Medical spirituality: defining domains and boundaries.

The rapidly accumulating evidence that personal spirituality has important influences on health care outcomes is somewhat difficult to integrate into daily medical practice, in part because accepting it requires adjustments to the standard biomedical worldview, and in part because it challenges established boundaries between chaplaincy and evidence-based medicine. We propose that the recognition of medical spirituality as a distinct, interdisciplinary field of interest, with its own well-developed body of clinical evidence, clinical skill, clinical ethics, and with well-defined clinical boundaries, can help overcome much of the current confusion about how to integrate the new knowledge, and help pre-empt developing "turf" issues. The new field would contribute significantly to reframing the worldview of healing practice, consistent with the evidence-based approach.