Spirituality manifests itself in parents confronting life-limiting conditions in their children through five crucial aspects: religion, hope, parental identity, personal development, and social connection. Paradoxically, each of these elements can act either as a profound source of strength or as a profound source of spiritual distress. They can drive Positive Religious-Spiritual Coping (PRSC), which fosters resilience and meaning, or Negative Religious-Spiritual Coping (NRSC), which can precipitate feelings of guilt and profound despair. The belief in a miracle (specifically, the "healing of the child") emerges as a paradigmatic component in this clinical setting. It is often misconstrued as an instance of NRSC, when, in reality, it constitutes a fundamental stage in the complex process of reframing and re-signifying this profoundly painful experience. A spiritual approach that is technical, welcoming, and deeply compassionate enables parents to discover and experience the "true miracle," which resides in their capacity to bond with and love their child in the completeness of body, soul, and spirit. The therapeutic work carried out by the PPC team with the family unit acts as a crucial strategy for fostering hope. This approach is capable of nurturing these existential strengths by directly addressing meaning, connection, hope, and faith. However, significant and pressing gaps persist in this field. The spiritual approach in PPC urgently lacks professionalization and robust empirical evidence regarding the efficacy of specific clinical interventions. Professional discomfort and a pronounced lack of adequate training remain evident and substantial barriers to optimal care. It is imperative to develop structured and culturally sensitive spiritual assessments, alongside comprehensive educational programs that empower healthcare teams to navigate the complex spiritual landscape of grieving families with both compassion and clinical proficiency.