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Roles for the church in improving end-of-life care: perceptions of Christian clergy and laity.

Although faith communities may seem to be logical places to discuss death and dying, few churches are engaged in extensive efforts to improve end-of-life care. To explore the meaning of a good death and potential roles for faith communities in this effort, the authors held focus groups involving 121 clergy and congregants affiliated with Christian churches in Honolulu. Participants' definitions of a good death were similar to those articulated in other studies, for example, pain is managed, inappropriate prolongation of dying is avoided, the family is present and supportive, conflicts are resolved, and spiritual/existential issues are addressed. Participants identified a number of roles for the church: (a) to help congregants prepare for death, both spiritually and practically; (b) to facilitate resolution of conflict and forgiveness; (c) to clarify if or how church theology should guide attitudes and practices related to death and dying; (d) to administer the appropriate rituals; and (e) to provide outreach to sick, dying, and bereaved members. A number of participants noted that attention to spiritual issues at life's end would be important to all people, and churches wanting to increase membership should expand offerings in this area. These findings suggest that faith communities can have a major impact on improving end-of-life care and that pastoral education include attention to these issues.

Christianity↗

Fatal myxedema pericarditis in a Christian Scientist.

A case of fatal cardiac tamponade due to myxedema pericarditis is reported. The woman, a 54-year-old Christian Scientist, had never sought medical care and died at home. The pericardial sac occupied most of the thorax and contained 2,270 mL of fluid. A thick, shaggy, fibrinous exudate on the pericardium contained abundant cholesterol clefts typical of chronic effusion and myxedema. Thyroid function tests on postmortem blood revealed profound hypothyroidism, and the thyroid was atrophied, with the histologic appearance of primary atrophic thyroiditis. Pericardial effusion is common in myxedema, but cardiac tamponade is rare, only 13 cases being previously reported, none of which was fatal.

Cardiac Tamponade↗

"Help must first come from the divine:" a response to Fr. George Eber's claim of the so-called incommensurability of Orthodox and non-Orthodox Christian bioethics.

Orthodox bioethics is distinctive in how it reflects on issues in bioethics. This distinctiveness is found in the relationship of spirituality and liturgy to ethics. Eber's essay, however, treats the distinctiveness as absolute uniqueness. In so focusing on the incommensurability of Orthodox bioethics Eber fails to tell his reader what Orthodox bioethics is about. Furthermore, his description of Western Christian ethics is seriously inaccurate.

Attitude to Death↗

Understanding equality in health care: a Christian free-market approach.

This paper examines the arguments presented by the Roman Catholic Bishops in their 1993 Pastoral Resolution, Comprehensive Health Care Reform: Protecting Human Life, Promoting Human Dignity, Pursuing the Common Good, concerning health care reform. Focusing on the meaning of equality in health care and traditional Roman Catholic doctrine, it is argued that the Bishops fail to grasp the force of the differences among persons, the value of the market, and traditional scholastic arguments concerning obligatory and extraordinary health care. To attempt to equalize the distribution of health care would be ruinous. A more traditional understanding of Christian thought reveals an acceptance of inequality in health care distribution and a bias against using the secular state to coerce a solution to such concerns for social justice.

Catholicism↗

Prolonging life: an Orthodox Christian perspective.

While Orthodox Christianity does not find explicit statements about the morality of prolonging life in the usual doctrinal sources, the Scriptures and the Fathers of the Church, there are elements in Tradition which bear upon the issue. These include Orthodox spirituality's emphasis on the "wholeness" of the human person, its liturgical and synergistic view of human life, and its understanding of our moral ambiguity as fallen human beings in a fallen world. This last point, in particular, means that we do not usually have a clear choice between right and wrong, and that we cannot always trust ourselves to know which choice is the right, or even the better one. Therefore, we must always approach decisions about death and dying with humility and in a spirit of repentance, aware of the imperfection of all we do and trusting in the mercy of God.

Attitude to Death↗

End-of-life decisions: Christian perspectives.

