Roles for the church in improving end-of-life care: perceptions of Christian clergy and laity

Although faith communities may seem to be logical places to discuss death and dying, few churches are engaged in extensive efforts to improve end-of-life care. To explore the meaning of a good death and potential roles for faith communities in this effort, the authors held focus groups involving 121 clergy and congregants affiliated with Christian churches in Honolulu. Participants' definitions of a good death were similar to those articulated in other studies, for example, pain is managed, inappropriate prolongation of dying is avoided, the family is present and supportive, conflicts are resolved, and spiritual/existential issues are addressed. Participants identified a number of roles for the church: (a) to help congregants prepare for death, both spiritually and practically; (b) to facilitate resolution of conflict and forgiveness; (c) to clarify if or how church theology should guide attitudes and practices related to death and dying; (d) to administer the appropriate rituals; and (e) to provide outreach to sick, dying, and bereaved members. A number of participants noted that attention to spiritual issues at life's end would be important to all people, and churches wanting to increase membership should expand offerings in this area. These findings suggest that faith communities can have a major impact on improving end-of-life care and that pastoral education include attention to these issues.