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To the Editor: The article by Dr Lo and colleagues1 recommends practical approaches for clinicians exploring the spiritual crises of gravely ill patients. We agree with Lo et al that the roles of physician and pastoral counselor should be separate in the early stages of the relationship because patients and their families may not be prepared initially to trust or understand the role of such a fused figure. However, as the patient-physician relationship develops, we believe that it may be of value to both the patient and the caregivers for the physician to explore the patient's existential and spiritual concerns. For physicians to attain the self-confidence to perform this function, however, requires a deeper understanding of the issues than can be provided by reading an article on practical guidelines. Our experience in a clinical pastoral education program modified for clinicians2 provided us with the skills, language, and experience to carry out the valuable recommendations of Lo et al.
Spiritual distress is also experienced by caregivers of critically ill patients. For example, in our neonatal intensive care unit, only 4% of staff surveyed denied experiencing suffering in their work and 83% reported privately praying for their infant patients.3 Many patients have expressed a wish to have their spiritual and religious concerns addressed by the physician. It behooves the medical profession to respond in a constructive way, recognizing both patients' and physicians' spiritual and religious needs.
This letter was shown to Dr Lo, who declined to reply.—ED.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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