Physicians and Patient Spirituality: Professional Boundaries, Competency, and Ethics

Abstract

Clinical studies are beginning to clarify how spirituality and religion can contribute to the coping strategies of many patients with severe, chronic, and terminal conditions. The ethical aspects of physician attention to the spiritual and religious dimensions of patients' experiences of illness require review and discussion. Should the physician discuss spiritual issues with his or her patients? What are the boundaries between the physician and patient regarding these issues? What are the professional boundaries between the physician and the chaplain? This article examines the physician-patient relationship and medical ethics at a time when researchers are beginning to appreciate the spiritual aspects of coping with illness.

Evaluating the Quality of Dying and Death

“…11 Preferences for dying and death are implicit in advance care planning informing treatment decisions at the end of life and these outcomes may need to be elicited as part of advance care planning. 56 Patients who can be identified prior to death, including patients with terminal diseases and those in hospice care, provide a means for validating proxy reports used more universally. Ideally, preference elicitation for patients should take place near death.…”

Teaching spirituality to student nurses

“…(3) Do you belong to a spiritual community? (4) How might health care providers address any needs in this area [59] ? Table 4: Methods for teaching spirituality  Lessons, seminars and small group discussions to augment learning are found to be an effective method.…”

“…One approach has gained wide acceptance. [59] Patients are invited to answer the following four questions:…”

Spirituality in general practice: a qualitative evidence synthesis

“…In the medical literature, there is considerable interest in and debate about how patients' religion and spirituality should be addressed. [12][13][14][15][16][17] Regardless of religious background, patients' willingness to discuss spiritual health issues may depend on the qualities of physicians, such as openness, a non-judgmental nature, respect for the spiritual views of others, and attitudes towards spiritual health. Patients' views of how physicians should address spiritual issues may favour a direct, principle-based, patient-centred approach in the context of 'getting to know the patient', rather than more structured approaches such as using spiritual-assessment tools.…”