This chapter also needs a major re-write along the lines of the index above. Note I think I am changing the definition of health slightly, putting maturity as 6, and splitting coping and adapting. Think this through again Michael. Note I need to remove major discussion on health from the other chapter dealing with WPH principles, and need to decide what to put where, or even combine chapter 9 and 10.

Development of a whole person approach
There have been articles and research papers describing a whole person approach to health care for over 40 years. Many of these have come from the USA where the strong Christian religious presence has stimulated an understanding of the importance of religion in health and quality of life. (McSherry, 1983), however the underlying concepts are much older with numerous medical researches from the time of Plato onwards indicating the importance of viewing mankind as body (soma), mind (psyche) and spirit (pneuma). ((Put some references in here))

McSherry describes the situation in the USA in the 1980’s where scientific evidence, mainly from the social science disciplines stressed that religious and spiritual values are one of the critical factors in the perception of quality of life. To quote her “The aspect of man concerned with reasoning, purpose and values, has been demonstrated by several social science disciplines to be key to thinking and motivation for health behaviour and quality of life” (McSherry, 1983 p 218). She goes on to describe several models of the delivery of whole person care in primary care centres, community centres and Churches. She also describes the studies indicating the effectiveness of including a whole person approach in managing ill health, especially in the chronic diseases. (Paper in 01.5)

Basic principles of whole-person health
Changing the underlying philosophy of medicine to one in which the whole-person is considered in all aspects of health care, makes a difference to the practice of medicine in virtually all aspects.  We will now look at these principles and divide them up into 10 main areas. Summarised in chapter 9 – here we need to put the background and research, and alternative viewpoints

The success and deficiencies of scientific medicine
These are exciting times in medical science with many new and fruitful avenues of investigation and treatment opening up for doctors. Cancer no longer holds quite the dread it did in the past. An understanding of the human genetic makeup appears to offer many ways in which we can alter these genes to provide better health. Never have there been so many good therapeutic treatments and useful surgical advances. We seem to have reached the pinnacle of scientific success and the only potential problem is one of the financial cost of these new advances.  Or is it?

These scientific medical advances have played a definite part in the increasing life span of people in developed countries, and could improve life expectancy in developing countries as well if only the resources and political will were available. People in the developed world have less disabling morbidity and longer life spans, so that must be a success. Yes, of course it is, up to a point. One of the less obvious costs of these advances has been the necessity of adopting a scientific humanistic world-view within which medical science can observe and manipulate the world. This states that we live in a closed physical domain where everything can be understood by cause and effect explanations which are all open to mankind’s powers of reason.  This has led to a reductionist form of rationalism relegating everything that cannot be “proved” by observation and experimentation to the non-scientific metaphysical world where “facts” are replaced by “faith”. This view of faith is not used correctly because most of science itself is built on faith – that is there are basic scientific assumptions which have to be accepted as true because they themselves cannot be proved.

Development of alternative views
Confidence in such rationalism began to be challenged among philosophers as long ago as the eighteenth century.  However, the reliance on analytical method and the expectation that science can provide the answers has persisted much longer among both scientists and the general public.  After more than a century of uneasy relations with the major religions, especially Christianity, physical science has now emerged as the main provider of beliefs and ideas about the world to people living in Western society.  When faced with a personal crisis, people living in Europe and the USA,  are now more likely to consult their family physician than a minister  or  priest, to use Prozac rather than prayer.  Science and medicine are credited with the ability to colonise outer space, cure cancer, develop unlimited quantities of sustainable fuels, and prevent genetic disease. 

To counter this success story of medical science there is increasing evidence that patients report suffering more ill-health than in the past. This may be a softening of people’s expectations so that they put up with less pain and inconvenience, or it may be due to those physical problems which science has solved being replaced with other illnesses and health issues that are resistant to these advances. It has been reported that up to 50% of the population in developed countries are prepared to consult an alternative practitioner for health issues as the “western” model has not been sufficient for their health needs. We are now said to be moving into a new world-view, that of post-modernism. This way of interpreting the world has evolved through the past four decades in Western society, and reflects an increase in the prominence of individualism, a rejection of paternalism and authoritarianism, and a sense of the complexity of life in societies. This view of the complexity of life has begun to question many of the assumptions of the scientific humanistic view-point, especially when it comes to considering the health of an individual person. Ill-health can now be described in social or personal terms as well as scientific ones. The power of the mind over the body is stressed and many people believe in the importance of spirituality. How can we make sense of all these strands and use them for our benefit?

