|Sister Mary Diana Dreger, O.P., addresses medical professionals and students during the Converging Roads Conference at the Catholic Pastoral Center on Saturday, Aug. 27. Sister Mary Diana, in her talk “Walking with Patients at the End of Life” encouraged physicians to develop relationships with their patients in order to provide better patient-centered care. Photos by Mary McWilliams|
Medical professionals should see their work as part of the eternity of God. That message, delivered by Sister Mary Diana Dreger, OP, a Nashville Dominican and a medical doctor, was one of many directed to healthcare professionals by Catholic physicians and medical ethicists during the Converging Roads Conference, held Aug. 27 at the Catholic Pastoral Center.
The conference, conducted by the John Paul II Foundation, attracted nearly 100 medical professionals and students. It was designed to engage and support Catholic caregivers “in bringing the Church’s rich moral tradition to bear upon ethical dilemmas and assist health care professionals to better realize the highest medical and ethical standards of their professions,” according to Bishop David Choby, host of the event.
The concept of rising to the highest medical and ethical standards for the patient is the point Sister Mary Diana, a primary care physician at Holy Family Health Center, was driving home during her address, “Walking with Patients at the End of Life.”
She quickly pointed out, that “end of life” is not exclusive to geriatric patients. She, in fact, took her audience through the journey she experienced with a 32-year-old mother with metastatic breast cancer. The woman was referred to Sister Mary Diana as she neared the end of her life.
Throughout the talk, Sister Mary Diana emphasized discussions and decisions with the patient that are framed in the best interest of the patient.
“We need a good … understanding of the human person,” she said. “And we especially need a good understanding that we are persons in the setting of eternity. It’s not just here.”
|Dr. John M. Haas, president of the National Catholic Bioethics Center in Philadelphia, addresses suffering at the end of life during the conference.|
A more “patient-centered” approach is one in which medical professionals communicate with one another and their patients, based on the patient’s individual needs. That involves creating a framework for end-of-life care which includes all the records and data available for the patient, but also developing a relationship with the patient and formulating a plan with appropriate expectations that include hope and reality.
An example of the hope and reality in the patient example that Sister Mary Diana offered, was that she expressed hope to her patient for a miracle, but the reality was that she probably would not survive another six months. She did, in fact, die in July, less than six months from their initial meeting.
Bringing in palliative care – treating the symptoms the patient experiences, not just the signs the physician finds upon examination – is another vital aspect of comprehensive medical care. Treat the patient, not the disease, she said.
All of this takes a commitment to communication by the medical profession, and she emphasized that “it’s not about systems and data.” It may also entail some difficult conversations with the patient.
Physicians need to stay in touch with one another for the well-being of the patient. This is often contrary to contemporary methods. We can do better patient-centered care if physicians will talk to one another, she said.
When patient suffering enters the scenario, however, Dr. John Haas, president of the National Catholic Bioethics Center in Philadelphia, asserts that the Catholic perspective is the only context in which to address it.
And while he conceded that his talk, entitled, “The Meaning of Human Suffering at the End of Life” is a topic of theology, not medical ethics, he said that Catholic positions are “drawn from the natural moral law” and “can be argued without any appeal to Catholic doctrine.”
Haas quoted extensively from the 2009 document “Ethical and Religious Directives for Catholic Health Care Services” and observed that non-Catholic physicians agree with certain portions of the document, as long as, Haas included, that they don’t know it was issued by the U.S. Conference of Catholic Bishops.
“Contemporary minds can make no sense of suffering … it’s seen as an affront to human dignity,” Haas said. But he reminded Catholics that only God gives dignity; it is rooted in sacredness. Religions treat the concept of suffering in different ways. Some ignore it, others bear it stoically as God’s will. Catholics, however, do something with it.
“Offer it up,” he enthused. “When those three words no longer escape from Catholic lips when faced with disappointment, pain or sorrow, then we will have lost a fundamental understanding of Catholic culture.”
That’s why patients should be helped to appreciate Christian understanding of redemptive suffering when suffering cannot be alleviated. And patients who are suffering should not be left solely to the doctors. He added that there are many forms of suffering and it is not always equal to physical pain; there is psychological suffering as well. Clergy, psychologists, and social workers should be involved as needed to help the patient understand meaning in their suffering.
“How we respond to suffering at the end of life can be an expression of a lifetime of choices and can be an example to our loved ones and our caregivers. Those choices can manifest our dignity as human beings,” Haas said.
Organizers of the Converging Roads conference already are planning another conference in Nashville on Aug. 12, 2017. Mary Caprio, St. John Paul II program director, considered the turnout successful for a first event in a new location.
Other topics included “Medical Futility: Seeking a Better Language for the End of Life Care” by Grattan Brown; “Clinical Aspects of End of Life Care” by Dr. William L Toffler; “Advanced Directives,” by Arland K. Nichols, president of the St. John Paull II Foundation; and “End of Life Issues at Life’s Beginnings,” by Dr. Robin Pierucci.
Partners and sponsors of the event were the St. John Paul II Foundation, Diocese of Nashville, Aquinas College, St. Thomas Health, and Catholic Medical Association Nashville Guild.