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Ignatian Discernment in Medical Decisions, by Christy Wilkens

If there’s one thing parents of special needs kids encounter more frequently than most other people on the planet, it’s decision-making.

When God sends us children who require extra care and attention, he assigns us the responsibility of discerning wisely about issues that range far beyond their clothing, feeding, and education. Often, we are faced with choices that are issues of literal life and death. Should we try surgery first, or try this drug with risky side effects? Should we agree to this new therapy now, or wait until more data comes in about its efficacy? Should we stick with Doctor A, who’s known and loved our child for a decade, or switch to hotshot Doctor B, who might shed new light on old problems? Sometimes, we have only moments to decide.

In those cases, I encourage you to try my number-one all-time favorite special-needs parenting prayer, the Surrender Novena: “O Jesus, I surrender myself to you; take care of everything.” (Or my easier-to-remember paraphrase: “Whatever you want, Jesus.”)

But if you’ve got some breathing room, let’s take a look at what St. Ignatius of Loyola, founder of the Jesuits, had to say about prayerful decision making, also known as discernment.

I’m going to start at the end, actually, with a firm reminder that all outcomes are subject to God. Your attitude should be, as far as possible, one of holy detachment toward the results of your decision. Our children are on loan, this earth is not our home, and ultimately, power resides at the throne of God. We are so, so little! Embrace your littleness—bask in it!—and remember that God loves your child, far more than you ever could.

But, since you’re the one signing the consent paperwork, here’s a step-by-step guide for bringing God into the room when you’re making medical decisions on behalf of your child. These are derived from steps 178-187 of St. Ignatius’s Spiritual Exercises.


  1. Hold the decision you need to make firmly in your mind. (Step one is easy! Pat yourself on the back.)

  2. Find your equilibrium. Try to find an internal balance where you are not secretly desiring one choice over another before you’ve even begun to consider. Keep your ultimate aim of heaven in mind.

  3. Ask God to move your will toward alignment with his. Note that you’re not praying for him to reveal his will, necessarily, but just to incline the ear of your heart toward his call. Pray for the grace to hear, and to move your own will in accord with what you hear.

  4. Weigh the pros and cons with respect to your own soul and your child’s. In this case, you are adding your rational consideration to your sensual experience in prayer. Which reasons are weightier, and which alternative seems more reasonable in that light?

  5. Maybe you’re feeling a pull in one direction or another by now. Next, consider what you might counsel a stranger to do, if they were in your situation. We’re often better at giving advice to other people than ourselves!

  6. Weigh your inclination against the Four Last Things: Death, Judgment, Heaven, and Hell. If you were on your deathbed, standing before Jesus, would you be at peace with the decision you’re about to move forward with?

  7. Having made a preliminary decision using the steps above, ask God to help you confirm it. One sign he often gives is peace or a sense of rightness.


Remember, too, that many decisions have no clear right or wrong answer. At the end of your discernment, you should not feel deep anxiety or depression, but you may not feel unwavering certainty, either. However, if you’ve followed the steps and brought God into your wise and prayerful discernment, you can trust that he will be with you when you step out in faith and abandon yourself to the decision you’ve made together, under his guidance and his mercy.


Christy Wilkens, wife and mother of six, is an armchair philosopher who lives in Austin, TX. She writes about disability, faith, doubt, suffering, community, and good reads. She is the author of, Awakening at Lourdes: How an Unanswered Prayer Healed Our Family and Restored Our Faith, a memoir about a Lourdes pilgrimage with her husband and son, published by Ave Maria Press. Find her at christywilkens.com.



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