Principles of whole-person health care
Over the past decades there have been several movements within medical practice which have sought to bring together the best of the physical scientific view-point with a person-centred approach, in which the experience and strength of the individual is allowed to play a part in creating a healthy life in spite of increasing disability and eventual death which faces all of us at some time.

Whole-person medicine seeks to bring together the best of these post-modern health care expressions whilst not losing the benefits of a physical scientific approach.  Starting from the base-line of the best Evidence Based Medicine the additional set of beliefs or principles upon which a whole-person approach is based are set out below. A fuller description of these principles is contained in the next chapter

Any model of medical care starts with a statement of the anthropology to be followed. This is a description of how men and women are made and function. The current western medical model is largely based on a scientific humanistic anthropology where man is considered as a superior kind of animal with highly developed intellectual, emotional and social components. A whole-person understanding of anthropology accepts that the physical component of people has many similarities to the animal kingdom, but the person-hood side is well developed into a psyche (mind and emotions) and spirit. Thus any understanding of ill-health in a whole person model demands a description of the problem in physical, psychological, social and spiritual terms.

Definitions of health
If we include spirituality in our model of ill-health we can no longer define health as the absence of a patho-physiological disease. Genetic science has opened our eyes to the fact that most of us are “diseased” before birth. When any person is examined closely you can find some evidence of disease within them, that is there is evidence of a patho-physiological process which has already, or will in the future, cause ill-health. Nor can we use a definition that talks of freedom from symptoms and suffering – for studies have shown that we all have some pain or physical symptoms of dysfunction almost every day. Rather we need to begin to consider health as the way we adapt and cope with our internal and external environments. Being healthy is more about managing the health problems we have rather than the absence of any problems. (Put refs in here)

Historical understanding of health

Very brief historical review – although most beliefs are still present in the world today
Make our understanding relevant in a wide variety of cultures, societies and belief systems
Mystical – spirit world or the will of allah
Natural causes – environment (Aristotle?)
Sin and wrong life-style
Development of scientific humanism
Laboratory based science and pathology
Limitations of this sort of definition – OK so there is coronary artery disease on PM – but why?
WHO definitions and later amendments

Why do we need a definition of health?
Our aim is to promote health and combat disease.
We need to understand a broad view of health otherwise we can be guilty of helping improve health in one aspect but making it worse in another. Simple example of this – coronary stent – releases one person and binds another with fear.

So where do we begin?
The health status of a person may be influenced by three dimensions –

Environment               The environment in which the person lives will have a profound effect on their health –
                                    Poverty or wealth
                                    Political system and injustice, social and cultural
                                    Housing
                                    Climate  etc etc
Physical body              Our traditional western medical way of defining health by the presence or absence of disease, pathology and symptoms
Person                         The person inhabiting the body will have a profound effect on health through their beliefs, attitudes and actions.

A broad definition of health which encompasses these three dimensions is more likely to lead to treatment goals which are likely to be more effective in improving the overall health of the patient. Thus advising a person to follow a particular diet if they are too poor to obtain it will not be effective. Likewise giving a patient antibiotics when they believe that they will poison him is likely to lead to non-compliance.

Anthropology
Throughout the world, in most religions and in people with no religion there is an understanding of the concept of thinking about ourselves as body and soul or spirit.. Most people still have a dualistic approach to humanity, which although based on a truth can lead to very un-helpful thinking. We can consider as an illustration of this concept the way in which anatomy and physiology has been taught at medical school in the past. The two subjects were completely separated in the past, so that anatomists could describe the structure, but know little of the function. Physiologists cared less about the structure and examined the function. However both aspects work completely together – there can be no function without the structure, and the structure has no purpose without the function. So with personhood – the physical being enables the person to exist as it’s function – you can’t have one without the other. We are a unity.

We are indivisible beings with many different functions and abilities which mainly include the addition of reasoning and intellect and a spiritual capacity to a physical body. As the Hebrew concept has taught us we are indivisible and a whole being. I cannot divide off my soul or my spirit and nurture that at the expense of my body. Maltreating the body also maltreats the spirit, and vica versa. Every action has spiritual, personal and physical dimensions.

Ill health is the common end pathway of any disorder or dis-ease in the person, whether in the body itself or in their mind, emotions, environment or spirit. The whole person functions together.

