When Faith Creates False Hope

Elle23 · Jan 10, 2014

These people have seemingly entered a state of delusion and are completely unable to accept the reality of the situation."[/quote']
As one who believes in miracles and the God who performs them, I take issue with you saying that having hope and faith is a "state of delusion".
If we have a terminally-ill patient, and a family member says, "I believe that God will heal her," do we have a professional obligation to reiterate the prognosis and dismiss their religious beliefs, or just nod our heads?
Having faith and hope doesn't mean we are unaware of the prognosis. It means we believe God will act despite the prognosis.

anon456, BSN, RN · Jan 10, 2014

I have seen a few families who believe and pray for complete healing and restoration of their family member to what they were before. It is very sad. Some accept finally that God is in control and they work with what they have left. Others become very bitter and angry at God and lose their faith. We have patients on our peds step-down unit who have survived their trauma but will never be the same child they were, and we are often caring for these families for months. I have seen several now who have gone through this process of grief/acceptance/faith. And what's sad for me is that some of the children do recover some function, while others do not. So while in one room the family is thankful that miracles are happening, in the next room the family is losing hope in miracles and in God. It's not fair, because both families are equal in faith, prayer and belief. It's just not fair.

Esme12, ASN, BSN, RN · Jan 10, 2014

In light of the Jahi McMath incident, I am left wondering how often my nursing colleagues have encountered the family of terminally-ill (or brain dead, etc.) patients in a state of complete denial that is bolstered by their faith. If you visit the Facebook page named "Keep Jahi Mcmath on life support", you will find dozens of people claiming that God will perform a miracle and allow Jahi to 'wake up', despite the fact that no less than five physicians have declared her brain dead, and the coroner issued a certificate of death on December 12th. These people have seemingly entered a state of delusion, and are completely unable to accept the reality of the situation.
If we have a terminally-ill patient, and a family member says, "I believe that God will heal her," do we have a professional obligation to reiterate the prognosis and dismiss their religious beliefs, or just nod our heads? Creating false hope is unethical, but it is also not our place to argue with peoples' religious beliefs.
How have you dealt with these situations, or how would you if put in a similar circumstance?

You have to be careful not to step on someones faith. They need it.

While I beleive that miracles can occur...they just don't happen every day nor that often. Those I have seen claimed a miracle by the families is just that the person was able to recover after nearing death.

I will respond to people who believe that a miracle will occur or they will be healed that it is good that they have their faith to sustain them during their loved ones critical condition/difficult time....that everything is being done that is humanly possible by medical standards and they rest is up to the "powers that be".

If they ask if I believe in miracles...I answer honestly...I say yes, but I have not seen one in my career...but I know their loved one is getting the best care possible on "our" end.....that their loved one is very critical and remains unstable on maximum mechanical support...and offer to contact clergy.

If they ask questions about the patient I answer them honestly and as gently as possible. While I have experienced this Jahi syndrome on a select few in my career...nature took over and decided for the family and the patient went into asystole. I had one family that refused to remove their mother after brain death, the MD's gave them 3 days then removed her..they didn't file a lawsuit and I lived in a state that allowed the removal of brain dead patients without actual "consent" of the family.

In my own family when my husbands mother suffered a massive MI and an extended resuscitation...his sister wanted my MIL flown out for a heart and brain transplant. :banghead: Thankfully the physician were eventually brutal with with my SIL and my husband and BIL were the voice of reason in the family (eastern Europe male dominated) My hubby asked me if there was really no hope I told him...no hope...they removed my SIL from the facility and then my MIL from life support.

My SIL now sees how ridiculous she was...but a the time she was out of control.

madwife2002, BSN, RN · Jan 10, 2014

Although it is inevitable death is one of the hardest things we all experience in life! Faith is to believe and to believe is faith-everybody believes in something I would never take away anybodies coping mechanism but I do think you have to be a realist when you are the health care professional.

I agree with Esme, in my long career I have encountered situations like the Jahi syndrome and like Esme nature has taken its course.

monkeybug · Jan 10, 2014

Faith is a wonderful thing, and may be all that some families have to get them through. You can be honest about the situation without killing their faith. I've seen a situation similar to this a couple of times. Once was a neonate who'd been deprived of oxygen for a long, long time. The family was insistent that the healthcare team was wrong, and if they could only get the baby transferred to a "better" facility then it would be fine. The doctors acquiesced, and the baby was transferred. The family got the same news at the new, "better" hospital, and probably got even less hand-holding there as it was a huge teaching facility. The baby passed shortly after transfer.

I cannot imagine losing a child. And if I could see that child's body "breathing" and feel its warmth, I'm sure it would be even harder to accept death. If this were an adult, I'd find it easier to feel like they needed firmness and no nonsense, but this is their baby.

