Awareness of the contribution that spirituality can make to health has come a long way.

Spiritual care

Aotearoa's healthcare system adopts a holistic approach, often encapsulated in the Maori model of health, te whare tapa wha, and its four interwoven dimensions: physical, mental, family/social and spiritual. The spiritual aspect (taha wairua) is not just an optional extra. It is woven into everything else.

Having a model is one thing. Having policies and delivery plans is another.

A 2022 study by Jacqui Tuffnell revealed that the New Zealand healthcare system's spiritual care delivery was fragmented.

She noted a huge variation in the provision of spiritual care across the country.

Of the 20 former district health boards, eight had no spiritual care policy in place.

For over 50 years, the Interchurch Council for Hospital Chaplaincy (ICHC) has been doing a great job providing hospital chaplains, but they operate in a policy vacuum and a rapidly changing context.

A major bicultural research project led by Associate Profs Richard Egan and Waikaremoana Waitoki has just been launched to examine how spiritual care can be improved across the healthcare sector.

The importance of their mahi is confirmed by a Royal Australian and New Zealand College of Psychiatrists (RANZCP) position statement on the relevance of religion and spirituality to psychiatric practice.

It says that religion/spirituality is crucial to achieving a more holistic understanding of a person's needs and supports.

Link between spirituality and religion

A notable feature of the RANZCP statement is the link that is assumed between spirituality and religion.

It defines religion as an institutional form of spirituality, consisting of the systems and practices of a community in relation to a divine or eternal guiding presence.

This begs a question: if spirituality is regarded as a contributor to health, might the same be said of religion? Or to put it more bluntly, is religion good for one's health?

The link between religious observance and mental health benefits has been demonstrated in numerous academic studies.

These include a sense of meaning and purpose, enhanced social support, effective coping mechanisms and stress reduction. In times of suffering, belief in a higher power can provide comfort and hope.

But care needs to be taken not to overstate the benefits. Religion can also be harmful.

Belief in faith-based healing can lead to a distrust of science, a rejection of conventional medicine, delays in seeking medical care and a refusal of life-saving treatments.

It can also trigger a crisis in faith when divine intervention does not materialise.

Moreover, doctrinal beliefs about divinely ordained conduct may induce feelings of shame in regard to one's sexuality and lifestyle choices, potentially leading to secrecy, risky behaviour and mental health struggles.

Other beliefs about heaven and hell may generate anxiety about being judged and found wanting.

Religious in different ways

In a paper on religion and spirituality in healthcare, a British mental health chaplain, Ruth Bierbaum, says it is important to understand that there are different ways of being religious.

Bierbaum uses the term "quest religiosity" to describe a healthy form of religion that integrates the whole of life, accommodates questions and doubt and allows re-evaluation in the light of experience.

It is faith seeking understanding, not faith locked in a rigid system of belief; faith that engages with evidence-based research in all fields of inquiry, not faith stuck inside an echo chamber; faith driven by curiosity, not blind obedience.

Quest religiosity may involve a revision of beliefs and searching questions, such as, "if God is good and all-powerful, why does God allow suffering? Am I being punished for my sins? Is my suffering a test of faith?"

A role of healthcare chaplains is to help people navigate existential questions and guide them to what Bierbaum calls "transitional spaces", where questioning and reflection are encouraged and images of God and self may be reimagined, opening up the possibility for spiritual growth and strengthening of mental health.

Charting the journey

Renowned New Zealand author Joy Cowley likens spirituality to a journey and religion to a map for the journey.

We receive maps that those who have gone before us have drawn, and as we journey, we make the maps our own.

Some markings are as helpful to us as they were to our forebears, but other markings have become obsolete, and some new and unmarked trails lead to exciting new vistas. We put down new markings.

This is a useful metaphor for quest religiosity. Religion is not static. It is an ever-changing map.

For those who experience it as such, it plays a positive role in their health. Their experience is worthy of respect.