Health and wholeness
We can no longer define health as the absence of disease. Genetic science has opened our eyes to the fact that we are “diseased” before birth. When any person is examined closely you can find evidence of disease within them. At the last count I had something like 16 diseases within my person – and yet I consider myself to be healthy. Nor can we use a definition that talks of freedom from symptoms and suffering – for studies have shown that we all have some pain or physical symptoms of dysfunction every day. Rather we need to begin to consider health as the way we adapt and cope with our internal and external environments. Health is more to do with how we manage our health problems rather than the absence of presence of those problems.

Health is a dynamic in which we grow and mature throughout our lives, and is the strength we have to enable us to live life to the full and complete the tasks to which we have been called. It involves an equilibrium between ourselves, and the world around us which is based on right relationships and values such as respect and loving kindness. Health is a therefore a journey through life and into death where we always seek to adapt to disability and suffering and cope with pain and difficulties in a way which matures us.

The dynamic aspects of health
If we are to understand a person’s health then we need to consider the following seven areas which make up our health status –

1. Self-esteem
1. What it is to be human. Self awareness.
2. The integration of the spiritual and physical within us.
3. How we relate to ourselves,

2. Coping and adapting

We all have some diseases within us, even from the day of our birth. Some of these are potential and may never be realised (I may have the genetic predisposition to lung cancer but reduce my risk of getting it by not smoking). Other diseases are relatively trivial in our society (such as my myopia which is well corrected by glasses, but prevented me from a career in the Royal Navy). Other diseases come with advancing age so that by the time of death a pathologist can list dozens of disease processes in various stages of advancement. Some diseases I have brought upon myself through my lifestyle (I think I am a little over-weight but my doctor says I am obese). Some diseases remain hidden for many years and cause few symptoms in the early days (such as high blood pressure). We also all have symptoms both physical and psychological for much of the time. So in the presence of a continuous presence of disease and symptoms, pain and suffering, our health depends on how we process, adapt to and cope with these health problems.

Various measures such as the locus of control or sense of coherence tests have attempted to demonstrate how much a person is able to take control of their own responses to challenges, and so improve their ability to function and enjoy life despite disabilities and difficulties. Work by investigators such as Aaron Antonovsky, who looked at women surviving the Holocaust, has demonstrated that where some people crumple and suffer health consequences for the rest of their lives, others are able to rise above the horror and become stronger and so less likely to encounter health problems later in life. Thus a healthy person is one who when faced with disease, disability, suffering or pain is able to find inner reserves which then strengthen the person for future challenges.

3. Self-fulfilment or Courage

Self-fulfilment has three important steps. First you need to have a correct self-awareness in which you understand your strengths and weaknesses, your gifts and abilities. Second these abilities need to be translated into the possibilities and dreams, the heights to which you could scale. But then third these goals and dreams need to be seen as an impossible or very difficult target to reach, but one which must be constantly aimed for. Thus we never achieve complete self-fulfilment, we never arrive at the end of the road – there is always further to go. Thus hope and realism need to be balanced throughout life to provide sensible goals for each stage of our existence. A healthy person can re0evaluate their situation and adapt their goals accordingly.

An important aspect of this concept is the fact that all people are made with creativity within them. The ability to create seems to be an essential human attribute. Each person has to discover where their creativity lies and use this in their life in some way. It may be obvious as in having and bringing up children. Or it may be more hidden in performing a difficult task well under trying circumstances.

The courage to take risks and seize opportunities – the enemy is fear
Hope and a future orientation
Element of pilgrimage

4. Relationships

The role of relationships in our lives constantly needs emphasising. We are made both by and for relationship. God created us to be in relationship with himself, and then so designed our world that we ourselves are formed as persons through our relationships. In recent times we have seen the equal dangers of treating people as isolated individuals (there is no such thing as society, just a collection of individuals, said Margaret Thatcher) or seeing individuals as insignificant parts of a controlling society as in communism.

Over the last few decades there has been a growing understanding amongst theologians that there is a third way which is more biblical. Here the person is constituted at the most fundamental level by his or her relations, both to others and to God. Christians have traditionally grounded their affirmation of human dignity and personhood in the creation of man in the image of God, yet what it means to be made in the image of God has been much debated. In the Augustian tradition a person was construed in their own relationship with themselves. Thus we began by “knowing our own mind”. However within theological study there has recently been a shift towards the understanding of the importance of relationships in the development of personhood. John Macmurray proposed a complete change of standpoint from the primacy of the cogito to the primacy of the self as agent and constituted by his relationship with another person. In his chapter Persons in Relation (in the book edited by Schobel and Gunton in1991 called “Persons Divine and Human”) MacMurray has said “The self is constituted by its relation to the other; that is, it has its being in its relationship; and that this relationship is necessarily personal”. The being of God, in whose image the Bible says we are made, is understood as a Trinity, in order to exhibit a relationship within the Godhead.  In creation God made us in his image, and then calls us to be in relationship with him.  The broken relationship consequent upon the Fall and man’s sinfulness, is then redeemed through Christ’s work on the cross.

