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Review Article| Volume 20, ISSUE 3, P487-504, July 2004

Spirituality in health: the role of spirituality in critical care

      The role that spirituality plays in the lives of patients has been getting more attention in research, literature, and in the education of future physicians. Increasingly, more studies are beginning to show an association between religion or spirituality and health outcomes such as hypertension, recovery from surgery, coping with illness, and the will to live [
      • Levin J
      • Larson D
      • Puchalski C
      Religion and spirituality in medicine.
      ,
      • Koenig H.G
      • McCullough M.E
      • Larson D.B
      ,

      Tsevat J., Sherman S.N., Feinberg J., Mrus J.M., Leonard A.C., Puchalski C.M., et al. Spirituality and religion in patients with HIV/Aids. VAMC & University of Cincinnati, Cincinnati, OH, VA Pittsburgh System, Pittsburgh, PA, George Washington University, Washington, DC

      ]. Other authors have engaged in a debate on the strength of the research and whether the research alone should warrant inclusion of spirituality into clinical practice [
      • Sloan R.P
      • Bagiella E
      • Powell T
      Religion, spirituality, and medicine.
      ,
      • Lawrence R.J
      The witches' brew of spirituality and medicine.
      ,
      • Cohen C.B
      • Wheeler S.E
      • et al.
      Walking a fine line: physician inquiries into patients' religious and spiritual beliefs.
      ]. At a recent consensus conference on the role of spirituality and health, a diverse group of academic physicians, chaplains, and medical ethicists acknowledged that, from an ethical perspective, a willingness and ability to address patients' spiritual issues, as they arise in the context of health care, is essential. The majority of participants felt that this attention to patients' spirituality is a need, not an amenity. Furthermore, participants felt that the recommendation for physicians to be attentive to patients' spiritual issues comes from an ethical obligation physicians have to treat the whole person and, in doing so, to respond compassionately to patients' spiritual and existential concerns. Consensus meeting participants also noted that spiritual care is not in any one person's domain, but it is the responsibility of everyone on the health care team—the nurse, physician, social worker, and chaplain—to address the spiritual issues of patients. Spiritual care, as with good medical care, should be interdisciplinary care [
      • Puchalski C.M
      • Anderson M.B
      • Lo B
      • et al.
      The development and dissemination of physician/patient guidelines on ethical parameters for incorporating spirituality into medical education and healthcare Report.
      ]. An earlier consensus group convened by the American College of Physicians concluded that physicians should extend their care for those with serious medical illness by attentiveness to psychosocial, existential, or spiritual suffering [
      • Lo B
      • Quill T
      • Tulsky J
      Discussing palliative care with patients. ACP-ASIM End-of-Life Care Consensus Panel.
      ].
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