A two-year $250,000 grant from the John and Wauna Harman Foundation will support a new Duke Divinity School program aimed at reducing racial disparities in advance care planning and overcoming racial inequities in health care. The Advance Care Planning and Healthy Living Through Faith (ACP-HLTF) program will help strengthen the capacity of the African American Advance Care Planning/Palliative Care (AA ACP/PC) Network to develop a community of clinicians, clergy, and scholars whose joint work improves the health and health care experiences of African Americans throughout their lives, with particular attention to the end of life.
Associate Research Professor of Theological Ethics and Bioethics Patrick T. Smith, is the faculty director of the program, which continues a legacy of work led by the late Dr. Richard Payne, who was the Esther Colliflower Professor Emeritus of Medicine and Divinity at Duke Divinity School. Payne, who passed away in 2019, was an internationally known expert in the areas of pain relief, palliative care, oncology, and neurology. Since December 2015, the John and Wauna Harman Foundation has supported multiple projects originally led by Payne and his colleagues at the Center for Practical Bioethics (CPB). These projects have cultivated partnerships between health care professionals, clergy, and lay people in predominantly African American religious congregations and supported the AA ACP/PC Network, a group of advance care planning and palliative care experts led by Dr. Payne advocating for greater access and participation of African Americans and other communities of color. The ACP-HLFT at Duke Divinity School, the new institutional home for this network, will take its work in new directions under Smith's leadership.
“We were honored to support this project in its early form,” said Julie Boudreau, executive director of the John and Wauna Harman Foundation. “The commitment [the network’s] leaders feel to Dr. Payne’s legacy is inspiring, and no one embodies this commitment more than Dr. Patrick Smith. When we learned that he and his colleagues at Duke Divinity School were stepping forward to assume leadership of the program, we knew we could not ask for a better partnership to honor and advance Dr. Payne's vision.”
Smith said he looks forward to extending the legacy of Payne’s work. “What Divinity School is uniquely positioned to contribute,” he said, “is theological reflection that acknowledges the role of the Black Church in the African American decision-making process—whether medical decisions or end-of-life care decisions—and how is that different from other race and ethnic communities.” The goal of this reflection is “not just doctrines, but practices,” he said, particularly “how embodied Christian practices within faith communities can dramatize what we believe about what it means to die well and live well to the glory of God.”
Other Duke faculty members on the program team include David Goatley, research professor of Black Church studies and director of the Office of Black Church Studies at Duke Divinity School; Kimberly Johnson, professor of medicine at Duke School of Medicine and senior fellow at the Center for the Study of Aging and Human Development; Farr Curlin, Josiah C. Trent Professor of Medical Humanities and co-director of the Theology, Medicine, and Culture (TMC) Initiative at Duke Divinity School; and Brett McCarty, assistant research professor of theological ethics, associate director of the TMC Initiative, and assistant professor in population health sciences at Duke School of Medicine.
Maria Mugweru, postdoctoral associate for the project, said Duke Divinity’s role in this work “demonstrates that instead of just a health or legal priority, it’s also faith priority.” Before coming to Duke, she led a law clinic in Wake Forest, N.C. that helped community members access free legal advice about advance directives. That experience, she said, helped her see the negative effects of not having this conversation early and inspired her to find ways to bring up a topic people tend to be hesitant to discuss. “People wanted to have that conversation over time and with someone they trust,” she said. “That naturally flowed into faith communities.”