By Edith M. Meyerson, Diane E. Meier, and Allison Kestenbaum

Rabbi, Associate Director, Pastoral Counseling and Bereavement Services, The Hertzberg Palliative Care Institute, Clinical Instructor, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai Co-Director, Patty and Jay Baker National Palliative Care Center; Director, Center to Advance Palliative Care; Professor, Department of Geriatrics and Palliative Medicine; Gaisman Professor of Medical Ethics, Icahn School of Medicine at Mount Sinai
Association for Clinical Pastoral Education Supervisor, Director of Programs, Center for Pastoral Education, Jewish Theological Seminary

Abstract

Palliative care is an interdisciplinary approach to caring for individuals and families who are suffering with serious illness. Medical and psycho-social-spiritual symptoms and needs are assessed and addressed. Much of palliative care is about working with patients and families to bring their context to light, that is, to understand not only their medical situation but also their wishes, values, cultural background, previous experiences, and quality of life. As pal- liative care clinicians, we have seen how popular understanding and misunderstanding about what it means to “honor thy mother and father” can inuence medical decision mak- ing. Whether or not adult children of patients have familiarity with the honor command- ment, the biblical text “honor thy father and mother,” or whether they identify with a particular religious tradition, this theme plays a central—and often unaddressed—role as adult children strive to make decisions with and for a seriously ill parent. In this article we examine the commandment to honor one’s father and mother by exploring its religious, spiritual, textual, and cultural origins, as well as subsequent Jewish commentary. We also contextualize the honor commandment in the palliative care setting through clinical case studies that illustrate the concerns of adult children who wish to honor their parents but are perplexed or conicted about what this mandate means in the face of difcult medical and psycho-social-spiritual circumstances.

KEYWORDS: spirituality, palliative care, honor commandment, family decision making, goals of care

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