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Life at the Far Boundary:
Science, Ethics, and Theology of End-of-Life
A Science and Theology Seminar,
Feb. 9-10, 2007,
Pollard Auditorium, Oak Ridge, TN.
Cost is $20 at the door.
Presented by First United Methodist Church, Oak Ridge, TN, and
The Center for Applied & Professional Ethics, The University of Tennessee, Knoxville.
Social, moral, and theological questions surrounding the end of life, especially as science and medical care allow us to extend the lifespan of individuals far beyond previous expectations. How far should we go to extend life? Who should make those decisions? And what about the quality of our lives versus the limits of health care dollars? How does faith factor in these decisions?
Join our fascinating panel of well-known physicians, theologians, educators and scientists as they -- and we -- grapple with the most difficult questions surrounding the issues of death and dying. Truly they are some of the most important questions of our lives.
Professor of the Practice of Pastoral Theology and Medicine, Duke University Divinity School. Co-director for the Center for Spirituality, Theology and Health in the Duke University Medical Center. Senior fellow in the Duke Center for the Study of Aging and Human Development.
Our therapeutic "culture” distorts both our understanding of health and our practice of Christianity. Formation in practices of caring within faith communities bearing witness to trust, gratitude, and hospitality provides a redemptive challenge to those distortions. How we care for one another throughout life will form how we care for each other at the end of life.
Associate Professor of Religious Studies, University of Dayton. Specializes in bioethics (genetics, reproductive technologies, stem cells, cloning, end of life issues), religion and bioethics
The death of Terri Schiavo during Holy Week in March 2005 polarized public consciousness around technical questions at the end-of-life. Although Christian public protest and commentary figured in promi-nently, Christian witness at the end-of-life ought not begin and end with questions of technology. How might this litur-gical context of the Schiavo case, and indeed, the liturgi-cal context of all Christians, whose lives are centered in the life, death, and resurrection of Jesus Christ, make a difference in how Christians begin to think about the end-of-life. The autobiography of Joseph Cardinal Bernardin, entitled The Gift of Peace, provides guidance. From Schiavo, Bernardin, and Holy Week, perhaps Christians can begin to chart a new way forward in living out Christian convictions in end-of-life cases.
Professor of Ethics, University of Tennessee
The triumphs of modern medicine over the past 50 years enable us to prolong life and postpone dying long enough so we no longer may have to deal with death at all. This may sound desir-able but the drawbacks in our “new kind of death,” both to dying patients and to others include: 1) we are tempted to misdescribe the crisis of death and to engage in technological brinksmanship, 2) we are forced to under-take difficult deeds or we will get stuck, and 3) we are focused on treatment decisions that tempt us to ignore the human tasks of dying. Such tasks involve the wisdom to recognize when our lives are over, the skill to wrap up our lives (both internally and in our community) and the courage and permission to leave the stage.
Co-Director, Pediatric Advance Comfort Team, Professor of Pediatrics,
Vanderbilt Children's Hospital (Neonatology)
Palliative care is a comprehensive, proactive and planned intervention, using a team approach to prevent or relieve any physical, psycho-logical, social, emotional, and spiritual suffering while improving the quality of life for dying patients and their families (World Health Organization). Since 1986, Medicare beneficiaries qualify for hospice benefits but must agree to forgo “curative” interven-tions. Barriers to optimal assessment and management of patients at the end of life involve a combination of medical, social, political and theological/philosophic matters, myths, and misunderstandings. When is it the "right time" to discuss a poor prognosis with the patient and family? How should one address conflicts between concerned parties over goals of care? What are the obstacles to improved access to palliative care? This session will address the epidemiology of end-of-life services, major diagnostic categories, symptoms and issues pertinent to patients, families, and health care professionals.
Randy: Tennessee State Senator and Pharmacist - What is the impact of end of life issues as it relates to access to care for state’s citizens? What is the cost/affordability of various options as balanced against other needs such as education, etc.? How do we meet the challenges of measuring impact and outcomes of new or discontinued programs and services?
Jan: Head of local hospital - What is the mission/duty of a not-for-profit hospital/healthcare system to provide needed care? How do end of life care issues relate to the following: Medical liability exposure, current financial climate and reimbursement environment, physician capacity and impact on access to care, meeting the expectations of the enlightened consumer of healthcare today, pace of technological advances, relationship of culture and technology to patient safety.
Associate Dean for Research, West Virginia University School of Nursing
Advances in the medical manage-ment of serious illness have resulted in marked changes in how we die. Death is seldom a quick ending; instead it more typically follows a slow, uncertain course. Individuals and their families may face great difficulty detecting when care goals should appropriately shift from cure to comfort. Data from prospective studies of the elderly pro-vide evidence for different patterns of functional decline among the trajectory groups. Data from Medicare claims indicate that decedents in different groups also have dif-ferent demographic characteristics and different patterns of health care utilization. These research findings will pro-vide the foundation for discussion of the personal and policy-level implications that these trajectories have for health care decision-making and delivery of supportive care services.
Schedule:
Feb 9,
7-10 p.m.
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CULTURE OF HEALING AND CLINICAL REALITY
Dr. Keith Meador, Professor of the Practice of Pastoral Theology & Medicine Director, Theology and Medicine Program, Duke University Divinity School, “Spirituality, Theology and Health: Formation in Practices of Caring.”
Dr. Brian S. Carter, Associate Professor of Pediatrics, Division of Neonatology, Vanderbilt University Children’s Hospital “Palliative, End-of-Life, and Bereavement Care - The Clinical Reality.”
Panel Discussion.
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Feb 10
9 a.m. - Noon
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DELIVERING TERMINAL CARE: POLICIES AND PRACTICES
Dr. June R. Lunney, Associate Dean for Research, West Virginia University
School of Nursing, “Trajectories of Dying: there’s more than one way to go.”
Jan McNally and Randy McNally, Director, Methodist Medical Center, and
State Senator of Tennessee, “Perspectives from an Organizational Healthcare Provider and a Tennessee State Legislator.”
Q & A
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Lunch and small group discussion (complimentary box lunch) |
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1:30-4:30 p.m.
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ETHICAL QUANDARIES AND GOD’S WILL
Dr. John R. Hardwig, Ph.D., Professor of Philosophy, University of Tennessee “Going to Meet Death: The Human Tasks of Dying in the Twenty-First Century.”
Dr. M. Therese Lysaught, Associate Professor of Religious Studies, University of Dayton, “Love your Enemies: The End-of-Life After Terri Schiavo.”
Panel Discussion. Closing Comments.
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Prof. Keith Meador
Prof. Therese Lysaught
Prof. John Hardwig
Dr. Brian Carter
and 
Dr. June Lunney