ethical implications of dses research

Ethical Implications of the Daily Spiritual Experience Scale, Bioethics Grand Rounds, Cleveland Clinic, September 11, 2012.


Recent research has asserted the value of incorporating the spiritual orientation, concerns and needs of the patient into the healthcare relationship, and accreditation requires attention to this aspect of the patient. Doing so raises a number of ethical issues, however. Use of the 16 questions from the Daily Spiritual Experience Scale (DSES) can help the health professional avoid some of these ethical problems by 1) focusing on experiences rather than beliefs, 2) using questions validated cross-culturally, 3) opening avenues for communication and understanding, and 4) emphasizing the spiritual aspect of life as a part of the whole person, rather than reducing it to a tool for improving physical health. The DSES questions also assist the professional in better delivering competent care that addresses this complex component of the human person.

The DSES is a 16-item, psychometrically validated scale, used in over 100 published studies and translated into over 20 languages. It measures reported frequency of such ordinary spiritual experiences as awe, compassionate love, mercy, divine closeness, sense of spiritual support, gratitude, and deep inner peace in daily life ( The research involved in its development used ethical principles such as respect for diversity to construct a scale that would reach many people substantively. It was based on extensive international qualitative research in multiple cultures, ages and socioeconomic status. It functions well for people from the various major religious traditions as well as for those who call themselves spiritual but not religious, and atheists. Higher scores have been linked with happiness, life satisfaction, less addictive behaviors, less depression and anxiety, better health behaviors, self-efficacy, less burnout, and improved relationships.

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