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Sunday, April 10, 2005
The End of Life-Who Decides—Part I
By Rev. Dr. Harvey C. Martz
Ecclesiastes 3:1-4
For everything there is a season, and a time for every matter under heaven: 2a time to be born, and a time to die; a time to plant, and a time to pluck up what is planted; 3a time to kill, and a time to heal; a time to break down, and a time to build up; 4a time to weep, and a time to laugh; a time to mourn, and a time to dance.
Don Messer is the former president of the Iliff School of Theology here in Denver, and is now a professor of missions there. He has been in worship at St Andrew recently and is bringing a class of his seminary students here on Tuesday to meet with some of our staff because he believes, as many of our staff and lay leaders do, that this congregation has some things to share with people who are going into the ordained ministry.
Dr. Messer and his former colleague at Iliff, Dr. Sally Geis, have edited a book a few years ago entitled “How Shall We Die?” and in the last chapter of the book Don tells the personal story about his own father’s death:
His father was the son of immigrant parents from Norway and Germany and, Don says, his father taught him how to live and how to die. Here is how he tells that story:
Without warning, my father was diagnosed with incurable liver cancer. Three weeks later he died. Just as he had taught his family how to live, he spent his final days demonstrating to us how to die. His instructions were clear: No expensive life prolonging but ultimately futile treatments like chemotherapy. No heroic actions. Bring the family home from around the country, so love hugs and kisses could be exchanged. Take care of mother. No intravenous feeding, once the family could no longer care for him at home and he would have to return to the hospital.
Death for dad came swiftly and he departed this life with dignity and grace. A few days later family and friends gathered in our small prairie town church and sang this Easter hymn:
Soar we now where Christ has led, alleluia!
Following our exalted head, Alleluia!
Made like him like him we rise, Alleluia!
Ours the cross the grave, the skies. Alleluia!
“He departed this life with dignity and grace.” Let me ask you to keep that story in mind as I tell some other stories. As a pastor for the past 35 years I have been with families as they faced together the inevitable death of a loved one. I have been in the Intensive Care Unit as families work through the painful decision to discontinue using the respirator because the tests have shown that there is no hope of recovery and that there is no consciousness in their loved one. I have visited our church members in hospice facilities where they know they are dying and where they have decided that they do not want to go on just existing so they have stopped eating and drinking on their own and they have waited in peace for what the book of Ecclesiastes says is the time to die.
It is out of my pastoral experiences and my conversations with church members filling out their own living will and deciding on advanced directives that refuse any extraordinary measures from health care professionals that I viewed the tragic news story of Terri Schiavo a few weeks ago.
I can’t remember a more complicated and emotional story about the end of life and about family conflicts and misunderstandings and family pain. There are some 18,000-25,000 people in our country who are in a “persistent vegetative state”, that is they have no awareness, no consciousness, no feeling. They seem awake but only have reflexes and exhibit random crying or smiling; they have no consciousness. They are not there.
This definition is part of the emotional response that so many people have had to Mrs. Schiavo. In some three year old video pictures it looked like she was aware but her physicians had been saying for several years that she had no awareness and that there was absolutely no hope of her getting better or recovering or becoming conscious or aware.
Of course when we put ourselves in the role of her parents we can see how easy it is to hold on to some kind of hope and to interpret reflexive acts as conscious responses. We would all want to hope that a daughter or son could get better—even after we have seen them for fifteen years in that condition. It would still be hard to let go of a loved one if we were hoping for some chance of recovery and if we could still go and visit what to others looked like the shell of that person.
On the other hand a large majority of us who had watched the over abundant media coverage of this tragedy said that if we ourselves were in the same state as Mrs. Schiavo, if we had no consciousness and had been in that persistent vegetative state for fifteen years and there was no hope of recovery, that we would choose for nature to take its course and for the feeding tube to be removed. How many of you would choose that for yourself under those same conditions? I would definitely choose that and have chosen that as Judy and I reaffirmed this week in our discussions with each other in filling out the forms in the Five Wishes document.
And 80% of respondents asked that same question said they would choose not to be continued on that kind of artificial life support as well.
That phrase “life support” raises an entirely different set of questions: what is life? When someone’s mind has been severely compromised as Terri Schiavo had been and they have no consciousness for fifteen years, is that “life” or is that just an existence? How do you define life? This question has gotten even more painful and complex with the presence of advocates from the disability community in the coverage of Mrs. Schiavo’s case. My wife and I are very connected to issues around disabilities as she is the president of one of the national advocacy and education groups. There is another advocacy group called “Not Dead Yet” that speaks out for people whose bodies are severely impaired but who have other abilities and gifts and who do not want us to become a society where we just dispose of someone who does not appear to have the kind of usefulness to society that we think it important.
I have much sympathy with that concern as the parent of a son with a cognitive disability and there is another whole range of issues here around what we define as life and about whether a person who has a disability should get equal consideration in the medical community when there is a need for an organ transplant or whether organs should just be reserved for those with the most ability or intelligence. We do not want to say to a person whose abilities are severely limited that their life should be over or that they have a “duty to die”.
This is a whole set of painful and complex questions that has become even more controversial with the presence of the film “Million Dollar Baby” which the “Not Dead Yet” group has been upset about because one of the characters in the film [I encourage you to see it this week before next Sunday because next week I am going to tell you which character] has decided that they do not want to live in their current condition and decides to end their life.
In one way this is good, I believe, that the disability advocates have been speaking about Terri Schiavo and in another way it has been a disservice because in my opinion she had not been disabled by her heart attack, she had been in a very different situation from someone who is disabled but who still has some consciousness and awareness and feeling. She had none of those.
Where does our faith make a difference in all of these questions? How can we think ethically and responsibly as Christians about the end of life? We will talk next week more fully about all of this and I will begin today with these observations: The Bible is more comfortable with death and with the inevitable end of life than many of us are. Our book says, life is fleeting, life is temporary, and life is very fragile. We are here only for a while. The psalmist says that from the point of view of God, people are like flowers that are here for a while and then are gone. Or people are like grass that is here for a while and then is gone. Each one of us has a beginning and an end and though we live in times when medical science has been able to prolong that time and postpone that end through technology, there will still be an end for each of us in this life. In spite of all our medical advances, the death rate is still 100%. And our Bible tells us how important it is for each of us to acknowledge that and come to terms with it and, I think make some plans about it. I had a next-door neighbor as a teenager, a fellow who died without a will because he had put off doing a will because he did not want to think about his death or did not want to accept his own mortality. There is a time to be born and a time to die, and though we are fortunate to live when surgeries and technologies can postpone that time to die, in the end there is still a time to die for each of us.
The other thing the Bible says is that each life is very important, each life is precious, and each life will be received back into the God who is the source of life. In the words of the apostle Paul, we may stand at the graves of our loved ones and weep, but we do not have to weep in despair because we trust God to love us and care for us in death as well as in life. That is our faith–that God is bigger than death and that death does not have the final word.
And in that faith we may even decide to approach death with the same sort of attitude that Dr. Messer’s father did in the opening story this morning—we may decide that we can embrace death with dignity.
There is an image for us to think and pray about for next week—what would it mean in your life and in your family to embrace death with dignity?
Let us pray. Gracious God, when we face the mysteries of life and death, we know we must turn to you. You are the one who gives us life and you are the one to whom we return when our life is over. Give us the grace to know that when we and our loved ones do face death that there is nothing, not even death, that can separate us from you. Amen.