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Opinions: Essay

How can clergy play a larger role in caring for the dying in American hospitals?

by Rabbi Gerald I. Wolpe

A rabbi for over 40 years, a faculty member of medical schools for 25 years, and a member of the bioethical academic community, I have also been a spousal caregiver for eleven years. The sudden illness of my wife has provided a vivid insight into the varied chords of my life. Therefore, my response comes from the perspective of a health system consumer as well as an activist in the religious and medical communities.

The dying process in most cultures involves a social response. Family caregivers, spiritual advisors, and health professionals are supposed to surround the dying in a cooperative effort and offer their individual touches of clinical expertise and loving concern. There should be no conflict or rivalry among members of that support system.

First, the clergy must be accepted as necessary companions to the health professionals. "Each person dies alone" but the act of dying should include those who can respond to the varied needs of the patient. The dying process is, of course, a physical act, but it involves a struggle with the meaning of life and the mystery of the unknown future. These themes, a key concern of religion, must be considered as part of the challenging journey from life to death.

Conversely, the clergy must be willing to learn the nuances of the protocol and discipline of the clinical care of the dying. In the rapidly changing world of health care, the clergy must be conversant with the language, techniques, and organizational world of the health professionals. He/she can be taught to work within the time frame and demands of good medical care and health care providers.

That cross-disciplinary education must include awareness of the special language used by both groups. Confusing use of medical and religious terms is one of the major complaints of caregivers and patients alike.

Essential is an understanding of the separate but intertwined needs of the caregiver who is caught in the midst of this emotional and spiritual challenge. The clergy is a vital part of the caregiver support system and can act as an important link between the dying and their families as well as to the medical and social service communities. In the midst of my own caregiving trials, the touch of clergy was vital for my own strength and resilience. Working in so many different professional communities, I have been used often as an ombudsman for families who are overwhelmed by the maze of demands placed upon them. There is a sense of confidence in clergy who are part of the health care process and yet separate from clinical activity. As spokesman and confidant, he/she can be an effective source of strength in a brutal existential trial.

Rabbi gerald I. Wolpe Rabbi Gerald I. Wolpe is currently Senior Rabbi at Har Zion Temple in Penn Valley, Pa.; Chairman of the Advisory Committee of the Center for Bioethics at the University of Pennsylvania; and Chairman of the Rabbinical Assembly Committee on Caregiving. He has also served on the faculties of Yale University, Jefferson Medical College, and Hahnemann Medical School.

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