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By Diane Marshall [other pieces by Diane Marshall]
Recently, an Angus Reid poll indicated that 68% of Canadians surveyed felt it should be up to a family member to decide whether to remove a patient in a vegetative state from life supports. A case currently before the courts in Manitoba has a Jewish family challenging the doctors and hospital who are arguing that their elderly father be removed from life supports.
As a family therapist, I have heard the stories of families agonizing over end of life decisions. During the past decade, there have been many ethicists engaged in both sides of the public debate over the dilemma of "persistent vegetative state" diagnoses. It is painful to see family members locked in argument over this issue, the root of which is our modern medical technology outpacing our ability to make coherent and wise ethical decisions.
When should life supports be provided? When should they be removed? Are we talking about prolonging life, or prolonging dying? What are the emotional, relational, financial, and physical costs involved? Should this be a decision made in consultation only with the doctor? What if a person has not made a Power of Attorney for Personal Care, including the giving or refusing of consent to treatment? This is a document which indicates what the person wills in the event of no reasonable expectation of recovery from extreme physical or mental disability unless kept alive by artificial means (or what is termed "heroic measures").
These are some of the ethical decisions facing modern families, and more than often such families have never had any discussion with one another about these matters. So under a time of profound stress, and grief, family members may be asked to make excruciating decisions, with very little emotional or psychological support or spiritual guidance.
I believe that churches can be of help in this matter, by sponsoring public discussions about the issues of death and dying. Panel discussions could be held with doctors and perhaps palliative care nurses, and lawyers and ethicists. This could begin a conversation on such issues which would then empower families to openly discuss with one another what is often a taboo subject: death and dying. By God's grace, through careful and thoughtful dialogue, family members could face these end of life questions together and come to some common understandings.
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Two recent films seek to explore the questions of family members facing the loss of a beloved spouse or of a parent. One, "Away From Her", sensitively addresses a marriage where one spouse develops Alzheimers, and the other is left bereft of relationship.
Another, "The Savages", looks at the complex relationship of two adult siblings as they come to terms with their aging father's dementia and death. Both these films could be used effectively in an adult fellowship group to stimulate discussion on end of life issues.
The words of the Psalmist are a profound comfort to those facing their own death, and to their family members holding vigil with the dying:
I lift up my eyes to the hills --
from where will my help come?
My help comes from the Lord,
who made heaven and earth.
He will not let your foot be moved:
He who keeps you will not slumber.
He who keeps Israel
will neither slumber nor sleep.
The Lord is your keeper;
the Lord is your shade at your right hand.
The sun shall not strike you by day,
nor the moon by night.
The Lord will keep you from all evil;
he will keep your life.
The Lord will keep your going out and your coming in
from this time on and forevermore.
Psalm 121
Diane Marshall, M.Ed., RMFT is with the Institute of Family Living (IFL), Toronto, and is a regular contributor to canadianchristianity.com.
IFL is a multi-disciplinary, cross-cultural team of professional therapists and physicians. Guided by Christian and Jewish faith traditions, they offer psychotherapy, assessment, and consultation to individuals, couples, families, and human service agencies. www.ifl.on.ca
February 20/2008
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