Skip to main content

End-of-Life Issues: Spirituality

Abstract

There is an increasing emphasis in medicine for healthcare providers to treat the whole patient. Whole patient care includes the physical, psychosocial and spiritual care of the patient. Contemporary medicine has focused on the physical illnesses of the patient, creating a large armamentarium of tools to combat disease processes. In addition, addressing the spiritual needs of critically ill patients is an important part of intensive care, particularly when the patients are dying in the hospital. This chapter will describe some differences between spirituality and religiosity, suggest some self-education tactics for physicians interested in expanding their understanding of spirituality and discuss approaches to some common requests of a spiritual nature in the intensive care unit (ICU).

Keywords

  • End-of-Life
  • Spirituality
  • Religion
  • Ethics
  • Prayer

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-319-15949-2_15
  • Chapter length: 14 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   119.00
Price excludes VAT (USA)
  • ISBN: 978-3-319-15949-2
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   159.00
Price excludes VAT (USA)
Hardcover Book
USD   159.00
Price excludes VAT (USA)

References

  1. Rothman DJ. Where we die. N Engl J Med. 2014;370(26):2457–60.

    CAS  CrossRef  PubMed  Google Scholar 

  2. Aslakson RA, Curtis JR, Nelson JE. The changing role of palliative care in the ICU. Crit Care Med. 2014;42(11):2418–28.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  3. Cook D, Rocker G. Dying with dignity in the intensive care unit. New Engl J Med. 2014;370(26):2506–14.

    CAS  CrossRef  PubMed  Google Scholar 

  4. The Joint Commission. Spiritual assessment. 2008. http://www.jointcommission.org/mobile/standards_information/jcfaqdetails.aspx?StandardsFAQId=290&StandardsFAQChapterId=29. Revised 24 Nov 2008. Accessed 16 May 2015.

  5. Davidson JE, Powers K, Hedayat KM, Tieszen M, Kon AA, Shepard E, et al. Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med. 2007;35(2):605–22.

    CrossRef  PubMed  Google Scholar 

  6. Jaul E, Zabari Y, Brodsky J. Spiritual background and its association with the medical decision of DNR at terminal life stages. Arch Geron Geriatr. 2014;58(1):25–9.

    CrossRef  Google Scholar 

  7. Kinzbrunner BM. Jewish medical ethics and end-of-life. J Palliat Med. 2004;7(4):558–73.

    CrossRef  PubMed  Google Scholar 

  8. United States Conference of Catholic Bishops. Ethical and religious directives for Catholic Health Care services. 5th ed. 2009. http://www.usccb.org/issues-and-action/human-life-and-dignity/health-care/upload/Ethical-Religious-Directives-Catholic-Health-Care-Services-fifth-edition-2009.pdf. Accessed 16 May 2015.

  9. Al-Shahri MZ, Al-Khenaizan A. Palliative care for Muslim patients. J Support Oncol. 2005;3(6):432–6.

    PubMed  Google Scholar 

  10. Ankerry RA, Clifford R, Jordens FC, Kerridge IH, Benson R. Religious perspectives on withdrawal of treatment from patients with multiple organ failure. Med J Aust. 2005;183(11/12):616–21.

    Google Scholar 

  11. Pew Research Center. “Religious groups” views on end-of-life issues. 2013. http://www.pewforum.org/2013/11/21/religious-groups-views-on-end-of-life-issues/. Accessed 16 May 2015.

  12. Bulow HH, Sprung CL, Reinhart K, Prayag S, Du B, Armaganidis A, Abroug F, Levy MM. The world’s major religions’ points of view on end-of-life decisions in the intensive care unit. Intensive Care Med. 2008;34(3):423–30.

    CrossRef  PubMed  Google Scholar 

  13. Puchalski C, Romer AL. Taking a spiritual history allows clinicians to understand patients more fully. J Palliat Med. 2000;3(1):129–37.

    CAS  CrossRef  PubMed  Google Scholar 

  14. Sulmasy DP. Spirituality, religion and clinical care. Chest. 2009;135(6):1634–42.

    CrossRef  PubMed  Google Scholar 

  15. Groopman J. God at the bedside. N Engl J Med. 2004;350(12):1176–8.

    CAS  CrossRef  PubMed  Google Scholar 

  16. Richardson P. Spirituality, religion and palliative care. Ann Palliat Med. 2014;3(3):150–9.

    PubMed  Google Scholar 

  17. Pesut B. A conversation on diverse perspectives of spirituality in nursing literature. Nurs Philos. 2008;9(2):98–109.

