The Hebraic view is of the indivisibility of the person. There is no divide between the sacred and secular – everything is holy, and I interpret this to mean that all physical things have a spiritual dimension
  3. This surely applies to mankind. We are unique in that we have been created as both physical and spiritual beings, and it seems that God did not do this by accident. It is not that we should really be spiritual beings and we can’t wait to throw off this mortal coil and get a “real” body. Instead God intends some form of union between the physical and spiritual through us.
  4. The incarnation is the final confirmation of this. God becoming a physical man and living with us. Both divine and human.

 

For me the obvious conclusion is that we cannot separate off a bio-physical approach to people’s problems from a psycho-spiritual one. The two not only co-exist but are inter-dependent.

So what issues does this raise if we look to a whole-person medical model? Again a few general points –

  1. We start from a world view that is Biblical and which understands the inter-relatedness of physical and spiritual problems
  2. We develop an anthropology that views the person as one unified whole which is indivisible. Within this whole different aspects or domains are inter-woven together like the inside of a golf ball. Although it is impossible to separate out say the physical aspects, it is possible to view the whole through different windows, and so look at the person’s problems through the physical window, or the psychological, social or spiritual ones.
  3. We acknowledge that psychological and spiritual illness can have marked effects on the physical body. You cannot understand the causes and multi-factorial issues behind a physical problem without understanding the psyche and the spirit. A bio-physical diagnosis is incomplete.
  4. The scientific methods and language we use today is not sacrosanct, and in many places are not fit for purpose. New scientific approaches such as complexity theory are developing ways of looking at non-linearity (which is “real life” rather than the approximations made using a linear mathematics). We are only at the beginning of developing the required evidence base for the whole person approach, but I believe that this is what we are called to do.
  5. We therefore need to make diagnoses in a new way. At present within the western humanistic reductionist model of medicine the diagnosis is made in patho-physiological terms. As we move into a more patient-centred approach we also use problem-oriented statements which encompass the patient’s experience of the illness. Finally as we move to a whole person understanding our diagnoses will probably take on the appearance of David Chaput's seven stage model which in my view has much to recommend it in opening us up to possibilities.
  6. Finally we look to new ways of treating problems, with need for a much more integrated approach (for example to the use of chaplains as Eleanor writes). Exploring what a whole-person team consists of is exciting. I could include doctor, nurse, physiotherapist, counsellor, pastoral specialist, art/music therapist, and of course the patient and their carers.

 

As far as a medical curriculum goes we would need to introduce students at an early stage to –

  1. Different world views, their resulting anthropologies and implications for illness and health
  2. The multi-factorial nature of disease causation, illness, and ill-health
  3. The ways of investigating all of these domains, or at least majoring on the physical, psychological and spiritual.
  4. Making diagnoses which are complete as far as possible and lead to better therapeutic interventions
  5. The range of therapies available to the whole health care team, how to refer and especially integrate the care for the benefit of the patient.

 

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  Updated January 7, 2008   Home >> Whole Person pages index >> Articles Index >> Article 13