Bringing the spiritual element into palliative care

Bringing more chaplains of different faiths into hospitals could help tackle the challenges healthcare providers face in providing culturally-competent medical care that addresses the religious and spiritual concerns of patients, an inter-faith symposium in Vatican City has heard.

The World Innovation Summit for Health (WISH), a Qatar Foundation (QF) initiative, and the Vatican’s Pontifical Academy for Life jointly organized the Religion and Medical Ethics: Palliative Care and the Mental Health of the Elderly symposium in Rome, spotlighting crucial issues at the point where religious and medical ethics converge.

Experts in medicine and ethics have exchanged dialogue and shared the perspectives of Islam, Christianity, and Judaism at the Rome conference, held in association with academic partners BMJ. During a panel discussion on the symposium’s opening day, Dr. Christina Puchalski, professor of Medicine and Health Science and the ‎Director of the George Washington University Institute of Spirituality and Health (GWish), said palliative care often overlooks patients’ spirituality.

In the discussion, titled Could An Interfaith Approach Better Highlight and Promote the Role of Spirituality in the Provision of Palliative Care?, Dr. Puchalski said “a compassionate presence is crucial” in helping those who are suffering, and this often comes from a chaplain who shares a patient’s faith. However, many medical systems do not give enough consideration to religion and spirituality when providing palliative care, and patients often do not have access to a chaplain.

"Patients want to be listened to and understood, and they want their suffering to be understood,” she said. "Countries that do not have healthcare chaplains face a challenge to provide the element of spirituality that is needed.”

Dr. Puchalski believes the role of volunteers in alleviating end-of-life suffering can also be overlooked, saying: “While they are not chaplains, they can provide accompaniment. We need to recognize the importance of them having the training of spiritual care professionals, in order to meet the needs of patients.”

She also said more nurses and doctors need to be equipped with knowledge of spiritual care and how it can ease patient suffering, rather than it being solely a task for chaplains.

Sheikh Muhammad Ali, a chaplain serving the Muslim community of NewYork-Presbyterian/Weill Cornell, said too few healthcare institutions have Muslim chaplains and this adds a layer of difficulty in treating people of the Islamic faith, explaining: “For some people, spirituality is rooted in religion.

“If they ask to talk to a Muslim chaplain and a healthcare institution does not have one, they will go to a community clergyman who is not trained in pastoral care, and doesn’t have the skills specific to palliative care.”

Another discussion saw experts agree that values, God. and relationships are common to all religions, and humility, dignity and compassion should be the “DNA of palliative care”.

Outlining a Christian approach to ethics and palliative care, Carlos Centeno Cortés, a consultant in Palliative Medicine at the University of Navarra Clinic, said: “What is common among all religions is that we want to help people and be at the side of the patient. 

"There is a place in hospital and hospices for religion, and diversity is a value in hospitals and medicine. We have to create a space for inter-faith religious dialogues in hospitals, and we can learn from countries – such as the US and Canada – who do this better than others.”

Dr. Mohammed Ghaly, Professor of Islam and Biomedical Ethics, Center for Islamic Legislation & Ethics (CILE) at QF member Hamad Bin Khalifa University, provided an Islamic perspective, saying: "We are not only religious beings - we are human beings. We don't deal with the patient, but the whole person; their worldview, ideas, thoughts, and convictions.”

“But what is vital is that human beings are given the best possible care, aligned with their individual beliefs”

And Dr Riccardo Di Segni, the Chief Rabbi of Rome, said: "The principle that has always guided Jewish thought is that life and health are aspects that we do not own - they were given to us and we are called to protect them, to cherish them as something precious.

“So it is imperative for us to preserve life, but the underlying importance is to provide the most compassionate end-of-life care for patients.”