Guest Column by the Rev. Tarris Rosell, Ph.D., D.Min.,
Rosemary Flanigan Chair, Center for Practical Bioethics
A recent news story quoted a father who said that his faith would not allow for his dying daughter to be moved to hospice. On religious grounds, he had demanded doctors keep trying to cure her long after they knew that comfort care was the best and most compassionate option.
I read this and wondered what sort of religion that man followed ascribed to and how badly he had misconstrued its actual teachings. I’m guessing that Dad and daughter had not talked this over, nor consulted faith leaders, in advance of her illness and dying. Too bad.
None of the world’s major religions insist on futile medical treatments or require adherents to demand of doctors what will not benefit patients. Religions differ on many matters of fact and faith; but most all of them teach compassion, the virtue of comforting the afflicted, and accepting the inevitability of physical death. No religion of which I’m aware condones torture — which is how futile medical treatments often are described by healthcare providers who feel forced to do things to patients that won’t help and might harm.
We need to talk about this.
Religion rightly construed is the friend and not foe of advance care planning. Advance directives, followed by direct conversations, address this sort of thing. They are a proven means of preventing the sort of situation that leads to family conflict and misunderstanding, and to surrogate decisions favoring futile and harmful treatments rather than comfort care when we’re terminally ill and dying. Therefore thousands of faith leaders have embraced advance care planning and encourage their congregants to do so as well.
But religion is not always rightly construed; so it might seem hard, even risky, to address advance care planning with some faith leaders or fellow congregants. What can be done then? Here are some ideas for doing this even in the face of religious resistance:
1. Complete your own advance directives, using documents available from your local hospital or online, such as Caring Conversations (free download at www.practicalbioethics.org).
2. Give a copy of your advance directives to your faith leader(s), with a request to discuss them together sometime — and then make an appointment to do so.
3. Become familiar with the scriptures and teachings of your faith tradition, particularly as they address dying and death. Initiate a small group study of these issues with other persons in your community of faith.
4. Initiate an adult religious education event at which a local expert on these matters (e.g., a clinical ethicist, a palliative care or hospice provider, a healthcare attorney, a hospital social worker or chaplain) is invited to speak. Have advance directive forms available for distribution and use, along with a notary public.
5. Ask your faith leader about the possibility of observing a day of worship focused on advance care planning and compassionate care of the dying. Introduce her or him to “Compassion Sabbath” (www.practicalbioethics.org) or other available resources for such an observance.
6. Volunteer to lead an interfaith initiative on advance care planning with other congregations in your community. Introduce this concept and resources to the regional interfaith coalition, and ask that they consider launching a community-wide effort to increase advance care planning so as to improve quality of care for the dying.