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  • Sept. 12, 2009

    Blog: How faith affects end-of-life decisions

    By Edward T. Creagan, M.D.

26 comments posted

The intersection of faith, belief systems and health is complex and sometimes bewildering. Nevertheless, it's an important topic and one that deserves further examination.

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The "Journal of the American Medical Association" published an excellent study earlier this year that found an association between religious faith and preferences for aggressive end-of-life care. In other words, individuals with positive religious coping seem more likely to request mechanical ventilation and other types of life-prolonging care, compared with individuals who do not have strong religious faith.

I must admit I was surprised by these findings. In my experience, individuals with deeply rooted faith are often willing to forego some of these measures. This study was an excellent reminder that we can't make assumptions about people's beliefs and desires regarding the end of life.

As I reflected on this, I thought back to one particular patient I cared for. He had advanced intestinal cancer. When asked to indicate his religious preference, he wrote "none at all" on his form. At our initial visit, we discussed the trajectory of his illness. He understood and accepted that cure wasn't likely and expressed the desire to be kept comfortable for the time remaining to him. He shared with me that he wished he had spiritual beliefs to provide comfort and consolation. He said he envied individuals who believed, but added "I just don't." His final days in the hospital were comfortable, but he didn't seem to me to be at peace in the same way as I've seen in individuals who have faith or spiritual beliefs.

The lesson here is a simple one: We need to respect others' beliefs and choices, and learn from one another as we face the decisions that arise at the end of life.

What would you like to add to the discussion?

26 comments posted

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  • December 30, 2009 1:01 p.m.

    I do believe in a higher power and in life after death. Evidence points rather strongly to that reality. Hainv known several people who have had near death experiences, I have no doubt in my mind about life after death. Like Janicem I too have been carried throughout some pretty difficult situations. Yes, there is a lot I can do in my own power, but that which I cannot do, I submit to Christ. Barbara A, author of "Cry Depression, Celebrate recovery." soon to come out.

    - Barbara A

  • December 11, 2009 9:43 a.m.

    The Bible is the Word of G0D, the hope of all mankind. Christ Jesus is the only one who will never leave us, never abandon us, and who gives us eternal life. Be not deceived, God's Word is eternal. The gospel is the saving grace offered to all who believe that Jesus is the Son of God who died according to the scriptures was buried and was resurrected by God the Father. He Christ cannot lie- Jesus tells us that physical death is not the end, but after this the judgement. Choose life in Christ.

    - june

  • November 15, 2009 10:09 p.m.

    My father has been in a nursing home for 4 years with Alzheimer's. He is now to the point that we believe he won't make it to next year. We ask ourselves why God won't take him home as he has no quality of life. He was a devote Christian man and we know he will be whole soon. Go thru this w/o God? No way. We are also watching a sister with stage IV lung cancer fight this battle. Where she is on her faith walk, i don't know. But i know i have peace from trusting in a merciful God. Who is my inspiration? My 88 year old mother who walks with God everyday. Her strength is from the Lord. Faith is what brings us strength, comfort, peace and hope for a better life for all. Dying isn't an ending, it's a beginning. Sadness and grief? Yes, we're human. The end? The end of life in these finite bodies, yes. Everlasting life? Yes. Religion has nothing to do with how we face life or death. Faith does. For now we see in a mirror dimly. No one religion has all the answers. Only God and we will get those answers when we cross over.

    - Liz

  • October 31, 2009 11:55 a.m.

    I was once a devout Christian, but being pragmatic I came to the conclusion that religion is merely a way to try and answer the unanswerable. If it brings peace to the believer that is wonderful for them. However, I am 84 years old and am not afraid of death. I think that it is the end - period. I am not fearful, unhappy, or afraid of the unknown as the religious would like to believe. In fact, I am more at peace than I ever was when I was filled with all of the religious doctrines of heaven and hell. I broke my hip, was not near a phone and was afraid I would not be discovered until after my death. I thought I was probably facing death and was not afraid. Of course, I did not die, but it is proof that I will not be afraid when death comes, as it will sooner than later. I have a living will and it clearly states no heroic measures.