• First published in the ODT
• Graham Redding is the lecturer in chaplaincy studies at Otago University and minister at Knox Church, Dunedin.

In a recent statement, the pro-life advocacy group Right to Life argues that while taxpayers have a moral obligation to contribute their taxes, they should not be obligated to fund "the murder of the innocent."

The group asserts that while the government upholds the killing of the unborn as a "reproductive choice for women," it denies taxpayers the right to choose not to finance abortions.

The comments come in a Right to Life budget statement about abortion as healthcare.

Right to Life says the government should abandon the notion that abortion is a healthcare service. It should also cease using taxpayers' funds to support the termination of innocent lives.

The organisation calls for greater consideration of the sanctity of unborn life and the moral implications associated with allocating public funds towards abortion.

The group's comments respond to the New Zealand government's 2023 "Wellbeing Budget".

The budget claims to support the present while building for the future. However, Right to Life argues the government's future well-being focus does not align with safeguarding the welfare of unborn children.

The organisation states that since 1977, when abortion was declared a core health service by a National government, subsequent administrations have consistently classified abortion as such, granting the "health service" unlimited funding and eliminating waiting lists.

Highlighting that $13 million has been allocated in the budget to support an estimated 13,000 unwanted unborn children, the group argues that the government is not prioritising the wellbeing of unborn children.

Drawing attention to the significant increase in healthcare spending since 2017, with the vote health budget nearly doubling from $76 billion to $136 billion, Right to Life points out the incongruity in the health service, where essential healthcare services struggle to meet their objectives while the termination of unborn children receives unfettered financial support.

While Right to Life commends the government's aim to reduce child poverty, it implores the administration to recognise what it calls "the greatest poverty" - the denial of life for unborn children.

The organisation questions how the well-being of future generations can be effectively promoted when approximately one in five unborn children's lives are prematurely terminated, representing a significant proportion (20%) of the unborn population.

Source

• Supplied: Right to Life

The comments come from staunch Catholic and former Australian Liberal Party Prime Minister, Tony Abbott.

Abbott claims COVID is costing as much as A$200,000 (~NZ $220,000) to give an elderly person an extra year's life.

He says the sum is substantially beyond what governments normally pay for life-saving drugs.

"In this climate of fear, it was hard for governments to ask ‘how much is a life worth?' because every life is precious, and every death is sad, but that has never stopped families sometimes electing to make elderly relatives as comfortable as possible while nature takes its course."

Abbott says the aim of preserving almost every life at any cost is a case of Governments shifting their goals from preventing hospitals from being overwhelmed with COVID patients to achieving zero transmission.

He accused Governments of approaching the pandemic trauma doctors instead of thinking like health economists trained to pose uncomfortable questions about a level of deaths countries might have to live with.

He told the Policy Exchange thinktank in London that it is not possible to pay so much to keep the elderly alive for another year while 40% of the workforce is on some kind of government benefit.

At some point we just have to live with this virus, he said.

Abbott claimed the response to COVID was causing a form of deep psychic damage.

"People once sturdily self-reliant are looking to the government more than ever for support and sustenance, a something-for-nothing mindset, reinforced amongst young people spared the need of searching for jobs."

"Every day it goes on, it risks establishing a new normal," adding: "Fear of falling sick is stopping us from feeling fully alive."

Abbott also claimed officials were getting trapped in crisis mode for longer than they needed, "especially if the crisis adds to their authority or boosts their standing."

Abbott proudly identifies as being pro-life and labelled last year's changes to the NSW abortion bill as "death on-demand" and "morally shocking" also opposes euthanasia.

Australian Opposition leader, Anthony Albanese was swift in his condemnation.

"Tony Abbott was never known for his compassion. This is a new low,"Albanese said.

Senior Liberal cabinet minister Mathias Cormann distanced himself from the former prime minister, saying the economic cost of the virus was justified.

