The release today of the 3rd edition of the NCP Guidelines was a wonderful occasion for everyone involved in palliative care, but especially for chaplains. While the palliative care model emphasizes all four dimensions of care- physical, emotional, social and spiritual, it is often the case that the spiritual dimension is neglected in practice. As Betty Ferrell said today, if you are not doing exceptional spiritual care, you are not doing palliative care. The point here is that lots of institutions are claiming to do palliative care without any kind of spiritual care- let alone spiritual care that could be called exceptional.

There are multiple causes of this situation. In general, health care providers are least comfortable dealing with the spiritual dimension of care. It is also clearly true that there is less evidence for the efficacy of spiritual care in the palliative care process than for any of the other domains. Finally, chaplains themselves have contributed by often being unwilling to be team players and be accountable for their practice to a team. Connie Dahlin was correct today when she emphasized the point of how training for palliative care teams has progressed by emphasizing that even chaplains now have certification in palliative care. As usual, we are the last to the party.

The new guidelines give all of us, but especially spiritual care providers, new “evidence” to support our contention that spiritual care should be a full partner in palliative care. Domain 5 which covers spiritual, religious and existential care has been vastly expanded to reflect the results of the National Consensus Project in 2009 and other efforts. The professional chaplaincy organizations in the US have responded by endorsing these guidelines. On behalf of professional chaplains and all who value the spiritual dimension of care, thanks to Betty Ferrell, Connie Dahlin, Diane Meier and the whole task force for their efforts on behalf of the care of the spirit.

George Handzo, BCC, CSSBB