“You Can See Your Loved One Now.” Can Visitor Restrictions During Covid Unduly Influence End-of-Life Decisions?

Di Melanie Smith, Julia Vermylen and Joshua Hauser

Original article:

Palliative doctors Melanie Smith, Julia Vermylen and Joshua Hauser* work for hospitals that during the Covid pandemic made the exception of allowing up to two family members or other loved ones to visit those (non-Covid) patients who were ‘actively dying’, meaning that death was expected to happen within hours or days. In this article, they are reflecting the impact of this practice in terms of end of life decisions on the part of the patients (or their surrogates), considering questions such as: Did some decide to cancel life-sustaining interventions during the visit in order to be accompanied by their loved ones during their last moments on earth?

The dilemma is surely a complicated one, and, as they also expressly state, there is no clear solution. But what is truly striking and makes this a challenging read is that the article highlights the crucial relevance of having loved ones at the bedside, something that instead is not addressed explicitly in advance care planning discussions (let alone in other settings).

*Melanie Smith, MD, Julia Vermylen, MD, MPH, and Joshua Hauser, MD, are palliative care physicians at Northwestern Feinberg School of Medicine and Northwestern Memorial Hospital in Chicago.

Religion During the Coronavirus Pandemic: Islamic Bioethical Perspectives

In this article, Mohammed Ghaly* describes the two main positions that were taken by Islamic scholars regarding the current pandemic. As it is well-known, Islam does not have a ‘central church’, meaning an individual or institution recognized as an authority from everyone; thus, there is no official position on the matter but only a variety of scholars who expressed their judgment, which is always fallible and debatable. He sketches the view of those who completely disregard scientific knowledge and evidences, even in the face of the pandemic, and argue that the response to Covid can only be a theological one (in a nutshell: repentance, which should be expressed through religion rituals as well, without exceptions or limitations); he also outlines the view of those who take the choice of not celebrating religious rituals and abstaining from mass gatherings to be an application of the principle of nonmaleficence, and believe that religious guidance should take into consideration scientific evidences, such as the evidence that mass gathering can allows the virus to spread more easily (such position was taken by al-Alzhar too). Besides the helpful analysis of the two main points of view taken by Islamic scholars during this time, Prof. Ghaly is interested in attacking in a powerful way the lack of consideration that the bioethical debate has shown with regards to all religious aspects, which were deeply involved in every aspect of the pandemic, and yet completely disregarded in the bioethical discourse. It is an invitation, once again, to rediscover what is at the core of medicine and bioethics: the human person, which should be looked at in a more unified, less sectarian, less reductive way.

*professor of Islam and Biomedical Ethics at Hamad Bin Khalifa University in Qatar and Editor-in-Chief of the Journal of Islamic Ethics

Faith leaders grapple with funerals amid global pandemic

The article describes the situation that all faith leaders had to face and are still facing during the current global pandemic. From Italy to the US, faith leaders of different denominations share how burial rituals were forced to change, when not banned altogether, and how this has had and will continue to have a strong impact on the way people mourn and process their loss.

While it is still heartwarming and comforting to see the creativity of people who find alternative ways to express closeness and affection (i.e., community prayers and eulogies shared on Zoom or other channels), proper funerals, burials and “healing hugs” have definitely been missing as crucial steps of the grieving process.

Chaplains also express sadness for the spiritual assistance they were not allow to offer to those facing death. The question remains open for everyone: did we do enough?

Read the article at the Link