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Catholic Voice
June 27, 2016   •   VOL. 54, NO. 12   •   Oakland, CA
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140 years of memories,
at Oakland's Sacred Heart

50 years of devotion celebrated
at Our Lady of Good Counsel
Exploring life-affirming
options for end-of-life care

Dr. LaVera Crawley

California's End of Life Option Act, which went into effect June 9, may be a response to a broken health care system, but it's not the answer for end-of-life care.

"The health care system is fractured," said Dr. LaVera Crawley, whose career has encompassed being a physician, bioethicist and now a hospital chaplain.

If we fill in the cracks in the broken health care system, Crawley said, the perceived need for physician-assisted suicide would go away.

"When we make palliative care state of the art, when we put it in public hospitals, when everyone can have access to good quality palliative care, when everybody knows about it, when they know to ask for it and demand it; that will fill in all the cracks," she said. "The need for the law will go away. Let's put our energy there."

Human beings are built for living.

"This is what I know as a physician and as a person who lost her parents; they died from cancer: It takes a lot to overcome life. Life has its own compelling energy to be. It takes a lot to die. It takes tremendous force: a bullet, a bad disease or a long life," Crawley said.

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"When someone decides they want to end their life, you have to think of that same tremendous force like a bullet. Something is going on that makes them want to end their life. Because life is going to figure out a way to stay in business.

"We need to find out why that person is suffering so much that they would choose to end their life," she said. "There's something they're suffering from deeply."

As for physician-assisted suicide, she said, "I am fully against the law."

But, she pointed out, it is law. "We've got to live with it, and we've got to figure our way through it," she said.

"I need to find out why this person is suffering so much this is why this is their choice," she said. "If you look at the data from Washington and Oregon, the bulk — 70-80-90 percent — of the people who have requested physician aid in dying isn't because they were writhing in pain. It wasn't because they were physically suffering.

"It was because they imagined that they would be somewhere down the line. They didn't want that, so upstream they made the decision. These are people who wanted to have control over their life," she said.

"As if we can," she added.

"When I hear that, I worry," she said. "If you are imagining that you're going to be suffering and you're not, that's a place for a lot of intervention.

"If you're imaging it because you think you're going to have physical pain, we have really moved greatly ahead with palliative care, with techniques, technologies, medications, strategies to address physical pain. It is rare that there is someone that there's not some sort of medical intervention that won't alleviate the pain."

"If you imagine you're going to have great existential pain, that's what my field in chaplaincy is about," she said. "We're here to help people come to peace with whatever existential concerns they have."

Professional chaplaincy is multifaith. "We don't try to impose our individual spiritual or religious beliefs on patients, but to try to accompany them based on what their faith tells them," Crawley said.

"I may believe that the law is wrong, but it's not for me to impose my ideas on a patient who is asking for it. My role is to help them make an informed decision, and part of that informing is to do a deep spiritual assessment to figure out what is the source of their suffering?"

Chaplaincy also involves not judging people. "This is what I've learned from Pope Francis, his stance against abortion, yes, it is morally wrong and I believe that, and what are we going to do with people who have had abortions? Are we going to shame them, are we going to shun them? No, we are going to love them.

"Maybe in offering that love as a form of palliative care, maybe it can be part of their decision to not go through with the law," she said.

"I think of chaplaincy as the art of spiritual companionship. Just learning to be with someone and not trying to fix them is a real gift to that person," she said.

A chaplain also provides spiritual care to health-care providers.

With her background as a physician, bioethicist and chaplain, "for weeks now, I've been getting phone calls from total strangers, as well as other physicians that I know, saying, 'What am I going to do?'

"Two of the physicians were not clear on how they felt about it. Regardless of how they felt about it, they wanted some advice on how do they talk about this with their patients who are asking for it," she said.

A woman of deep faith — "I love my faith," she said — Crawley is a parishioner at Holy Spirit Parish/Newman Hall in Berkeley. She facilitates the JustFaith ministry at her parish.

Influenced by Franciscan theology, Crawley is a student of Father Richard Rohr. "One of the things I've learned from that teaching," she said, "it's not only my joys but my sufferings that will lift me up."

(Dr. LaVera Crawley invites those who have personal questions regarding end-of-life care to contact her at lcrawleyjustfaith@gmail.com.)

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