An unusual point of view.
To mention the word God in conjunction with a well defined professional discipline seems rather strange in a secularized and science-informed society. Based on my own lived experience with human beings, whom I was able to accompany in living and in dying, I would yet dare to apply such a provocative point of view for some thoughts.
Eine deutsche Fassung des Eintrags gibt es hier zu lesen: Palliative Care als Gottes Dienst?
Palliative Care is a young, but nowadays recognized medical specialty that prides itself for working inter-disciplinary and for putting people’s comprehensive needs at the core of its practice. Why do these aspects have to be highlighted so much? Is it not absolutely self-evident to the average person and the affected? Would it be possible to conclude from this emphasis that the other medical specialties were too special to work inter-disciplinay? Are they so corrupted as a system and within the contemporary economic and societal discourses (of power) that the needs of an individual person, who is seeking or in need of treatment, is not their top priority?
*God* is a universal, spiritual human experience, independent of religious attitude or church affiliation. I know convinced atheists among my circle of friends who recognize that they have been able to experience *God* in their lives. The way individual people understand human beings is closely related to their image of God. And this view is in a strak contrast to the medical-scientific view: The foundational textbook in my nursing curriculum for understanding the future client was called “form and function” – which was an authoritative description of how the human organism was built and how it had to function.
In critical moments of my nursing work, I see clearly that people do not understand themselves as an interplay of form and function. People with catastrophic diagnoses and apparent affliction by illness or disease still see and describe themselves a whole and healthy. Others feel ill and suffer, despite the fact that every part of their body is formed optimally and functioning properly. Thus I draw the conclusion that a unique understanding of being human – and a closely related image of God – are much closer, more important and significant for the self-image of people than the scientifically correct fundamentals of physiology and pathology.
Therefore, I find it horrible to speak of cancer patients, incurable clients, disabling illness, or even of hopeless cases for which there is nothing we can do, of medical problems and functional deficits, and similar terminology used widely in professional practice. And what are the judging assumptions behind the often used description for the process of dying as the generalized worsening of a patient’s condition?
“The WHO defines Palliative Care as: Palliative Care is an attitude and treatment that intends to improve the quality of life of patients and their relatives in the presence of a life-threatening illness. This is achieved thru early and active investigation of pain, physical, psycho-social, and spiritual problems, their ongoing reassessment, and appropriate treatment.”
(translated from the website of the cantonal health department, Grisons;
These are the words of a human being who sits in a dominant position at the top of a power gradient. The truthfulness of these assessments and judgments of a comprehensive set of problems is not always beyond doubt, as I have experienced myself: My life is testimony to the unforeseeable possibilities after I was discharged from medical treatment as a 24-year-old heart patient with irreversible deficits and lasting disabilities. I have never given much meaning to those undeniably scientifically-correct professional opinions; I simply lived a life that essentially covered my needs with the gifts I had or received!
In existential moments, as they are recognized more often during critical situations or near the end of life, people increasingly experience themselves as being one; a unity that includes disease, illness, and the processes of dying. The individual, as the embodiment of the ego, receives an experience that is much bigger and more universal: as a human being, one becomes immersed in the ‘ground of being’ and is able to experience this unity. Several spiritual and scientific authors (i.e. Meister Eckhard, C.G. Jung) postulate that a conscious separation from this unity (i.e in form of individualism, war against aging, disease, or death), or a denial of the divine spark within (the self), is a key to the personal understanding of health and illness, regardless of the respective physiological constitution.
Palliative Care as a form of worship – in the sense that we as practitioners approach human beings first of all as embodiments of a divine spark and as unique particles of the whole universe. With such an attitude, we cannot but focus our practice on the needs of the individual, the affected. Nonetheless, I use ultra-modern technology and evidence based therapeutical means; I continue to include the scientific theories of chemistry, biology, physics, and medicine in my decision making at the bedside. I am able to do so while I am reaching out to convey human security by holding a hand – as an expression of human interconnectedness and as a reminder of the dignity of the one I care for (who is also embodied grace of God). Or I can do so while sitting in silence with family care givers, listening to hallucinatory perceptions from the inbetween-worlds.
I cannot let my service in palliative care be dominated by the self-ascribed importance that comes with the specialization of scientific disciplines. Even less so do I subscribe to the more domineering schools of thought of efficiency and market economy, with which we torture ourselves systematically (fee-for-service vs bundled payments, insurability vs affordable care, patient choice and consumer rights discourses within a free market model).
This way, I can live Palliative Care from an attitude of love, which is not only in Christian faith one of the highest qualities for defining *God*. Palliative Care as a form of worship – a basic attitude that enables human beings to live their full lives in dignity and to be able to die in peace.
Another essay on a health topic: Healthism – a war on wholeness