The Essence of Both Palliative and Spiritual Care

This evening as part of my “From the Palliative/Spiritual Care Bookshelf” series, I highlight an informative article from the spring/summer 2015 issue of Caring for the Human Spirit, a publication of the HealthCare Chaplaincy Network, dedicated to “advancing the integration of spiritual care in health care.”

As most reading this would know, since September 2018 I’ve been working as a palliative care interfaith chaplain (or spiritual health provider) in a hospital in the north-west metro of the Twin Cities of St. Paul/Minneapolis.

The article I share tonight is by Rabbi Edith Meyerson and Dr. Diane Meier. Entitled “Hearing Our Patients’ Voices,” this article focuses specifically on spiritual care in the context of palliative care. In doing so, it defines and explores the essence of both of these types of care.

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The essence of palliative care is understanding who the patient is as a person – what matters most to that person. This – the search for meaning – is also the essence of spiritual care.

This medical speciality focuses on patient- and family-centered care, operating within the construct of an interdisciplinary team comprised of physicians, nurses, social workers, chaplains, massage and yoga therapists, and other health care professionals, and provided across all health care setting to assist patients and their loved ones navigate serious or life-threatening illness.

Eligibility and appropriateness for palliative care is based on need and not prognosis. It is appropriate for people pursuing cure (for example, head and neck cancer or acute myeloid leukemia); living with long-term chronic but debilitating illness like chronic obstructive pilmonary disease (COPD), dementia, or congestive heart failure; and approaching the end of life as a result of a progressive disease (e.g., stage 4 lung cancer metastatic to brain and liver). Patients can be receiving both curative chemotherapy and palliative care.

As palliative care clinicians, we empower people who are navigating serious illness to make decisions that are right for them in the context of the reality of the illness. We hear our patients' voices and ask them important questions. “Tell us about your life.” “Who are you and what is important to you?” “What are your greates hopes and concerns?” “Tell us about your family.” “How do you want to live your life?”

Too often in the treatment of serious and chronic illness, patients and families struggle to voice a great many things, and things are left unsaid even at the end of life. The palliative care team, trained and expert in communication skills, helps patients and families express their true feelings, questions and concerns. They work to ensure that those involved have the appropriate information about the diagnosis and have space to express how they would like to proceed -- keeping the patient’s priorities and goals at the center.

When there are discrepancies in a family’s wishes, the team helps the parties assert their opinions and needs, and then attempts to mediate, bringing the conversation back to what matters most to the patient. For patients, for their families, for consulting providers, for all human beings, to be known and understood, to be heard, is the basis for spiritual care.

Our patients and their families so often are grateful for the infusion of authenticity the palliative care team provides. Patients will say, “This is the first time anyone has sat down with me or with my family to ask us who we are, how we’re doing, and to have a conversation about the big picture.” Within the fragmented, time-pressured, health care system, the team approach that characterize palliative care permits skilled staff the time and attention necessary to do just that.

. . . Who are you and what is important to you? This is the basis for palliative care and for spiritual care.

– Rabbi Edith M. Meyerson, D.Min., BCC
and Diane E. Meier, M.D. FACP
Excerpted from “Hearing Our Patients’ Voices”
in Caring for the Human Spirit
Spring/Summer 2015

Related Off-site Links:
Finding Meaning in Serious Illness: The Role of Spiritual, Religious, and Existential Care in Palliative Support – National Coalition for Hospice and Palliative Care (March 9, 2025).
The Nature of Religious and Spiritual Needs in Palliative Care Patients, Carers, and Families and How They Can Be Addressed from a Specialist Spiritual Care Perspective – Kate L. Bradford (MDPI, January 16, 2023).
Integrating Spirituality in Palliative Care Goals of Care Conversations – Denise Hess (Palliative Care Network of Wisconsin, October 15, 2018).
State of the Science of Spirituality and Palliative Care Research – Karen E. Steinhauser, at el (Journal of Pain and Symptom Management, September 2017).


See also the previous Wild Reed posts:
• From the Palliative/Spiritual Care Bookshelf – Part I | II | III | IV | V | VI | VII | VIII
• Arthur Kleinman on the “Soul of Care”
• Chaplaincy: A Ministry of Welcome
• Interfaith Chaplaincy: Meeting People Where They're At
• Spirituality and the Healthcare Setting
• World Hospice and Palliative Care Day
• Resilience and Hope
• George Yancy on the “Unspoken Reality of Death”
• “Call Upon Those You Love”
• Yahia Lababidi: “Poetry Is How We Pray Now”
• The Calm Before the Storm
• Out and About – Spring 2020
• A Pandemic Year
• Out and About – Autumn 2021
• Difficult Choices
• On the 2nd Anniversary of the Coronavirus Pandemic, Words of Gratitude and Hope