Palliative Care as Prophetic Work: A Call to Action
Danielle Gilchrist, Temple University Health System, Arika Moore Patneaude, Bioethics, Palliative Care, and Journey Grief Support Programs,Seattle Children's Hospital, Treuman Katz Center for Pediatric Bioethics & Palliative Care, Seattle Children's Hospital Research Institute, University of Washington School of Social Work, and Luke Mosley, Division of Bioethics & Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Treuman Katz Center for Pediatric Bioethics & Palliative Care, Seattle Children's Hospital Research Institute
Drawing on the rich resources of longstanding religious tradition and thought, we contend that the work of palliative care is inherently prophetic. Palliative care clinicians seek to provide whole-person centered care to patients and their families in the setting of serious illness. Utilizing advanced training in communication skills and symptom management, palliative care specialists help patients navigate complex medical decision making while aligning medical care with patient values and goals, in addition to a focus on the relief of suffering and pursuit of improved quality of life.
Employing Brueggemann’s seminal analysis of the Biblical prophets among other scholarship, we maintain that palliative care, rightly understood and exercised in clinical practice, offers: 1) a resistance to the hegemony of modern technocratic and biophysiologic medicine as well as 2) a witness to an alternative vision of human flourishing grounded in vulnerability, community, and hope. In this paper we analyze the prophetic dimensions of palliative care as a critique of the imposition of the modern medical “empire” over patients, which refuses to acknowledge finitude, rejects any outcome outside of cure as failure, and reflexively operates from a logic of endless intervention. Palliative care instead operates from an imperative of speaking truth – including the compassionate sharing of devastating diagnoses and honest appraisal of possible (or perhaps recognition of impossible) treatment options). Doing so creates space for mourning and lamentation, with authentic acknowledgment of the pain of sickness, frailty, and death. Like the prophets, however, palliative care providers do not leave those in sickness and mourning alone. Through the embodied acts of compassionate presence, truth telling, and bearing witness to suffering, palliative care specialists have the opportunity to prophetically explore and help reimagine what life might be in the setting of serious illness. From (rather than despite) the place of truthful mourning, voice can be given to a counter-narrative of human flourishing that sees patients as more than merely biological bodies and centers or even celebrates finitude and dependency as fundamental to life. Like the Biblical prophets, palliative care clinicians enact a countercultural imagination - one that grieves truthfully and hopes faithfully.
In exploring palliative care as a kind of prophetic work, we also issue a call to action for our colleagues. To recognize the prophetic nature of our vocation is to be reawakened to the moral and spiritual depth of our everyday clinical practice. In a culture of medicine that prizes efficiency, intervention, and control, clinicians are invited to reclaim the countercultural practices of truth-telling, lament, and compassionate imagination. This call is not to dramatic displays, but to the steady, embodied work of accompanying others in their suffering – speaking truth even when it disrupts comfort, tending to pain and suffering when it cannot be cured, and bearing witness to the dignity of those who are nearing the end of their life. Identifying palliative care as prophetic work recognizes that our simple acts of presence and compassion are themselves acts of resistance against the numbing forces of modern medicine, and gestures of hope toward a more human-centered and faithful practice of care.
Employing Brueggemann’s seminal analysis of the Biblical prophets among other scholarship, we maintain that palliative care, rightly understood and exercised in clinical practice, offers: 1) a resistance to the hegemony of modern technocratic and biophysiologic medicine as well as 2) a witness to an alternative vision of human flourishing grounded in vulnerability, community, and hope. In this paper we analyze the prophetic dimensions of palliative care as a critique of the imposition of the modern medical “empire” over patients, which refuses to acknowledge finitude, rejects any outcome outside of cure as failure, and reflexively operates from a logic of endless intervention. Palliative care instead operates from an imperative of speaking truth – including the compassionate sharing of devastating diagnoses and honest appraisal of possible (or perhaps recognition of impossible) treatment options). Doing so creates space for mourning and lamentation, with authentic acknowledgment of the pain of sickness, frailty, and death. Like the prophets, however, palliative care providers do not leave those in sickness and mourning alone. Through the embodied acts of compassionate presence, truth telling, and bearing witness to suffering, palliative care specialists have the opportunity to prophetically explore and help reimagine what life might be in the setting of serious illness. From (rather than despite) the place of truthful mourning, voice can be given to a counter-narrative of human flourishing that sees patients as more than merely biological bodies and centers or even celebrates finitude and dependency as fundamental to life. Like the Biblical prophets, palliative care clinicians enact a countercultural imagination - one that grieves truthfully and hopes faithfully.
In exploring palliative care as a kind of prophetic work, we also issue a call to action for our colleagues. To recognize the prophetic nature of our vocation is to be reawakened to the moral and spiritual depth of our everyday clinical practice. In a culture of medicine that prizes efficiency, intervention, and control, clinicians are invited to reclaim the countercultural practices of truth-telling, lament, and compassionate imagination. This call is not to dramatic displays, but to the steady, embodied work of accompanying others in their suffering – speaking truth even when it disrupts comfort, tending to pain and suffering when it cannot be cured, and bearing witness to the dignity of those who are nearing the end of their life. Identifying palliative care as prophetic work recognizes that our simple acts of presence and compassion are themselves acts of resistance against the numbing forces of modern medicine, and gestures of hope toward a more human-centered and faithful practice of care.