"Clearly, the first priority was to protect people's health and save people's lives by suppressing the spread of the virus, and that was absolutely necessary," he told reporters at Parliament House.

"As part of that, we did have to impose significant restrictions on the economy in order to suppress the spread of the virus, and that was appropriate."

Sources

• The Telgraph
• The Guardian
• The New Daily
• The Canberra Times

This unprecedented proposal is contained in the government's consultation document on giving greater access to medicinal cannabis. Read more

The company was established by Kaitaia GP, Dr Lance O'Sullivan and his wife Tracy O'Sullivan

Both nominations are due in large part to iMOKO, a healthcare software program which utilises technology to deliver high quality basic health services.

iMOKO started out as a grassroots initiative.

"Members of my community approached me at my practice, telling me they couldn't get access to the healthcare services they needed," Lance explains.

So iMOKO was developed by Navilluso Medical to target communities with high needs and vulnerable children.

Lance figured if he could get the right technology within the communities, and train locals to use it he would not only reduce staff costs but increase care.

iMOKO "is is a digital healthcare platform where we are actually wanting to democratise health care by putting simple technologies in to the hands of whanau to achieve better health outcomes."

The iMOKO programme starts by placing smart tablets with iMOKO software into schools and early child care centres.

Lance and his team train approved people to conduct health assessments of common child health problems, such as skin and dental infections, strep throat, and head lice.

He believes the relationships already established between kaiawhina and tamariki is beneficial when assessing the health of vulnerable children.

So from a "kanohi ki te kanohi" point of view, its actually about optimising who's the best person to be the face of health care.

Around 6000 children across 110 sites from all over the country are in the iMOKO database to date.

Lance says this is only the beginning and his ultimate goal is to have 400,000 children accessing health care through iMOKO.

Source

• inner.kiwi
• maoritelevision.com
• Image: Screenshot Maori Television

It provides a clear set of guidelines to modern ethical concerns such as euthanasia and the creation of human-animal chimeras. Read more

He said in his view any public policy or private initiative regarding health care that does not make the dignity of the human person its central concern "engenders attitudes that can even lead to exploitation of the misfortune of others. And this is very serious."

"If there is a sector in which the ‘throwaway culture' demonstrates its most painful consequences, it is the health-care sector." Read more

• Should young people be able to jump queues for costly drugs at the expense of older people who've already had a long life?
• Are poor people more deserving of help than rich people"?

The proposals are among a raft of provocative questions being asked by Pharmac as it conducts a consultation exercise about the criteria it uses when deciding how to spend its budget, which last year was $783 million.

Other questions being posed are:

• Should the underprivileged groups such as Maori and Pasifika get priority access to drugs?
• Should it take into account the ability of parents of sick children to return to work?
• Should it assess the future earning potential of children?
• Should it have different priorities for providing treatment of conditions considered "preventable", compared to those that are genetically based?

Source

• Stuff.co.nz
• Image: Hacklive.ru

In his book Arbuckle argues that a values-based approach would change healthcare and systems and be a much better approach to healthcare than the current financial perspective.

In Humanizing Heathcare Reforms, Arbuckle suggests that without being able to identify clearly the values and goals that unite their members, healthcare organisations are unlikely to be able to meet the demands of the constant and varied pressures they face.

Dr Maria Theresa Ho, Former Associate Professor and Associate Dean, Head of the Medical Program, Faculty of Medicine, University of Sydney, Australia, says the message the book conveys is "critically relevant, timely and desperately needed."

The book is described as a much needed, very-accessible book, and as an essential read for anyone interested in a better approach to healthcare reform.

During 2010 Fr. Arbuckle worked at Campion Hall, Oxford University, researching issues confronting the National Health Service in England. In 2011 he gave the Martin D'Arcy Memorial Lectures at Oxford University upon which this book is based.

Those interested can order the book from Amazon.

