Agressive and Palliative Spiritual Care

Someone gave me a quote today-- quote by one of my favorite spiritual writers, Henri Nouwen:

When we honestly ask ourselves which person in our lives means the most to us, we often find that it is those who, instead of giving advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a warm and tender hand. the friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality of our powerlessness, that is the friend who cares.

It's a great description of what I do with my hospice patients in my role as an interfaith chaplain. I meet them where they are, discerning what is spiritually important to them, providing comfort and assurance.

Medically, hospice is about palliative care. It is about keeping a patient comfortable. No agressive or curative treatment is pursued.

Spiritually, palliative care is often called for: comfort, assurance. End-of-life is such a time, I believe, unless of course, a patient demonstrates a need for something else: reconciliation with God, reconciliation with others. But what about in my role as pastor? When is it appropriate to engage in curative spiritual care? When do I need to risk a little bit of pain, possibly on the part of one who I am caring for, and definitely on my part, to help someone over a hump, or to mirror what I see as a detrimental issue in their life?

I imagine it would have to be if they themselves request me to take such a position. Or, as a prophetic voice, which, generally, is not comfortable for me, there may be times when I should take the initiative.

Finley Peter Dunne is credited with originating the saying "Comfort the afflicted and afflict the comfortable." He was referring to the role of the newspaper. It has since been applied to the role of spiritual leaders and the church. It requires great discernment. I can think of times when both have been used where the other may have been appropriate.