ETHICS AT THE END OF LIFE:
GUARDING OUR DIGNITY
Sunday, September 1, 2002
Today we will conclude a series on end-of-life issues. This message is hard but necessary. A large segment of our society is advocating that we should terminate our lives when things get difficult or when we fear pain and the loss of dignity. Unless we understand this issue as a church and as a people, we will be unable to answer the questions people pose and we will lose this issue and our society to this strong undercurrent.
One reason that people justify taking a person’s life is the fear of pain. A better solution is to realize that every pain medicine exists that is needed to alleviate all types of pain. We have the technology to keep people from suffering, and there are a lot of doctors and hospitals who understand this.
There are other types of pain that we often mistake for physical pain: emotional pain, relational pain, and spiritual pain–realizing we are mortal. This is a dark hole if you don’t have hope in God. Those who advocate terminating one’s life are those who simply want to avoid confronting God. This is hard for me to understand because when you confront God, you find light and hope and life. There is nothing to fear, and yet so many fear confronting their own mortality.
Today we will discuss the issue of dignity. In a nutshell, losing my dignity is the fear of behaving in a way that is contradictory to my rational self. The prototypical example that we use is an Alzheimer’s patient. A lady I know named Grace was one of the best accountants in the county in which I lived. Because of Alzheimer’s disease, she doesn’t know who she is or who anyone is. She exists in a world that no one understands. Is that reality a strong enough justification to permit a person to end their life or the life of another in clear contradiction of Exodus 20:13 which tells us, “You shall not murder.” If not, is there a better solution?
What is the probability that you will lose your rational self? Well, five percent of the general population will enter a nursing home, so 95% of us will never see that. Of those in the nursing home, 50% are there because they have outlived everyone they know and there’s no one to care for them. They are there just for that purpose. They are otherwise rational and are doing just fine. Forty percent of patients in nursing homes are Alzheimer’s patients. If you compute that out, the percentage is 1.25% that you could develop Alzheimer’s. Another study states that ten percent of us will experience some form of senility.
Senility, however, they are finding is not a product of aging. It is a product of your lifestyle. Like Galatians 6:7 reminds us, you will reap what you sow. I was reminded of this recently. I was having breakfast with a retired pastor who is 80 years old. I thought he was 55 or 60. He asked me, “Are you exercising?” I said, “No. I have four children now and that’s all the exercise I can handle.” He said, “I am reaping the benefits of what I sowed earlier in my life. You need to exercise, and you will reap the benefits. If you don’t, you will reap the negative consequences.”
The same thing is true of senility. If we are really concerned about losing our dignity, instead of taking our lives later on, we need to do some things right now. We need to live a healthy lifestyle. That means quit smoking, quit drinking excessively, lose weight, don’t abuse legal or illegal drugs, eat right, exercise, have regular check-ups and use your mind regularly. If you do these things, you can avoid the fear of losing your rational self.
You might say that you know someone who has done all these things and still became irrational and lost their dignity. This can be a blessing in a way because if you are in that state, you don’t know it. They call Alzheimer’s the “painless disease” because there is no pain. The greatest pain is borne by the family and friends who knew what the person was like in the past.
In every case, no one perceives this person as having lost their dignity. Why? Because we know that what we see is not the person that we knew. We know that what we see is the disease, so we uphold their dignity. We love and care for them because we know that it is the illness.
The bottom line is that I can’t promise you that you won’t become senile or that you won’t lose your dignity. I will say that the probability is 1.25%. Can you trust God with your life in the future when you have 98.75% probability on your side with God?
For many of those who advocate the taking of life, they are the people who have been in control of their lives for many years and they want control to the very end. If it looks as if they are going to lose control, they would rather terminate their life. As a Christian, should we be worried about losing control of our lives? It seems to me that this smacks of the sin of pride than it does a faithful response to God because isn’t the focus on ourselves, and isn’t the root of it that there are some things that we believe are below ourselves? As Christians, how can we believe that when we read passages like John 12: 3-4 where it tells us that our Lord, on the night on which he was to be betrayed, took a towel and wrapped it around him and went around and washed the disciples’ feet, the lowest thing you could do in that society. As his people, we are called to serve and not to think about ourselves. Was Jesus thinking about what was going to happen to himself? No, he was serving people to the very end, trusting God for whatever would happen in the future. He lived a life of service, and there was nothing that was too undignified for him.
