The cost of compassion

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MYRNA BROWN, HOST: It’s Thursday the 26th of March.

Glad to have you along for today’s edition of The World and Everything in It. Good morning, I’m Myrna Brown.

MARY REICHARD, HOST: And I’m Mary Reichard.

First up: Christians caught in the wake of assisted suicide.

More U.S. states are approving assisted suicide laws. That leads Christian hospice providers to question what the practice means for their work.

BROWN: Some of the largest hospice providers in the US say they won’t be directly involved.

Still, some chaplains and medical staff are left to decide whether to remove themselves from a care team. WORLD’s Lauren Canterberry has the story.

LAUREN CANTERBERRY: As a hospice chaplain, Austin Fairchild walks with patients and their families each day as they approach death.

FAIRCHILD: The work is really hard, and some days are really dark. But I’ve just seen so much beauty from a really hard moment, especially with Christians. When you see a believer look death in the face and know they’ll be with Jesus in just a few minutes, and you get to hold their hand, stand with their family in those moments … yeah, that’s been a real privilege to do.

In his role, Fairchild is not allowed to proselytize his patients. But patients may share their fears, concerns, or doubts as they near death.

FAIRCHILD: It’s not an evangelism role. If they open the door, I am fully free to share the gospel.

Though Medicaid requires chaplains to be part of the hospice staff, some patients are resistant to talking with one.

One of Fairchild’s recent patients did not want to talk about spiritual things at first. But when Fairchild asked her about her life and her family she began opening up.

FAIRCHILD: There were a lot of loose ends that she needed to tie up emotionally. She realized that she wasn’t quite ready to die.

These kinds of conversations illustrate the importance of chaplains serving people near the end of their lives. But as more states consider allowing people to take their own lives using prescribed lethal drugs, Fairchild and his colleagues worry that some people may never have those discussions.

Ten states currently permit physician assisted suicide and similar legislation is set to take effect in New York and Illinois later this year. Another 14 states are currently considering bills that would legalize medical assistance in dying, sometimes referred to as MAiD.

Fairchild works in Illinois. As his state prepares for the law to go into effect this September, he has thought about his recent patient.

FAIRCHILD: If MAiD was already available, she’s the kind of woman that would have taken it really quickly.

As a Christian, Fairchild says he struggles with how–and if–to support patients who decide to pursue assisted suicide.

Ahead of Illinois’ new law taking effect, the company Fairchild works for said that it will take a neutral stance on the practice. Staff will not actively prescribe or administer the drugs, and they won’t be required to care for a patient who has chosen to take their own life.

Three of the country’s largest hospice providers have taken this approach, saying they will not allow their employees to actively participate in a patient’s suicide but will provide palliative and bereavement care.

But Fairchild says these policies still leave questions about his role.

FAIRCHILD: Typically as a chaplain, I say that my belief is that the Lord knows the day and the moment. It’s not up to us. But that’s changing now.

Fred Ouderkerken is a hospice chaplain in California, where assisted suicide is legal.

OUDERKERKEN: From my perspective and probably the training that we have for our chaplains is that we would recuse ourselves from that once that decision was made.

Ouderkerken is also the executive director at= Healthcare Chaplains Ministry Association, which trains Christian chaplains.

In most cases, Ouderkerken and other chaplains can offer advice and help people process their choices, but they never make a final decision for a patient. That’s especially important when it comes to assisted suicide.

OUDERKERKEN: We want to provide comfort and we want to provide care, but we also don’t want to give the impression or the idea that we agree with what’s taking place.

Ouderkerken’s association and other training organizations advise their chaplains to adhere to the stance their endorsing denomination or certifying agency takes on assisted suicide.

Many of those have made it clear that they take a Biblical view of life—that only God determines our first and final breath. But as hospice companies and hospitals take neutral stances on assisted suicide, Christians are still left to decide for themselves what their involvement will be.

MCFARLAND: There is a sense of moral distress in this experience, in this role. And I think it’s growing for some of us.

Carol McFarland is a hospice nurse in Washington state, which legalized assisted suicide in 2008. Some of her patients have requested assisted suicide.

Proponents of these laws often refer to them as death with dignity laws. McFarland says that term seems to suggest that a patient can only have dignity at the end of their life if they choose assisted suicide. But many of her patients still die naturally and their final minutes are no less dignified. She recalls one woman who was able to go on several trips before she passed.

MCFARLAND: She was able to die at home with her family. That was death with dignity.

Back in Illinois, Fairchild says he is grateful his patient did not have the option to take her own life. After her health took a turn, she told him she wasn’t sure where she would go after she died.

FAIRCHILD: I said, ‘do you want to know how to be ready to go to heaven?’ In that moment I was able to tell her about Jesus and we prayed together at the end.

She heard the gospel. And died the next day.

Reporting for WORLD, I’m Lauren Canterberry.

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