Embracing the Paradox: Spiritual Issues in General Practice

Human beings know they are born to die. Coming to terms with this paradox sends them on a lifelong spiritual journey. This research sets out to explore the way spirituality is understood and experienced by general practitioners in New Zealand both for themselves and as presented by patients. Formal research was conducted over two years, but the roots of this thesis subsist in many years of General Practice in a number of different cultures. A pragmatic generic qualitative method was used. Semi-structured interviews were undertaken with general practitioners from a wide variety of practices and across a considerable range of experience. In addition a number of group sessions and workshops were also conducted on themes emerging from the interviews. Findings that emerged from both interviews and groups showed the immense diversity of both understanding and experience of spirituality. Participants expressed an openness to spirituality along with a widespread rejection of religion. The dynamic and interrelated nature of the various aspects of spirituality connecting self, others, the natural world and the transcendent was also evident. The thesis concludes with an exploration of the nature of spirituality in general practice. It looks at the way general practitioners seek to enable hope, meaning and healing, while bearing witness to suffering and death. It considers ways of sustaining and enabling spirituality. It suggests that there is a conflict of paradigms between a reductionist biomedical approach and care of the whole person. There is a vital difference between cure and healing. This finding raises important issues in terms of management and training of general practitioners