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Spiritual care: whose job is it anyway?

Article Excerpt
Abstract: The use of spirituality and religion in coping with illness is widespread among primary care patients. Although the overwhelming majority of healthcare providers agree that they should be aware of patients' spiritual beliefs, that these beliefs may influence their healing, and that patients benefit from spiritual care, there remains considerable debate about who should inquire about spiritual beliefs and deliver spiritual care. The authors, a physician and a chaplain, propose that, in general, the role of the physician is to assess spiritual needs as they relate to healthcare (ie, briefly screen) and then refer to a professional pastoral caregiver as indicated (ie, to address those needs). The chaplain is the spiritual care specialist on the healthcare team and has the training necessary to treat spiritual distress in all its forms. Seeing the physician as the generalist in spiritual care and the chaplain as the specialist is a helpful model.

Key Words: chaplain, religion, spiritual care, spirituality

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In recent years, the role of spirituality and religion in the economy of health has been broadly acknowledged. Between 85% and 93% of physicians agree that they should be aware of or consider a patient's religious and spiritual beliefs (1,2). Of all primary care specialties, family physicians are the most likely to be sensitive to these issues. (1) Even those who dispute the soundness of the scientific evidence linking religion and health agree that the sick and their loved ones can benefit from spiritual care. The Joint Commission on the Accreditation of Healthcare Organizations mandates that healthcare institutions ensure that patients' spiritual beliefs and practices are assessed and accommodated. (3)

There is little disagreement any more in the healthcare community about whether spiritual care should be part of the treatment process. In many forums, the question has shifted to how spiritual care is to be provided and, more specifically, who should provide it. Spirituality might best be defined as "... the personal quest for understanding answers to ultimate questions about life, about meaning, and about relationship to the sacred or transcendent, which may (or may not) lead to or arise from the development of religious rituals and the formation of community." (4)

This question of who should provide spiritual care can be contentious for several reasons. Every major profession...

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