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Caring for the Dying & Physician-Assisted Suicide Issues
Discussing Religious and Spiritual Issues at the
End of Life - A Practical Guide for Physicians
Bernard Lo, MD; etc. for the Working Group on Religious and Spiritual
Issues at the End of Life
As patients near the end of life, their spiritual and religious concerns
may be awakened or intensified. Many physicians, however, feel unskilled
and uncomfortable discussing these concerns. This article suggests how physicians
might respond when patients or families raise such concerns.
1. Some patients may explicitly base decisions about life-sustaining
interventions on their spiritual or religious beliefs. Physicians need to
explore those beliefs to help patients think through their preferences regarding
2. Other patients may not bring up spiritual or religious concerns
but are troubled by them. Physicians should identify such concerns and listen
to them empathetically, without trying to alleviate the patient's spiritual
suffering or offering premature reassurance.
3. Some patients or families may have religious reasons for insisting
on life-sustaining interventions that physicians advise against. The physician
should listen and try to understand the patient's viewpoint. Listening
respectfully does not require the physician to agree with the patient or
misrepresent his or her own views.
Patients and families who feel that the physician understands them and cares
about them may be more willing to consider the physician's views on prognosis
and treatment. By responding to patients' spiritual and religious concerns
and needs, physicians may help them find comfort and closure near the end
Feb. 13, 2002;287:749-754
Attitudes and Desires Related to Euthanasia and Physician-Assisted Suicide
Among Terminally Ill Patients and Their Caregivers - Ezekiel
J. Emanuel, MD, PhD; Diane L. Fairclough, DPH; Linda L. Emanuel, MD, PhD
Nov. 15, 2000;284:2460-2468
Psychiatric Aspects of Excellent End-of-Life Care
Academy of Psychosomatic
Medicine - Position Paper
In Search of a Good Death: Observations of Patients, Families, and Providers
-Karen E. Steinhauser
Intern Med. May 16, 2000;132:825-832.
Assisted Suicide: Finding Common Ground -- L. Snyder and
of Internal Medicine, 21 March 2000. 132:468-469
Attitudes and Practices Concerning the End of Life
A Comparison Between Physicians From the United States and From the
Netherlands - Dick L. Willems
IM Jan.10, 2000;160:63
Caring for the Dying -- Congressional Mischief
New England Journal of Medicine -- December 16, 1999 -- Vol. 341, No. 25
The Supreme Court and physician-assisted suicide -- the ultimate right.
New England Journal of Medicine -- January 2, 1997 -- Vol. 336, No. 1:50
Legalized physician-assisted suicide in Oregon -- the first year's experience.
Chin AE, Hedberg K, Higginson GK, Fleming DW.
New England Journal of Medicine -- February 18, 1999 -- Vol. 340, No.
Legalizing assisted suicide -- views of physicians in Oregon.
Lee MA, Nelson HD, Tilden VP, Ganzini L, Schmidt TA, Tolle SW.
New England Journal of Medicine -- February 1, 1996 -- Vol. 334, No.
Oregon's Death With Dignity Act - 14 Months and Counting -
Howard Wineberg, PhD
IM Jan.10, 2000;160:21
Coming to terms with grief and loss
Can skills for dealing with bereavement be learned?
Kathryn J. Zerbe, MD; Deborah L. Steinberg, MD
108 / NO 6 / NOVEMBER 2000 / POSTGRADUATE MEDICINE
and Dying in America
National Hospice Foundation
Institute for Health Care Improvement: Improving Care
at the End of Life
Journal of Palliative Care Online