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To the Editor: The article by Dr Lo and colleagues¹ recommends practical approaches for clinicians exploring the spiritual crises of gravely ill patients. We agree with Lo et al that the roles of physician and pastoral counselor should be separate in the early stages of the relationship because patients and their families may not be prepared initially to trust or understand the role of such a fused figure. However, as the patient-physician relationship develops, we believe that it may be of value to both the patient and the caregivers for the physician to explore the patient's existential and spiritual concerns. For physicians to attain the self-confidence to perform this function, however, requires a deeper understanding of the issues than can be provided by reading an article on practical guidelines. Our experience in a clinical pastoral education program modified for clinicians² provided us with the skills, language, and experience to carry . . . [Full Text of this Article]

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