The caring of a person who has made the choice to end their life through physician assisted dying is now a possibility in New Zealand. Continuing on in this series of articles to resource and support our churches at this time, experienced hospice and hospital chaplain, Donna Denmead shares some thoughts for family and friends who are caring for the dying.
Other articles in The End of Life Choice Act series:
- Faithful Christianity by Jonathan Robinson
- Pastoral responses by Phil Halstead
- The practicalities by Rebekah Kilpatrick
As we walked around the base track of Mauao this morning it felt a very long way from suffering and dying. The pōhutukawa were bursting into flower and the sea was calm and tranquil. So different from the experiences of many facing a terminal illness.
Although it is a year since I worked in palliative care as a hospice chaplain, conversations about death occur surprisingly often in the public hospital setting. On one recent visit every patient I had a significant in-depth conversation with, brought up the prospect of dying and how they had faced a time in their illness when they would have welcomed a way of escape. Although none of these were terminally ill, many others are and there is now a legal way of escape they can pursue; physician assisted dying (PAS).
I was recently introduced to a description of chaplains as being Ministers of Consolation and Hope. Not a new idea but a great way of describing what chaplains are. We strive to always be bearers of hope and represent the comfort of God where we minister. These attributes are not only for chaplains, but for all Jesus followers.
For a patient bringing up the conversation of wanting to hasten their death by physician assisted dying, a chaplain’s approach is the same as their approach to all conversations. Asking questions is a good way to begin. For example, “What is happening for you now that you want to consider this?” An open question enables the other to explore more what may lie behind their decision. This can happen prior to the chaplain following their employer’s directives on this matter. However, for the reader of this article you probably won’t be bound by policies and directives and therefore I offer more thoughts about how you may approach this with a family member or friend who has made the choice to end their life in this way.
The question offered already may be a good one to begin with. A pastoral response is not to start an argument or push our own thoughts and opinions on another. Being inquisitive and giving the opportunity for the other to share their inmost thoughts and feelings requires some particular postures of the soul. Facing our own mortality is helpful if we want to support someone dying, asking ourselves what it might be like to be diagnosed with a terminal illness. What scares you the most; what will you grieve over, who will support you; what will you need?
Then from a posture of humility find out more about their story and the reason for the decision. Overseas’ studies have revealed that the predominate reason someone pursues euthanasia, is not physical suffering, e.g. uncontrolled pain, but rather psychological suffering. Fear of being a burden; social isolation; or the desire to be in control. Knowing this enables us to listen with an ear for these things and having ways to respond. We can do this by reassuring the person who doesn’t want to be a burden that they are loved and wanted. The social isolation can be relieved by you faithfully turning up and visiting even when the visits may be hard going. When someone needs to go into full time care because their family carer is exhausted, having a friend consistently showing up speaks volumes to their sense of worth. When they lose control and struggle with that, validate these feelings rather than trying to make them think differently. Go back to considering what you might struggle with if you were dying.
Find out what the local palliative care team or hospice offers by way of support for the patient and their whānau. Not everyone knows this and if they are reluctant to connect with the hospice; a conversation about this with you may be a means to relieve more suffering. Hospices have volunteers who can sit with the patient, record their biography, take them on outings, and relieve their caregiver to go and meet up with a friend or do the shopping. Ask the family member what they need. Hospices have chaplains, social workers and counsellors as well as occupational therapists and physiotherapists, all trained to support patients and whanau. It is a free service and although they will not allow the act of physician assisted dying to occur on their premises or with any of their staff present, support is given prior to the death, and afterwards bereavement support for the family.
If the person you want to support decides to go ahead with dying in this way, still be a friend but an honest conversation may be needed should they ask for you to be present at the time they are given the medication to end their life. I have had a conversation about this and being open about what I could and could not do was received with respect and understanding. As already mentioned, chaplains must adhere to their employer’s policies and in that we are able to make our position clear: that we cannot be present at the time of death. But it is different for a friend or family member, and I recommend navigating this with care. If you would like support for yourself through this, you may be able to chat with a local chaplain, or with your local church pastor.
Grace and shalom for you as you decide what is best for you.
Contributor: Donna Denmead, Locum hospital chaplain, Tauranga, Welcome Bay Baptist Church.
Other articles in The End of Life Choice Act series: