Mosoiu-WMA EoL Presentation Vatican-Nov2017

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Suffering at the end of life
-an orthodox perspective
Assoc Prof Daniela Mosoiu -Romania
Assoc Prof Nicolae Mosoiu
Prof Daniel Hinshaw
Suffering in an incurable illness
– Helplessness
– Fears concerning self and worries for the
bellowed ones
– Battle / augmentation of passions that can
color suffering and intensify it.
– Challenge of values
– Thoughts about own mortality
…
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Remember Your Death
An Orthodox Christian Medical Directive
In everything you do,
remember your
end, and you will never
sin. Sirach 7:36
…No one who has
acquired the
remembrance of death
will ever be able to sin.
Hesychius the Horebite as quoted by
St John Climacus in The Ladder of
Divine Ascent
Death today
A Problem To Be Solved
• The biomedical healthcare model
emphatically denies the reality of death.
• Its approach is wedded to the modern
notion of progress: It s just a matter of
time before we conquer aging, etc!
Death as transition
• Suffering is an inherent component of our
mortal condition, as is dying.
• In the Nicene Creed, …He was crucified
under Pontius Pilate, suffered, and was
buried and resurrected …
Paschal Troparion
Christ has risen from
the dead,
Trampling down
death by death,
And upon those in
the tombs
bestowing life!
• „The Son of God makes use even of the death
in order to defeat it. He overturns the sense of
death and it is used by Him as means of
defeating it and of entering as man in the
eternal life”.
• Pr.Prof.Dumitru Stăniloae, Chipul nemuritor al lui
Dumnezeu, Craiova, 1986, p.186
Petre’s Story
• 11 years, part of large family
• All family members are deaf
and mute
• Family living in poor conditions
• Renal cancer with bone secondary’s unresponsive
to chemotherapy
• Because of severe pain he has to be admitted in
the hospice although he would like to stay at
home
Iunie 2010
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Who is suffering
• The patient
• The family and community around him/her
• The professionals who witness the suffering
and offer care
Suffering occurs in persons
• Human body -“temple of the Holy Spirit” (1Co.6:19)
• The human body is animated and the soul is embodied,”
• Olivier Clement, 1996, Trupul morţii şi al slavei, Scurtă introducere la o
teopoetică a trupului, Bucureşti, Editura Christiana, p.8
• The body must be understood not for a single moment, not
even theoretically, apart from its deep relationship with the
soul, and this natural solidarity manifests itself in various
ways. The human being fundamentally belongs both to the
earthly and to the heavenly world, but the person must
undergo an endless movement of ascent
• Marius Lazurca, Invenţia trupului, Ed. Anastasia, Bucureşti, f.a., p. 97.
Pain control should be used not only to
comfort the patient but to aid the patient in
preparing for death…opportunity for
repentance.
HT Engelhardt The Foundations of Christian Bioethics pp. 326, 331
Curing and healing
• curing refers to the physiological
reconstruction of the physical body,
• healing has many meanings
– inner peace,
– forgiveness,
– removing the stigma (disease associated with sin)
– eliminating social barriers -the man with leprosy,
told in the Gospel of Saint Mark (1:40-45
Essential Elements of Healing
• Transformation of suffering
• Reconciliation
• Acquaintance with one s death
• Silence
• Gratitude and Worship
• Communion
Transformation of Suffering
.
• Relief of pain and other forms of physical distress
(i.e., symptoms) do not end suffering. However, good
symptom relief makes it easier to fully explore and
address the deeper spiritual issues that underlie one s
suffering.
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Reconciliation
Repentance
It is necessary to prepare for
death through a stern and
liberating process of coming to
terms with life, making one s
peace with everyone, with
oneself, with one s conscience,
with one s circumstances, with
the present and the past, with
events and with people – and
indeed with the future, the
coming of death itself…. One
cannot enter into eternity tied
and fettered by hatred.
Metropolitan Anthony Bloom
Acquaintance with One s Death
• For the patient to know the diagnosis is
critical. Although the diagnosis may be terrible
(e.g., metastatic cancer), not knowing it robs
patients of the ability to directly confront the
evil facing them and may add to their suffering.
Acceptance versus Denial
The sick one who is
familiar with his
illness is easily
cured, and the one
who acknowledges
his pain is close to
healing.
St. Isaac of Syria
Silence
Hesychia and Kenosis
• A life-threatening illness can focus one s
attention like nothing else; becoming aware of
our mortal nature, but as a realistic perception
grounded in the hope of the Resurrection.
• living this, can then be our kenosis, a stripping
away of the noise so that real silence –
hesychia can be experienced.
• Then we can really begin to listen.
Gratitude and Worship
nAs Orthodox Christians, healing also includes
giving glory and thanks to God – it is
doxological and eucharistic.
nChrist cured ten lepers of their leprosy in Luke
17:11-19 and one (the Samaritan) who glorified
God and gave thanks was healed.
nOur worship is a source of healing, if it gives
glory and thanksgiving to God regardless of
our condition and the apparent outcome.
Communion
• Ultimately, healing is all
about communion (Greek:
koinonia) or fellowship – a
deep, intimate relationship
with God and our neighbor.
Love one another as I have
loved you. (John 15:12)
• Communion in the Christian
sense, is an intimacy
between persons modeled on
and enervated by the
continuous love flowing
between the persons of the
Holy Trinity.
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…When we have
reached love, we
have reached God
and our journey is
complete. We have
crossed over to the
island which lies
beyond the
world…
St Isaac of Syria
Holy sacraments
collective experiences
The Holy Sacrament of Unction
• provides a deep sense of solidarity due to Bible
readings, prayers and anointing itselfall those
present are anointed with holy oil: the sick, the
healthy, the priests and all others and creates a
special bond between the patient and others.
Deepest sense of communion is given by
celebration of the Holy Liturgy followed by the
reception of Holy Communion, the Body and
Blood of Christ, by which we acquire
consanguinity with both mystical Christ and
with other participants
Is suffering the ultimate evil for a
human being ?
• If Yes – everything is permitted to end it
included killing the person who suffers
• If NO – we believe suffering can bring human
growth and healing of the sick person and
those around them
God whispers to us in our pleasures,
speaks in our conscience, but shouts in
our pains: it is His megaphone to rouse a
deaf world.
C.S. Lewis
The Problem of Pain
“Suffering, therefore, can become an effective
means for creating a deep and intimate
communion with Christ and with the afflicted
members of his Body.
Breck, J, The Sacred Gift of Life, p. 221; SVS Press
Evolving definition of palliative care
Palliative care is the about relieve of suffering for
patients with a chronic progressive illnesses,
quality of life for them and their families, support
of families in the bereavement period
“A Christian ending to our life, painless, blameless,
peaceful, and a good defense before the dread
judgment seat of Christ, let us ask”
Holy Liturgy
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