Even though we physicians are dedicated to saving, prolonging, and improving the lives of our patients, we often don't ask about what gives their lives meaning.[1] I know that I, as a patient, have never been asked that. Even Dr. Kevorkian apparently did not ask that kind of question to people before assisting them to die.[2] In not doing so, we physicians may be missing an important opportunity. The rise of public interest in spirituality suggests that people are indeed looking more than ever to find meaning in their lives.
Some physicians lead the way. Dr. Breitbart has found that asking terminally ill cancer patients to focus on 4 sources of meaning helped them to dramatically reduce their requests for assistance in dying.[3] These sources are:
creativity;
reviewing experiences;
a positive attitude; and
one's perceived legacy.
Dr. Van Pelt has successfully done something similar with adolescent patients as well as those with headaches.[4] I have recently begun to do so successfully with my new psychiatry patients, either in the interview or with a simple homework question of “What has given your life meaning so far, and what do you hope will give it meaning in the future?”
There are many ways that such a 2-part question can help almost any patient. First of all, it can help us to connect treatment to what is important to each patient. It also can strengthen the patient-physician relationship in a time of brief visits. And it can deepen our own understanding of the meaning of our own lives.
That's my opinion. I'm Dr. Steven Moffic, Professor of Psychiatry at the Medical College of Wisconsin.
Footnotes
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Readers are encouraged to respond to the author at smoffic@mcw.edu or to George Lundberg, MD, Editor in Chief of The Medscape Journal of Medicine, for the editor's eyes only or for possible publication as an actual Letter in the Medscape Journal via email: glundberg@medscape.net
References
- 1.Musick D, Cheever TR, Quinlivan S, Nora LM. Spirituality in medicine: a comparison of medical students' attitudes and clinical performance. Acad Psychiatry. 2003;27:67–73. doi: 10.1176/appi.ap.27.2.67. [DOI] [PubMed] [Google Scholar]
- 2.Moffic HS. Dr. Death and the meaning of life. Clinical Psychiatry News. 2007 Sept;54 [Google Scholar]
- 3.Breitbart W. Spirituality and meaning in supportive care: spirituality- and meaning-centered group psychotherapy interventions in advanced cancer. Support Care Cancer. 2002;10:272–280. doi: 10.1007/s005200100289. [DOI] [PubMed] [Google Scholar]
- 4.Van Pelt IH. Perceptions of headache control: clinical experience with strengthening patient internal control ability. Headache & Pain. 2004;15:44–48. [Google Scholar]