While legal rights to make medical treatment decisions at the end of one's life have been recognized by the courts, particular religious traditions put axiological and metaphysical meat on the bare bones of legal rights. Mere legal rights do not capture the full reality, meaning and importance of death. End-of-life decisions reflect not only the meaning we find in dying, but also the meaning we have found in living. The Christian religions bring particular understandings of the vision of life as a gift from God, human responsibility for stewardship of that life, the wholeness of the person, and the importance of the dying process in preparing spiritually for life beyond earthly life, to bear on end-of-life decisions.

Attitude to Death↗

Does social work oppress evangelical christians? A "new class" analysis of society and social work.

This article argues that social work, informed by "new class" ideology, oppresses Evangelical Christians. The article discusses the rise of the "new class," along with its attendant ideology, which sanctions and legitimizes discrimination against Evangelicals and other people of faith. The role of social work, a "new class" profession, in the oppression of Evangelicals is profiled, and its inability to extend tolerance to this population is traced to its "new class" ideology, which inhibits it from functioning in accordance with its professed values and ethics. Consequently, the article suggests that social work is losing touch with numerous ethnic and religious minority groups, and unless the profession deconstructs the ideology that informs it, it will be unable to provide services to or facilitate dialogue among the increasingly diverse populations of North America.

Christianity↗

Christian Science visited.

An objective appraisal of Christian Science and its relevance to the contemporary practice or medicine are presented. The history, nature, and healing aspects of the movement are briefly surveyed. Emphasis is placed upon the fact that despite more than 100 years of coexistence no accommodation between points of view is possible either now or in the future.

Christian Science↗

Use of a medical facility by Christian Scientists.

Our study, unique in its use of medical records as well as self-report data, was conducted to ascertain the extent to which Christian Scientists used a medical facility and whether or not such use was related to the experience of psychologic stress. Their use of medical facilities was found to be low, and it was positively related to stress.

Christian Science↗

The Norwegian translation of the Francis Scale of Attitude toward Christianity.

This paper reviews the development of the Francis Scale of Attitude toward Christianity and then examines the psychometric properties of the Norwegian translation of this instrument among a sample of 479 young people between the ages of 11 and 18 years attending secondary school. The data support the reliability of this instrument and commend it for further validation studies and for wider general use among young people in Norway.

Adolescent↗

Spiritual care in Christian parish nursing.

AIM: This paper reports the development of a substantive theory to explain the process parish nurses use to provide spiritual care to parishioners in Christian churches in a context where patients and nurses share a common set of values. BACKGROUND: Despite a surge of interest in spirituality and spiritual care in nursing, consensus is lacking on how care should be conceptualized and provided. METHOD: Grounded theory method was used to explore and describe the processes 10 American parish nurses experienced and used as they gave spiritual care. Data were collected between 1998 and 2001. Participants were interviewed and audiotapes transcribed verbatim. Constant comparative methods were used to analyse more than 50 separate incidents reported by the nurses. FINDINGS: From its initial emergence as the core category, 'Bringing God Near' became a Basic Social Process theory of giving spiritual care for these parish nurses. This Basic Social Process became a theory through writing theoretical memos that described how the 'main concern' of the nurses to give spiritual care was resolved. Phases within the process include: trusting God, forming relationships with the patient/family, opening to God, activating/nurturing faith and recognizing spiritual renewal or growth. The essence is bringing God near to people as they face health challenges. Findings from the study and spiritual care literature are integrated in the discussion. CONCLUSION: The parish nurses' spiritual challenge is to respond to what God is directing the nurse to be and do to strengthen people spiritually. This spiritual care can help restore the patient's sense of well-being, and encourage growth in faith. Those interested in providing and teaching spiritual care in the church context will find this theory useful as a conceptual guide.

Adult↗

Sacred practices in highly religious families: Christian, Jewish, Mormon, and Muslim perspectives.

Quantitative research examining linkages between family relationships and religious experience has increased substantially in recent years. However, related qualitative research, including research that examines the processes and meanings behind recurring religion-family correlations, remains scant. To address this paucity, a racially diverse sample (N = 24) of married, highly religious Christian, Jewish, Mormon, and Muslim parents of school-aged children were interviewed regarding the importance of religious family interactions, rituals, and practices in their families. Mothers and fathers discussed several religious practices that were meaningful to them and explained why these practices were meaningful. Parents also identified costs and challenges associated with these practices. Interview data are presented in connection with three themes: (1) "practicing [and parenting] what you preach," (2) religious practices, family connection, and family communion, and (3) costs of family religious practices. The importance of family clinicians and researchers attending to the influence of religious practice in the lives of highly religious individuals and families is discussed.

