The Greatest Gift

I think the chaplains can accompany people who are struggling with these issues,” says C. George Fitzgerald, PhD, director of the spiritual care service at Stanford Hospital and Clinics in Palo Alto, Calif. Some patients and their families find it easiest to approach the subject of death with a clergy member. Much about religious belief concerns the afterlife, and some of the deepest reservations about end-of-life planning are rooted in questions about faith. Patients fear leaving family members and the unknowns of death itself. “The chaplain can help them through this wilderness experience,” Fitzgerald says.

Planning for death often means coming to terms with apparent conflicts with faith, says Stanford chaplain Susan Scott. “Patients will want to know: Am I supposed to keep trying? If I stop, does that mean I’m going against God’s will?” she says. “They sometimes need that conversation about God’s will in their life.” Planning for death does not mean you are giving up hope, she tells them, or that you are giving up on the possibility of a miracle.

For someone who sits with families trying to make these life and death decisions, I can say that planning is the greatest gift to your family.

Chaplains can also assist with some of the most painful deathbed choices, Scott says. “I think the most difficult decision to make has to do with withdrawing life-support systems,” Scott says. “If we discontinue life support, are we turning that person over to death? The challenge is to help patients recognize that artificial life-support is prolonging the dying person. I think that’s the most difficult decision to come to, and usually it takes a while.”

Above all, it’s important for patients to reach out to the person they are most comfortable with, no matter who that may be, says Carol Taylor, RN, PhD, of the Georgetown University Center for Clinical Bioethics. Otherwise, family members are left to reach these decisions in moments of great anxiety. “For someone who sits with families trying to make these life and death decisions,” she says, “I can say that planning is the greatest gift to your family.”