Let’s just say . . . .

You’re taking care of a patient who is dying of lung cancer. She’s a young 45 – strong willed, confident in herself, her beliefs and her ideas. She knows who she is and what she’s about – and she really has no regrets in life. She has settled herself into her own fate and is spending her time enjoying every minute with her family and friends.

You’re her nurse – – or caregiver, or doctor or counselor, it doesn’t matter which. You’re having a heart to heart with her about her spiritual beliefs and if there is anything you can do for her to support her wishes. You offer her the chaplain services that are provided by your agency. The patient declines these services.

She discloses to you that she is an atheist – and has been for the past 25 years. Her direct quote to you is, “I don’t believe in a god – – I’m not religious and I really don’t want you bringing that in to my home.”

You agree because you’re her nurse – – you’re not the saviour of the world. You’re not the keeper of souls. It is not your place to save the soul of every person you meet. You’re not some messenger from some god. It is not your place to impose your values, judgments, beliefs or ideals onto anyone, particularly a patient who is dying and is comfortable in her own skin.

Then – the patient declines to the point that her mental status is variable, at best. She has very brief moments in the day when you might think she is having a lucid moment – – maybe. She’s still alert, but very confused. . . delusional, hallucinatory – – some of it is from the pain medication, some of it is due to the spread of the cancer into her brain.

Now. Someone from within your agency decides that it’s important for this patient to go to heaven. This particular someone is a self-professed ‘born-again’ christian who tells her tale of spiritual testimony to anyone who will listen. She cannot stand the thought that this woman, who is about to die, is going to do it without being embraced in the arms of this god.

She makes it her personal mission – – her own personal ministry, to visit this patient 2-3 times per week to pray with her. To quote daily devotionals. To get this confused, delusional, hallucinatory woman who is not of her own mind and hasn’t been for sometime now . . to get this woman to say the words “I accept jesus christ as my personal saviour”.

Now, because of the relationship that you developed with this patient when she was of her right mind – – you know how adamantly opposed she was about bringing this kind of….”crap” (her words)..into her home. That’s not her view of hospice and it’s not something that is of any importance to her. Because of your relationship with her, prior to her decline — you know, for a fact, of what her outrage would be in the face of this type of coercion.

But this person that you work with thinks it should be important to her – – so this person you work with makes it her goal to make god, praying and devotionals a daily part of this dying womans last days. A dying woman who can no longer speak for herself and is vulnerable to the actions and words of those around her. This dying woman who put her faith into a group of hospice workers whose promise is to abide by their patient’s wishes and to strongly advocate for that patient and her personal wishes.

You have real big ethical questions about this kind of practice. This kind of imposition. This kind of total and utter disregard for the patient’s beliefs and wishes.

To make it worse – – this person is your boss. Now what?

I asked her – Tina, my boss – – I asked her if she felt it was an utter imposition to disregard this patient’s wishes and to waltz in and shove religion and god down her throat?

Tina’s response to me was that she answers to a higher power than the company who employs her – and she felt it her personal responsibility to save the souls of those who have lost their way.


So I ask her — “Tina – if you were laying in a hospital bed, dying of some terrible disease. You have the stress of that discomfort – – the fear of the unknown. . the frustration of watching your family members around you in sorrow and pain….imagine that I walk in … I sit down and hold your hand…I look at you and stroke your forehead to try and comfort you – – and then I ask, ‘Tina – would you like me to pray with you?’ – – – would you welcome that, Tina?”

Tina says, “Yes – of course I would – you know that.”

I tell her, “Ok – so then I bend down and bring a book out of my bag — I open it up and start to quote the spiritual text. The book I’m reading from is the Koran. You, Tina – – because of your illness, you lack the strength to stop me from quoting the Koran and your forced to lay there and listen to me — how would you feel then? The Koran . . . Buddha’s teachings . . . Some Wiccan phrases, maybe…how would you feel, Tina?”

She said, “I would hate that, Lisa – – you know that I don’t believe in those things. You know that, in my mind, it’s blasphemy and I would be offended by it.”

“Exactly my point, Tina — you nailed it.”

Amazing I still have a job, hey?

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10 thoughts on “Hypothetical”

  1. Didn’t she have a “sit down” with you about your spiritual damnation a couple of weeks ago?

    I’d say this is entirely wrong. Good intentions don’t always equal good actions.

  2. Err, I hate to say this but Christ and saving people is sooo 1980s Tammy Faye Baker. Why even bother with people that do not understand religious divsions or for that matter cannot understand simple concepts of how religion evovled. Someone that feels its their “god given duty” to “witness” to you is more than likely a sheep.
    Faith is exactly that. Faith. Not something to be discussed or witnessed to. I hate to say it, but the american christian religious movement makes a mockery of its own itself.

  3. Yes, Vinny – she did have that ‘sit down’ with me. It’s one thing for her to try and save MY soul – – – I’m not defensless and I can stand up for myself. I think it’s disgraceful what she did with a patient who is utterly vulnerable.

  4. Lori – hell yea there is a policy for this kind of crap. It’s called professional ethics and responsibility. Any regulatory body (and we do have one) who catches wind of crap like this will come down on said agency harder than Michael Moore on a park bench!

    Tho – the family isn’t aware of this happening (they were never present for it, and the patient of course couldn’t relay the situation) – so no one outside of our office knows that it happened.

    Quite a spot to be in, let me just say.

  5. I’m a Christian but I think Tina was way out of line! If she wanted to do something of a spiritual nature for the patient, she should have prayed silently and kept her mouth shut.

    I worked with a lady like that who was always trying to convert her home health patients, and she was disciplined for it. But she was a home health aide and not the boss.

    That was a good example you gave her. I hope she got the message.

  6. Please don’t get too angry but I am going to play devil’s advocate here. What harm is caused to offer anyone faith – any faith? Honestly, how much damage did she do to this women? Throughout your life, you hear things that you don’t agree with – YOU choose to accept or not accept. That is the beauty of being human. We have choice. Maybe the debate is about that this women did not have a choice to NOT hear it. For those of you who believe in god, maybe that is the way he wanted it? Maybe that was the only way god could get to her and he wanted her bad? Maybe that was God’s last attempt to save her soul? For those of you who do not believe in god – what is the worst thing that could happen? If she is out of it, as you say, she doesn’t hear this person anyway. If she is with it and has to listen to it – then she has a choice to believe or not to believe. Maybe even a choice to not listen to her – tune her out. What if this women who you knew thought it was “crap” – changed her mind but has no way of telling you? There are countless stories of people (even ones you’d never suspect) converting just before death. Would you want to be responsible for taking that away from her? I’d much rather play the safe side here and let the women decide for herself whether she wants this “crap” or not. If there is a heaven then she might meet you there, if not then in her dieing days, if she knew what was going on, she had to tune someone out. It couldn’t be the worst thing to happen to you before death. No harm done. If she could tell your boss to go away herself then your boss should respect her wishes – I agree. However, if the women is no longer capable of doing so – there is no harm in doing what you can for her. I encourage everyone of all faiths to share with people who are dieing (alert or not alert) so if they still have a choice, they can make thier final choice! If your faith is in nothing then you have nothing to offer her but believe me and you – that women may have shared your faith and as hard as it would be to convince you otherwise, it was going to be that hard to convince her also. It all works out in the end. You’d rather give too much than give too less.

    Just some thoughts.

    Thanks for sharing this story.

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