Beliefs and Competing Priorities

I heard this on the radio this morning. Radio Nottingham was focusing on how doctors who were strongly religious were reluctant to engage in end of life care for patients – interesting enough. I then wandered the internet to find out more… and saw that the Guardian has apparently taken the opposite perspective, that atheist doctors are more likely to help patients to die. Same story, but slightly more rabble-rousing.

While this could be considered a balanced perspective (ie both sides of an argument), it’s fascinating to see how the same story can be presented in two entirely different ways by the news media. Rather than encouraging the reader to make up their own mind, however, each story points them towards the conclusion that we need to be worried about our doctor’s faith when faced with terminal decisions.

Now, my particular reason for focusing on this today is that I have direct experience of the truth of it – specifically how those medical professionals who hold strong faith beliefs allow this to influence patient care. And we do indeed need to be aware of it, as pagans and those who will inevitably need to consult a doctor at some point in our future. But more importantly, we need to be aware of our own wishes at times of medical emergency.

While working in the NHS, I have been in charge of administrating End of Life Care Decisions – the final wishes of those who know that they are to pass on shortly. While still known in some areas as ‘DNR’ (Do Not Resuscitate) Orders, EOLCDs can in fact relate to anything. I had a lovely communication from a lady who wished to die on the beach at Skegness, surrounded by her family – a logistical fiddle, but one that was a quiet pleasure to help with.

I used to say that while I never met these people, I was one of a scant few medical professionals who was charged with their care at this crucial time, when they were most vulnerable and in need of help. Sometimes the ‘Next of Kin’ box was blank – they had no family or loved ones. Care homes can be good, but as we have no doubt seen on revelatory ‘real life trauma’ programmes, can be less than caring as well. I would spend a good deal of time calling to confirm everything was in place, and despite some managers chuckling at how I was going far beyond the demands of the role, I didn’t care. Some GPs had no idea of who this patient was. Care homes had no knowledge of terminal wishes. I advised, politely but firmly, that this was quite important to the patient – but sadly only when potential legal comeback was mentioned would I get a reaction.

What I did get from time to time was a call from a GP, furiously accusing me of supporting euthanasia and virtually assisting in the murder/suicide of their patient. How dare I – did I not trust him, as a qualified Doctor, to administer the correct treatment to keep them alive? And, more often than you’d think, a GP refusing to sign off a patient’s EOLCD (ie their affirmed wish) – because the doctor was a Christian and could not ethically allow it.

I have also been told of a gentleman who was deeply claustrophobic and had left specific instructions for a Viking-style funeral, rather than a burial – the worst thing he could imagine was being put in a hole in the ground. Unfortunately, he was a large fellow, and the local Council and crematorium felt otherwise. He was duly buried. His friends were actually planning to exhume him in secret and organise something, so shocked were they at this callous attitude to his expressed wishes.

This, to me, was the crux of the issue. At what point do our wishes become invalid when placed alongside those of others? The key point of contention for euthanasia there, but very relevant to any major decision, in which personal beliefs are strongly held. But what gives us the right to inflict our beliefs on others? Professional medical training versus belief? Or patient wellbeing contrasted with right to life?

We all have a right to life – absolutely. But I received EOLCDs from fully fit people in their 30s, who simply knew there was a history of dementia in their family and wished to record a decision for their life not to be prolonged if quality and awareness dropped below a certain point (in one gentleman’s words, ‘not to live as a vegetable’). Others are so ill, their list of diagnoses is too long for the box on the form. Their quality of life is virtually nil, and they’ve had enough. As with Organ Donor Cards, these wishes must be respected.

The one certainty in life, I have often been told with a grin, is that we will die. Death is a side-effect of life suffered by 100% of us. Yet more people seem unwilling to face this fact. While I understand the wish to fight tooth and nail to stay alive, I also understand and appreciate the need for personal wishes to be respected – no matter how they may clash with our own. Support must be provided, but to create comfort in the sick, not to encourage them to go against their own wishes. If you are terminal, do you wish to be told that your final request is wrong?

I am honoured to be part of an NHS Multi-Faith Forum, full of very wise folk from a huge variety of traditions, all endeavouring to advise rather than evangelise. None wish to inflict their beliefs on others, but simply acknowledge and prepare for potential requests from those who are sick and in need. This includes the famous cases of Jehovah’s Witnesses refusing blood transfusions and suchlike.

The reason I am there is because I was called by a lady who was anticipating her forthcoming demise, and was actively frightened by the treatment she had received from her local hospital. She had removed the word ‘Pagan’ from her records, as the doctor who would be performing surgery on her had told her bluntly of his own strong Christian beliefs, and that she would be ‘in the hands of God’ (ie him). When she was giving birth, three midwives were called – because they had seen That Word and truly believed there was a chance she would sacrifice her new-born baby. She was refused chaplaincy – an offence under the Human Rights Act and current NHS Policy – because they did not acknowledge her Paganism as a ‘proper’ religion.

While we are chronologically in the 21st Century, the current fear of causing offence due to religion has unfortunately meant that faith and belief issues (whether directly religious or not) are instead disregarded. This in itself is unethical as human beings. Times of medical crisis come to us all, and it is crucial that we do our best to make our wishes known – and those in a position to do so allow those wishes to be adhered to. This may be the most difficult thing in the world – I know Ambulance crews who have had to stand back from a patient in cardiac arrest because she wishes for no resuscitation. Others look on in horror… but that was her wish. That crew are there for her in the way she wanted – and that took more bravery than those rib-cracking chest compressions and defibrillation.

The Guardian, fortunately, has come to a similar conclusion in an associated Opinion. Understanding can be reached if we communicate – important for us as people as well as followers of the Pagan path. Most of my work seems to boil down to this fact: gently communicating, explaining rather than arguing or shouting. My passion comes across in my words, truly felt and thought through, expressing my Duty of Care to fellow beings. Sometimes this is enough to stop a rant in its tracks – and once others start to really listen, half the battle is won.

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