#  Sanders: Seeking and Accepting: U.S. Clergy Theological and Moral Perspectives Informing Decision Making at the End of Life 

 



 *Background:* People with serious illness frequently rely on religion/spirituality to cope with their diagnosis, with potentially positive and negative consequences. Clergy are uniquely positioned to help patients consider medical decisions at or near the end of life within a religious/spiritual framework.

 **Objective:** We aimed to examine clergy knowledge of end-of-life (EOL) care and beliefs about the role of faith in EOL decision making for patients with serious illness.

 **Design:** Key informant interviews, focus groups, and survey.

 **Setting/Subjects:** A purposive sample of 35 active clergy in five U.S. states as part of the National Clergy End-of-Life Project.

 **Measurement:** We assessed participant knowledge of and desire for further education about EOL care. We transcribed interviews and focus groups for the purpose of qualitative analysis.

 **Results:** Clergy had poor knowledge of EOL care; 75% desired more EOL training. Qualitative analysis revealed a theological framework for decision making in serious illness that balances *seeking life* and *accepting death*. Clergy viewed comfort-focused treatments as consistent with their faith traditions' views of a good death. They employed a moral framework to determine the appropriateness of EOL decisions, which weighs the impact of multiple factors and upholds the importance of God-given free will. They viewed EOL care choices to be the primary prerogative of patients and families. Clergy described ambivalence about and a passive approach to counseling congregants about decision making despite having defined beliefs regarding EOL care.

 **Conclusions:** Poor knowledge of EOL care may lead clergy to passively enable congregants with serious illness to pursue potentially nonbeneficial treatments that are associated with increased suffering.

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 See also:- [ Faculty Research ](/faculty-research/faculty-research)