Hopecare, 740 4th St. N, Saint Petersburg, Florida, 33701, USA.
F1000Res. 2022 Mar 2;11:268. doi: 10.12688/f1000research.109811.1. eCollection 2022.
Racial and ethnic disparities in end-of-life healthcare can be reduced by showing physicians how to best respond to a documented underlying cause: African American families' hopes for a miracle via divine intervention influence their end-of-life medical decisions, like, for example, making them not want to withdraw ventilatory support in cases of poor neurologic prognosis because they are still hoping for God to intervene. Autoethnographic research probing the author's Spiritual Care experience in this context yields a nuanced, 90-second point-of-care spiritual intervention physicians can use to address the religious aspect of African American families who base end-of-life medical decisions on their hopes for a miracle via divine intervention. Autoethnographic analysis is framed by physician-author, Dr. Jessica Zitter's documented journey of grappling with this context. The evolution of Dr. Zitter's responses to miracle-hoping African American families provides a framework for applying autoethnographic analysis to a critical appropriation of the Johns Hopkins "AMEN" communication protocol for families hoping for a miracle. The common instinct of white physicians to remain neutral, holding miracle-hoping African American families at arm's length, rather than supportively engaging their hopes, is shown to be an intellectual ruse for emotional avoidance. A novel, counterintuitive spiritual intervention for the religious aspect of miracle-hoping African American families is integrated into an existing physician communication protocol for responding to families hoping for a miracle with recommendations for utilization of existing communication technology when necessary. Properly addressing the religious dimension of African American families hoping for a miracle may help physicians to increase their therapeutic connection with families, decrease their own stress/burnout levels, and eliminate racial and ethnic disparities in end-of-life healthcare. .
通过向医生展示如何最好地回应一个已记录的根本原因，可以减少临终关怀方面的种族和民族差异：非裔美国家庭通过神圣干预获得奇迹的希望影响他们的临终医疗决策，例如，在神经预后不佳的情况下，他们不想放弃呼吸机支持，因为他们仍希望上帝介入。在这种情况下，探究作者精神关怀经验的民族自传研究产生了一个细微的、90 秒的即时精神干预措施，医生可以用来解决基于通过神圣干预获得奇迹的希望来做出临终医疗决策的非裔美国家庭的宗教方面。医生作者杰西卡·齐特博士对这一背景的有案可稽的探索过程为民族自传分析提供了框架。齐特博士对抱有奇迹希望的非裔美国家庭的反应的演变为将民族自传分析应用于对希望获得奇迹的家庭使用约翰霍普金斯“AMEN”沟通协议的关键应用提供了一个框架。白人医生保持中立、与抱有奇迹希望的非裔美国家庭保持距离而不是支持他们的希望的共同本能，被证明是一种情感回避的智力策略。针对抱有奇迹希望的非裔美国家庭的宗教方面的一种新颖的、反直觉的精神干预措施被整合到现有的医生沟通协议中，以回应希望获得奇迹的家庭，并建议在必要时利用现有的沟通技术。正确处理抱有奇迹希望的非裔美国家庭的宗教层面问题，可能有助于医生增加与家庭的治疗联系，降低自身压力/倦怠水平，并消除临终关怀方面的种族和民族差异。
