Pain management vs religion dilema

  1. I have a sweet little patient with prostate cancer that has more than likely metastasized to the bone. He c/o frequently of severe pain in the hip, thigh and pelvis region. We have lortab 7.5mg available for him to use and have offered him a duragesic patch, but he refuses both. The problem is, the use of medication is against his religion. He is a member of the Church of the Firstborn. He feels strongly that it is a weakness of his faith if he takes the pain meds. I understand that it is not my job to change his beliefs but to support them. I'm just not sure how to deal with his beliefs when they keep me from being able to do my job. Has anyone else ever experieinced a situation like this?? How did you handle it?? Do you think that non-medicinal pain management techniques would be helpful and if so, what do you suggest?? I appreciate any advice or suggestions!! Thanks in advance!
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  2. 6 Comments

  3. by   z's playa
    Oh my ! I feel so bad for you to have to watch this pt torture himself like that. Torture for you to have to watch it and torture for him to go through pain for the sake of his religion and to suffer the suffering of Christ I'm guessing. (albeit welcomed torture to him)

    I would try to change his mind....but we're taught to support aren't we . It's a tough call for sure! It sounds callous to say, but I hope he passes soon and his suffering stops.

    ((((((((((hugs))))))))))))))))

    You're a kind soul with a big heart. Good luck !

    Z
  4. by   sirI
    Quote from RN4ustat
    I have a sweet little patient with prostate cancer that has more than likely metastasized to the bone. He c/o frequently of severe pain in the hip, thigh and pelvis region. We have lortab 7.5mg available for him to use and have offered him a duragesic patch, but he refuses both. The problem is, the use of medication is against his religion. He is a member of the Church of the Firstborn. He feels strongly that it is a weakness of his faith if he takes the pain meds. I understand that it is not my job to change his beliefs but to support them. I'm just not sure how to deal with his beliefs when they keep me from being able to do my job. Has anyone else ever experieinced a situation like this?? How did you handle it?? Do you think that non-medicinal pain management techniques would be helpful and if so, what do you suggest?? I appreciate any advice or suggestions!! Thanks in advance!
    Hello, RN4ustat,

    As z's playa said, not much you can do except support this individual. I wonder if the physician has offered pallative tx, radiation tx.......this has helped many patients with bone metastasis. Just wondering.

    You do have a very kind heart and I feel for you. {{{{HUGS}}}}
  5. by   CHATSDALE
    tough call...but ultimately we all have to make decisions for ourselves...maybe someone from his church would come in a talk with him about the options..if this is truly what he believes in support him...i did not work directly with this patient but a nurse on ob told me of this mother who refused a blood transfusion d/t religion principles..she and baby both died...so sad
  6. by   doodlemom
    Quote from z's playa
    Oh my ! I feel so bad for you to have to watch this pt torture himself like that. Torture for you to have to watch it and torture for him to go through pain for the sake of his religion and to suffer the suffering of Christ I'm guessing. (albeit welcomed torture to him)

    I would try to change his mind....but we're taught to support aren't we . It's a tough call for sure! It sounds callous to say, but I hope he passes soon and his suffering stops.

    ((((((((((hugs))))))))))))))))

    You're a kind soul with a big heart. Good luck !

    Z
    It doesn't sound callous to me, just compassionate.
  7. by   RN4ustat
    The patient's church's position on medicine "is based primarily on a Bible verse from James 5:12-16. The citation reads in part: 'Is any sick among you? Let him call for the elders of the church; and let them pray over him, anointing him with oil in the name of the Lord.'"

    I spent a lot of time with him today asking him about his beliefs and why his church believed that they had to suffer. I explained to him that I wanted to understand his beliefs better so that I could better understand him and figure out a way to help him that supported his beliefs but allowed me to do my job. I also explained to him that there were various types of healing and that perhaps when his church elders prayed over him, the answer to their prayers came in the form of a nurse or doctor with the knowledge, technology and medicine capable of making him feel better. He didn't agree with that because "it doesn't say that in the bible". I asked him if he felt that the Lord worked through people and he said yes. So I asked him if he thought that nurses and doctors could be doing the Lord's work and he also said yes. Not sure if I accomplished anything or not but it was at least worth a shot. We'll see how this plays out. If anyone has dealt with a similar situation, I sure would appreciate some advice. Thanks again.
  8. by   aimeee
    You may not be able to get him to take pain meds, but will he take other meds? Dexamethasone might be helpful to reduce the bony inflammation. Or perhaps he would accept a topical agent that might bring some small local relief, such as aspercreme?

    If he will not accept any medication, then sessions of prayer with guided imagery to help him mentally put himself in that place of blissful relief from suffering. The mind is a powerful tool and he must have a powerful faith already so perhaps you would be able to guide his brain into releasing more of its own endorphins. Music that is meaningful and Godly in his view may also be helpful in reaching that state. Also, does his church use anything with a particular scent? If there is a scent associated with church then that would also help evoke that state of grace.

    Massage of other areas, such as arms/hands, scalp, back, feet (especially feet since there is another Biblical association there and they are so full of nerve pathways!), may offer sensory distraction as well as being relaxing. In addition, some accupressure could be combined with the massage technique. Heat can bring enormous relief to those muscles so long tense against pain.

    I'm thinking you could work WITH that Bible passage and make it come true for him...ask an Elder to pray for God's blessing on some massage oil to bring some healing relief for him.

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