Vital Decisions

Twice during my decade-long tenure at St. Paul's UC we offered end-of-life and funeral planning seminars. They were really good, if I do say so. In the first of two sessions I involved a palliative care physician from the congregation in dialogue about family attitudes and approaches, as well as creating end-of-life directives. The second was a panel with three funeral directors who were given questions I had developed. At the end of both evenings the participants (30 or more) were encouraged to ask their own questions.

Many of the participants were there to think through realities which were not necessarily close at hand for them, although in several cases either someone present or a loved one was terminally ill. Others were trying to figure out what needed to happen for elderly parents.

Of course our pastoral care team, pastoral care minister, and myself were all involved in ongoing support for members who were dealing with healthcare issues, as we are here at Bridge St UC. I imagine most of us hope that this is what congregations will do as part of their ministry.

I was interested to read that in the States there is a program called Vital Decisions which involves phone contact and counseling to those who are seriously or terminally ill. Trained counselors and social workers contact clients of insurance companies to talk through their health issues, provide emotional support, and help them plan. Needless to say, some of the people contacted are wary. What is the motive? The insurers admit that these conversations save thousands of dollars because clients are less inclined to visit their doctors if they have someone to talk with about their loneliness or frustration, as well as the practical stuff. The NPR piece about Vital Decisions interviewed a palliative care physician:

Dr. Robert Arnold, who heads the palliative care division at the University of Pittsburgh Medical Center, says he thinks that insurers may be well-situated to address the communication disconnect, at least while some doctors and others who deliver care work through their own discomfort and improve their skills. He sees companies like Vital Decisions as part of a larger trend.

"Would I prefer that we live in a health care system where doctors, nurses, nurse practitioners and social workers who knew the patient were having these conversations? Yes," he says, but adds, "This is better than what patients have currently been getting."

This may be true, and I can see value in this program, but I'm glad that congregations can still offer the spiritual care and emotional support for their members. We can build relationships, share tears, hold hands, say prayers. We are involved in "vital decisions" which include God, and I think this is irreplaceable.

Comments?