Adolescent↗

Medical ethics--a Christian view.

All ethics has a religious dimension. This paper considers how specific Christian insights concerning death, suffering, human nature and human creatureliness can help to expose more fully the moral issues at stake in some of the dilemmas faced by doctors. It ends by acknowledging the crushing burden of decision-making which rests on many in the medical profession, and indicates the importance of religious resources in dealing with this.

Bioethical Issues↗

Killing, karma and caring: euthanasia in Buddhism and Christianity.

In 1993 The Parliament of the World's Religions produced a declaration known as A Global Ethic which set out fundamental points of agreement on moral tissues between the religions of the world. However, the declaration did not deal explicitly with medical ethics. This article examines Buddhist and Christian perspectives on euthanasia and finds that in spite of their cultural and theological differences both oppose it for broadly similar reasons. Both traditions reject consequentialist patterns of justification and espouse a 'sanctity of life' position which precludes the intentional destruction of human life by act or omission.

Buddhism↗

Genetic differentiation of Jordanian Moslems and Christians.

Two samples representing the Moslem and Christian communities of Jordan were examined for the polymorphic serum proteins AHSG, BF, FXIIIB, GC, HP, PI, PLG, and TF. The results revealed similar allele distributions, and low interpopulation differentiation (GST = 0.0004) between the two communities. The low HP*1S (< 0.12) allele frequencies and the comparatively high PLG*B (> 0.40) and BF*S.07 (approximately equal to 0.05) frequencies are characteristic of the populations of this region.

Adolescent↗

The evangelical Christian in psychotherapy.

The history of the evangelical attitudes to therapy is complex. Several of the historical roots to a general suspicion of psychological perceptive are explored. Freudian psychoanalysis and fundamentalism were not compatible and for decades no attempt at rapprochement developed. The liberal wing of Christianity made early attempts with the religion/psychiatry dialogue of the 1960s. Drastic changes in the youth of the evangelical, especially on the college campus in the 1960s, broke through some of the resistance. A growing disillusionment on the part of the evangelical in the pew concerning the efficacy of the traditional spiritual approach to relational and emotional problems accompanied these changes. The literalism and rigidity of a paranoid stance toward psychological insights has given way to a kind of chaos. The evangelical person seeks outside the church too. There is no consensus theoretically or practically among the many from within the church who are therapists. There are many strengths in the evangelical. These include family and developmental emphases in psychotherapy. The effective therapist will comfortably explore the religious life of the evangelical as it is relevant to the therapeutic task. Acceptance and elimination of countertransferential bias will foster the honesty and mutual respect that are essential for positive outcomes in therapy.

Christianity↗

Christian patients' views of spiritual care.

The purpose of this qualitative study was to discover the essential structure of spiritual care by obtaining detailed descriptions of the phenomenon from those who have received such care. Data were generated through open-ended interviews with 10 Christian volunteers and analyzed using Colaizzi's phenomenological approach. Findings revealed that spiritual care was given and received in a context in which the recipient was vulnerable and receptive to spiritual care. Three theme clusters included enabling transcendence of the present situations for higher meaning and purpose, enabling hope, and establishing connectedness. Implications for nurse clinicians, educators, and researchers are discussed.

Caregivers↗

How Françoise Dolto links Lacanian psychoanalysis with the Christian Gospels.

This article introduces to an English-speaking audience of pastoral therapists, the writings of the French Lacanian psychoanalyst, Françoise Dolto (1908-1988) on the links she discovered between the most profound question raised by Lacanian psychoanalysis in its dynamics effects and the questions raised by the Christian Gospels. The author summarizes the main points of Dolto's Lacanian thought and where she departed from Lacan in her interpretation of the unconscious ethic of desire. Using Dolto's three writings on Lacanian psychoanalysis and the Bible, as well as material from her published clinical studies, the author illustrates Dolto's approach to the Bible, the parable of the Good Samaritan, and her application of the dialectical principles of desire in three case studies.

Canada↗