Ethical Dilemma: Spiritual Care

What was she thinking? That’s a logical question to ask about UK nurse Sarah Kuteh’s manner of giving spiritual care to a patient—care that was not acceptable in her employer’s view and resulted in the loss of her job.  Court decisions have since upheld the firing. A recent UK news account detailed the situation. 

Were Kuteh’s actions appropriate? That’s a question for each nurse to consider in light of his or her own spiritual caregiving. Was Kuteh simply giving away her Bible, praying for her patient with cancer, and offering good spiritual support? 

The patient had stated he was “open-minded” about religion on the hospital admission form. Consider these points:

  • What further spiritual assessment did Kuteh conduct? 
  • What spiritual needs did the patient relay? 
  • Did he ask or consent to her prayer with him? Did he agree to singing “The Lord is My Shepherd”? 
  • Was she supporting the patient’s spiritual and religious preferences?

In the current issue of the Journal of Christian Nursing, Marcia Fowler presents an informative examination of this topic in “Evangelism in Patient Care: An Ethical Analysis.” This article, which will be discussed during the July 18 Journal Club, considers essential ethical issues including religious diversity, vulnerability, spiritual care, harm, and the Great Commission and offers nurses guidelines for clinical practice. Every nurse can benefit from reading this article.

Patients certainly have spiritual needs and the Holy Spirit wants to use Christian nurses to support those needs. We should be prepared to spiritually assess patients and respond to expressed spiritual needs based on current, accurate assessment information. God calls us to share the good news of Jesus Christ in nursing, but we must do so ethically. In the context of the nurse-patient relationship, we care in ways agreeable to the patient and with his or her consent.

Remember that you and I should “always be prepared to give an answer to everyone who asks you to give the reason for the hope you have. But do this with gentleness and respect” (1 Peter 3:15). 

Kathy Schoonover-Shoffner, PhD, RN, is the National Director of Nurses Christian Fellowship and editor-in-chief of the Journal of Christian Nursing.



I was reprimanded for discussing spiritual aspects of care of patients. i asked for More instruction on how to do this properly. No response to that request. One patient who had artificial insemination done reported to me that it felt almost like an assault to get pregnant that way. In trying to explore this with her, I asked if there was any thought of a religious aspect to her feelings. I was later fired for continuing to discuss spiritual aspects of care. After that event, I went to training for Parish Nurse care and learned better ways to ask spiritual questions.
My husband and I had an appointment right after I was fired (and still visibly upset) with our attorney about an unrelated manner. He asked if I wanted to sue, but I didn't have the energy.
God later blessed me with two different jobs that not only provided for us, but the last one, prior to retirement, helped us be financially much more ready to retire.
Nurses need to continue to give spiritual care within context of patient need and interest.

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