    CrossRef  PubMed  Google Scholar 

  18. Todres DI, Catlin EA, Thiel MM. The intensivist in a spiritual care training program adapted for clinicians. Crit Care Med. 2005;33(12):2733–6.

    CrossRef  PubMed  Google Scholar 

  19. Saguil A, Phelps K. The spiritual assessment. Am Fam Physician. 2012;86(6):546–50.

    PubMed  Google Scholar 

  20. Sulmasy DP. Spiritual issues in the care of dying patients: “…it’s okay between me and God. JAMA. 2006;296(11):1385–92.

    CAS  CrossRef  PubMed  Google Scholar 

  21. Fitchett G. Next steps for spiritual assessment in healthcare. In: Cobb M, Pulchalski CM, Rumbold B, editors. Oxford textbook of spirituality in healthcare. New York: Oxford University Press; 2012. p. 299–305.

    CrossRef  Google Scholar 

  22. Yardley SJ, Walshe CE, Parr A. Improving training in spiritual care: a qualitative study exploring patient perceptions of professional educational requirements. Palliat Med. 2009;23(7):601–7.

    CAS  CrossRef  PubMed  Google Scholar 

  23. Marie Curie Cancer Care. Spiritual and religious care competencies for specialist palliative care. 2003. www.mariecurie.org. Accessed 6 Jan 2015. p. 4–8.

  24. Coulehan JL, Platt FW, Egener B, Frankel B, Lin C, Lown B, Salazar WH. “Let me see if I have this right…”: words that help build empathy. Ann Intern Med. 2001;135(3):221–7.

    CAS  CrossRef  PubMed  Google Scholar 

  25. Quill TE, Arnold R, Back AL. Discussing treatment preferences with patients who want “everything”. Ann Intern Med. 2009;151(5):345–9.

    CrossRef  PubMed  Google Scholar 

  26. Brett AS, Jersild P. “Inappropriate” treatment near the end of life: conflict between religious convictions and clinical judgment. Arch Intern Med. 2003;163(14):1645–9.

    CrossRef  PubMed  Google Scholar 

  27. Eck DL. Chapter 7: Is our god listening? In: Encountering god: a spiritual journey from Bozeman to Banaras. Boston: Beacon Press; 1993. p. 166–99.

    Google Scholar 

  28. Sulmasy DP. Ethical principles for spiritual care. In: Cobb M, Pulchalski CM, Rumbold B, editors. Oxford textbook of spirituality in healthcare. New York: Oxford University Press; 2012. p. 465–70.

    CrossRef  Google Scholar 

  29. Pinches C. Miracles: a Christian theological overview. South Med J. 2007;100(12):1236–42.

    CrossRef  PubMed  Google Scholar 

  30. Yu C. Eye on religion: miracles in the Chinese Buddhist tradition. South Med J. 2007;100(12):1243–5.

    CrossRef  PubMed  Google Scholar 

  31. Khan F. Miraculous medical recoveries and the Islamic tradition. South Med J. 2007;100(12):1246–51.

    CrossRef  PubMed  Google Scholar 

  32. Mackler AL. Eye on religion: a Jewish view on miracles of healing. South Med J. 2007;100(12):1252–4.

    CrossRef  PubMed  Google Scholar 

  33. DeLisser HM. A practical approach to the family that expect a miracle. Chest. 2009;135(6):1643–7.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  34. Sulmasy DP. Distinguishing denial from authentic faith in miracles: a clinical-pastoral approach. South Med J. 2007;100(12):1268–72.

    CrossRef  PubMed  Google Scholar 

  35. Orr RD. Responding to patient beliefs in miracles. South Med J. 2007;100(12):1263–7.

    CrossRef  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cynthiane J. Morgenweck MD, MA .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Morgenweck, C.J. (2015). End-of-Life Issues: Spirituality. In: Jericho, B. (eds) Ethical Issues in Anesthesiology and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-15949-2_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-15949-2_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15948-5

  • Online ISBN: 978-3-319-15949-2

  • eBook Packages: MedicineMedicine (R0)