    - Darlene

  • October 29, 2009 1:16 p.m.

    iam a born again preacher and i submit that based on my experience with faith and spirituality,a human being can only have true peace both in this life and at its end if and only if their conviction is based upon a true experience with God,not as a being one has heard about but as a reality with whom he/she is daily in contact and whose fellowship one delights in every day of this life. most people may seem to confess what i can call 'band wagon beliefs'-the kind of faith that stands upon the foundation of numbers and associations not personal relationship with the divine.since death is a one-on-one affair between man and death,it remains true that the hypothetical believer remains lonely and desperate in the face of the sense of 'nowhere' or 'no one' he or she is about to confront.this is the real reason behind the loneliness and desolation in the face of death. genuine faith therefore creates a longing and yearning for the face of the unseen companion through life's weary way.faith in the christian victory over death as a result of the death of jesus christ on the cross completely removes all fear from it,even as paul said"death where is your sting?,o grave,where is your victory?. victory over the fear of death therefore comes only through genuine faith and relationship with jesus christ-the one who has victory over it.

    - achilla

  • October 28, 2009 8:31 p.m.

    21 years ago I did hospice care for my mother. I could not have done this work without the grace and strength provided by the Lord God Almighty. I truely know what it "tastes" like to be "carried," as the Footprints poem says. I Know that I will se my mom again because we are both born again Christians. This gives me great comfort.

    - Janice

  • October 28, 2009 11:02 a.m.

    I was involved in caring for my best friend's physical needs during her dying time of uterine cancer. She never accepted that she was dying and her death was excruciatingly and agonizingly painful, yet, she attended church every Sunday and even had a Penacostal preacher and accompaning parishioners pray over her. However, they also told her on her death bed that if she did not repent of her "sins" she would surely die. Her oncologist did not put her on an IV as he said it would "feed the cancer". The oral morphine we administered was ineffective because she could not swallow and her rasping death rattle filled the house for three days. I am haunted by her horrific dying process and the lack of real hospice empathetic care. The day before her passing, I began to read to her from St. John, and her breathing became loud and laboured and I took that as a sign that she did not want to hear it. She was in a coma. Next night she mercifully died.

    - Kaye

  • October 27, 2009 9:38 p.m.

    As a nursing home social worker I must accept all of the different choices that people make about end of life. I would have thought that those whose spirituality leads them to believe that there is something after life might be more accepting of death. More often than not I see children so distressed and guilt ridden that instead of staying true to their parents wishes that they will make choices that even go against what has been put in writing. Personally I believe that if we as a culture talked about death instead of hiding these discussions we would be more accepting that with life comes death. Dr Robert Martensen in his book A Life Worthe Living speaks about the the mortality rate of an 80 year old in the year 1400 AD being exactly the same as the mortality rate of an 80 year old today, despite all of the advances in technology. Death will not evade us.

    - Julie

  • October 25, 2009 9:13 a.m.

    My father passed away 4 wks ago. He was a staunch Christian. Five years ago, he wrote a living will stating he wanted "everything done". Being a nurse, I helped him understand what that meant. He understood and kept it that way. Six months ago, he quit eating for 3 days. It was a scary situation. I approached him about his living will, since the doctors asked me to. He said "it was important then and is important now". He said that if he couldn't eat anymore, he wanted a feeding tube. The doctors kept mentioning that he was becoming more demented, and I should seriously consider making him a "no code". I thought long and hard, and decided that the living will is for those that can't speak for themselves anymore, and I felt I should honor his wishes. When dad went into respiratory arrest on Sept 8, clutching his chest, trying to breathe and voicing fear. I made the decision to take him to the ER. He died one week later. While he was in the hospital, I made decisions about his living will based on his unconsciousness. I got so much harassment from the physicians that it made me heartsick. They were upset that I even brought him to the ER, "I should have left him go". You are right that "we need to respect others' beliefs and choices" and that's what I did for my dad. I will never regret that I tried to honor his requests. I understood the physicians viewpoint...Dad was 92...but dad's decision was that he wanted someone to try. W

    - NJ

  • October 8, 2009 2:29 p.m.

    Dear Anne, Your friend needs someone who will get her to talk about her fears and get them out in the open. Once she can share, the nightmares should stop. We all need to know that someone who loves us shares our concerns and fears. I am having to prepare to leave my family who still needs me, but I have seen them to adulthood and I am so proud of them. The good we have done is what really defines us. I think your friend has so much to celebrate. Remind her of this.

    - Kathryn

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