Ms. June is a 58-year-old Buddhist woman from Thailand with half a dozen or so of her family now here in the States. Her husband died seven years ago and she moved here after that critical event. She and her husband had been very close through their years of raising four children (40, 38, 35, and 32) on a small farm in Thailand. She, herself, had been raised by a strong mother after her father had died when she was just two years old. Family, farming, and Buddhism were the constants of her life and she depended on each of them to help her manage life well. The differences in context between Thailand and the US for these three constants in her life were dramatic.
Feeling tired for at least a year now, Ms. June tried to help herself feel better by using some over-the-counter pain relievers, sleep aids, and various other things she could afford from her local drug store. She did not want to go to the hospital, in part, because she did not think she could financially afford it, but when her symptoms got worse she went to the emergency room. She was subsequently diagnosed with liver cancer with metastases to other organs. In the hospital for most of the last two months, she was introduced to and received a good deal of help from the palliative care specialists there. Eventually, however, the conflict between family and providers began so her family took her home to use their old, tried, and true methods from their family’s Buddhist traditions. They held a number of ritual ceremonies in the hope of healing her cancer. Ms. June grew worse and her pain increased so much that her family brought her back to the ER. She had dyspnea and an abdomen pain score of 10/10.
In the hospital, Ms. June was intubated and placed on ventilator support. She grew increasingly agitated and restless and at one point even tried to extubate herself. The physician and care team gave Ms. June some morphine to calm her down. This helped stabilize her but the cancer was killing her. The doctor told her family that “She is at the end of her life,” and that “She may die at any moment.” In a quick and loving response, her children and their monk brought a number of things into the ICU to help her in these last hours. The monk used some cords that he wrapped around her bed, then sprinkled some special sort of water, and he appeared to be praying for her. But as he was doing these special Buddhist ministries, the ICU nurse got very uneasy and finally, a unit manager came to Ms. June’s room and told the family and the monk to stop what they were doing. Supposedly, these things were disturbing other patients and had some potential to cause infections. This just made Ms. June’s family angry. They insisted that the ICU stop treating her and let them take her home.
QUESTIONS FOR ABOVE SCENARIO
Consider the following questions during your participation in this discussion:
Is there anything the ICU could do at this point to help make sure Ms. June has the best care possible while she dies?
Is it okay to let a patient like Ms. June go home under these circumstances? It seems unsafe; does the hospital incur any liability for her safety?
What is so disruptive about Buddhist prayers/rituals that it would upset an ICU?
How might a team of healthcare providers with better knowledge of the Buddhist tradition have responded differently to Ms. June’s needs?
SOURCES THAT NEED TO BE USED:
https://rise.articulate.com/share/U2CXiHj9_Lbg7OXLAtIdX6bbNR6xgS7w#/
https://www-taylorfrancis-com.ezproxy.lib.usf.edu/books/edit/10.4324/9781315641775/world-religions-healthcare-professionals-siroj-sorajjakool-mark-carr-ernest-bursey-siroj-ssorajjakool-mark-carr-julius-nam
