The authors of a recent literature review looked at the current state of spiritual care in the ICU setting.1 The findings reveal both the benefits of spiritual care services and the persistent unmet needs.

“There is a growing body of evidence that patients experience significant spiritual stress when confronted with advanced illness,” says Ware Kuschner, MD, chief of the pulmonary section at Veterans Affairs Palo Alto (CA) Health Care System.

Patients often want these spiritual needs addressed by physicians and other healthcare professionals. Clinical practice guidelines also recommend the spiritual support of critically ill patients. Despite this, says Kuschner, “there are few published reports addressing spiritual needs of patients and families in the critical care setting compared with other patient care settings.”

Most U.S. hospitals offer chaplaincy services. But ICU clinicians also have an important role in providing spiritual care to patients, says Kuschner.

“Ethicists in the ICU setting must recognize that emphasizing biomedical facts and dismissing spiritual beliefs to advance a clinical argument may provoke distrust,” says Kuschner.

Ethicists should try to explore and understand patients’ and family members’ spiritual views, if any. “Once the patient’s or family’s views have been clarified, the ethicist can often then find common ground, achieve improved communication, and realize good outcomes,” says Kuschner.

This commonly requires referral to a chaplain. Regardless of whether pastoral care is available, says Kuschner, “the ethicist should remain mindful of the spiritual needs, beliefs, and practices of patients and family members.”


1. Ho JQ, Nguyen CD, Lopes R, et al. Spiritual care in the intensive care unit: A narrative review. J Intensive Care Med 2018; 33:279-287.