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Hope for a Miracle: Treatment Requests at the End of Life

Blackler, Liz LCSW-R, MBE

Journal of Hospice & Palliative Nursing: April 2017 - Volume 19 - Issue 2 - p 115–119
doi: 10.1097/NJH.0000000000000322
Ethics Series

Living with a life-threatening illness is challenging. It is not uncommon for patients and caregivers facing medical uncertainties to utilize religious coping as a tool to foster adjustment to changes along an illness trajectory. Religious coping can promote a sense of meaning, emotional well-being, and hope. This article explores requests for aggressive treatment stemming from strongly held religious beliefs and overarching hope for a miracle. A case example highlights the complexities of religious coping, belief in miracles, and requests for life-prolonging treatment at the end of life. The article closes with a discussion of the ethical considerations and strategies for best communicating with and caring for patients who request life-prolonging medical care in advanced illness.

Liz Blackler, LCSW-R, MBE, is senior clinical social worker and clinical ethics consultant, Memorial Sloan Kettering, New York.

Address correspondence to Liz Blackler, LCSW-R, MBE, Memorial Sloan Kettering, 1275 York Ave, New York, NY 10065 (

The author has no conflicts of interest to disclose.

© 2017 by The Hospice and Palliative Nurses Association.