How should doctors deal with parents who believe their child will be saved by divine intervention?
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Medical ethics
How should doctors deal with parents who believe their child will be saved by divine intervention?
Discuss ethical issues with the Medical Ethics department of the BMA and the Institute of Medical Ethics. Please note, the views posted here do not necessarily represent the views of the BMA or the IME
The Journal of Medical Ethics has recently published an interesting series of articles. One of them looks at the ethical problem faced by doctors involved in paediatric intensive care, who face the p
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How should doctors deal with parents who believe their child will be saved by divine intervention?
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How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 14/8/2012 10:39 AM BST
on bmj.com
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*Moderator*
Posts: 1497
First: 7/4/2011 Last: 19/6/2013 |
The Journal of Medical Ethics has recently published an interesting series of articles. One of them looks at the ethical problem faced by doctors involved in paediatric intensive care, who face the problem of when parents of a child insist on continuing life-sustaining treatment, in the hope that a divine miracle will save their child, even when all medical opinion suggests that the outcome is very bleak. Here’s an further extract: “Despite overwhelming medical evidence and advice about the eventual outcome, some parents insist on everything being done for their child in a belief that their religion would expect nothing less and would not condone any action or decision that would result in death. There is also a hope or even expectation of a ‘miracle cure’, with time for further prayer and demonstrations of faith necessary for a favourable outcome. For some families in this difficult situation there are additional extraneous pressures from the religious community or church leaders.” “Protracted dialogue was often unable to resolve these differences [between parents and staff], while the child was subject to pain and discomfort from invasive ventilation, suctioning and multiple injections. We suggest it is time to reconsider current ethical and legal structures and facilitate rapid default access to courts in such situations when the best interests of the child are compromised in expectation of the miraculous. http://jme.bmj.com/content/early/2012/03/08/medethics-2011-100104.full How would you deal with this situation? Have you dealt with a situation like this before? Should ethical and legal structures be rethought to address parents who believe a miracle will happen? Or should doctors receive better training to address this issue? |
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Re: How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 14/8/2012 10:56 AM BST
on bmj.com
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Posts: 1216
First: 19/4/2010 Last: 19/6/2013 |
The colleague I share an office with, a religious man, has told me this story: "A man's boat capsizes in the ocean, leaving him stranded. He prays to (a) God to save him. After some time a fisherman comes along in a small boat, and offers assistance. The man says 'no, God will save me'. A short time later a helicoper comes, and offers assistance. The mans says 'no, God will save me'. A short time later, the man drowns. He meets his God and asks why he didn't save him. God replies 'I sent enough help, why didn't you take it...?'" I'm squarely atheist, so sometimes find it hard to understand the cases of patients wishing for divine intervention. I *do* however understand the need to do everything we can realistically do to help our patients, up to the point of a realistic positive outcome. The capsized man analogy works well to persuade a parent that we should treat their child, if they are refusing our help, waiting for divine intervention. If the parent wants more treatment, when we know it's not realistic, does the same analogy work? It's early in the week for religion, Matt - Politics next? |
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Re: How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 14/8/2012 2:18 PM BST
on bmj.com
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*Moderator*
Posts: 1497
First: 7/4/2011 Last: 19/6/2013 |
We love our medical ethics here, on doc2doc. Good to start an in depth discussion like this - good to see if everyone is still awake. |
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Re: How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 14/8/2012 8:55 PM BST
on bmj.com
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Posts: 1343
First: 13/4/2010 Last: 19/6/2013 |
DundeeChest's story reminds me of the story of the banker who died suddenly and found himself before the gates of Heaven but couldn't get in. He pleaded with the gate keeper - "I bid generously at a charity auction last month" - but the gate keeper just shook their head. The man tried again - "But I saved the life of a blind man who nearly walked out in front of a bus last week". But still no luck. Finally, in a last ditch attempt, the banker said "But I gave a £50 note to that beggar outside Marks and Spencers yesterday". The gatekeeper said "Hold on a minute - I'll just speak to God". Five minutes later the gatekeeper returned holding a piece of paper and said to the banker "Here's your £50 now get lost!" There's also another story about two preachers of different persuasions who find themselves stranded on a desert island. After many years a ship finally spots them. When the captain comes ashore he finds the two preachers but also three churches. He says to the preachers "What church is that on the left?". "Oh, that's mine" says one of the preachers. The then captain says "What about the one on the right?" "That's mine" says the second preacher. "And what about the one in the middle?" the captain says. In unison the preachers say "That's the church that neither of us will go into!" Anyway to be serious. I think the above scenario is clearly a matter for the Courts if it is clear to all concerned that the parents are actually not acting in the best interests of the child. |
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Re: How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 14/8/2012 10:00 PM BST
on bmj.com
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Posts: 1361
First: 25/1/2009 Last: 20/6/2013 |
Its often a difficult situation when you get this in the real world. I've known two instances - the first a premature baby with a terrible neurological prognosis who we wanted to withdraw care on but the parents wished us to keep alive while a special Buddist preist came from abroad to work his miracles. The second more recently a child with imenently terminal brain cancer who had been brought from scotland so the family could take him to a faith healer. There is a very narrow line to tread between trampling on a family's beliefs and helping to prolong a child's suffering against reasonable medical ethics. These cases have to be taken on a case by case basis, but unfortunatley the problem is often that while awaiting an ethics committee's decision you have to opt to prolong life. |
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Re: How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 15/8/2012 12:36 AM BST
