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Circling the Dome

AMEN to That

amen in the center of speech bubbles

In the face of a terminal prognosis for a family member, 57 percent of adults say they believe that God could “intervene” to save their loved one, notes Rhonda Cooper, chaplain of the Johns Hopkins Kimmel Cancer Center.

The way a doctor responds to this hope for a miracle is crucial, she says. “If the provider makes a comment that sounds dismissive of God or the person’s faith or beliefs, that definitely will affect the trust relationship. The goal of the conversation between provider and the patient or family is to stay connected, not debate the possibility of miracles happening or not happening.”

To help health care providers navigate these delicate waters, Cooper and her clinician colleagues at the Kimmel Cancer Center have come up with a straightforward script, easily recalled by the apt acronym AMEN: affirm, meet, educate, no matter what. In practice, the protocol’s aim is to affirm or acknowledge a patient’s hope, share the patient’s wish with others, continue to educate the patient and family about medical issues, and assure them that their health care team will remain with them throughout the duration of their care, “no matter what” (i.e., in the transition from aggressive to palliative care).

The goal of the tool, says Cooper, is to help medical experts see the hope for a miracle as an opportunity to join the patient or family in their end-of-life conversation. She and her colleagues described the conversational protocol online in the May 6 issue of the Journal of Oncology Practice.