Spirituality Presents a Paradox in End-of-Life Care
In her practice at Dana Farber, Balboni says she's seen many times when "this fixation on the possibility of a miracle by both patients and their religious communities makes it difficult to change the focus of care" to deal with symptoms like pain, and to make end of life as comfortable as possible, and away from getting cured.
Medicine as Divine Intervention
"It's like they're saying, 'God is a God of miracles. We'll pray for you that you will be healed of this illness.' And there might be concerns whether choosing not to undergo certain therapies is potentially violating the sanctity of life, and that somehow continuing these therapies is choosing life, as opposed to the assumption—and I've actually heard this from patients—that it would be going against God's will to stop therapies.
"One patient was concerned that stopping chemotherapy would be equivalent to committing suicide, which was against that person's religious beliefs."
Balboni emphasizes that it's not categorically wrong for a terminally ill patient with advanced stage cancer to try experimental drugs, particularly if they are very young. "Often it's very appropriate to choose medical technologies and interventions with the hope of providing better quality of life and better survival," she says.
But if it's at the expense of embracing the kind of spiritual preparation that people need to prepare for at the end of life, well, that's probably not what the patient would want if they could appreciate the gravity of their situation.
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