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The issues of spirituality and spiritual care have drawn a lot of attention in health care literature within the last two decades. Theological discourse in Germany, especially in the field of pastoral care, has not been aware of this rise in interest nor of the way in which spiritual issues are discussed. The article wants to point out the significance of spirituality in patient care and the challenges to health care chaplaincy, both on the individual level of patient care and on the level of multiprofessional teams and within organisational settings. Spiritual care opens a new field of opportunities for health care chaplaincy especially in education, training-on-the-job, and research.