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The topic of spiritual care is booming! Whilst some talk about a multi-disciplinary concept of "spiritual care" from a palliative medical point of view, or of a new specialist area for human medicine, others are thinking of a more modern version of clinical pastoral care. In order to clarify this, we shall first explore the international development and expansion history. After illustrating the theoretical and practical design of spiritual care, there is room for constructively critical questions. Based on ascertainable (in-)compatibilities between spiritual care and pastoral care, Nauer provocatively puts in a nutshell, why spiritual care is a serious challenge for health care employees, pastoral carers, churches and charities/ welfare institutions.