How should healthcare providers respond when their patients say they're waiting for a miracle?

Back in 2007, a survey found that 79% of Americans still believe in miracles. Of those surveyed, 60% of the public and 20% of trauma professionals believed patients in a permanent coma can be saved by a miracle. Taking these surprising figures into account, what are healthcare providers supposed to do when patients and families say they're waiting for a miracle? And what if they demand changes to their treatments as a result?

These are questions that were asked by Dr. Wendy Cadge in a recent Psychology Today Op-Ed. The answer, she says, is that it depends — and that it's all in how you frame it.

Much of the issue has to do with the environment. Hospitals and other healthcare settings are characterized by anxiety, drama, and high stakes. When a patient pulls through unexpectedly, or recovers quicker than predicted, many people are inclined to attribute it to divine intervention. And as Cadge noted in her article, it's not just a sentiment felt by the families — it's something healthcare workers feel as well:

I heard family members and nurses talk of "miracle babies" during my research in a neonatal intensive care unit. These were babies that survived despite poor medical prognoses. Their healings were miraculous, some nurses told me, but the nurses differed in what they saw as the source of the miracles. For some these were miracles of medical science. In the words of one nurse, "I don't think it's a miracle like they talk about with the saints and all that stuff — it is a miracle that our doctors and nurses and staff can do. We're a very good hospital with a good reputation, and we can do miraculous things. It's not like somebody came down and put a magical sprinkle on to make the baby go, you know, a certain way."

Other nurses were less sure of the source of miracles, and still others attributed these healings to divine sources. "I guess if anything, it always goes back to God," a nurse told me. One described a miracle that happened in another ICU. "I can't even tell you the whole story because it was a while ago. But some of the nurses actually went to Rome because this person [who facilitated the miracle] was a [Catholic] nun, I guess, and sainted or something."

But some medical staff won't go to that extent:

Many healthcare providers, in this unit and a medical intensive care unit where I spent time, were not very patient with talk of miracles. Many did what they could to encourage families to continue with appropriate standards of care, especially in end of life situations. "I don't challenge them [families] not to believe in a miracle," a social worker told me, "I challenge them to continue to work with the staff in what we understand to be best practice….I also suggest that sometimes people who have been so ill before they even get here [to the hospital], maybe the miracle has come and gone. If you look back over the time period and see that they maybe had a miracle to be here."

And this is essentially the point that Cadge is trying to make: Healthcare providers, in order to remain sensitive and sympathetic to their patients, should help their patients reframe what is meant by a "miracle." Rather than waiting for a big, Biblical sort of miracle to happen, Cadge says that health workers should actively point out less dramatic put important "miracles" nonetheless. As one chaplain noted, "I used to always think a miracle was when they [a patient] would get cured of whatever it was; but I think the true miracle is coming to some kind of an ability to live with the illness they have." At the same time, it's also fine to find a miracle in the life that was lived, or the strength and durability a person showed during a prolonged battle with an illness.

A cynic would suggest that this is still tantamount to pandering. And indeed, it's easy to get frustrated when a patient or family ascribes a recovery to God rather than the skills of the medical team and the advances of medical science. That said, the hospital setting is not the time and place to question peoples' religious convictions — especially when they're going through a very difficult time.

The challenge for healthcare professionals, it would seem, is remaining sympathetic to the beliefs of their patients and families, while ensuring that they take the most responsible and informed courses of action for their treatments.

Image: Shutterstock.com/vita khorzhevska.