What is the role of spiritual care in end-of-life ethics, and how can nurses support it?

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End-of-life care is most effective when spiritual beliefs and meaning are acknowledged because they shape how patients experience illness, make sense of suffering, and decide about goals of care. Spiritual beliefs influence what gives life purpose, what constitutes comfort, and how individuals cope with dying. Nurses can support this by assessing spiritual needs early and ongoing, listening with empathy, and creating space for patients to express values, hopes, fears, and questions about meaning. They can help connect patients with chaplaincy or other spiritual care resources when desired, ensuring access to rituals, prayer, sacraments, or sacred practices that matter to the patient. Respecting diverse beliefs and rituals, facilitating discussions about what is sacred to the patient, and coordinating care around these needs enhances dignity, reduces distress, and supports informed, values-based decisions. This collaborative, patient-centered approach aligns care with autonomy and holistic well-being, not disregarding spirituality as separate from physical symptoms.