Jammin' in JAMA

As the author noted, spiritual issues arise frequently in the care of dying patients, yet health care professionals may not recognize them, may not believe they have a duty to address them, and may not understand how best to respond to their patients' spiritual needs. In distinguishing spirituality from religion, Sulmasy described the salient spiritual needs of patients at the end of life, delineated the role physicians ought to play in ascertaining and responding to those needs, and discussed the particular issue of hope for miracles, concluding that expectations of miraculous cure ought not preclude referral to hospice care nor force a plan of curative treatment (eg, chemotherapy) that a team believes to be futile. Better understanding of Mr W's beliefs and more explicit conversation regarding spiritual matters between the patient and his treating team might have provided opportunities for an improved plan of care, including enrollment in hospice.

Amy J. Markowitz, JD; Stephen J. McPhee, MD
JAMA. 2006;296:2254.