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Spirituality Presents a Paradox in End-of-Life Care

Cheryl Clark, for HealthLeaders Media, May 9, 2013

"I think there needs to be better collaboration and communication between those providing medical care of patients and religious communities, about end-of-life care, palliative care, and hospice, and what certain technologies can offer, and help them understand what their congregants are facing when they're dealing with a terminal illness," she says.

"It's hard for them to appreciate when and if death will occur. So if they're unsure, they of course want to pray for the miracle and the hope for the benefits of the medical technology."

Researching the literature, I see that this is not the first study of its kind. In 2009, Balboni and colleagues drew similar conclusions in a JAMA paper about how terminally ill cancer patients use religion to justify futile end-of-life care. In fact, there are numerous studies drawing similar conclusions.

The authors point out that their findings "emphasize the need for clinician spiritual care training, particularly given their frequent lack of training and its association with increased spiritual care provision."

Eventually, they may be able to convince their spiritually-minded patients that "choosing to withhold aggressive end-of-life measures does not constitute taking matters out of 'God's hands."


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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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.