{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T05:03:33Z","timestamp":1784351013226,"version":"3.55.0"},"reference-count":13,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:p>Among palliative care patients, spiritual uncertainty about what may await them after death is a fairly common but often overlooked source of anxiety. Specifically, patients (especially those from orthodox Christian backgrounds that propound the concept of hell as a literal place) may harbor unexpressed fears about being consigned to hell due to the perceived sins they have committed in life. Such fears can be genuinely debilitating and may result in non-responsiveness to traditional palliative therapy. Here, we discuss our experiences with this phenomenon and propose some possible solutions. We offer readers suggestions for how to best identify potential sufferers, broach the subject with such patients, and reassure them.<\/jats:p>","DOI":"10.1089\/jpm.2025.0058","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T10:43:29Z","timestamp":1750157009000},"page":"1143-1145","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Fireproofing the Soul: Navigating Fear of the Afterlife Among Palliative Care Patients"],"prefix":"10.1177","volume":"28","author":[{"given":"Ptr Shannon","family":"Blower","sequence":"first","affiliation":[{"name":"Pastoral Care, Summa Health, Akron, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA."},{"name":"Modestly Mindful, LLC, Fort Wayne, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucius","family":"Walker","sequence":"additional","affiliation":[{"name":"Deputy Editor, Bayou City Press, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Radwany","sequence":"additional","affiliation":[{"name":"Medical Director, Grace House Akron, Akron, Ohio, USA."},{"name":"Division of Palliative Medicine, Department of Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.05.010"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216316665562"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2007.07.013"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2018.01.011"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.70068"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NJH.0000306714.50539.1a"},{"key":"e_1_3_3_8_2","unstructured":"Prabhakar A Smith T. Palliative Care Network of Wisconsin. Fast Facts and Concepts #417: Total Pain. 2021. Available from: https:\/\/www.mypcnow.org\/fast-fact\/total-pain\/ [Last accessed: January2025]."},{"key":"e_1_3_3_9_2","unstructured":"Norty J Lipka M Alvarado J. Few Americans Blame God or Say Faith Has Been Shaken Amid Pandemic Other Tragedies. Pew Research Center; 2021. Available from: https:\/\/www.pewresearch.org\/wp-content\/uploads\/sites\/20\/2021\/11\/PF_23.11.21_problem_of_evil.pdf [Last accessed: January2025]."},{"key":"e_1_3_3_10_2","unstructured":"Larsen S. National Center for PTSD US Department of Veterans Affairs. PTSD and End of Life. Clinical Considerations for PTSD in Palliative or Hospice Care. Available from: https:\/\/www.ptsd.va.gov\/professional\/treat\/specific\/ptsd_end_of_life.asp [Last accessed: January2025]."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-016-3425-6"},{"issue":"4","key":"e_1_3_3_12_2","first-page":"354","article-title":"Testing items to screen for religious or spiritual distress in adult outpatient cancer care","volume":"33","author":"Labuschagne D","year":"2025","unstructured":"Labuschagne D, , Palmer P, , Deshields T, et al. Testing items to screen for religious or spiritual distress in adult outpatient cancer care. 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