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Spirituality Presents a Paradox in End-of-Life Care

Cheryl Clark, for HealthLeaders Media, May 9, 2013

In their paper, Balboni and co-authors rhetorically ask why this belief in the potential for "miraculous healing" might result in "more aggressive medical care, when one might rather conclude that it should motivate a belief in divine miracles that do not require medical technologies?

"One possibility is that religious people consider medicine to be a primary means of divine intervention," according to a telephone survey in the Southeast, 80% of whose respondents "endorsed a belief that God acts through physicians to cure illness. Hence, religious congregations may view choosing to withhold medical technologies as curtailing the principal avenue by which divine healing can take place or even taking the trajectory of the person's life out of 'God's hands.' "

Additionally, religious communities, she says, may emphasize "hope found through suffering," which may compel patients to fight their diseases.

Costs Not Quantified

Balboni's paper did not quantify the cost of care for these patients during their last months of life, a defect in the report and a topic in an ongoing research project, she says. But it's a safe bet that aggressive care is much more expensive than a palliative or hospice approach.

So how do we fix the problem? For starters, Balboni says that more funding for hospital chaplaincy programs might be a good start. But medical teams need to reach out to religious communities to improve communication and education.

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4 comments on "Spirituality Presents a Paradox in End-of-Life Care"


David Dismas (5/14/2013 at 2:16 PM)
Sadly I think that clergy are no more comfortable with death than the rest of the population ... what may appear to be pushing for the miracle may actually be avoiding the obvious at all costs. Fortunately, the hospital and hospice chaplains have [hopefully] worked through their issues with death and are in a better place to help the dying. Alas, I wish there was more outreach by those chaplains to help parish clergy process their issues around death and dying with an end towards better pastoral care.

Rev. Porch (5/10/2013 at 11:36 PM)
It has been my experience as a pastor, that families seeking aggressive care are the same ones who aggressively seek the pastor to be there. Are the researchers making a false assumption about cause and effect? Is there an underlying cause that effects the level of spiritual support and the level of medical care? Does aggressive medical care cause the pastor to show up more often? In my experience the answer is yes. I believe the level of pastor care and medical care are related, but both are the results, not the cause.

Peggy Salvatore (5/9/2013 at 5:11 PM)
This exactly corresponds to an experience I am having right now with my dying uncle. We have a faith-based family, and they are taking extraordinary measures. I found this perplexing, but this explains it.