Evidence Live 2015, Examination Schools, University of Oxford, UK April 13-14, 2015 Mt. Olive Hospital Okinawa, Japan Chairman . Shinichi Tagami, Ed.D, Ph.D. “Fixing the problems with EBM: Refocusing on useable evidence that benefits patients in real world settings APPROPREATENESS AND EFFECTIVENESS OF RELIGIOUS CARE BASED ON EVIDENCE Background As our culture becomes increasingly pluralistic, for some people spiritual care may also mean facilitating relationships with various spirits. Thus, there are conflicts and contradictions in understanding the methods of religious care.（Patient/Problem） In order to determine appropriate and effective approaches to the methods of religious care, the objective evidence must be considered, just as in physical care. Otherwise we may harm patients with “wrong treatments” in providing religious care. There are two poles of religious care as follows: The first rule of spiritual care should be the same as for any medical intervention—do no harm. Although these therapies may look harmless and inviting, before using them we must first investigate their spiritual sources and ultimate ends, as well as their safety and effectiveness. (Shelly, 2000) As we Christians respect our own faith in a mature society, we must respect others’ faith and viewpoints. This attitude is very important in hospice care. It is not desirable to take care of a dying person with a caregiver’s faith as a priori, forcing their faith upon them. Christians need to accept people as they are. (Kanda, 1999) Aims While respecting others’ faith and viewpoints in our practice, based on the evidence, we must determine which of the various approaches are appropriate and effective. （Intervention） Methods Cursing in a traditional Okinawan folk religion is contrasted and compared to the approach of forgiveness in Christianity for alleviating patients’ fears and sense of peace during their terminal period.（Comparison） Deceased in peace ＋Spiritual Level Examined Period Hospitalization with fear 0 Curse by a shaman No peace Patient’ Response “How much is it for prayer?” Denial of faith －Spiritual Level Forgiveness with a dream of Christ Chaplain’s answer “Jesus paid it all” Reconciliation Cursing Negative Karma Always not enough Forgiveness Deliverance Paid it off As he went along, he saw a man blind from birth. His disciples asked him, “Rabbi, who sinned, this man or his parents, that he was born blind?” “Neither this man nor his parents sinned,” said Jesus, “but this happened so that the works of God might be displayed in him. John 9:1-3 The Spirit you received does not make you slaves, so that you live in fear again; rather, the Spirit you received brought about your adoption to sonship. And by him we cry, “Abba, Father.” Romans 8:15 Results Cursing caused fear while forgiveness gave peacefulness in patients in their terminal stages. （Outcome）