The understanding of man as a relational being is one of the main themes of the work of Alistair McFadyen and is developed in his book The call to personhood (Cambridge University Press 1990).  McFadyen argues that each person can only be understood in social terms, thus “we become the people we are through our relationships with others”.  After describing the two common models of personhood (the models of individualism and collectivism as quoted above), he describes a third way in which a relational model of personhood is developed which does justice to personal freedom and autonomy whilst simultaneously acknowledging the role of social relations and institutions.  From the outset he stresses that this model does not just encompass inter-personal relationships but also includes social, cultural, historical, political and moral relationships.

This concept of a person is both dialogical (formed through social interaction, through address and response), and dialectical (never coming to rest in a final unity, if only because one is never removed from relationship). Talk of how human beings have their being in our society has been so completely secularised that we find it increasingly difficult to talk of humanity with reference to God in a way which is meaningful in our contemporary situation.  It is my belief that this missing dimension makes a real and important difference to our health and to our every day practice and mode of living.

5. Faith and belief

An important part of our health status concerns what we believe in.  It seems that we are made to work through faith.  We develop a world view which describes what we believe in. However in order to act on our beliefs we need to move, and this acting on our beliefs we can call faith. Everyday we have to put our faith in many things, otherwise we would never get out of bed. So assuming that this is correct and we live day by day thought acts of faith, does it matter what we believe in?  Is some belief better than others, or is it all relative?

Understanding the truth about us and our world is the aim of all religions and belief systems, and each person believes that there own version is the best (but then they have to don’t they?). As doctors we constantly espouse that our way (the western scientific model of illness) is the correct one and seek to get people to follow our advice with pills and medical interventions. Of course we are well intentioned and really do believe what we practice. But what of the growing alternative medicine field – where equally intelligent and committed people believe and practice quite different things. Is it all the same in the end – does whatever you fancy do you good?

There are two parts to the answer to this question. In the first part it may be argued that it doesn’t matter what you believe in, it is the power of belief itself which makes you better. This takes us into the whole area of the placebo response which has been argued to account for a significant proportion of the good done to us by both conventional and alternative medical practice. The power of belief affects our internal coping mechanisms and either makes us better, or helps us to feel better.

However the second answer to the question has to draw distinctions between activities that definitely do us harm, and those which may be beneficial or neutral to our health. Let us take a simple example using diets. All sorts of food allergies, over-indulgence or shortages of essentials in the diet have been put forward as causes of ill-health. When starting a new diet most of us feel better at first (perhaps the placebo part), but then for our health to really improve in the long term the diet we are following must contain certain elements. Thus a diet with no fibre, minerals or vitamins will eventually lead to serious ill-health. The composition of a healthy balanced diet has been well researched, and we should all eat this (with the obvious exception of people who have known allergies to certain foods) in order to maximise our health.

6. Maturity

So health is a journey rather than a state. We move on through different levels of health. We develop a story which we are always willing to tell to others. This health narrative is an important part of the process of being healthy. The story needs to reflect our response to the illness, but also be truthful as to the causes of the problems. Here we enter the difficult area of sense of coherence and locus of control. Two expressions which seek to encapsulate how much control the person has over their own health. With a good sense of coherence and an internal locus of control the person is able to “do something for myself” to make them healthier. With a poor sense of coherence and an external locus of control the person does not believe that they have any role in making themselves better, but quickly adopt the “sick role” and expect others to make them better.

Thus two people with exactly the same disease process can have completely different understandings of their health. One can quickly follow medical advice, and do numerous things to make themselves fitter over-all, and so minimise or adapt to the pathology which is present. Others will believe that the disease processes cannot be influenced or altered, except by medical intervention, and so become passive.

Health measurements change with age – if as a 65 year old my present good health was in a 25 year old he would be unhealthy (Express this better !!)

