Your patient is carrying a double burden – his health problems and his self-blame for not being healed. It may be that his sense of failure about not being healed is reinforced by members of his family or faith community who believe that prayers offered in deep faith will be answered. As his prayers for healing go unanswered, he may also feel abandoned or rejected by God. This may be tied to questions about whether his illness is a sign of God’s judgement of him for some sin or failure in his life. It is also very likely that fear of dying and sadness about coming to the end of his life are part of his spiritual struggles.

Your patient’s illness is having a negative impact on his faith in God and his experience of God in his life. Rather than being a resource to help him in cope with his illness, his beliefs about prayer and healing have added to his suffering. These struggles detract from what is important to him in whatever time remains in his life. He is in spiritual distress.

When spiritual distress is identified, a referral to the team’s spiritual care provider (chaplain) is usually appropriate. If your team does not have a spiritual care provider, you could suggest arranging for your patient to talk about his spiritual struggles with a spiritual leader from his faith community. If you feel comfortable, you may want to ask your patient the following questions:

• “What can you tell me about some of the miracles within your tradition?”
  
• “When you think of accounts of miracles within your tradition, are these events dependent on the faith of the person or on God's faithfulness? How does this relate to your current situation?”
  
• “Is it possible that the miracle God has for you is not physical healing, but spiritual healing?”
  

Your patient’s struggles also give you an opportunity to reflect on your own beliefs about faith, hope and healing. You may find it helpful to make quiet space and unhurried time in your life to consider these questions:

• What does it mean to have hope in the face of a serious prognosis?
• How does hope change when our focus moves from the future to the present?
• What meaning and growth can we find in the midst of a life-limiting illness?
• How do our images of God affect the way we pray about an illness?
• In what ways do miracles involve “a shift of perception?”[1]
• How do we use religion as a way to avoid facing situations too uncomfortable to accept?
• What are some of the things that have helped you in the past when it seemed as though all hope was lost ?[2]
• What does healing mean to you? What does wholeness mean to you?[2]
  

As you reflect on questions such as these and find your own answers, you will have a better sense of how to talk with your patient about his struggles. Your task is not to challenge or dispute his beliefs, but to look for opportunities to respectfully share perspectives that are meaningful to you. Your respect and concern for his struggle and readiness to share your own spiritual perspectives may help him look at his situation differently and find resources in his faith that provide comfort, hope and courage.

References

1. Schucman H. Course on Miracles. 3rd ed. Mill Valley, CA: Foundation for Inner Peace; 2007.

2. O’Rourke M, Dufour E. Embracing the End of Life: Help for Those Who Accompany the Dying. Toronto, ON: Novalis; 2012.