A Guide for Clergy on Issues Related to the Care of the Dying

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Review of a book by John Vlainic

This book is intended for pastors of local churches to help them learn about basic issues and situations related to care at the end of life. 

The attached table of contents provides information on the topics covered in this book. I will] highlight a few things here and end by emphasizing that you WILL NOT MISUSE THIS BOOK. 

The section on “OUR OWN DEMONS” is very important. I have come to believe that much of the suffering and inefficiency in the care of the dying and their loved ones could be remedied if those who care for the dying (including pastors) knew more of our own mortality. This section begins as follows:

“Clergy have a responsibility to help those in their congregations make many difficult decisions in their lives. One of these decisions concerns the end of a life, how we want to die and what we hope to accomplish before we die.

If we do not confront our own demons regarding life and death, we cannot equip our followers to face the most difficult decisions to be made. ***Decisions about how one wants to live out the last days of one’s life are decisions that must be made, where possible, through a process of discernment. 

In addition to their religious beliefs, people have financial and family worries as well as a desire to be spared from suffering. No one should or could make decisions about end-of-life issues quickly and without praying for discernment. 

As clergy, we are not always necessarily prepared to “take care of ourselves.” For us, these are the hardest things to do. Unfortunately, when we don’t take care of ourselves, our boundaries can waver and our minds can be easily distracted. The overwork and fatigue (burnout) caused by compassion are at our doorstep, and ready to knock. Taking care of ourselves is just as important as preparing to deliver a sermon, tend to a budget meeting, or perform our other clerical duties.  

When caring for those who are dying, it is especially important to care for ourselves. You may, however, begin to feel more comfortable when you are in contact with those who are dying. But it still wears you down and you have to be aware of your own feelings towards the person who is dying. It may be a parishioner with whom you had a meaningful relationship for years, or someone with whom you often disagreed. It is important for you to be present in both cases for this person and for their family, but to be present for yourself and for your own need to go through this grief. » 

She then shares her own story.

“I thought I took very good care of myself, that God had given me this gift that allowed me to ‘take care of anything’ and move on for the rest of my day. . I would “commit everything to God” when I walked out of a room or after seeing family from the intensive care room or from their car. I had no idea that residue had accumulated in me. Then there was the November 11, 2001 (9/11) disaster and I spent a tremendous amount of time at ‘Ground Zero’ with the rescue and recovery workers. At the time, I thought I was fine – after all, I was handing it all over to God after listening to these stories of hurt and hurt, pain, and loss. But, I constantly questioned myself about “why could God let this happen?” »  

Then I began to notice that my soul had become “quiet.” I wasn’t able to deal with other people’s problems and I didn’t see any point in doing that anymore. I didn’t want to hear another story or say a prayer with anyone anymore. My sympathy was gone. 

What a surprise this was for me, since I thought I was taking such good care of myself.”

The author includes a good TOOL FOR DISCERNMENT that we can use to familiarize ourselves with our own mortality.

I also liked his list of GENERAL INDICATORS OF IMMINENT DEATH and his list of THINGS THAT CAN HAPPEN AT THE TIME OF DEATH. I learned about it from a friend who is the head nurse of the intensive care unit (ICU).

The chapter on MIRACLES AND CURES is well balanced and biblical. Something just happened in the last two weeks. A chaplain, a doctor, and a social worker all told us stories of people who insisted on only one form of miraculous cure (thus causing a lot of painful stress for everyone involved). 

I predict that you will be better prepared for your own life and death, and also to minister to your loved ones – who will also have to live and die – if you study this book. However, I must insist on one point before concluding.

I recommend that you read this book because it will help you raise many, many good questions, many of which we are rarely asked until we are in the midst of a crisis.

However, remember that this book was written in the United States. So it’s fitting that the author repeatedly tells readers that the laws and definitions are different in different states. 

Because we serve as ministers in a different country, our laws are different from those of the United States in some important details. 

Generally, and most of the time, things look the same here and there. For example, I checked with our ethics officer in Canada and she confirmed that the distinction described by the author between capacity and competence is generally accurate.

However, remember that different Canadian provinces have different laws. In fact, I wouldn’t be surprised to learn that there are subtle differences in interpretation from hospital to hospital and doctor to doctor. So, if you get this excellent book, BE SURE YOU GET HELP WITH THE QUESTIONS TO ASK. The answers might be somewhat different in your jurisdiction.  

Most important: CHECK THIS BOOK FOR HELP WITH THE QUESTIONS MUCH MORE THAN THE ANSWERS!! Just knowing what the real issues are will help all of us better help our people in crisis.

When you need specific ANSWERS talk to a doctor you trust or consult with ethics people at your hospital if things are really complicated.

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