Role and Place of the Church in Development of Palliative Care in Ukraine

The Ukrainian Orthodox Church, treating with maternal love both her faithful children and everyone needing sympathy, care, love and mercy, cannot but pay special attention to those people whose life is coming to an end, and who endure bodily and spiritual pain and sufferings.  

Among the problems which arise, as we believe, on the way of creation and development of the effective system of palliative care in Ukraine, the central place belongs to the problems of spiritual   ideological and axiological character, concerning first of all the concept of palliative care as such, and of the problems pertaining to the attitude of the society to the incurable death-marked patients.   

I'd like to dwell upon some aspects of a possible place and role of the Church within the given scope of problems.    

First of all I'd like to mention that  palliative care, at least in the Christian outlook, may acquire autonomous and self-sufficient axiological significance and value both in purely medical and the wider socio-cultural context, opening for the incurable people the way and  the possibilities of revealing spiritual side of their personalities, and will embody the virtues  of mercy, compassion and service to the neighbour as self-sufficient values.  

In such sense the palliative care may be important as such, both for patient  and the people patronizing them.  The Church emphasizes that sympathy with a dying neighbour in its active realization is an inalienable part of the personal and social moral, and an important means of consolidation of the people's social life.   

That is why we believe the positive spiritually conscious attitude to incurable patients in the society to be a necessary precondition for the solution of the problems of such patients by means of palliative care. 

Our Church recognises its major function in this sphere in the development of such kind of attitude.  This function can be performed by different means and ways, proceeding from the historical and spiritual experience of the Church, and from her experience of the social ministry. 

On the whole the following means should be emphasized:  

• the church sermon (liturgical and  non-liturgical);

• educational, pedagogical  and enlightenment work carried out through the network of Sunday schools, mass-media etc;

•holding public prayer activities;

• educational work in the higher educational establishments;

• finally, personal example  of service by the clergy and faithful to the death-marked patients.


On this occasion iI'd like to note that changing the attitude to the dying in the society should begin with  our personal active and spiritual motivated attitude to them, and first of all it concerns their relatives and close ones, irrespective of the special institutions and specialized organisations. Another aspect of the Church's role and place, and it is the second one I'd like to mention,  is the direct spiritual and social assistance to incurable patients and their families.   I mean the spiritual pastoral care of the sick and their families, and charitable actions and social support that have always been performed by the Church and which are inherent in her social ministry.  Thanks God, nowadays this opportunity exists in our state,  and it was impossible even to think of  that in the past, in the Soviet times.  I won't analyze this aspect in detail.  Its pastoral component is expounded in the "Regulations for palliative care", which we introduced for consideration of the Coordination Council of the Ministry of Health.  
The third important aspect is participation of the Church or her individual representatives and church organisation in the palliative care activities, as well as in the work of palliative care establishments, medical and medical social establishments and other institutions rendering palliative care of the incurable patients.   Such participation may be effected:  

• by means of immediate work of pastors, spiritual and social workers, believers-volunteer workers in the functional teams and groups for palliative care;
• by means of involvement of the church representatives into the development of the national state and international programmes of palliative care;
• by means of involvement of the Church and her representatives into the management of the establishments for palliative care, also as members of guardians' boards  and supervisory councils of these establishments, of commissions for ethics etc;
• by means of organizing charitable and fund-raising activities, etc;
• by means of organizing and introduction in the religious educational establishments of the courses for social and spiritual workers (medical chaplains) and the sisters of mercy, focusing on spiritual and  social work with incurable and critically ill patients and care for them.

The last point should include state certification and state recognition of the diplomas of such religious educational establishments or certain special courses. That is what I actually wanted to tell concerning  spiritual aspects of palliative care and possible participation of the Church in the development of palliative care in our society.