When Roger, a gentleman in his mid-80s, arrived in intensive care, he was already suffering from the terminal effects of several illnesses. His health had declined so much that even reading the Bible proved difficult. Already exhausted by the disease, he agreed to an attempt at resection of his cancer only to please his family, and he urged his wife not to authorize CPR or the use of a ventilator if his condition worsened. after the operation. “I want you to let me be with God when he calls me,” he told her.
Unfortunately, after the operation, his lungs failed. In accordance with her wishes, rather than resorting to a ventilator, her care focused on comfort. His wife spent that evening by his side, stroking his hand, praying for him and singing softly to him.
But later that night, the couple’s estranged son burst into the intensive care unit. “You’re not going to kill my father!” he shouted to the staff. “I know my father. He was a God-fearing man who, until six months ago, went to church every Sunday. He would not How’s it going ! »
Roger’s family’s heartbreaking situation is terribly common. The veil of medical technology surrounding death increasingly confronts families with confusing dilemmas regarding end-of-life care. Until 70 percent of people cannot vouch for themselves at the end of their lives, and in such cases the burden of decision-making falls on their loved ones, many of whom are already reeling from fear and grief. The price to pay for families is heavy; loved ones often suffer from depressionanxiety, and even PTSD up to a year after making end-of-life decisions.
Like alone a third of Americans have advance directives, most families go through these conflicts rudderless. Those of us who follow Christ instinctively rely on our faith to guide us through such storms, but the landscape of hospital death is so foreign that, as with Roger’s family, we may have struggling to apply the truths we proclaim every Sunday to harsh realities. bedside realities.
How can we honor both God and our loved ones in end-of-life decisions, when every path seems fraught with sorrow?
Although the Bible does not mention ventilators or CPR, it remains a lamp to our feet and a light to our path (Ps. 119:105). An approach to end-of-life care from a Christian perspective requires reflection on the following key principles:
1. The sanctity of mortal life
As beings created in the image of God, we each possess irrevocable value, and the Lord entrusts us with life and commands us to cherish it (Gen. 1:26-28; Ex. 20:13; 1 Cor. 6:19-20). . The sanctity of mortal life compels us to advocate on behalf of the unborn and protect ourselves against physician-assisted suicide. When you are grappling with a series of decisions about life-sustaining measures, for the sake of life we should consider treatments with the potential to cure.
2. God’s authority over life and death
Death persists in this earthly realm as the wages of our sin (Rom. 6:23), and until Christ returns, it will overtake us all (Isa. 40:6-8; Rom. 5:12). When we blind ourselves to our own mortality, we risk rejecting the power of His grace in our lives through the resurrection of Christ. The sanctity of mortal life does not refute the inevitability of death or God’s work and authority over it.
3. Mercy and compassion
As Christians reflecting on God’s grace toward us in Christ, we must show mercy to the oppressed and afflicted (John 13:34; 1 John 3:16-17; Luke 6:36). Although ventilators and CPR can save people with reversible illness, such measures are applied at the end of life. risk of suffering without vital benefit. Mercy does not justify active euthanasia or physician-assisted suicide, but it keeps us away from aggressive and painful interventions if such measures are futile.
4. Hope in Christ
God’s love for us is so vast that in Christ there is nothing – not even death! – cannot tear us away from him. Even when we suffer, we enjoy the promise of the resurrection of the body and the hope of eternal union with God (John 11:25-26; 1 Thess. 4:14). Rather than the last enemy that must be feared at all costs, death, thanks to Christ, is the end of our sins and the entrance into eternal life. Even though we die, we are alive in Christ.
To summarize, when faced with end-of-life dilemmas, the Bible guides us towards
- seek a cure when healing is possible but also
- accept death When it happens,
- to be concerned about sufferingAnd
- while remaining attached to our hope in Christwhich transforms death.
These principles seem crude on paper, but confusing and messy at the bedside. A key question can help decipher them: Is the process that threatens the life of my loved one reversible?? Expressed differently, Does the treatment promise preservation of life or prolongation of death and suffering?
It is crucial to clarify that life-sustaining measures are united, not curative. Ventilators, CPR, and similar interventions do not cure the disease, but rather buy time, supporting organ function while doctors work to treat the underlying disease. To help discern whether such measures promise to save lives or prolong death, ask the medical team the following questions:
- What is the life-threatening condition of my loved one?
- Why is this life threatening?
- What is the probability of recovery?
- What about my loved one’s past health issues impact the chances of recovery?
- Can available treatments provide a cure?
- Will available treatments worsen suffering with little chance of benefit?
When recovery is possible, continued treatment is appropriate. On the other hand, when a disease cannot be cured or even ameliorated, aggressive measures can prolong death and inflict unnecessary suffering.
When treatment effectiveness is ambiguous, the task is even more difficult. The key question to ask is What would my loved one say about the options? Such an approach requires that we view our loved one as God sees them: cherished, forgiven, wonderfully created and uniquewithout equal on earth (Ps. 139:13-14; Eph. 1:7). While the responsibility stuns us, another set of questions can guide us:
- What matters most to my loved one? What motivates him in life?
- What comments has she made in the past regarding end-of-life care, if any?
- What are its short-term goals? For his life in general?
- What is she willing to endure to achieve these goals? What wouldn’t she want to face?
- How well has my loved one tolerated pain in the past? Addiction? Disability? Fear?
- If he could speak for himself, what would he say about the current situation?
Such questions are intended to shed light on a loved one’s personality, experiences, and values so that when you make these life-altering decisions, you speak for them and not for yourself.
Even as you struggle with grief and uncertainty, when you give your dying loved one a voice, you give them a parting gift. You honor Him as worthy of love, and in doing so you serve as an instrument of Christ (John 13:34-35). Remember that you serve the One who has already swallowed up death in victory (1 Cor. 15:54). And even though for now we groan (Rom. 8:22), he makes all things new (Revelation 21:4-5).
Kathryn Butler, MD (Columbia University) retired from trauma surgery to homeschool her children and is the author of several books, including Between Life and Death: A Gospel-Centered Guide to End-of-Life Medical Care and Glimmers of Grace: A Physician’s Reflections on Faith, Suffering, and the Goodness of God.
