Abstract
It is hoped that these reflections on the pastoral care of patients with chronic renal failure will be relevant in a wider context, even though they are set within a north European health care system. Many of the issues raised apply to chronic conditions in general. Matters of ultimate value and meaning, which transcend differences of culture and race, are addressed from a Christian understanding of the world, but pose related questions for those of other living faiths or of none. This paper suggests that renal failure is experienced by patients as a form of captivity from which they long to escape. It explores the nature of that captivity, the perceived means of escape and the tensions arising from the struggle for freedom. Pastoral care is understood as the process whereby patients are helped to draw on personal and faith resources in order to cope.

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