Life Matters Media
Start the most difficult conversation American isn’t having- the conversation about our end of life preferences

Advance Directives In Church: Honoring Choices Wisconsin Encourages Christians To Plan


Evangelical and mainline Protestants need encouragement from medical providers within their own churches to better engage in comprehensive end of life planning, said the Rev. Charles A. Orme-Rogers at the Wisconsin Medical Society’s annual conference.

“When end of life discussions take place in a comfortable space, like a church, people are more trusting,” Rogers, an Episcopalian, told the crowd of nurses and doctors gathered Wednesday in Madison.

In 2013, Rogers helped launch the Association of Spiritual Caregivers Faith Ambassador Program, a fledgling effort to create educational materials for the incremental introduction of advance care planning conversations within faith communities. A group of 17 “faith ambassadors” tour the state’s capital to encourage families to make their healthcare wishes known through thoughtful dialogue with each other.

“Before each meeting, I need to check my bias at the door,” Rogers said. “We need to be nonjudgmental in how we present end of life materials to individuals of various faiths.”

Faith ambassadors have visited 20 faith and community centers in 2014. More than 260 have attended, Rogers said; about 60 percent signed or updated their current Power of Attorney for Healthcare (POAHC) directive.

The program is backed by the advance care planning initiative “Honoring Choices Wisconsin.” The statewide advocacy and education project is based on Respecting Choices, a program developed at Gundersen Lutheran Health System in LaCrosse, Wisconsin. Respecting Choices projects are also underway across Minnesota, northern Florida, Virginia and the Kaiser Permanente health system.

Rev. Charles A. Orme-Rogers, Association for Clinical Pastoral Education
Rev. Charles A. Orme-Rogers, Association for Clinical Pastoral Education

“We need to let the person being facilitated lead the dance,” Rogers said. “They need to unpack their process and also ask their faith leaders and doctors questions.”

An advance health care directive may take the form of a living will, power of attorney or the Five Wishes collection. The overall purpose of such forms is to help ensure one’s end of life wishes are executed in case of serious illness or incapacity.

In 2009, the Journal of the American Medical Association published a study linking religion to longer and more intense end of life treatment, even when suffering ensues. Faith was cited as the second most important factor influencing treatment decisions, after oncologist recommendations.

However, a report issued last month by the Institute of Medicine called for such public engagement strategies to address informed decision-making. According to findings published in Dying in America, not only do most Americans lack knowledge about end of life care choices, but community leaders “have not fully utilized strategies to make that knowledge available, meaningful, and relevant across diverse population groups.”

The Institute of Medicine report cited the present as an opportune time to normalize conversations about death and dying. It pointed to the social trends of health consumers’ motivation to pursue high-quality care, a growing willingness to share stories about end of life care experience that resonate across diverse populations, and engaged leadership within local communities.