The contemporary historical moment, marked for two years by the COVID-19 pandemic, prompted the entire scientific community—among others—to face new challenges. From the bioethical point of view, the scientific community found itself confronted by unprecedented and complex situations, where health care providers (as Medicians of Department of Palliative, Rehabilitation and Integrative Medicine or Department of Palliative Oncology) scientist and researcher (as Moral Theology Professors or member of the International Association for Hospice and Palliative Care) were often required to commit the bulk of their attention and focus on the strictly clinical sphere. This narrow approach in various situations of care, underestimated the different implications that each strictly clinical decision had on human suffering.
The text published by Kathleen Benton and Renzo Pegoraro, entitled Finding dignity at the end of life, at this point, and in this context, has been revealed as a source of interest and crucial importance.
The book, Finding dignity at the end of life, was published in 2021 and brings together eighteen essays by authors from different disciplines–including bioethics, theology, palliative medicine, and public health–and from different backgrounds, cultures, and spiritual beliefs. The focus of the book, as is clear from the title, is on palliative care and its perception within different cultural–and especially spiritual–contexts, which is hardly addressed in the management of clinical and bioethical issues.
Starting from the introduction, and throughout the all book, the authors and contributors focus on the need for collaboration and synergy between the different aspects related to palliative care that characterize a practical situation.
Humans are scientifically driven, meaning we seek the answers to our questions, and we try to discover and predict outcomes. However, is it necessary for science to seek to achieve answers and interventions worthy of recommendation to many, or should it simply seek to answer the most challenging questions?
However, the religious, spiritual, and peace-seeking minds of individual patients are too diverse to wholly align with the modern medical process, thus, in this book, the essays concentrate on these areas–i,e., religion, culture, dignity–to reveal some of the many spiritual lenses that can inform scientific outcomes and bioethical issues.
In fact, as clinicians and healthcare providers working with patients, their personal backgrounds, interpersonal beliefs, and communities must be basically understood and reflected upon in order to provide treatment that considers the whole person.
The volume is organized in three parts that gather the eighteen essays. Part One, Religion, Spirituality and Palliative Care, initially seeks to define the concept of death according to an individual perspective, and to the farthest extent possible, to exclude spiritual and religious influences. This part then offers a reflection on the concept of human dignity through different individual’s cases and in different spiritual and cultural contexts.
The second half of Part One consists of essays that offer insight into the concept of palliative care through the gaze of different geographical areas and religious/spiritual traditions, including wisdom from Middle Eastern, Jewish, and Hindu perspectives.
Part Two of the book, Palliative Care and Practice, focuses mainly on practical aspects related to palliative care, such as suffering, accompaniment, and patient communication in the palliative conversation. Part Three, however, collects several contributions under the title New Direction on Palliative Care, and provides proposals and evidence of positive findings in specific cases faced by patients in need of palliative care–including patients from pediatric to geriatric age. In addition to the presentation of concrete cases concerning palliative care in advanced age and pediatrics, Part Three also addresses the generally underestimated issue of the relationship between mindfulness, care, and dignity.
The conclusion allows for further reflection from the reader, highlighting that perhaps the clinical field today is actually specialized in solving the medical problem of a patient, but sometimes the human, ethical, and communicative aspect, is unable to match the progress of the clinical setting, rendering tools, such as those found in palliative care, “limited”. Learning to pay attention to the communicative aspects of the patient, as well as to the fractionality of different cultures, traditions and religions, allows health care providers to take charge of a patient’s treatment from a 360-degree view, by accepting the patient’s needs in full, and thus successfully guaranteeing a degree of dignity in the care of the same that is as desirable as possible.
The book is a short read, and the texts are very clear and accessible: at the end of each chapter, questions are presented that allow the reader to resume the lines of a reflection proposing some questions, to develop arguments on these different topics, and to deepen their knowledge on the subject by exploring the resources provided. Finding dignity at the end of life is a useful contribution to university students who already have a basic knowledge of bioethics and palliative care, but also–and above all–to clinical professionals. It should be recognized that, although Finding dignity at the end of life cannot be considered a basic text for the approach to bioethics, it is a new text, which brings new considerations and opportunities for reflection on palliative care, specifically on the general relationship between spirituality and clinical practice. The hope is that texts like this, while made up of rather short contributions, are only starting points to ensure a holistic approach to palliative care by professionals from different fields, beliefs, countries, and cultures.
Footnotes
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