Discerning the Spirits Haunting Hospice and Palliative Care
Ethan Schimmoeller, MD, MA, Resident Physician, Beacon Health System, South Bend, Indiana
For traditionally minded Christian physicians, hospice and palliative care at the end of life presents an opportunity to practice medicine on the threshold of eternity. Pain, suffering, and ultimately mortality are a refiner’s fire purifying patients and those caring for them. They throw into relief the “one thing needful”: configuring one’s life and death to Christ, who “endured the cross, disregarding its shame” for the sake of the joy of life eternal. As a result of such clarity, the gifts of modern medicine can be appropriately contextualized as gifts from on high. Morphine can serve transcendent ends as the border between this life and the next wears thin. Dame Cicely Saunders, in large part, embodied this spiritual vision when she founded the modern hospice movement. She wed faith, science, and compassion in correction to mainstream medicine, ever more enraptured with technical possibilities. However, as the movement migrated across the Atlantic and took its place in the panoply of modern medical specialties, palliative care traded Saunders for more agnostic icons such as Victor Frankl. He has helped inculcate a novel form of spirituality rather distant from the original Christocentric vision.
This paper will critically examine Victor Frankl’s theory of logotherapy and its ongoing role in contemporary hospice and palliative care. For Frankl, man is not primarily a biological or psychological being driven by pleasure or power but a noö-logical one. He is driven existentially towards finding meaning – logos – in all circumstances. Indeed, no other creature under the sun is capable of transcending instincts, whims, material goods, and suffering for a higher purpose. Man is a spiritual being for Frankl, though not necessarily religious. In fact, he lamented the connotations of spirituality with religion as he believed one could satisfactorily find meaning without a religious tradition. Thus the logos lacks significant content, and his theory consequentially runs aground on agnosticism. This weakness, however, has made him an ideal teacher of secular spirituality for hospice and palliative care hoping to embrace all people in a common spiritual vision while offending none. I argue that instead of discovering a way to articulate spirituality generically, Frankl rather helped set hospice and palliative care against religious traditions by defining spirituality for a secular age. To turn a phrase from Flannery O’Connor, modern hospice is not Christ-centered though it is haunted by spirits.
This paper will critically examine Victor Frankl’s theory of logotherapy and its ongoing role in contemporary hospice and palliative care. For Frankl, man is not primarily a biological or psychological being driven by pleasure or power but a noö-logical one. He is driven existentially towards finding meaning – logos – in all circumstances. Indeed, no other creature under the sun is capable of transcending instincts, whims, material goods, and suffering for a higher purpose. Man is a spiritual being for Frankl, though not necessarily religious. In fact, he lamented the connotations of spirituality with religion as he believed one could satisfactorily find meaning without a religious tradition. Thus the logos lacks significant content, and his theory consequentially runs aground on agnosticism. This weakness, however, has made him an ideal teacher of secular spirituality for hospice and palliative care hoping to embrace all people in a common spiritual vision while offending none. I argue that instead of discovering a way to articulate spirituality generically, Frankl rather helped set hospice and palliative care against religious traditions by defining spirituality for a secular age. To turn a phrase from Flannery O’Connor, modern hospice is not Christ-centered though it is haunted by spirits.