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In Andrew Root’s analysis of the crisis mainline churches in the Western world encounter today, he attends to Hartmut Rosa’s social theory of acceleration, alienation and resonance, using these concepts to address the struggle for relevance of local congregations and pastors, within a secular context. Root shows in what ways the multifaceted concept of resonance can give rise to hope, trust and action, empowering churches, while living in an immanent world, to embrace an alternative narrative-shaped map, shaped by the community’s strong evaluation. In this article, a summary of Root’s creative reception of Rosa is followed by an attempt to appropriate Root’s ecclesiology of hope towards the practice of preaching. The concept of ‘preaching as waiting’ is sketched in which the uncontrollability of the preaching event paves the way for a homiletical encounter with the openness of the unseen, both in the life of the preacher and the lives of the listeners. A recent sermon on Psalm 85, preached in a local congregation in The Netherlands, is presented as an example of ‘preaching as waiting’ in homiletical practice.
There is a growing public support for medical interventions at the End of Life (EoL), such as euthanasia and physician assisted suicide (EPAS) and palliative sedation (PS). This paper explores pastors' views and their pastoral care on the place of EPAS and PS and uses a 2.556 pastors' survey. Whereas only 38% were in favour of EPAS, more than 90% could justify PS. This paper analyses the differences in pastors' attitudes regarding EPAS versus PS.
BACKGROUND:Discussing end-of-life care with people with dementia and their family soon after diagnosis is a crucial aspect of professional care. Research in the hospital setting is scarce. AIM:To investigate how often end-of-life issues and euthanasia are discussed during hospital consultations with people with dementia; identify who initiates these conversations; explore physicians' perceptions of their own role in these conversations compared to actual practice and physicians' views on the family's involvement. DESIGN:Convergent mixed-method study.Setting/participant:11 Dutch hospitals involving 31 physicians. RESULTS:End-of-life topics were discussed in 36% of consultations (in regional hospitals, 53%; in academic settings, 27%), and predominantly during diagnostic consultations (54%). Euthanasia was discussed in 21%, often initiated by the patient (60%) or the family (31%). Family members were present in 96% of consultations. We identified 3 themes. (1) Struggle to initiate end-of-life conversations. Physicians acknowledged the importance of timely end-of-life discussions, but struggled to initiate those discussions. Introducing euthanasia is considered undesirable. (2) Appreciation and concern about family input. Physicians' experiences of family involvement were positive in both end-of-life and euthanasia conversations, yet the latter also raised concerns. (3) Moral concerns regarding euthanasia for dementia. Physicians emphasized the importance of raising patient awareness about other end-of-life options. CONCLUSIONS AND RELEVANCE:End-of-life conversations with patients with dementia are not standard practice in the hospital setting. The availability of euthanasia can narrow patients' perspective on other end-of-life options. This hinders physicians from initiating end-of-life conversations and possibly end-of-life decision making and care.
BACKGROUND:Paediatric and neonatal intensive care nurses are frequently confronted with the suffering of prematurely born babies or critically ill children, which has a profound emotional impact on them. Yet, little is known about how they interpret such suffering and how they perceive their professional role in these situations. AIM:To explore how nurses in the neonatal intensive care unit (NICU) and paediatric intensive care unit (PICU) perceive their professional role when confronted with patient suffering. STUDY DESIGN:A qualitative study using semi-structured interviews with NICU and PICU nurses in an academic hospital in the Netherlands. The transcribed interviews were thematically analysed. FINDINGS:Nine NICU nurses and 10 PICU nurses were interviewed. They were deeply aware of their role and responsibility when confronted with the suffering of their patients. Especially when they considered the continuation of treatment to be pointless and harmful, nurses struggled with their role to advocate for their patient. This advocacy can place them in conflict with physicians or parents. During medical case deliberations, many nurses found it hard to bring their professional view forward. CONCLUSIONS:The suffering of patients has a severe impact on paediatric and neonatal ICU nurses and they deserve support and management to deal with it. Future studies should explore how nurses at the neonatal and paediatric ICU may bring forward their expertise during medical case deliberations. RELEVANCE TO CLINICAL PRACTICE:This study highlights the barriers and enablers experienced by PICU and NICU nurses when caring for suffering patients. Understanding these dynamics can inform strategies to better support nurses in their critical advocacy role.
This study explores the extent to which chaplains employ structured methods in their practice in view of home-based chaplaincy in the Netherlands by conducting a secondary analysis of 40 case studies from the Dutch Case Studies Project (2016-21). Findings indicate that chaplains employ a broad range of interventions, among which two structured methods were identified: The Diamond Model and mindfulness. Both methods support clients in coping with vulnerability and making life decisions using different theoretical and spiritual approaches. It was found that both methods were applied flexibly, reflecting a balance between professional discretion and methodological integrity. Overall, the findings suggest that chaplains aim to integrate interventions, maintaining a balance between structured methods and relational presence, ultimately striving to foster inner peace through varied theoretical and spiritual approaches.