Source:

• SMNZ
• Image: HPSI

Sr Chanel Hardiman, who is in her late 70s, was honoured at a farewell function at Marinoto House, in Dunedin, on Wednesday.

She entered the Sister of Mercy's novice training in South Dunedin, aged 20, in 1953.

She told her guests much had changed during her career. Technology altered "everything", in terms of equipment used and the job's demands.

Read Gerald's blog below:
The parable of the compassionate Samaritan is a classical example of the teaching of Jesus about our neighbour. Any one who is in need, no matter who they are, is our neighbour (Luke 10: 25-28). To make his point strongly, Jesus tells us that it is a Samaritan, a foreigner and one despised by the Jewish people, who goes to the aid of the dying Jew. Two pillars of Jewish society, the priest and the lawyer, ignore the plight of their fellow countryman.

Moreover, there is another reason why the listeners to the story would have been profoundly shocked that the Samaritan is the unexpected care-giver. He of all people was not expected to be generous and compassionate, simply because he belonged to a class of merchants, namely wine and oil sellers, considered in their business dealings to be shady, if not thoroughly dishonest. Also remarkable, the Samaritan spontaneously shared with the severely injured stranger not from his surplus, but as a trader he gave of his capital - oil, wine, and money. The reason? People in need have a right to share equitably in what God has created.

This parable, told two thousands of years ago, continues to influence people's lives today, even if they profess no religion or know nothing about the story. The story, says Charles Taylor, a leading Canadian philosopher, is one of the original building blocks of our Western civilisation. Chris Marshall, Victoria University, repeats this insight. He writes that "it is hard to think of another story that has been more influential in moulding personal and political virtue."

They are right. The parable became the original founding story of all healthcare services in the Western world. Inspired by the parable permanent charitable institutions first sprang up within a generation or two after the end of the persecution of the Christians in the 4^th century. Christians formed a miniature welfare state in the Roman empire which for the most part lacked social services. Later the monasteries in particular continued to emphasize the fact that compassionate care and hospitality for the marginalized in society is at the very heart of the Christian message. Every stranger in need is a neighbour, the image of God, and to whom the love and compassion of God ought to be demonstrated.

So in recent times we find Barbara Castle, when Health Minister in Britain in the 1970s, stating in parliament that their universal healthcare system "is the nearest thing to the embodiment of the Good Samaritan story that we have in any aspect of our public policy." And our own Michael Joseph Savage, as prime minister of New Zealand, when establishing in 1938 the beginnings of our own universal healthcare system, also recognized that its roots are to be found in the parable: "What is more valuable in our Christianity than to be our brother's keepers in reality?"

Why does this story of compassion have such a lasting impact? Compassion is a value originally founded on kinship obligations, whether natural or symbolic. The Hebrew word is derived from the word for womb, implying the need to feel for others because they are born of the same mother. God is that mother, and we are all children of that womb and must accordingly feel with, and care for, each other as brothers and sisters. Thus the Samaritan feels the inner pain of marginalization that the victim - his brother - is experiencing.

Compassion asserts that there is nothing more urgent than the pain of another person because that other person is profoundly, intimately, deeply connected to us through our common origins as human beings. The more one feels the pain of the other person the more one is anxious to remove the injustices and oppressions that cause that pain. For this reason compassion is a powerfully subversive value, a value that can turn society upside-down. And this is why it had, and continues to have, a lasting impact on our cultures.

As New Zealanders we are proud of our universal healthcare services, with its founding roots in the Good Samaritan story, but we must be ever vigilant. Healthcare is not commodity, to be available only to those who have money. It is a fundamental right. When people on the margins of our society begin to find it difficult to access our healthcare services, then we have grave reasons to be worried. We must relearn the fundamental message of the Good Samaritan story and insist it always be at the heart of our welfare and healthcare services.

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Further information on this theme is available in Arbuckle's book: Laughing with God: Humor, Culture, and Transformation (Collegeville: Liturgical Press, 2008).