Exploratory Review of Spiritual Care in the Voluntary Assisted Dying Environment: Towards a Holistic Theoretical Framework

This non-systematic exploratory review examined the literature regarding spiritual care in the voluntary assisted dying (VAD) environment, ultimately establishing a holistic theoretical framework for care. Drawing on previously established conceptualisations of spirituality, two dimensions of VAD care were identified: internal spiritual concerns and relational spiritual concerns. Care for internal spiritual issues in the VAD environment involves establishing internal congruence within a patient and exploring the existential meaning the VAD experience holds for them. Family members can be a crucial psychosocial–spiritual support, which often leads to their involvement in treatment, thereby creating potential relational spiritual concerns; however, VAD itself can create interpersonal challenges that diminish familial support. A patient’s philosophical, religious or spiritual community and relevant spiritual leaders also provide highly beneficial significant patient relationships that can be challenged by the VAD environment. Therefore, spiritual care practitioners must support these significant relationships of family and community to optimise patient wellbeing by managing relational spiritual concerns while also addressing patients’ internal spiritual concerns. This places the spiritual care practitioner in a nexus of patient relationships, internal concerns, and community systems.