Torch, Spring/Summer 2007

many conflicting emotions. Today’s medical treatments are amazing, but there are some conditions for which medical treatments will not be effective. It may be hard for patients and families to accept the fact that a cure is not possible. They often urge doctors to “try everything.” Conflicts occur when physicians believe the only right thing to do is to stop treatment, while the patient and family want to continue. Or there may be a struggle when the patient and family accept the inevitability of death, even when a physician is urging them to try just one more treatment. Sometimes patients and their family members disagree about what bioethicist Leon Kass calls the “just right thing to do.” Clinical bioethics is all about helping people face tough choices and decide which way to turn. A clinical bioethicist has advanced training in both ethics and healthcare and is a person doctors, nurses, patients, and families can turn to when they are not sure what to do. (Read more about how a bioethicist assists others in “Jenna’s Story” below.) Because patients and families face difficult ethical issues surrounding a terminal illness and care at life’s end, consider making “advance medical directives” to clarify your treatment wishes (a “living will” or “five wishes” document). Appoint a trusted person to make your medical treatment decisions if you are not able to speak for yourself (a “durable power of attorney for health care” document). Any hospital can provide the necessary forms. Remember that you have certain rights as a hospital patient. Ask to receive a written list of those rights Jenna’s Story A bout 80 percent of all Americans who die this year will die in hospitals. It is frightening but true that more than one half of all Medicare dollars spent in America go toward care given in the last weeks of a patient’s life, care that usually does no good. Families may be bewildered by the complexity of technology surrounding a loved one’s hospital bed and the confusing medical terms used by healthcare professionals. Quality-of-life questions also often surround the dying process. Both health professionals and family members ask tough questions. • How can I help someone who is dying? • What is a good death? • How can people who love this individual make the dying process less painful or frightening or isolating? • When is enough truly enough? • How does anyone know when to stop medical treatments that don’t seem to be of benefit? • Should we speak up and say something, and to whom should we say it when the patient can no longer speak for himself or herself? One of the painful realities patients and family members face is a conflict of values when a loved one is dying. Christians can accept the reality of death quite differently from other people. Death is not irrevocable and not the end of existence, because Jesus says that everyone who believes in Him will have eternal life (John 3:15). Yet when a loved one is diagnosed with a terminal illness, both the patient and family experience Spring-Summer 2007 11 doctor again asked Jenna’s mother for permission to stop treatment. She said, “Please don’t give up on my daughter just because she is mentally retarded.” Jenna’s doctor asked a clinical bioethicist to intervene. The bioethicist asked Jenna’s mother for permission to include her pastor in discussions about the difficult decisions that had to be made for Jenna. The bioethicist and pastor considered what key characteristics came together to create this ethical problem. They considered Jenna’s rights and what options were in her best interest, and they asked for God’s guidance. They prayed with Jenna’s mother. They did not make a decision themselves, nor did they coerce Jenna’s mother in any way. Yet they were honest and forthright because they had two obligations. They had to protect Jenna’s right not to be subjected to meaningless suffering, as well as her mother’s right to speak for her daughter and remain true to her own faith. Over the next week, Jenna’s mother, the doctor, the bioethicist, and the pastor talked T and prayed daily. During that time, they helped Jenna’s mother accept the idea that stopping medical treatment did not mean giving up on Jenna. The pastor helped Jenna’s mother share her fear that what happened to Jenna was her fault for leaving to go shopping. The team reassured her of God’s love for Jenna and for her, so that she could accept the idea that God might be ready to take Jenna home. She became ready to accept His will for her daughter.