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I have no doubt that differences were noted between two populations in this study. However, I would suggest that variables really being studied would be more accurately described as hope/optimism versus fatalism/despair. The word "spiritual" used in conjunction with studies conducted by religious institutions typically implies a much more constricted belief system, than is necessary to make a difference in one's own health. Beyond that, when those who have very strong belief systems or describe themselves as deeply spiritual, don't survive, and everyone, regardless of the presence or absence of what would be described in studies such as this, is going to die eventually, how is that explained? Not enough faith/spirituallity, or not strong enough, or the wrong kind? Many will die peacefully, many will not, but their belief system will not keep them from their eventual death. To me, the ultimate, truest, purest belief in a power that has the ability and desire to protect one, and intervene for one's well-being, would be evidenced by total avoidance of any earthly medical intervention.