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Invited Commentary
October 2015

Religion, Spirituality, and the Intensive Care UnitThe Sound of Silence

Author Affiliations
  • 1Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 2Department of Radiation Oncology, Dana-Farber/Brigham and Women’s Cancer Center, Boston, Massachusetts
  • 3Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois
JAMA Intern Med. 2015;175(10):1669-1670. doi:10.1001/jamainternmed.2015.4471

Visualize for a moment the philosophical quandary of a tree falling in the uninhabited forest and whether it makes a sound—the dying tree, its surroundings of fellow trees, foliage, and earth—with no person to hear its fall. This visualization hardly seems relevant to the intensive care unit (ICU), particularly because these seem to be manifestly opposing environments—one is quiet, organic, and verdant with life while the other is characterized by the sounds of human and technological activity, sterility, and illness. And yet the quandary posed by this visual exercise is central to the article by Ernecoff and colleagues1 and to the question of the role of spirituality in caring for seriously ill patients and their families.

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