Emergent, RN · Jan 10, 2014

These behaviors by families are not always faith-based. I think it's a personality type that just can't let go. If it's not a far-fetched hope for divine intervention, it's believing that science will have a breakthrough that will rescue the person.

When my mother had a brain aneurysm, I saw my very non-religious stepfather act in a controlling fashion, not able to let go. But, he's been a control freak his whole life.

kabfighter · Jan 10, 2014

As one who believes in miracles and the God who performs them, I take issue with you saying that having hope and faith is a "state of delusion".
Having faith and hope doesn't mean we are unaware of the prognosis. It means we believe God will act despite the prognosis.

Hi Elle23, thanks for the input, although you didn't quite answer my question. I think you can provide a unique perspective on this, since you would tend to have the same faith in miracles as the family members. Would you agree with them that God could heal the patient, or would you stick to the facts (as they pertain to this plane of existence)? Is this considered prognosing, which fall outside our scope of practice?

As far as my choice of words, I looked up 'delusion', and it fits exactly into what I was trying to convey. A delusion is a belief held despite enormous contrary evidence; it seems to fit in this scenario. Please note that I said 'state of delusion', not that these people are all delusional regarding any aspect of their faith. With or without religious beliefs, it is a delusional thought to believe that someone (a dead body, indeed) with a liquefied brain can make a full recovery. It is as deluded a thought as believing that someone with a severed limb will regrow it.

HappyWife77, BSN, RN · Jan 10, 2014

I am a woman of faith. Faith gives us Grace and strength to walk thru lifes challenges.

Denial is a different story.....I think the people you are talking about are using denial as their coping mechanism...which is one of the first stages of grieving...

So Sad for everyone involved. :'(

Esme12, ASN, BSN, RN · Jan 10, 2014

Hi Elle23, thanks for the input, although you didn't quite answer my question. I think you can provide a unique perspective on this, since you would tend to have the same faith in miracles as the family members. Would you agree with them that God could heal the patient, or would you stick to the facts (as they pertain to this plane of existence)? Is this considered prognosing, which fall outside our scope of practice?

NO you are not prognosising you are stating the medical facts as laid out buy the MD and diagnostic indicators. While you don't have to agree with them that the limb will grow back and the individual will dangle and have breakfast in the morning....you can acknowledge their belief brings them the strenght necessary at this diffucult time....while inserting medical facts.

As far as my choice of words, I looked up 'delusion', and it fits exactly into what I was trying to convey. A delusion is a belief held despite enormous contrary evidence; it seems to fit in this scenario. Please note that I said 'state of delusion', not that these people are all delusional regarding any aspect of their faith. With or without religious beliefs, it is a delusional thought to believe that someone (a dead body, indeed) with a liquefied brain can make a full recovery. It is as deluded a thought as believing that someone with a severed limb will regrow it.

You are confusing a majority of patients and families that believe they may have a miracle and those that take it to the extreme. Jahi's family are the extreme.

As a critical care nurse/ED nurse for 35 years while I have had families upset, deny, beg and plead ALL have come to the realization that death is inevitable.

Jahi's case is the extreme and I pray I don't ever come across someone like this family in my practice of nursing. However if I do you behave professionally..... To be confrontational with someones faith is NEVER a good option and will lead to hostility. You acknowledge the families beliefs while inserting medical facts respectfully.

This particular mother is crazed with grief. I have found in all my years this extreme behavior is usually associated with some sort of guilt. This combined with opportunists...like the lawyer who I see and the devil whispering in her ear, and that crazy hair dresser in NY, or the Uncle Omari...seeing this as an opportunity and perpetuating this mothers grief/disbelief.

If they found someone or some where to perform these procedures all the power to them....it won't however change the outcome.

anon456, BSN, RN · Jan 10, 2014

As a critical care nurse/ED nurse for 35 years while I have had families upset, deny, beg and plead ALL have come to the realization that death is inevitable.

What I struggle with at my workplace is not death (as you said it is inevitable) but my young patients in young bodies with strong hearts and lungs, who often hold on for *years* in persistent vegetative states while their families have told me with all sincerity that their child will one day walk again. It's sad. It's also hard to listen to the ones who are losing faith. One said to me, "I was always told that God had a plan for each one of us. I can't accept that God would have this kind of plan for my child where they suffer so much every day." What can anyone say to this? Often I am at a loss for words.

Guests · Jan 10, 2014

If we have a terminally-ill patient, and a family member says, "I believe that God will heal her," do we have a professional obligation to reiterate the prognosis and dismiss their religious beliefs, or just nod our heads?

I respond with something like a heartfelt and sincere, "Oh, I really hope so because s/he's really struggling right now" or something appropriate to the patient's condition.

One can be compassionate and empathetic - and even sincere (sometimes I really wish that God would perform a miracle) - without providing false hope or being an ass and trampling on someone else's faith.