This is really a call to us as we see someone who is not in their rational mind. We need to take up the towel like Jesus did, to enter their indignity, and to wash their feet, even if the washing of their feet is really the washing of bedsores. Can we trust God with that?
Is our attitude in life to be thinking about ourselves. In Philippians 2: 5-8, we are reminded about what our attitude should be:
“Your attitude should be the same as that of Christ Jesus who being the very nature of God did not consider equality with God something to be grasped, but he made himself nothing, taking the very nature of a servant, being made in human likeness and being found in appearance as a man, he humbled himself and became obedient to death, even death on a cross.”
To the very end, our mind is to be that of Christ who humbled himself. He wasn’t worried about himself or how he looked. He became a servant and sought to serve God his entire life. Even at the very end of life, can we take on a servant model and not think about ourselves and what might happen but to simply trust God and serve Christ.
Doesn’t being a Christian indicate that we are to relinquish control of our lives? Isn’t the very first confession we have “Jesus Christ is Lord.” When we receive him, don’t we remove ourselves from the throne of our lives and put him on the throne so that he then controls our lives? II Corinthians 6: 9-10, “Don’t you know that your body is the temple of the Holy Spirit who is in you whom you received from God. You are not your own. You were bought at a price. Honor God with your body.”
Is it our calling as Christians to be in control of our lives? No. We are to relinquish that control to God and honor him with our bodies. Doe honoring God with our bodies include terminating our lives? Romans 12 tells us that we are not dead bodies but living sacrifices. Are we willing to be a living sacrifice for him?
Romans 14: 7-8 says, “For none of us lives to himself alone, and none of us dies to himself alone. If we live, we live to the Lord, and if we die, we die to the Lord. So whether we live or die, we belong to the Lord.”
As Christians, we spend most of the time in our services learning how to give God our lives. This passage also calls us to give God our deaths. Can you give God the full extent of your life–both your living and your dying? If we confess Jesus as Lord, then he is Lord of it all–from birth to death.
I think of the story of the fiery furnace. The three Israelites were told to bow down to the golden image, and they would not do it. I love their prayer because it is real. In Daniel 3:18, they tell Nebuchadnezzer that they believe God will deliver them. In verse 18 they say, “But, if he does not, we will not bow down.” Do we have the faith to face whatever fiery furnace we encounter? Maybe it is the fear of our future, of losing our dignity. Do we have the faith to say to our culture which is tempting us to take our lives at the end, “We believe God will deliver us, but if not, if I suffer indignity, I will not bow down to the cultural idols around me.”
If we are going to fear something, at least let it be something Biblical. Luke 12:5, “I will show you who you should fear. Fear him who is able, after killing the body, to turn you and send you to hell.” Do we fear what happens to the body more than we fear what happens to the soul? Do we fear what happens to our physical flesh, which is just a shell, or do we fear God more and trust him more?
If you fear the loss of dignity, hear these words in a new way: “Therefore, I tell you do not worry about your life, what you eat and what you drink, or about your body, what you will wear. Is not life more important than food and the body more important than clothes. Look at the birds of the air. They do not sow or reap or store away in barns. Yet, your heavenly father feeds them. Are you not more valuable than they? Why do you worry about your clothes? See how the lilies of the field grow. They don’t labor or spin yet I tell you that even Solomon in all his splendor was not dressed like one of these. If this is how God clothes the grass of the field which is here today and gone tomorrow, will he not much more clothe you, oh you of little faith. So do not worry, what you shall eat or what you shall drink or what you shall wear, for the pagans run after these things, and your heavenly father knows that you need them. But seek first his kingdom and his righteousness, and all these things will be given to you as well. Therefore, do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.”
