The debate between Professors Poole and Cook appears to ignore the fact that spirituality, transcendency and individual religious beliefs expressed in prayer are historically and culturally bound to the social institution of organised religion: the first estate. Neither author acknowledges how the sociology of religion and its place in our society affects whether prayer should be shared between doctor and patient. The Christian religion has been firmly bound to the functioning of organised Western society for well over a thousand years. Consideration of the spiritual needs of patients has been part of holistic care models for decades and is present in the delivery of individualised care plans in most mental health services. However, prayer in day-to-day life does not have an individual identity that is divorced from structured religion. There is a potent social boundary here and it should not be crossed, for sociocultural reasons as well as individual professional ethics.Poole focuses on the individual boundaries that are appropriate in the doctor-patient relationship, but we have social boundaries based on our religious history that have resulted in our modern social institutions having a broad secular base. When in the UK in 2011, religious assassination of police officers occurs within 'the single-faith Christian tradition', when football managers receive bullets in the post because of their particular Christian tradition, when the UK still has regions where religion is more about the fire in the belly and less about the angst between the ears, less 'happy clappy' and more 'happy slappy', it seems a little naive of Cook to view prayer as a therapeutic tool that can exclude the history of Christianity in this country and the challenges this may pose.
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