Anticipatory Grief Amidst Questions of Ethics...

I suppose the few people that read my humble blog may wonder why I have chosen this as my narrative source. I decided to start this journal-like blog in our technology hungry society because I need the very services I provide to my music therapy clients: support, validation, guidance, and reflection. As a new professional in the music therapy world, I have found myself suffering from imposter syndrome and just simply wondering, "Am I doing the very best that I can with my provided resources in this moment?"

I have been riddled with ethical questions regarding an unresponsive patient with terminal cancer in the hospital. How is it that she is still hanging on? Why have I never seen a family member despite my countless sessions with her? As I try to provide comfort support through her palliative care plan, I can't help but feel like there is no actual meaning behind this music therapy treatment; she is on a vent and has been prounounced brain dead. How is my music helping her? What is the therapeutic purpose behind my treatment if she has left her body? Yet I continue to provide my services day after day, as her cheeks and eyes become more sunken. You see...I have a gut feeling that she needs me and my music. But I have no clinical justification or fancy numbers or language to support my gut feeling. The children of this patient will not sign a DNR. They watch their mom suffer because they are waiting for their medical miracle...and that is their choice. But is it ethical? As it turns out, the woman's care team thinks it is very unethical, and that providing medical services to this woman is actually causing more harm than good as organs shuts down one by one. So I ask again....is it ethical?

I am lucky to share an office with a wonderfully supportive team of chaplains. Today I was reassured by the palliative care chaplain that there is really nothing I can do to help this ill woman...except to just be there and sing the spiritual music she loves and to be a support to her. Because if it were my mother, grandmother, friend....the thought of them dying in a hospital room with nobody around them breaks my heart. In a peer music therapy supervision session today I was given similar framework but with one appreciated exception- keep providing supportive music therapy services....BUT intuitively provide closure interventions for myself. I see palliative care patients and their families and often address anticipatory grief and coping with impending death...but now I am experiencing anticipatory grief as a clinician. I have now recognized this patient and our sessions as spiritually and emotionally taxing. I am now giving myself permission to be there for this stranger...but within my own boundaries and practice.

I was advised by my colleagues to journal my hardships, struggles, and successes. Today was very hard and served as a reminder that my job is not always fun. But I know more than ever that my services to this patient are meaningful, and so is this field of Music Therapy.

Comments

  1. Your comments in this blog further confirm for me that you are an excellent Music Therapist. Your vocation, as does the palliative care chaplains, needs sensitivity and empathy. Your intuition that the man needs you is spot on. Perhaps in a way, you need him.
    Mike Kuner

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    1. Thank you so much, Mike. I do think this was a lesson for me in humility, grace, and empathy. :)

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  2. You are such a blessing to our profession. Keep on keeping on. This work is not for wimps. And what you are doing for your patient means everything. I believe you will not know that during this life time, but just wait until Heaven when you two meet up and she is able to tell you all that your beautiful music meant to her in her final days and hours! LOVE YOU.

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    1. LOVE YOU MORE. Thank you for the reassurance...sometimes I do think that music therapy seems so silly when there are greater difficulties such as this patient's suffering. It's nice to have feedback from friends and peers. xo

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