What Would You Do?

Oftentimes in my job as a chaplain I get called to do what is called a "family consultation."  Typically this experience is when the medical staff needs to discuss end-of-life goals and/or advanced directive decisions with the family and think it would be beneficial for a chaplain to be present to provide comfort and support.  The family is often asked a myriad of difficult, complex decisions about what kind of care to provide for their loved one.  Do we intubate?  Do we perform a tracheotomy?  Would you like comfort-care to be given?  Do you want us to resuscitate your loved one if they experience cardiac arrest? 

The family is often at a loss as how to respond; either they don't fully understand the questions or what implications the decision will have, or they struggle emotionally with having that power and being asked to decide about what is next for their loved one.  In those times, my presence as a chaplain is important because we offer compassionate support.  However, we are often viewed by the families as a source of spiritual authority.  "Oh he's the chaplain; he'll know what we should do."  A visit that was about my offering compassionate presence suddenly becomes an encounter where I am asked for advice.  "Chaplain, what should we do?  What would you do?"

As someone at odds with himself spiritually, having this position of spiritual authority foisted upon me makes me feel deeply uncomfortable and anxious.  If I am asked what I would do or what I would want, then I will offer an honest opinion of what my wishes would be.  However, in many of these visits it becomes a strange, uncomfortable moment of spiritual advice.  "What should we do?  What would God want us to do?" Today, I was called to one such visit and I fell into this all-too-familiar yet all-the-same uncomfortable moment.  My insides churned a ulcerous batch of stomach acids as I was asked what "we should do as Christians."  Unfortunately, many religious people view the discontinuation of care as "giving up."  If you are not doing everything you can to preserve your loved one's life, then you are giving up on them and effectively killing them.  Omission of action is viewed as something sinful in itself. 

It is a cringe-worthy moment when you are conscripted by a family to be a source of spiritual authority and power.  I find it alienating.  Why are you asking me?  I don't know...

For those of my friends who are in the clergy, aspire to be, or conversely if you serve in the medical field, be mindful of the power that is ascribed to you simply on the basis of your role as pastor, minister, chaplain, doctor, etc.  Our roles are not our identities, but they do inform them.  Be conscious of that when you enter the room and are put into areas of difficult ethical decision-making.  All we can do is be compassionate and mindful, absorb the shock and anger, and reflect statements previously made that reinforce what they've previously indicated as their desire for their loved one. 

I'm sure that some of you have been on the other end of this encounter: you were the family member who had to make a difficult decision regarding care.  Drawing from that personal experience is a boon in your service to others and will help you connect to people at the human level.  For those who haven't experienced this yet, just remembered that you are invoking the divine presence so avoid the easy, cloying temptation to play God or even God's representative.  You cannot know God's will, but you can pray, offer compassionate words, and reflect God's mercy.

Anyway, crazy times ahead on this shift.  That is all.