7. Transcendent Relationship

For Christians, Jews and Muslims the final aspect of health is their relationship with God. This of course is a two way affair and we must first recognise that we are often baffled and confused by God’s relationship with us. Many Christians feel that God has deserted them, especially at times of pain and suffering.. It does seem that God uses illness and suffering to help us grow and mature. God’s ultimate desire seems to be for us to enjoy heaven, starting here and continuing after death. Some people seem to reach this point even in the midst of great pain, but for most of us we are still struggling on the journey.

We seek for shalom – that peace with ourselves, with others and with God which is the ultimate aim for us all.

HEALTH IS ………
So we can summarise our understanding of health with the statement that health is …..

1. understanding the truth about one’s self, having a right self-awareness
2. the ability to adapt to and cope with changing situations, both internal and external;
3. being fulfilled, and completing one’s goals in life;
4. being in right relationships with others;
5. putting one’s faith in the right things;
6. completing the journey through life towards maturity,
7. being in a right relationship with the Transcendent

NOTE – this is unbalanced, I must emphasise that health is to do with diminishing or curing when possible the patho-physiological processes which lead to illness. In the same way I need to do the same with the psychosocial, and thirdly with the spiritual, SO re-order all of the above into these 3 categories.

Telling the whole story
Strength to be human – the strength to live and die
Chris’s concept of an “Overwhelming”- where one element completely overwhelms the person’s ability to be healthy. This may be external such as in extreme poverty, in the body such as extreme pain or in the person such as extreme depression

Final chapter in life of a healthy death
Shalom – wholeness and well-being – the space and strength to live life to the full

Measurement of Health
It’s difficult to measure a story or a journey, however some of the aspects of our definition of health do enable us to use both quantitative and qualitative measures to describe them. Some of these measurements will be physical, others behavioural, cognitive and spiritual. We can encourage people to tell the story of their health in a Health narrative which seeks to demonstrate the progression of understanding and movement towards the goal of Shalom – peace in the midst of the clamour of life.

Chris suggested putting the measurement and assessment of each area of health within the paper – I need to work on this

Health is therefore a dynamic in which we grow and mature throughout our lives, and is the strength we have to enable us to live life to the full and complete the tasks to which we have been called. It involves an equilibrium between ourselves and the world around us, which is based on right relationships and values such as respect and loving kindness. Health is a therefore a journey through life and into death where we always seek to adapt to disability and suffering and cope with pain and difficulties in a way which matures us as whole people.

So we can summarise our understanding of health with the statement that health is …..

1. understanding the truth about one’s self, having a right self-awareness
2. the ability to adapt to and cope with changing situations, both internal and external;
3. being fulfilled, and completing one’s goals in life;
4. being in right relationships with others;
5. putting one’s faith in the right things;
6. completing the journey through life towards maturity,
7. being in a right relationship with the Transcendent (God).

Patient centred care.
Illness is the patient’s experience of the disease and other health processes working within them. These symptoms are interpreted by the patient and affect the way they live. Each person is unique and a pain which one person would shrug off as they continued working may force their neighbour to stop work and retire to bed. Each person’s health story is different, but in the whole-person approach we validate their story by listening to it, help them to understand its complexity and then give them the power to change their story to one that is healthier – that is enabling them to function more effectively than before. Above all else we seek to maximise the person’s ability to understand their health story and so participate fully in the process of becoming healthy again.

The importance of narrative – the true health story
The narrative approach to medicine has emphasised the importance of the patient’s experience and understanding of their health problems. The story they tell reflects their beliefs about health and their understanding of how they came to be ill. It is in the telling of their story that the patient comes to realise how they got to where they are, and should enable them, with appropriate professional help, to re-write their future story to one that is healthier.

An understanding of the true health story is an essential first requirement for going on to change that story. The understanding of the patient comes mainly through the telling of their story to the listening health professional who can help the patient reflect on the events and situations which led up to the problem, and the likely factors which will keep the person in ill-health if they are not changed.

Making a diagnosis in whole person terms
In the bio-medical model the diagnosis is usually made in patho-physiological terms. Thus the observed alterations in tissues, organs and physiological functions are used to name the condition the patient has. In a patient-centred approach the illness is more usually described in terms of health problems, recognising that some of these problems may have a biological basis, and others being psychological or social problems. The whole person approach goes one step further and recognises the complex, multi-factorial nature of the causes of ill-health. Thus a headache, whilst having a common final physical pathway, may be caused by a physical disease (a tumour), or a psychological condition (depression), or a social condition (stress due to over-work) or finally a spiritual condition (a broken relationship due to hurt and unforgiveness). It seems obvious to state that the treatment follows on from the diagnosis, so it is important to unravel the causes of the problem, especially when several co-exist, so that treatment may be effective.