on bmj.com
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Posts: 1302
First: 9/12/2011 Last: 12/6/2013 |
This is a topic where attitudes sometimes become contentious. As a Christian, I would not allow a child of mine to suffer, if the Doctor advised there was no hope I would request life support be withdrawn. In the end Religion must be framed by reason and temperance, and logic must dictate that a Just, Sane, and Loving God would not want a child to suffer. I think it is safe to say, No Real God would want this to happen, hence no real religious person should go against reason when dealing with suffering. Indeed Gods middle name must by necessity be Mercy-Love-and Kindness! Who are we to go against God, so I say that any parent who allows their child to suffer is in direct conflict with their religions Teachings. DuaneF |
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Re: How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 15/8/2012 12:07 PM BST
on bmj.com
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Posts: 1828
First: 7/3/2009 Last: 18/6/2013 |
This is not an easy topic at all. Some of you are very confident about how you would behave. had someone told you there is no hope for your child. Is that so? Until you are in that situation, I would not be definitive about anything, because when you encounter such a situation you will hang to the last straw and will hope that something will happen. What are the facts we base upon our assumptions about prognosis? Our knowledge, what literature says, our experience in such situations,the various scientific data in front of us, our colleagues opinions, our beliefs( not religious, but what we feel). There is a constant fear among us doctors not to get emotionally involved, as that impeds judgement, drains our energy, wears us off etc, blabla/ But emotional it is, and instead of asserting our own opinions I believe in working with parents not against them. To say "we have done all we know and unfortunately it doesn't seem to help" and tell the parents that if they would line to call in a person of religion we have nothing against, it is better than trying to stop at all causes using court etc. Take the parents, talk to them, explain again and again, gently, no steely tone, let them absorb the information, you can't expect that it will settle in immediately. Work with them during the process of saying farewell, let them time to release to let it go. If they want a man of religion nearby let them have it.
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Re: How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 15/8/2012 12:30 PM BST
on bmj.com
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Posts: 1343
First: 13/4/2010 Last: 19/6/2013 |
Yoram - I would not generalise. You're correct in assuming I haven't been in this situation with a child of mine (although I have with an adult loved one) but I can assure you - speaking for myself only - I would not hesitate to follow the advice of colleagues I respected and trusted and nor would I do anything that caused unnecessary suffering to any of my children. |
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Re: How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 15/8/2012 3:27 PM BST
on bmj.com
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Posts: 1302
First: 9/12/2011 Last: 12/6/2013 |
Actually Yoram, Although I have not experienced the loss of a child, I have had 3 Older family members lost due to Terminal conditions, so I speak from Experiential rather than Hypothetical based logic. I prefer not to let family members suffer in the event of No Hope diagnosises, Mercy is delivered through logical decision making, and thinking of the sick persons suffering level, rather than your own emotions. DuaneF In Response to Re: How should doctors deal with parents who believe their child will be saved by divine intervention?: This is not an easy topic at all. Some of you are very confident about how you would behave. had someone told you there is no hope for your child. Is that so? Until you are in that situation, I would not be definitive about anything, because when you encounter such a situation you will hang to the last straw and will hope that something will happen. What are the facts we base upon our assumptions about prognosis? Our knowledge, what literature says, our experience in such situations,the various scientific data in front of us, our colleagues opinions, our beliefs( not religious, but what we feel). There is a constant fear among us doctors not to get emotionally involved, as that impeds judgement, drains our energy, wears us off etc, blabla/ But emotional it is, and instead of asserting our own opinions I believe in working with parents not against them. To say "we have done all we know and unfortunately it doesn't seem to help" and tell the parents that if they would line to call in a person of religion we have nothing against, it is better than trying to stop at all causes using court etc. Take the parents, talk to them, explain again and again, gently, no steely tone, let them absorb the information, you can't expect that it will settle in immediately. Work with them during the process of saying farewell, let them time to release to let it go. If they want a man of religion nearby let them have it. Posted by yoram chaiter |
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Re: How should doctors deal with parents who believe their child will be saved by divine intervention?
posted at 15/8/2012 6:24 PM BST
on bmj.com
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Posts: 1828
First: 7/3/2009 Last: 18/6/2013 |
I was talking about the way to let go rather than the decision of let go.And that is where I was going with what I said about not knowing what will happen when you are in a similar situation, You took it to another place. No offence meant here by me. I lost my mother , father and grandmother in similar situations of nothing to be done, And believe me I did everything possible and impossible to save them and with understanding that each step that did not work meant chances got slimmer and slimmer.They wanted to live. So, I also speak from similar experience.Moreover, I allowed myself to get involved, and I know that we did everything and no stone was left unturned. About what the suffering person would like for himself, I agree, but when there is no such clear wish set, your default would be to save lives. What I am getting at is that we should be very careful not to be absolutely confident about our standings on such issues but rather periodically question ourselves. That is not bad to assume we know little.What was impossible 50 years ago is possible today. Suffering is brought on too many times as excuse or justification not to pursue further procedures. There is no absolute scale of suffering. I don't say it is of no consideration. I say again, each case is individual. But even when you decide to let go, do it with a lot of care and a lot of support for families, especially parents of children.I saw too many cases when things were done in a way that left relatives with a lot of questions and mixed feelings as towaht could've been done more and of cold hearted medical staff. |
Forums » Open clinical » Medical ethics » How should doctors deal with parents who believe their child will be saved by divine intervention?
