University of Malta

Study-Unit Description
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TITLE Suffering, Spirituality and Palliative Care

LEVEL 05 - Postgraduate Modular Diploma or Degree Course


DEPARTMENT Moral Theology

DESCRIPTION The obligation of healthcare professionals to relieve pain and suffering stretches back into antiquity. In spite of the increasing power of modern medicine, pain and suffering are still an integral dimension of the human condition. This fact raises the question about the relationship between suffering and the goals of medicine.

This study-unit highlights the ethical debate on the use of today’s methods of relief and control of suffering and pain by palliative care, particularly palliative sedation. It focuses on patient’s wish to take more control over their own lives and deaths, on resources which have become scarce, and technologies which have created controversial life-prolonging treatments.

End-of-life decisions in the case of terminal patients and the issue of euthanasia, particularly the ethical problem of withholding and withdrawal treatment, cannot be discussed adequately without taking into account the setting up of palliative support teams.

Moreover, the course raises the philosophical and religious issues of the experience of suffering. Why does God permit suffering? How could the image of God as love, omnipotent and omniscient be reconciled with the experience of suffering? This study-unit addresses these issues which trouble every human being who is faced with the problem of suffering and pain.

Spirituality is an essential part of human experience and is nowadays recognised as a factor that contributes to health. In fact, spirituality constitutes an essential element of how individuals experience their suffering and illness, contributing to one’s seeking of meaning and purpose in life. Spiritual beliefs and issues may also impact patients’ illness and health care decision-making, as well as influence diagnosis, treatment, and coping.

This study-unit will thus focus on the impact of illness on individuals and the spiritual distress they suffer during a health crisis situation. It will examine the mystery of suffering, focusing not only on how individuals might find meaning and purpose in illness but also on how health care professionals might assess the spiritual needs of patients in their suffering.

Study-unit Aims:

This study-unit aims to:
a) explain the relationship between suffering and the goals of medicine.
b) present the ethical debate on the use of methods of relief and control of suffering and pain by palliative care.
c) discuss the End-of-life issues, including euthanasia and the withholding and withdrawal of treatment.
d) present the philosophical and religious issues related to suffering.
e) show that spirituality is recognised as a factor that contributes to health.

Learning Outcomes:

1. Knowledge & Understanding:

By the end of the study-unit the student will be able to:
a) discuss the ethical issues which arise in palliative care.
b) analyze the philosophical and religious debate on the human experience of suffering.
c) recognise that spiritual beliefs and issues may impact patients’ illness and health care decision-making.

2. Skills:

By the end of the study-unit the student will be able to:
a) argue about the ethical issues raised by palliative care and life-sustaining treatment.
b) apply theories and research to the assessment of spiritual needs.
c) assess individual’s spiritual coping methods.

Main Text/s and any supplementary readings:

- BALDACCHINO D., Spirituality in Illness and Care, Preca Library, Malta 2003.
- CASSELL Eric J., The Nature of Suffering and the Goals of Medicine, Oxford University Press, Oxford, 1991.
- HALL J., “Spirituality at the beginning of life”, in Journal of Clinical Nursing 15 (2006) 804-810.
- HARRINGTON Daniel., Why do we suffer?, Sheed & Ward, Wisconsin, 2000.
- HAUERWAS Stanley, God, Medicine and Suffering, William B. Eerdmans Pub, Michigan, 1990.
- JANSSENS R., Palliative Care. Concepts and Ethics, Nijmegen University Press, Nijmegen, 2001.
- MILLER W.R. & THOPENSON G.E., “Spirituality, religion and health”, in American Psychologist 58 (2003) 24-35.
- MINER-WILLIAMS D., “Putting a puzzle together: making spirituality meaningful for nursing using an evolving theoretical framework”, in Journal of Clinical Nursing 15 (2006) 811-821.
- MOHR S, BRANDT P, BORRAS L, GILLIERON C, & HUGUELET P., “Towards an integration of spirituality and religiousness into the psychosocial dimension of schizophrenia”, in American Journal of Psychiatry 163 (2006) 1952-1959.
- NARAYANASAMY A., “A review of spirituality as applied to nursing”, in International Journal of Nursing Studies 36 (1999) 117-125.
- PERRIN David P., Studying Christian Spirituality, Routledge, New York and London, 2007.
- RANDALL F. & DOWNIE RS (eds), Palliative Care Ethics. A Companion for all Specialists, Oxford University Press, Oxford, 1999.
- SCHOTMANS Paul & Meutenbergs (eds), Euthanasia and Palliative Care in the Low Countries, Peeters, Leuven, 2005.
- TEN HAVE Henk & JANSSENS R (eds), Palliative Care in Europe. Concepts and Policies, IOS Press, Amsterdam, 2001.
- WOODS Richard J., Christian Spirituality, God’s Presence through the Ages, Orbis Books, New York, 2006.

STUDY-UNIT TYPE Lecture and Independent Study

Assessment Component/s Resit Availability Weighting
Presentation Yes 40%
Assignment Yes 60%

LECTURER/S Emmanuel Agius

The University makes every effort to ensure that the published Courses Plans, Programmes of Study and Study-Unit information are complete and up-to-date at the time of publication. The University reserves the right to make changes in case errors are detected after publication.
The availability of optional units may be subject to timetabling constraints.
Units not attracting a sufficient number of registrations may be withdrawn without notice.
It should be noted that all the information in the study-unit description above applies to the academic year 2017/8, if study-unit is available during this academic year, and may be subject to change in subsequent years.

Augustinian Institute Academic Year 2017-18

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