Dignity Therapy: Advancing the Science of Spiritual Care in Terminal Illness

Abstract

In this issue of theJournalofClinicalOncology, Chochinov et al 1 make a major contribution to advancing care for the terminally ill through their study “Dignity Therapy: A Novel Psychotherapeutic Intervention for Patients Near the End of Life.” This international study, testing a novel intervention to address dignity and meaning in the final days of life, was conducted in Canada and Australia; however, it has significance for other countries attempting to address this highly neglected aspect of health care. The investigators have advanced an area of palliative care that has been cited in recent years by groups such as the WHO, Institute of Medicine, National Cancer Institute, and others as being in serious need of improvement. Many clinicians and institutions have struggled to advance the most basic aspects of care in advanced disease, such as improvements in the treatment of pain and symptoms or treatment of common psychological problems such as anxiety and depression. These investigators, however, have advanced an aspect of terminal care that is perhaps far more challenging than titrating doses of opioids. “Dignity therapy,” which addresses psychosocial and existential distress, is of great importance and shows promise as a novel intervention to diminished suffering and distress in end-of-life care. Several characteristics of this intervention are noteworthy.