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Asking the Clergy: What does faith say about do-not-resuscitate orders?

From left, Rabbi Randy Ellen Sheinberg of Temple

From left, Rabbi Randy Ellen Sheinberg of Temple Tikvah, Faroque A. Khan of the Interfaith Institute of Long Island, and the Rev. Donna Marie Field of St. Paul's Reformed Church in North Babylon and Northwell Health clinical medical ethics consultant. Credit: Marty Cohen; Newsday / John Paraskevas; Donna Marie Field

Last month, as the deadly COVID-19 pandemic entered its second year, the Interfaith Institute of Long Island hosted a webinar at which medical experts and religious leaders spoke about the ethical implications of do-not-resuscitate (or DNR) orders. This week’s clergy, who were among the webinar presenters, discuss DNR and other end-of-life issues from a Christian, Jewish and Muslim perspective.

The Rev. Donna Marie Field

Senior minister, St. Paul’s Reformed Church in North Babylon, and Northwell Health clinical medical ethics consultant

Do-not-resuscitate (DNR) and do-not-intubate (DNI) orders are not prohibited in mainline Christian faith traditions. In the Reformed Protestant tradition, "The Heidelberg Catechism" teaches that our only comfort is living a life with Christ as our focus. Christ’s dying on the cross is what gives us eternal life, not the technological advances of today’s modern medicine.

Those who are faced with life-limiting diseases will express miracle language, often not knowing what that miracle looks like. Spiritual resilience is fragile during this time and needs to be acknowledged. Parish ministers are some of the first to hear of a person’s medical diagnosis when prayers are being asked for. When professional clergy are aware of New York State Advance Directives, they can help the congregant navigate these confusing terms to better prepare them for their medical and hospital journey.

There is a common misconception that when a patient is considered DNR/DNI, treatment and care will no longer be given to the patient. This is very far from the truth. The patient will suffer more when natural death is occurring if cardiopulmonary resuscitation takes place. CPR can be a painful process and steal a person’s dignity while dying.

Faroque A. Khan

Chairman, Interfaith Institute of Long Island

I have thought often about this issue, both as a retired pulmonologist and former Stony Brook University professor of medicine and a practicing Muslim. The Quran says, "Life is precious and should be preserved" (5:32), but it also says, "Wherever you are, death will find you out." (4:78).

The Quran offers no clear definition of death aside from a broad statement that death occurs when the soul leaves the body. But where does the soul reside? In the heart? Lungs? The brain? After extensive medical research and soul-searching, I believe that it is the last, and that brain death is an additional criteria for the end of life.

As a physician and as a person of faith, I believe we should maintain life until brain death, and then get out of the way and not impede the process of dying. People can assist their loved ones in making end-of-life decisions with such advance directives as a living will, a DNR and a health care proxy, which appoints someone to make your health care decisions if you are unable to do so on your own. When death is imminent, clergy can be involved in decision-making, preferably at the bedside of the patient.

Rabbi Randy Ellen Sheinberg

Temple Tikvah in New Hyde Park

Judaism teaches that life is sacred, a treasured gift from God. The Talmud (Jewish law) likens saving one life to saving an entire universe. Given this, you might think that Judaism would require the preservation of life, regardless of its quality, for as long as possible. Not so.

A physician’s job is to heal a patient, even if the treatment is expensive or harsh. But if a treatment can’t reasonably be expected to heal a condition, then the doctor isn’t required to offer it, and the patient, or others acting on her behalf, can refuse it. There comes a point where medical treatment is no longer about preserving life, but rather about delaying imminent and inevitable death. When this is the case, treatments like a feeding tube or ventilator aren’t lifesaving; they are impediments to the natural process of dying.

Making the decision to refuse medical treatment isn’t always clear-cut, and it can be heart-wrenching. If possible, talk with your loved ones about their wishes long before a crisis arises. Every situation is unique, but decisions made out of love, through prayer and with respect for the dignity of life, honor God’s creation.

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