Spiritual issues in surgical palliative care

For Americans, death is un-American, and an affront to every citizen's inalienable right to life, liberty and the pursuit of happiness [1]. Every American will have the opportunity to experience this affront to the American way of life. This article represents an expansion and modification of themes that were presented elsewhere [2,3] and intends to find a common ground for understanding the spiritual issues that confront the dying and their surgeons in our highly diverse culture. Specifically, it (1) attempts to provide a working definition of spirituality in relation to religion; (2) explores the concept of a "good death" and whether current practice meets the expectations of the dying; (3) examines the nature of suffering and its relationship to spiritual distress; (4) identifies ways in which surgeons can alleviate spiritual distress; (5) examines the impact of grief oil surgeons' care of their patients; and (6) explores the potential for healing in the terminally ill.