Spirituality, religion, and healing in palliative care
Section snippets
Spirituality and religion
Spirituality can be defined broadly as that which gives people meaning and purpose in life. The definition that is used as a basis for medical school courses on spirituality and health is as follows:
Spirituality is recognized as a factor that contributes to health in many persons. This concept is found in all cultures and societies. It is expressed in an individual's search for ultimate meaning through participation in a religion, but it can be much broader than that, such as, belief in God,
Data on the role of spirituality and health
There have been numerous studies on spirituality/religion and health [5], [6], [7], [8]. That spirituality is central to the dying person is well recognized by many experts and, most importantly, by patients. Several national surveys have documented patients' desires to have their spiritual concerns addressed by their physicians. A 1990 Gallup Poll [9] showed that religion, one expression of spirituality, plays a central role in the lives of many Americans. A more recent Gallup survey [10]
The whole person
Beginning with Plato, Western philosophy describes the human being as consisting of two separate parts: The body is the animal in us, and the mind is what makes us distinctly human. Assuming that dichotomy, a stock issue in Western thought has been the “mind-body” problem—in other words, if the body and mind are separate, how are they connected? Early Christian sources assumed a similar dichotomy between body and soul. This influenced scientific thought as well, and during the Renaissance
Community
There is an increasing emphasis in health care today on viewing the patient as part of a larger picture, part of a larger circle of family, friends, religious or spiritual groups, pets, and others. Not only are people integrated in their personal faculties, they also are integrated into families and communities. It is mistake to think of people as isolated individuals. From the moment we are born, we are part of other people's lives. We have a strong need to interact with others, and that is
Suffering
Suffering is intrinsic to the human condition [3]. People experience suffering on all levels—physical, emotional, social, and spiritual. Cassell [35] defined suffering as a state of severe distress associated with events that threaten the intactness of personhood. At the root of suffering is a sense that “what ought to be whole is being split apart” [36]. People with serious illness or people who are dying suffer not only physical pain, but also a separation from self, from others, and from God
Healing
Society tends to equate healing with cure. When illness is incurable, there is a common misperception that healing also is not possible. Yet there is an opportunity for healing, even in the midst of an incurable illness. Healing can be manifested as inner peace; peace and reconciliation with God, self, and others; acceptance; letting go; and, finally, a peaceful death.
In Christianity, healing can be achieved through one's relationship with Christ and others. Healing occurs when one deepens the
Religious and spiritual values
Spirituality and religion may help people cope with suffering by finding meaning in the suffering. Spiritual and religious values in themselves may help people navigate illness and the process of dying. Three important values—forgiveness, hope, and belief in life after death—may play a role in the health care of patients. Hope is a powerful mediator of well-being. Hopelessness is associated with increased suicide and depression, but hope has the potential for supporting positive coping [45].
Medical ethics at the end of life
Each of the three major religious traditions discussed here offer different perspectives on ethical issues related to end-of-life care.
Before death
In addition to ensuring that the person has left a will to distribute his or her property and praying with and for the patient and visiting often, the only specific ritual that Judaism mandates is tzidduk ha-din, a prayer said by or for the patient in which the patient prays for God's forgiveness and accepts God's judgment.
For Catholic Christians, sacraments are a sign of God's presence. They are a source of grace and strength. For the sick and dying, frequent receipt of the Eucharist provides
Practical tools for spiritual care
Spirituality can be defined not only as the relationship with the transcendent, but also with others. The connections that physicians, other health care providers, and families make with the ill and dying patient is, at its root, spiritual. The care that the physician provides is rooted in spirituality through compassion, hopefulness, and a recognition that, although a person's life may be limited or no longer productive, it remains full of possibility [56]. Although a person no longer can have
Summary
Spirituality is essential to the care of patients. In end-of-life care, attending to spiritual needs ensures that a dying patient has the opportunity to find meaning in the midst of suffering and to have the opportunity for love, compassion, and partnership in their final journey. This article summarizes some of the beliefs and traditions from Judaism, Islam, and Christianity that affect people as they face their own dying and mortality. People who do not participate in any formal religion also
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Spiritual Considerations
2018, Hematology/Oncology Clinics of North AmericaCitation Excerpt :Thus, all clinicians should address patients’ spirituality, identify and treat spiritual distress, and support spiritual resources of strength. In-depth spiritual counseling and exploration should be referred to the trained chaplain.14,16 As with other aspects of oncology care, this multidisciplinary collaboration is important when it comes to addressing spirituality.
“To a better place”: The role of religious belief for staff in residential aged care in coping with resident deaths
2018, European Journal of Integrative MedicineState of the Science of Spirituality and Palliative Care Research Part I: Definitions, Measurement, and Outcomes
2017, Journal of Pain and Symptom ManagementHow Islam Influences End-of-Life Care: Education for Palliative Care Clinicians
2016, Journal of Pain and Symptom ManagementCitation Excerpt :In a survey of 3412 Americans, only 54% correctly identified the holy book of Islam (the Quran), and only 52% correctly identified the holy month of Islam (Ramadan).3 If nearly half of Americans do not know simple facts about Islam, it seems likely that clinicians may not understand Islamic teachings regarding end-of-life care, which are just as complex and nuanced as other religions.2 At our institution, an informal needs assessment indicated a lack of knowledge of Islamic teachings regarding end-of-life care.
Components of spirituality in older adults: A phenomenological study through interviews based on dignity therapy
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