Terminal care as life care : a pastoral approach to death and dying

[摘要] ENGLISH ABSTRACT: The thesis introduces a spiritual understanding of terminal care as life carewithin a pastoral approach to death and dying. The presupposition is that lifeand death are unavoidably connected, and that a meaningful approach to deathand dying in terms of a Christian theological hermeneutics needs to start withthe question 'What is life?The concept of a theological hermeneutics serves as an overallparadigm, which is implied within the interplay of life and death. The aim of ahermeneutical approach is to find meaning in living and dying in thefundamental God-human relationship. The eschatological perspective plays asignificant role, as it emphasises the already and not yet of eschatology thatbecome evident in every life event.An analysis of the theoretical paradigms and philosophicalpresuppositions behind a widespread 'psychology of death and dying showsthat the phenomenological, client-centred models suffer from an overreliance oninner human potentials in coping with dying. Although these models providevaluable insights into the needs of the dying, they fail to equip individuals with ameaningful paradigm that lasts despite the reality of death.As a result, I propose a 'theology of death and dying that opts for amuch more holistic approach to terminal care. Based on the impact of aChristian spiritual concept of life and a pastoral anthropology on a pastoralapproach to terminal care, I argue that we do not have to cope with dying byourselves but can trust in the faithfulness of God who will keep us strong to theend (1 Cor 1:8). As fear of death can effectively only be coped with by caring forlife, pastoral care to the dying needs to emphasise the fundamental God-humanrelationship that guarantees life in spite of death. A unique stance of hopefollows from a Christian spiritual understanding of life that overcomes theparadigmatic gap left by psychological approaches to death and dying, andmakes us aware that the new life in the Spirit is a quality that we alreadypossess.Eventually, the life care approach is applied to a pastoral preventionstrategy in the context of the HIV pandemic. I argue the thesis that prevailing HIV prevention programmes suffer from a lack of an overall frame of referencefrom which to reflect on the necessity for behavioural change. To fill this gap, aspiritual life care approach to the HIV pandemic emphasises the development ofa Christian ethos based on an internalised assurance of the purpose anddestiny of human life, which can function as an overall paradigm behind aprevention strategy. This pastoral prevention strategy is based on theassumption that positive change, the anticipation of a better future and truehope derive from an understanding of who we are as human beings before andin relationship with God.

[发布机构] Stellenbosch University