Discussing Religious and Spiritual Issues

As patients approach the end of their life and grapple with their mortality, their spiritual and religious concerns may be awakened or intensified. Although some physicians may be uncomfortable discussing a patient's spiritual and religious concerns, they can listen respectfully without judgment or discussion of religious views. Patients who believe that the physician really understands their concerns no longer feel isolated or alone in their final days (Low et al., 2002).

One way to approach this issue is to ask the patient, "Is faith or religion important to you in this illness?" In a study of patients with advanced cancer, 88% reported that religion and spirituality were important factors in adjusting to their illness (Balboni et al., 2007). Although religious coping can offer patients a sense of meaning and comfort when facing a life-threatening illness, it is somewhat surprising that a high level of religiousness is associated with preference for aggressive end-of-life care such as mechanical ventilation. These patients may have a greater trust that God will heal them through the treatment even when near death (Phelps et al., 2009).

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