Spiritual issues in suffering: creating a dialogue between clergy and palliative care providers

Spirituality in western hospice and palliative care has become increasingly defined in secular terms, effectively dissociating it from the major faith traditions. This may significantly limit the ability of palliative care organizations to address the spiritual needs of patients whose spirituality is primarily defined in religious terms. We hypothesized that a dialogue can be initiated between clergy representatives from a specific faith tradition and palliative care practitioners from various health-related professions to inform a deeper level of mutual understanding which could facilitate development of palliative care programs attuned to the specific needs of patients sharing that tradition. A conference at a spiritual retreat center in Romania was organized during which participants were introduced to the Total Pain concept of Dame Cicely Saunders. Other sessions were devoted to small group work in which participants examined clinical/pastoral problems related to suffering, ethical issues at the end of life and spiritual care of the dying. A final session was devoted to plenary dialogue and identifying future directions. Outcomes of the conference included recognition of the need for interdisciplinary training in palliative care across all disciplines, a commitment from several attendees to start faith-based hospice organizations and development of the first graduate degree in palliative care in Romania. The enthusiasm of the participants and the universal nature of the spiritual issues discussed support the feasibility of developing similar conferences for representatives from other major faith traditions.