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Assisted dying downgrades the importance of the palliative care approach

True compassion and hope at the end of life is about courage and vulnerability

True compassion at the end of life is about being able to sit with struggle of not having answers. Photograph: Tom Honan

Dr Margaret Naughton
Sun Jun 23 2024 - 00:30

As a chaplaincy supervisor and educator, I often find myself reminding my students that the patients we encounter are our best teachers if we are open to learning from them.

I say this having met many over the past 15 years who have been my “best teachers” – teaching me more about compassion and hope than I would ever have imagined possible. They have taught me about living well and dying well with compassion and hope.

The word compassion comes from Latin and translates to “suffer with”. This concept gathers considerable momentum and importance when set against the backdrop of the recent debate around assisted dying – a myopic move to enable people to end their lives with greater freedom.

Such thoughts of assisted dying downgrade the importance of the long-established palliative care approach to caring for the dying when we choose to play God and try to control death.

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An alternative paradigm of care to assisted dying might be what Pope Francis has spoken of in Samaritanus Bonus – the 2020 letter on the care of people in the critical and terminal phases of life – as accompaniment of the suffering that not only promotes their intrinsic value as a child of God but sees “the highest worth of their existence”.

Such an approach neither sanitises nor seeks to control or eradicate suffering but in contrast offers a pathway of pastoral care that drives compassionate and hope-filled accompaniment.

I remember with great sadness and affection the first person that I accompanied spiritually to the end of her life. I was a young trainee hospital chaplain when I encountered a woman who was terminally ill. I was drawn to her for many reasons but, on reflection, I now know that I was particularly taken by her openness to name the fact that she was dying. While I was moved with compassion, I was also frightened, overwhelmed by the blunt force of her honesty – fearful that I had nothing to give to this woman who in many ways was ministering to me.

However, I “suffered with” this woman, who I will call Mary. I accompanied her (and her family) to the end of her life over a period of eight weeks. I believe that I heard her story, gave her space to share her regrets, cried with her, laughed with her and learned of the enduring gift of pastoral presence.

Mary was full of courage but she was also afraid of dying, sad that she was leaving young adult children behind her who were very much in the prime of their lives, but certain she was going home to God. I “suffered with” Mary as she faced the reality that she was dying, that every day could have been her last.

Of course, I will never know the impact of my ministry to her but I do know that she taught me about what compassion, true compassion, might look like at the end of life; about being able to sit with struggle of not having answers, of wrestling with the powerlessness of not being able to say or do anything tangible to make things better, to support someone in their process of digging deep when they find themselves facing their own mortality.

To feel the need to impose Christian hope upon the dying person can be a detrimental and ignorant place to begin from

To draw from the American writer Brene Brown, “when we are looking for compassion, we need someone who is deeply rooted, able to bend and most of all someone who embraces us for our strengths and struggles”.

As followers of Christ, we are called to be deeply rooted in the well of our tradition, to have the compassion of heart and soul to suffer with, to be present to the many strengths and the struggles of the end-of-life trajectory. As followers of Christ, we are called to be moved with compassion for those who are sick and dying and to accompany them with a pastoral heart.

And what of hope, one of our three theological virtues? How can we bring Christian hope to the bedside of the dying? How can we be that agent of hope that Donald Capps has written about when someone is dying?

It is important to acknowledge that this is a complex challenge. It is a troubling quagmire from which we cannot easily extrapolate a framework. After all, to feel the need to impose Christian hope upon the dying person can be a detrimental and ignorant place to begin from. In many ways, it imposes a hierarchy between the dying and their minister. It leaves no space for God to do His work or for us to be conduits of true Christian hope. And yet, hope is integral to the Christian narrative. Hope is what the death of Jesus on the Cross has given us a glimpse of. Hope for those who accompany the dying might look like this – meeting the person where they are at, listening to their existential questioning, to their “why me?” questions, staying with the wrestle and struggle of not having anything to offer except your presence and your vulnerability.

True compassion and hope at the end of life is about courage and vulnerability. It is demonstrating that all life has a value no matter what.

Dr Margaret Naughton is a Clinical Pastoral Educational Supervisor and Healthcare Chaplain at University Hospital Kerry

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