The integrated therapeutic team
The doctor is no longer a “single-handed” healing professional but one of a growing team with a wide variety of skills and training. The doctor may still be at the centre of this team but he or she must no longer act alone. An integrated team including nurses, counsellors, carers and other therapists are needed to help patients regain their health. An integrated team demands good communication and support between the professionals, carers and patient.

Healing therapeutic relationships
Much research has centred on the value of a trusting and continuing doctor/patient relationship, with the person of the doctor being seen in the role of healer. Perhaps we need to talk of the relationship between the patient and all the people involved in caring for them. Therapist is a term which can cover doctor, physician, counsellor, physiotherapist and all others including carers. It therefore seems best to reduce the use of the individual terms like doctor, nurse, chaplain and counsellor and assume that everyone who enters into a “healing relationship” with a patient is a therapist for that time and encounter. We therefore make an immediate assumption that no one person can be “the therapist” for a patient as so many different skills will be needed in a whole-person approach. However we do also need to recognise the individual skills and training required in a therapeutic relationship and so retain the well known titles except when talking generally.

These healing relationships require a level of trust to overcome the vulnerability felt by patients as they share intimate details of their life experience. This trust depends on acceptance, respect and affirmation from the therapist. Each therapist needs to concentrate on the patient and participate in their narrative as an informed and supportive friend on the journey.

Self-help
A vital part of empowering patients to become healthier is the provision of tools and methods which the patient can use themselves to improve their health. There will be times when the patient needs to be dependent on therapists and carers, however at all times we should seek to involve the patient, encourage and empower them to be fully involved in the process of becoming healthier.

Successful outcomes
The obvious first successful outcome is that the person is healthier, although the extended definition of health is needed (as outlined in section 2 above). Thus the patient has increased self-awareness and power to change their health story. They have a greater ability to help themselves in therapeutic terms and also the ability to help others. They will have matured in their ability to cope with distressing situations and also learned to adapt themselves and their environment. Finally they have more courage and security to face life’s challenges.

We can summarise the benefits of this whole-person approach as the following key outcomes would be sought.

By the patient

1. Recognition of the Wholistic nature of the person, where the patient can acknowledge that their thinking, feeling and values does influence their state of health
2. Recognition of the role of relationships, and the effect these have on life in general, and ill-health in particular
3. Understanding the separation possible between “me” and the disease processes going on in the body
4. Greater self-acceptance, understanding strengths and weaknesses
5. Understanding of how stress works in their lives to reduce health status
6. Understanding of what health is – not absence of disease and symptoms
7. Learning about coping mechanisms, and what methods the patient uses to cope with stress and illness

By the doctor

1. Seeing the whole-person, their fears, hopes and values
2. Seeing how to support and strengthen weak areas within their coping strategies
3. Seeing how to provide help in dealing with relationships, past hurts and wrong understandings which impact health and health behaviour
4. Fitting in therapy to the individual, so increasing compliance and patient cooperation with therapy
5.  

Health, peace and well-being
Finally we need to recognise that good health is not an end in itself, but a part of the rich tapestry of life. Many people have chronic illness and disabilities, yet each of these can maximise their health status. It is the main objective of a whole-person approach that each patient can arrive at a place of inner peace (Shalom) and well-being. The process of health care therefore lasts until death, and the right balance needs to be struck to avoid the danger of over-medicalising life’s problems, and on the other hand ignoring hidden health issues which reduce the quality of life.

Summary
These 10 principles form the basis of a whole-person approach. This is definitely not seen as an alternative approach to the usual medical model but rather a complementing and completing of the physical scientific approach, which on its own is insufficient to meet all of the health needs of people. Thus it is an integrated model of health care taking the best of medical science and adding a person centred approach with an understanding of the multi-factorial nature of ill-health and a diagnostic approach which recognises that people are spiritual beings as well as physical ones.

Whats missing??

WPM seeks to combine the best of EBM, the understanding of the psychological, emotional and social aspects of health with an understanding of the contribution to health by the spiritual aspects of mankind. Thus learning from several “post-modern” movements we also see the importance of being patient centred, using narrative effectively etc etc

At first sight this just looks like a hotch potch of every latest fad tacked onto our usual medical model, but it is more – as you seek to look at the whole it becomes more than the sum of the parts. New understandings can be added as it is in the early stages of development.

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