Spiritual concerns can get in the way of saving lives

If a competent adult knowingly refuses necessary treatment on some irrational ground [“A Spiritual Treatment,” Feb. 28], that’s her right. But for some third party -- family member or not -- to refuse lifesaving treatment on behalf of a person unable to accept or refuse treatment herself, it is murder. And a physician who meekly complies with the irrational demands is an accomplice.

I once complied with a husband who refused lifesaving treatment for his wife, and within a week of her death he moved in with his secretary. I never made that mistake again, nor should any other doctor.

Harvey S. Frey, M.D.

Santa Monica

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Your article about the role of spirituality in medical care seems to me to present a controversy artificially generated by the ambiguous meaning of the term “spirituality.” The topic would be far less controversial if, for example, it were framed as a discussion of the role of morale in medical care.

Virtually no clinician would question the importance of morale in a seriously ill patient, and the real issue is how best to maintain patient morale. If the patient is involved in a “spiritual” system -- meaning a system that has long provided the patient an ongoing sense of belongingness, support and validation -- there can be little doubt of the value of maintaining the patient’s morale by enhancing his or her feeling of connection to that system. In the case of the Hmong woman that the article presents, this process appears to have been central to the success of utilizing “spiritual” procedures.

Larry Selk

Los Angeles