Irenic Thoughts

Irenic. The word means peaceful. This web log (or blog) exists to create an ongoing, and hopefully peaceful, series of comments on the life of King of Peace Episcopal Church. This is not a closed community. You are highly encouraged to comment on any post or to send your own posts.


Belief and Practice

This week, we enter more fully into the last week of Jesus' life and ministry leading up to his death and resurrection. In this context, I found a recent study intriguing. A survey found that terminally ill cancer patients who say they find comfort in religion are the ones most likely to undertake "aggressive, life-prolonging care." They are far more likely than those who do not find comfort in their faith to ask the doctor to do everything possible to keep them alive.

“People think that spiritual patients are more likely to say their lives are in God’s hands — ’Let what happens happen’ — but in fact we know they want more aggressive care,” said Holly G. Prigerson, the study’s senior author and director of the Center for Psychosocial Oncology and Palliative Care Research at the Dana-Farber Cancer Institute in Boston.

“To religious people, life is sacred and sanctified,” Dr. Prigerson said, “and there’s a sense they feel it’s their duty and obligation to stay alive as long as possible.”

Medicare pays out about a third of its money on the last year of a patient's life and much of that on the last weeks. But that is at the dollar cost level. There is also the increase in suffering patients take on in order to prolong their lives.

The study published in the Journal of the American medical Association found that A vast majority of patients, religious or not, did not want heroic measures taken. But in some indicators, those of faith varied substantively. For example 11.3 percent of the most religious patients received mechanical ventilation during the last week of life, compared with only 3.6 percent of the least religious.

Faith in God was a more influential factor than the recommendations of their family doctors, their spouses and children, and even information about whether treatment would cure the disease.

Doesn't this approach to prolong life at any cost make an idol out of our lives. Is living longer the greatest good in all situations? Or can't quality of life for a shorter amount of time be a faithful option for Christians?

For most of human history, options including chemotherapy and various surgeries, etc. were not available. But now that they are options to consider, must a Christian always opt for the maximum care possible. I say no. In saying no, I certainly am not in any way addressing those for whom care has a chance of returning the person to health. When there is a chance of being returned to health, then that seems like it is always the right choice. I am addressing only end of life care when a return to full health is not possible and it is only a matter of how long one will live.

In that setting, I do think taking less extreme measures to assure a better quality of life. So, for example, a person can be lucid and have less pain and suffering for three months rather than to go through a very difficult final six months.

That's my take, but then I am not currently making this decision for myself and so do not seek to judge someone who is in that position. I have walked with families making that journey and am continually amazed at the grace and love found in difficult circumstances. I am not looking at this with specific cases in mind, but with the total numbers in view and asking this Holy Week whether those of faith should not show their belief in the resurrection in their practice of making end of life decisions. What do you think?

The Rev. Frank Logue, Pastor



  • At 4/06/2009 10:23 PM, Blogger anything but typical said…

    As someone who has spent many years as a critical care nurse, it is important to understand that many times these decisions are not made by the patient, but by family members who are unprepared for the dying process and who are afraid of what they see, or who are just not ready to say goodbye. And unless there is an Advance Medical Directive or Living Will, the patient's wishes may be left by the wayside and discarded in the face of family members who may sue the healthcare providers.

    Often they are torn by guilt in not "doing everything." Many times people simply do not understand what that means. They don't understand what they are asking me to do to their dying family member in keeping them in this world. I have seen those family members who were most insistent on aggressive treatment become horrified at when they saw the suffering of their loved one due the aggressive treatment they thought they wanted.

    Sometimes family members need more time to say those goodbyes. A well-trained hospital chaplain or a pastor trained to deal with end-of-life issues can really make a difference with helping these families come to decisions that they can live with.

    As for why people of faith tend to request aggressive treatment for themselves and their families more often, I don't think it is as much a doubt of the resurrection power of Christ. I believe it has more to do with their faith in the presence and workings of God in this world. People really do look and pray for the miracles. Unfortunately for some, the acceptance of an impending death is seen as a loss of faith. It is perceived as giving up on their healing. This is especially true of faith traditions that emphasize divine healing, and the teaching that if you truly believe, God WILL heal. The inverse corollary is that if you fail to believe, He doesn't.

    And while I believe that God does heal people (I have seen this), God would not be all-powerful if He could not say No. I believe that sometimes God says we've had enough, and it's time to go home.


  • At 4/06/2009 10:35 PM, Anonymous Kelly said…

    Well stated, Debby! :) I totally agree!!!

  • At 4/08/2009 7:38 AM, Blogger All Saints Episcopal Church said…

    I encourage everyone to think through the kind of care they would like to receive if they cannot speak for themselves. An excellent and easy to use tool for this is the booklet "Five Wishes," which, when properly filled out, becomes a Living Will in many states.

  • At 4/09/2009 9:48 PM, Blogger anything but typical said…

    "Five Wishes" is a great guide. Most hospitals have copies as do many Hospice programs. Locally, our hospital chaplain, (my Dad, by the way) has copies. He can be contacted through the hospital, through me, or through Fr. Frank.



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