Religious and Spiritual Differences Within Families: Influences on End-of-life Decision Making

•Religious and spiritual diversity are increasing in the US.•US baby boomers in greater numbers have embraced faiths divergent from their families of origin.•Different religious beliefs within families can present unique challenges at the end of life.•A case is presented of family traditions in Buddhism, Catholicism, and a nonreligious spirituality.

Religious and spiritual diversity are increasing in the United States. This can present unique challenges at the end of life, especially when individuals within the same family have differing beliefs. There are wide variations in individual interpretations of religious teachings. There is also a lack of homogeneity within religions. Health care providers may find it challenging to understand the nuances of individual religious traditions. Clinicians should approach patients and families with humility. A case is presented of a family with diverse traditions in Buddhism, Catholicism, and a nonreligious spirituality.