When a person is diagnosed with serious illness, it is obvious that medical intervention is necessary, if only to describe the condition. In an increasingly secular society, at least in the Western world, spiritual needs may not seem to be so urgent, or indeed to exist at all. Yet while there is a drift away from organized religion there is also a growing realization that humans have spiritual concerns and that along with physical and social pain, there is emotional and spiritual pain. Pastoral care can be described as an integral and necessary part of good palliative care.

Pastoral care has been described thus: At its most basic, pastoral care is an active and purposeful concern for people within the context of ultimate meaning and value. This broad definition should cover a wide variety of religious and spiritual practices. Pastoral care is not evangelism. The pastor approaches the sick person at her invitation and seeks to discover specific questions and concerns. He does not seek to impose his own views. Nor is pastoral care to be equated with social work. Pastors have a distinct training and particular gifts to offer, which may include skill in social care matters, but which are specific to those with pastoral training.

Pastoral care will be delivered by clergy but not only by such specially designated persons. Some patients, entering the last phase of their lives, will wish to be visited by their own priest or minister or another person from the worshipping congregation.