After all, physicians are reported to have an unusually high death anxiety that medical school does little to alleviate. The role of a physician is already overwhelmingly complex. Moreover, the bewildering array of unfamiliar medical specialists that patients face at the end of life would fragment any spiritual care beyond usefulness, and the cost-containment pressures that are forcing physicians to spend less and less time with any one patient perhaps effectively prohibit serious attention to spiritual concerns. We ought not put doctors in charge of the care of the terminally ill. The hospice movement has taken steps in that direction, but the care of a much broader spectrum of dying patients would need to be removed from the hands of physicians.
Spiritual care is the core of care for the dying.
A Nonreligious, Spiritual Discussion I believe we must move the discussion of spiritual issues at the end of life to center stage in bioethics. The discussion must be, in large part at least, an inclusive, nonreligious discussion. We need such an inclusive discussion because the spiritual needs of the unreligious must also be met. For nontheists, only a nonreligious discussion can hope to articulate the spiritual needs of a secular world. Also, for members of religious communities, only a nonreligious discussion can lay bare the concerns and mind set of our contemporary culture, revealing the spiritual issues at the end of life that even religious discussions will have to address.