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A Holiday Gift for Loved Ones -- and it's free!

Posted by Dr. Lachlan Forrow December 19, 2012 11:08 AM
Are you still finalizing year-end holiday season gifts for special loved ones?  Even if you already have something for everyone, The Conversation Project has an additional idea that fits in anyone's budget -- the "gift of conversation".  

And not just any conversation, but "the conversation" that we all mean to have but that most of us keep putting off.

Yes, we all care deeply that the latter part of the lives of those we love is the way they would want.  Yes, we all know that if we haven't talked about that in advance, it may not happen.  Yes, we know how much we will then regret that "it was always too early until it was too late."  

But the truth is that it is hard to get started.

So The Conversation Project is offering all of us not just an "idea", but simple concrete help -- a "gift kit" for anyone who has email.  All you need to do is visit the "Gift of Conversation" web page, personalize their simple introduction, and send the message.

They offer this message for you to personalize:

I want to talk with you about what matters most to each of us at the end of our lives. Let's talk about it together. 

When you hit "send", automatically attached is their conversation "starter kit", and a tag line:

Or you might be even gentler than their proposed message -- maybe something like:

Have you heard about "The Conversation Project"?  I'd love to know what you think...

It literally only will take you a minute.

And while you're at it, you might also email other friends about this, so that they, too, can finally do, for and with their loved ones, something very important, something they've likely been meaning to do for a long time.  

And then, have wonderfully Happy Holidays.

Reverence for Life and Human Mortality

Posted by Dr. Lachlan Forrow December 17, 2012 05:00 AM

Last weekend a patient of ours at BIDMC died in one of our ICUs.  She was young (early 60's), with complications from major surgery, kidney failure, and multiple infections.  As sad as it was -  especially for a deeply devoted brother -- when it became clear that her impending death was inevitable, I was struck by how at peace everyone felt.  Very sad, but at peace.


In part it was because, thanks especially to her brother, everyone knew that we were taking care of her the way she would have wanted.  She and her brother had spoken openly over the years of her illnesses -- they had had "the conversation" regularly, as her illnesses evolved, and so he never had any serious doubt about what she would be thinking.   Whenever she wasn't able to speak for herself, he was able to be her "voice", with confidence.  Not long before she died he refused, on her behalf, one more round of surgery that the doctors were willing to do.

The usual way of describing this is that we "respected" her wishes, which we did. 

But I don't think that the word "respect" deeply enough captures the way she was treated, or even what our goal should be as professionals caring for patients, or as family members seeking care for our loved ones.

Albert Schweitzer had a different word -- Ehrfurcht in German -- that we translate in English as reverence.  He believed that all true "ethics" is anchored in our capacity as human beings to experience and then express a reverence for the lives we find around us. 

I once heard Naomi Tutu (Nobel Peace laureate Desmond Tutu's daughter) explain the difference between Dr. Schweitzer's idea of "reverence" and the more common moral language of "respect" and "rights".  When someone has "respect" for me and my "rights", she said, there's a kind of distance between us.  When someone has "reverence" for me, she continued, they are engaged, they care deeply, we are connected in a way that "respect" for me and my "rights" doesn't capture.

Decisions about "life and death" can be almost overwhelmingly complex.  Our failures to save a patient's life, or return them to health, can be almost overwhelmingly sad.  And yet after all the complexity, and amidst all of the sadness, there is something deeply gratifying when each of us -- family and professional caregivers -- can look back and say: "she was cared for with reverence." 


About the author

Lachlan Forrow, MD is Director of Ethics Programs and Director of Palliative Care Programs at Boston's Beth Israel Deaconess Medical Center and Associate Professor of Medicine at Harvard Medical School. More »

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