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A WHILE AGO I read about a nurse who asked an alert, dying patient if she was "saved." Other nursing colleagues said this was wrong, putting her down for bringing her religious beliefs to work. A clinical nurse specialist in death and dying agreed, saying the patient was vulnerable and may not have had the strength to say no to proselytizing. She acknowledged that nurses shouldn't disregard patients' religious faith, but advises nurses to ask patients if they'd like a visit from clergy. According to her, calling a chaplain meets the patient's needs but asking patients if they are "saved" meets the nurse's needs.


Is it ethical to ask personal, spiritual questions of vulnerable patients? Is this "proselytizing," or could it be considered in a more positive light? Do privacy laws prevent asking patients faith-related questions, or are there circumstances that allow doing so?


No one recommends walking up to a patient and saying, "Are you saved?" To ask such a question outside a prior relationship or appropriate context is offensive and unethical. However, nurses are mandated to care for patients' physical, mental, emotional, interpersonal and spiritual needs. Furthermore, Jesus commissioned every believer to share the good news about his death for our sins and his resurrection to eternal life, a life that all people are invited to share. While referring patients to a chaplain is appropriate (especially if your institution has a viable pastoral care team), nurses need not be afraid to ask spiritual questions or offer spiritual care.


As a competent and caring nurse, perform ongoing spiritual assessment of your patients, looking for signs of spiritual distress or need. Remember that spiritual needs are basic and universal: love, forgiveness, hope, etc. It is these universal spiritual needs that underlie our seeking for God. Most patients, Christians or not, welcome a caring nurse who gently listens, unafraid, to their concerns in these areas.


If patients express spiritual concerns, explore their need. For example, if patients say they are afraid or wonder what will happen after they die, explore this further. You can repeat the concern back to them, implying, "Talk more if you'd like; I'm listening." You can ask what they believe or have heard about life after death. At some point you can ask them if they would like you to share what you believe. And you can ask if they would like you to pray with them. Note that what you are doing is following the patient's lead, and you are obtaining their consent to proceed. A patient's ongoing response, along with the Holy Spirit, is your guide to continuing the conversation.


Scripture teaches that the Holy Spirit gives discernment about the right time and way to introduce the gospel. We are to live godly lives that appeal to unbelievers (Col 4:5-6; 1 Pet 3:15-16); know how to share the good news about Jesus Christ (2 Tim 2:15); pray for unbelievers (1 Tim 2:1-4); ask God to give us opportunities to share the gospel (Eph 6:19-20; Col 4:3); and remain alert to those around us who are spiritually seeking.


Coming to know Jesus in a personal relationship, praying and confirming Christ as Lord and Savior, is a spiritual event and not simply a religious ritual. While others may see us as trying to engage patients in religious rituals, proselytizing for converts, when someone responds to the gospel, it is the most significant spiritual event that will ever happen to them. Proselytizing actually means making converts to any viewpoint, whether it be a political party, faith tradition, etc. The word comes from the Greek word, proselytos: a newcomer. Evangelizing is more specific; it means bringing the good news of Jesus, instructing in the gospel. Christians evangelize because we are obedient to Christ (Mt 28:18-20). We never press patients or families inappropriately, but we are ready to give a reason, gently and respectfully, for the spiritual hope we have (1 Pet 3:15).