Addressing Spirituality-related Moral Challenges in Palliative Care: Perspectives of Spiritual Counselors

Spiritual beliefs are increasingly important toward the end-of-life as they shape perspectives on good care, life, and death. However, in pluralistic societies, the spiritual beliefs of patients and care providers may differ. Care providers can find it difficult to be responsive to spiritual diversity and to how different belief systems of patients and their families may influence perspectives on care and dying. This can lead to moral challenges. Dialogical clinical ethics support (CES) helps care providers to jointly reflect on and deal with moral challenges. However, while spirituality shapes perspectives on good care, it is rarely addressed explicitly in CES sessions. We interviewed ten spiritual counselors of different denominations in The Netherlands to explore spirituality-related moral challenges in the delivery of palliative care, and to gain insight into their perspectives on what is needed to make both dialogues with patients and family and dialogical CES more responsive to spiritual diversity.