PART VI. PHILOSOPHICAL-RELIGIOUS BELIEFS & READINESS FOR DEATH
Questions 23: What philosophical, ethical, or religious beliefs
do you hold that are relevant
to your medical care and other end-of-life decisions?
Medical ethics seldom acknowledges its roots
in religious beliefs,
but most doctors and nurses at least come from some religious tradition.
And their ways of handling difficult questions
—especially questions arising at the end of life—
are often affected by their implicit religious faiths.
Patients might be even more deeply religious
than their care-givers.
And they probably have no scientific training as doctors or nurses.
But when you come to the end of your life,
you are correct to apply your own philosophical and religious beliefs
in making your end-of-life decisions,
even if a more scientific orientation might lead to other choices.
Medical ethics itself is not based in science.
fundamental values of right and wrong
from religious tradition, cultural patterns,
are based on rational argument—or some combination of these.
any case, the fundamental values concerning life and death
usually more presupposed, implicit, unstated than scientific.
You should apply your religious and
creating your medical ethics and in writing your Advance Directive.
are not laying out patterns for others to follow.
are deciding for yourself
you want to be treated at the end of your life
which path toward death seems best to you.
It might be argued that all the religions of
least in part—attempts to cope with death.
of these religions have definite beliefs about death.
no discussion of death would be complete
taking religious beliefs into account.
Medical practice generally respects religious
part because of the personal beliefs
the doctors, nurses, & other health-care workers themselves.
sometimes the very institutions in which they provide health care
established by religious organizations.
medical personnel have learned to respect religious values,
when they do not share the same world-views.
Beliefs about death might be stronger than
of the emotional impact of facing death
your own death or the deaths of your loved ones.
if you paid little attention to religion during most of your life,
might become intensely religious as you approach death.
these forms of faith might be quite traditional
you have not created your own system of beliefs.
facing death, you might remember your childhood faith.
Thus, medical personnel are frequently
but fervently-held religious beliefs about death.
families have automatic responses to ethical questions
they grew up in a well-established religion.
you believe that there are absolute rights and wrongs
if you do not know what the absolute standards are
how to apply such standards to the situation at hand.
YOUR LAST YEAR: CREATING YOUR ADVANCE DIRECTIVE
FOR MEDICAL CARE
Consequently, you might turn to religious
answers to questions you have not seriously faced before.
is the way that professional religious leaders
priests, rabbis, mullahs, etc.)
drawn into the discussion of medical ethics.
sometimes the religious leaders are even called upon
make life-and-death recommendations based on their religious
But general medical ethics
the United States and other Western countries
based on a secular consensus about life and death.
secular system of beliefs is not well defined
it often clashes with traditional religious beliefs.
there is a clash, the religious beliefs generally prevail
they directly contradict a scientific perspective
a way that affects treatment decisions.
A common example of this is the Jehovah's
of blood transfusions and blood products
of their religious beliefs on these matters.
on a few Biblical passages, they believe that voluntarily
transfusions or blood products will exclude them from heaven.
have ruled that those who hold such beliefs
allowed to refuse blood for themselves (but not for their children)
if such refusal leads to their premature deaths.
choices based on more exotic religions
usually rejected in modern hospitals.
Because of the everyday experience of
patients and families who have strongly-held religious ethics,
medical ethics takes on a religious tone,
when there is no scientific basis for the belief
as the belief that a soul survives death.
even modern hospitals have religious chaplains,
religious beliefs are so important to many patients.
Completely secular patients might be the first
hospital-ethics-in-practice have a religious tone.
religious members of the staff take religious references for
if the hospital was built by a religious organization.
many of the hospital staff have religious motivations.
it is 'natural' for a religious tone to slip into health care,
in ways that are not noticed by religious people.
An Advance Directive is an appropriate place
state your religious or non-religious philosophy
it applies to life-and-death decisions.
you do not state your religious beliefs,
will be treated as if you have generic religious beliefs,
is the basis of the hospital chaplaincy program.
might be nothing more than a vague spiritual tone,
reference to any specific religious tradition.
medical staff may assume the patients are basically religious;
they will "do onto others as you would have others do unto you".
And this might be appropriate for you,
if you have not worked out your own religious beliefs in
will be treated as a normally-religious American person.
But if you are more religious or less
religious than average,
should state your beliefs in your Advance Directive.
you have non-religious ethical beliefs, you should state them,
as they apply to life-and-death decisions.
a brief statement of such relevant beliefs
based on religion or on some secular philosophy)
be an occasion for a meaningful discussion with your proxies
the members of your Medical Care Decisions Committee.
The medical system must allow broad latitude
all religious and non-religious beliefs.
the medical staff should not be expected to be mind-readers.
should they be expected to understand your beliefs
because you registered your 'religious preference or affiliation'
you were admitted to the hospital, nursing home, or hospice.
that you are a Catholic or Protestant will probably not be
religious beliefs have probably affected
you answered the other Questions in this book.
here is your opportunity to state the bases of your ethical choices.
These philosophical and spiritual matters
the medical decisions that will issue from them—
be settled (at least tentatively)
before a medical problem puts you in a health-care institution.
selection above is the first four pages of Question 23 from the book:
Year: Creating Your Own Advance Directive for Medical Care.
If you click
this title, you will see
the complete table of contents.
Two more pages on this Question explore other implications of
relilgious or ethical beliefs.
would like to see one person's Answer to this Question,
go to James
Park's Advance Directive for Medical Care.
Scroll down to Answer 23.