Good for the soul?
The spiritual dimension of hospice and palliative care
Confronting mortality in the face of approaching death may be a deeply disturbing experience (Ainsworth-Smith and Speck 1999; Lawton 2000). Yet amidst the imminence of separation and the disintegration of self, a wellspring of spiritual activity may frequently be found. In this chapter, I address such activity from three perspectives: the conceptual perspective, the patient and family perspective and the institutional perspective. I will show that as dying patients address their spiritual and religious needs, health professionals have an opportunity to play a vital and supportive role. Where appropriate, data will be presented from a doctoral study1 undertaken by the author between 1998 and 2001 (Wright 2001a).
When Cicely Saunders founded St Christopher's Hospice (Sydenham) in 1967, she sought to recapture the spirit of the former Christian 'hospices', welcoming the sick and performing the works of mercy found in Matthew 25 verses 35 and 362 (Saunders 1986). At this time, her evangelical zeal was probably at its highest. In a letter to the Reverend Bruce Reed, she tellingly wrote: 'I long to bring patients to know the Lord' (Clark 1998: 50). Yet Dr Saunders did not establish a religious community, preferring instead to pioneer a new pattern of relationships exemplified by the multidisciplinary team.
As hospice philosophy developed, however, questions came to be asked about its religious foundations. Was the Christian perspective part of the essence of hospice, or did it merely provide a motivating force among likeminded pioneers? The debate surrounding these questions was influenced by three factors: the establishment of palliative care, a changing pattern of