Introduction
This topic covers the spiritual dimension of patient care and the ethical concept of medical futility. Students should be able to explain how spirituality differs from religion, why it matters in illness, how a clinician can take a spiritual history, and how futility is defined, recognised and handled in practice without undermining trust or respect for the patient.
Spirituality: definition and relevance
Spirituality is the search for meaning, purpose, connectedness and transcendence in life. It is broader than religion. A person may be spiritual without belonging to any religious community, and a religious person may still experience spiritual distress. In illness, spiritual concerns often appear when a patient faces suffering, loss, guilt, or the question of what their life means.
- Core dimensions: meaning and purpose, hope, relationships with self, others, nature or a higher power, and values.
- Spiritual distress: anger at God or fate, feeling punished, loss of meaning, isolation, or fear of dying without reconciliation.
- Spiritual well-being is linked in research with coping, adherence to care and quality of life, but the evidence on direct effects on survival is limited.