Over time, Western medicine has gradually separated the physical from the spiritual. But when medicine confronts life-limiting illness and the promise of a cure dims, another approach is required.

Confronting dying often brings with it questions such as, “Why me?” or “What will happen to me when life ends?” or “What has my life meant?” These are inherently issues of the spirit, not issues for biology or chemistry. Physicians and other health care providers increasingly recognize that good care of the dying is as much or more about these questions as it is about the relief of pain and symptoms.

• The word “religion” is often identified with adherence to a particular set of institutionalized belief systems and for some has a suggestion of the supernatural. The term “spirituality” is a more neutral term through which we acknowledge our common human need to find meaning in our lives and in our relationship to something beyond ourselves.
• Spirituality is an expression of how a person relates to a larger whole–that which an individual perceives as greater than him- or herself. The nature of this transcendent purpose can be expressed in different ways. For instance, it might be expressed through a specific religious tradition or, perhaps, through a regard for nature. For another person it might be expressed through connection to the human family itself or in some other way.
• Spirituality provides a source of meaning and understanding about the significance of being human. It addresses the question of “Why am I here?” An expression of spirituality can occur without any specific religious belief.
• Spirituality often contains habits, rituals, gestures and symbols that can help a person interpret and manage existence. Some of these may be acquired through or adapted from a specific religious tradition. Others may be ones that a person, family or community has developed.
• Religion, itself, plays an important part in the lives of Americans. A 2001 Gallup poll found 95 percent of those surveyed believed in God; 68 percent indicated they were members of a religious institution, and 44 percent had attended one in the past seven days. 58 percent said that religion was “very important in life.”
• Increasingly, medical schools are realizing that addressing spirituality can be an important and useful part of patient care. 61 medical schools now include some teaching about spirituality and medicine.
• In medical school courses on spirituality, students learn to work with many facets of spirituality and focus on the clinical integration of these themes into pregnancy, childbirth, chronic pain, psychiatric illness, addiction and dependency disorders, disability, and care of the dying.
• People want their doctors to ask them about spiritual concerns. A 1996 USA Today survey found that 63 percent of those surveyed believe it is good for doctors to talk to patients about spiritual beliefs.
• Research increasingly shows that spiritual practices have a positive effect on overall health and well being. By providing social support, such practices buffer stress and enhance coping.
  • Doctors should concern themselves with patients' spirituality because: They will gain a deeper insight into the patient's experience and into the person that patient is.
  • Understanding the patient's spiritual journey provides a context for making medical decisions. When a patient is near the end of life this can be especially crucial.
  • It helps doctors to limit suffering and not abandon the patient. Encouraging a patient to express spiritual pain is one way to help heal a person's spirit, especially when cure is no longer possible. They may help a patient find other resources and assistance, such as arranging a meeting with a chaplain or allowing a family and patient to conduct devotions in a hospital setting, for example.

Editor's Note: This article was originally published on www.lastacts.org, the Web site for Last Acts, formerly a national program of the Robert Wood Johnson Foundation. Be advised that the content of this article might be dated or inaccurate. The Foundation is reprinting the article here as a matter of general and historical interest.