Caring for dying human patients

Jerry Risser’s recent post about his experience with euthanasia of his veterinary patients caused me to reflect on the patients whose deaths I most remember from the past thirty-plus years of practicing family medicine in small towns in the Midwest. I spent 28 of those years in a small town in northern Indiana and now practice in an even smaller town in east central Indiana. The people whose deaths I remember most clearly tend not to be ones who died in the hospital. They are the ones who died at home or in a nursing home where I was caring for them as they went through the final stages of their life. Some received hospice care. Some died before that was available in a small town. They all went through a period of time during which there was nothing that I could do that would change the fact that they were going to die. Sometimes there were things that I could do to help them be more comfortable. Sometimes there was not much that I could do other that just be with them.

One woman that I remember most clearly from years ago was slowly dying of cancer. She gradually became weaker and weaker, but had little pain. There was little I had to offer her medically, but she still wanted me to come out to her home to check on her. I would go and we would talk and many times I would leave feeling that she had ministered more to me than I had to her. She was at peace and when the time came she was ready to go to be with her Lord.

Thinking about her and many others, I realize that one of the most significant differences between Jerry and me is that I have a personal relationship with my patients. Since my patients are human they are made in the image of God. Part of what that means is that they are made to love and have relationships similar to how God is love and has eternally been in relationship within the persons of Father, Son and Spirit. While there can be affection between a pet and the pet’s owner, the relationship we have with other human beings is different and is more like divine relationships. Like Jerry I also have a relationship with those who care about the one who is dying, and part of what I do is help them deal with the approaching death of the one they love. I also get cards of thanks that seem to come most often in those situations in which there was very little I was able to offer medically, but was just there.

I have never had a patient ask me about euthanasia. That is probably related to the values of the small-town Midwestern communities in which I have practiced. If I were asked, the reason I would have to decline would be related to what on reflection seems to be one of the most important things I have been able to provide for my patients who were dying. By being with them even when there was little I could do medically, I was affirming each one was important to me as a person and that his or her life had value as someone created in God’s image. To agree to intentionally end that life, even as a means of ending suffering, would be to say that his or her life was not of value and would not be an expression of caring for that person. As one who cares for human patients I would agree with the members of the Ramsey Colloquium who expressed back in 1992 that “In relating to the sick, the suffering, the incompetent, the disabled, and the dying, we must learn again the wisdom that teaches us always to care, never to kill.

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