The Surprising Ways Spirituality Shows Up at End-of-Life

When we think about spirituality in healthcare, the image often begins and ends with a chaplain at the bedside or a family gathered in prayer.

Dr. Adjoa Boateng Evans, an anesthesiologist and palliative care physician who has practiced at institutions including Stanford and Duke, believes medicine’s deepest work often happens beyond charts, tubes, and monitors.

Here, she reflects on the radical bravery required to risk vulnerability in the ICU and how making space for spirituality can bridge the distance between doctor and patient.

Spirituality in Unexpected Places

For Adjoa, spirituality is not confined to organized religion.

“We all have spirituality, especially at the end of life. We just might not call it that.”

She recalls caring for a patient who died after a sudden rupture of the heart. His partner, a public health scholar who did not identify as religious, asked to bathe his body and wrap it in a special cloth before it was taken to the morgue.

“We usually ask patients if they have any formal religious practices they’d like at the end of life. For him, he said no. But as he performed this ritual, that is spirituality.”

The moment revealed how spirituality can emerge anywhere meaning is created through ritual, presence, and love made tangible.

What Counts as Spirituality Today?

Generational differences may shape how spirituality appears.

“Whether your spirituality is TikTok or whether it is the mosque, we all believe in something, which is what fuels our thoughts around the end of life.”

The communities people build online, the mindfulness practices they follow, and the self-care rituals they return to can carry spiritual meaning alongside more traditional forms of faith.

Spirituality may be found in prayer or painting, in a religious service or on a hiking trail, in scripture or around a table shared with friends.

When Hope and Medicine Meet

Healthcare often struggles with the tension between spiritual hope and medical reality. Families may speak of miracles at the same moment clinicians are trying to explain a prognosis.

Adjoa encourages providers to listen more carefully to what families are communicating.

“They’re not telling you they’re completely impervious to understanding what’s going on. They’re telling you that this language, this invitation, is important to their healing and dying process.”

The challenge is learning to hold hope and honesty at the same time. Spiritual language may help patients and families make sense of what is happening, remain connected to one another, and endure circumstances they cannot change.

What Is Your True Spirituality?

At End Well’s Radical Bravery 2025 conference, Adjoa will invite attendees to ask themselves a central question:

“What is your true spirituality?”

She encourages people to look beyond the labels they use and consider what truly receives their devotion.

“We wear labels. I’m a Christian. But is that what I’m devoting my time, energy, money, resources, thoughts, and beliefs to? Or is it something else? Whatever that thing is, that’s probably your spirituality.”

The question asks us to consider where we place our attention, what gives our lives meaning, and what we return to when certainty disappears.

Hope as a Universal Current

For Adjoa, spirituality is inseparable from hope.

“We wake up every day and go to meetings, or travel to Japan, or play with our kids because we have hope in something. I hope this trip will enlighten me. I hope this meal will help my family connect.”

Hope runs through ordinary life.

Near the end of life, it may shift in form. A person may hope for more time, relief from pain, reconciliation, a final gathering, or the chance to say goodbye.

Hope can remain meaningful even when a cure is no longer possible.

Who Holds the Healers?

Spirituality also matters for the people providing care.

Healthcare workers often carry the emotional weight of supporting patients and families without feeling supported themselves.

“There’s this tension between trying to hold people and feeling not held yourself.”

Recognizing the spiritual dimension of caregiving can help clinicians reconnect with the meaning in their work.

Witnessing, listening, and remaining present are forms of care. They can also help providers navigate grief, moral distress, and burnout.

The Language That Holds Us

When families speak about miracles or use religious and spiritual language, they are not necessarily refusing to understand reality.

They may be reaching for a language that helps them remain grounded, connected, and hopeful.

That language deserves attention.

Spirituality at the end of life is an essential way people make meaning during their most difficult moments. When providers recognize and honor it, patients, families, and care teams can move forward together with greater truth and tenderness.