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End of life care Resources

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The Essential Elements of Spirituality in the End-of-Life Care

Primary Author: Katrina M. Scott, MDiv, BCC, Massachusetts General Hospital

The National Consensus Projects Clinical Practice Guidelines for Quality Palliative Care, published in 2004, defines eight domains of care essential to palliative care clinical practice. The National Quality Forums 2006 document, A National Framework and Preferred Practices for Palliative and Hospice Care Quality: A Consensus Report, which is based on the Guidelines, identifies 38 evidence-based preferred practices for palliative care. This article demonstrates how the Guidelines and Preferred Practices may be operationalized in practice, focusing specifically on Domain 5 of the Guidelines, Spiritual, Religious and Existential Aspects of Care, which incorporates many pertinent aspects of hospice and palliative care related to addressing the spiritual needs of the dying patient and his or her family. In particular, the article addresses methods for assessing the need for spiritual care; methods for communicating with the patient and family about the need for spiritual care; the role of the spiritual adviser on the interdisciplinary palliative care team; the advantages of including certified chaplains on the palliative team; the need for sensitivity toward culture and religious diversity in administering spiritual care; the need for specialized palliative care spiritual advisors to build relationships with community clergy; and more.

Date Last Modified 09/01/2008 Article, Clinical practice guidelines

Bioethics for clinicians: Jewish bioethics

Primary Author: Gary Goldsand, University of Toronto

Article from the Canadian Medical Association Journal (CMAJ). The article covers different approaches to Jewish legal and ethical thinking, common ways in which Judaism might affect health care decisions, practical measures to consider when caring for Jewish patients, and provides an example case.

Date Last Modified 01/23/2001 Article, Case example/study

Patient Perspectives on Spirituality and the Patient-Physican Relationship

Primary Author: Randy S. Herbert, Johns Hopkins University School of Medicine

Article from the Journal of General Internal Medicine describing an in-depth study of 22 patients hospitalized with a life-threatening illness. The authors found that all participants stressed the importance of physician empathy, but physician-initiated conversation without a strong patient-physician relationship was viewed as inappropriate.

Date Last Modified 10/16/2001 Article

An Exploratory Study of Spiritual Care at the End of Life

Primary Author: Timothy P. Daaleman, University of North Carolina at Chapel Hill

Article from the Annals of Family Medicine describing a qualitative research study into how spiritual care is perceived and delivered at the end of life. The authors concluded that "Clinicians and other health care workers consider spiritual care at the end of life as a series of highly fluid interpersonal processes ... rather than a set of prescribed and proscribed roles".

Date Last Modified 09/01/2008 Article

Enhancing Meaning, Hope, and Dignity Near the End of Life

Primary Author: Innovations in End-of-Life Care

The November-December 2002 issue (Vol. 4, No. 6) of the journal Innovations in End-of-Life Care covered the theme of Enhancing Meaning, Hope, and Dignity Near the End of Life. It includes articles by and about Harvey Max Chochinov, William Breitbart, Zbigniew Zylicz, and Janice Mulder.

Date Last Modified 11/01/2002 Article