For persons who are seriously ill

Feb 02, 2024

When I mentioned the Pope’s prayer focus for February, which is praying for the terminally ill, Datuk Seri Dr T. Devaraj expressed concern about the term ‘terminally ill,” finding it ambiguous and restrictive. Dr Devaraj, soon to be a centenarian, serves as chairman of the Penang Hospice Society and vice-chairman of the National Cancer Society of Malaysia, Penang Branch, reflective of his truly altruistic contribution to society.

The term “terminally ill” is often used to describe individuals diagnosed with medical conditions which cannot be cured. While the term is widely understood and commonly used in medical and healthcare contexts pertaining to the inevitable outcome of the medical condition, focusing on the endpoint of life, some feel that it may not fully capture the complexity of the situation, as its genesis usually is one of many years, or convey the full range of experiences, emotions, and challenges that individuals facing a life-limiting illness, and their loved ones go through.

Additionally, using person-first language, such as “individuals with serious illnesses” or “people facing critical health challenges,” emphasises the person rather than the condition. It’s essential to be mindful of the language used to ensure respect and empathy for those experiencing difficult health situations.

Hence, I am going to refer to the prayer intention as praying “for persons who are seriously ill”. I believe that it is vital to reflect on how we ‘categorise’ persons who are seriously ill. This will determine not only our prayer for them but also our relationship with them.

Dr Devaraj also discussed the challenges of caring for patients in hospice and how it can be tough for everyone involved — patients and families, medical professionals, other caregivers. Shortage of volunteers makes the situation more demanding. On why he chose this path, Dr Devaraj credited his family, especially his father, who cared deeply about the wellbeing of individuals and society. This made me think about our families, BECs and parish communities as essential places to nurture and empower persons to care for persons who are seriously ill. It should not be the work of just a few; everyone in the community must be involved. Persons facing serious illness should also be at the heart of the Church’s story, not pushed to the margins/peripheries. It’s a call for all of us to pray for and be present to those who are seriously ill, making our communities places of comfort and support.

From the time I was a seminarian right until today I have found it very challenging to visit, pray and support individuals facing serious illness and approaching the end of their lives. While relying on The Roman Ritual with the set prayers for the sacrament of the anointing of the sick and Viaticum, the difficult task was always to find meaningful ways to pray for, pray with, or pray over these persons and to just be with them. In these moments, it was important for me to remember what we learnt during the Clinical Pastoral Education programme and that is to avoid cliched expressions, such as “I know how you feel,” “I can imagine how you feel,” “Live for today,” “You’re so brave,” “Everything happens for a reason,” “It’s God’s will” “God doesn’t give us more than we can handle,” and “You are going to a better place.” The goal is to offer genuine and comforting words that do not inadvertently upset the person who is unwell.

Prof. Xavier Pereira, psychiatrist and psychotherapist, brought to my attention the five stages of dying, commonly known as the Kübler-Ross model. Initially identified by psychiatrist Dr Elisabeth Kübler-Ross, these stages represent a framework for understanding the emotional and psychological experiences that individuals may go through when facing serious illness or the prospect of death. The stages are:

1. Denial: The initial stage involves disbelief and a refusal to accept the reality of the diagnosis or prognosis.

2. Anger: As the gravity of the situation sets in, individuals may experience frustration, resentment, and anger. This can be directed towards themselves, family members, others, or even a higher power.

3. Bargaining: In this stage, individuals may attempt to negotiate or make deals in an effort to postpone or change the outcome. This can involve seeking alternative treatments, making promises to a higher power, or trying to find ways to extend life.

4. Depression: As the reality of the situation becomes more apparent, a sense of sadness, helplessness, and mourning may set in. This stage involves coming to terms with the impending loss.

5. Acceptance: The final stage involves acknowledging and accepting the inevitability of death. It doesn’t necessarily mean that the individual is happy about it, but there is a sense of peace and readiness to face and even plan for the end. Within the family there is more openness and bonding.

Prof Xavier emphasised that individuals, whether they are medical professionals, caregivers, priests, chaplains, or family members, can enhance their ability to discern the appropriate pastoral care for those facing serious illness. By understanding and acknowledging the five stages of dying, we can cultivate greater empathy and provide optimal care to those in need.

The Kübler-Ross model serves as a general framework rather than a rigid roadmap for everyone facing the end of life. Its stages can also vary with the ill person.

In responding to the Pope’s call to pray for persons who are seriously ill, we are called to embody the essence of compassion. This entails advocating for comprehensive physical care, acknowledging the significance of spiritual support, and actively participating in the accompaniment of those facing the end of life.

As a society, we have the power to shape an environment that values every life, regardless of its duration, and that ensures that no one walks the path of serious illness alone.

May this prayer serve as a catalyst for change, inspiring individuals, communities, and policymakers to work together in creating a world where the persons who are seriously ill, and their families, find solace, dignity, and love in the midst of life’s most profound challenges. 

(Fr Fabian Dicom is the National Office Director for Caritas Malaysia.)