Spirituality and health: an initial proposal to incorporate spiritual health in health impact assessment

Abstract

This paper explores current understanding on spiritual dimensions of health via Thomas Kuhn's notion of scientific paradigm. It suggests that the difficulties to include spirituality as a component in health impact assessment scheme are due to the conflicts between two underlying paradigms. Mainstream scientific thought, which has been dominated by Newtonian and Cartesian paradigm, is characterized by its reductionistic and materialistic worldview. In this paradigm, a complex whole (be it an ecological system or a living organism) is viewed as reducible and can be explicable only by objectively examining and measuring its components. In other words, the whole is understood in this paradigm by the properties of its parts. Spirituality as an aspect of life belongs to a differing paradigm of thought with entirely different ontological and epistemological assumptions. Spirituality is an emergent property of a complex living system and exists only when such a system is examined in a holistic manner. This paper offers an initial understanding towards a cross-paradigm dialogue in the attempt to incorporate spiritual dimensions of life into the process of health impact assessment. It proposes that an approach starting with an attempt to clarify once and for all the definition of spirituality may be too restrictive since defining is essentially an objectification of knowledge which presupposes a separation between the knower and the known. Contrary to the maxim “I think, therefore I am,” understanding spiritual life is achievable not by thinking or cognitive contemplation on the definition. Instead, it is “realized” through practices and its embodied form of knowledge often resists objectification and verbalization. Rather than emphasizing on definition, this paper suggests a practical conceptual framework for appraising spiritual aspects of life through assessing supportive infrastructure of spiritual life (i.e. knowledge source, institutional components, socio-spatial organization of life) and the conducive environment.