I Peter 5: 6-7 says, “Humble yourselves, therefore, under the mighty hand of God and he will exalt you in due time. Cast all your anxiety upon him because he cares for you.” People, God cares for you. Do you really think He is going to allow you to suffer indignity? Do you really think God is that uncaring? He cares for you.
Ultimately, this fear comes down to pride and Scott Peck picks up on this:
“It is my impression that whenever resistance is markedly severe, it is at least as much a spiritual as a psychological problem. The person is unwilling to suffer the slightest dethronement of self or his/her ego in submission to a higher power, even when that power is merely labeled “life” or “reality” or maybe labeled “God.” Something is seriously out of whack at a radical level in such a person’s relationship to the world and to God.”
Are our lives out of whack in relationship to the world and to God? What is death with dignity? Is it really putting someone to sleep like we do an animal? No. It is do to exactly what Jesus did–to care for them, to wash their feet, and to love them.
I would like to end with two quick things. One is political. There may come a day in Delaware when you will have to vote like they did in Oregon and Washington about whether or not we should allow doctors or persons to take their own lives. I think it is incumbent upon the church to stand up and say no. Some people cite the Dutch experiment where taking one’s life was legalized. The Dutch are getting rid of the program because it has been a tragedy. More people have died out of greed than for medical reasons. Thousands have died because their families put them to sleep because they wanted the inheritance.
Last is regarding living wills and powers-of-attorney for medical purposes. A general living will or power-of-attorney for medical purposes should be done at the moment that you go into the hospital. They are useless unless you become unconscious, and they are useless unless your doctor agrees with them. It is important for you to discuss this issue with your doctor first. If the people in the ER disagree with your decision, they do not have to honor your living will.
If you make out a living will when you are 25, extraordinary versus ordinary means will be different than when you are 85. There is no specificity about extra-ordinary versus ordinary. It is important for these matters to be very time sensitive. The best solution is for you to have a doctor who knows you and knows how you respond to illnesses, that you talk to your family about your desires, and then have a living will prepared for the time that you go into the hospital and to communicate things clearly to people and give them the power to make decisions for you.
If you disagree with me, you also have to disagree with the U.S. Surgeon General. Here’s his conclusion:
“I am in the life-saving business. That comes first. But I recognize also that I am in the business of alleviating suffering. I never take a deliberate action with the motivation of terminating a patient’s life. It is possible that a patient’s life might be shortened by some therapeutic measure I employ with the intent of relieving suffering. In some circumstances where I believe that I have sufficient experience and expertise in the life history of the disease and my patient’s response to the disease as well as to his therapy, I might withhold treatment that would be considered extraordinary or heroic in a given circumstance in reference to the quality of life that might be salvaged for a short period of time. Even as I write these words, I recognize full well the chances for error in judgment. Because of that, I try to err only on the side of life.”
What is our response to the loss of dignity? To fear or to have faith? I think with the percentages of 1.25% versus 98.75%, God’s clear call for us is to serve him and not think about the future or become anxious. There are no scripture passages that I could find that tell us to guard our dignity. I Corinthians 4:10 calls us to be fools for Christ. Are we willing to be fools for Christ our whole lives?
This series is an example of being a fool for Christ because it is not an easy one. I had a lot of fellow pastors ask me if I was out of my mind. They reminded me that this is a hard issue and that I would stir up the waters. They told me it was better to keep things quiet, to not challenge people and rock the boat, but to keep them happy. My response is, “Is that faithful and is that right?”
I will close with this statement that challenged my heart, and I hope it challenges you:
“Since this issue is spiritual as well as medical, it would be entirely appropriate for the euthanasia debate to be waged most vigorously in our churches, synagogues, mosques and temples. I am not, however, optimistic that this will happen. My overwhelming experience with religious congregations is that they will do almost anything to avoid open debate. Just as the members tend to want a manageable deity, so they want a smooth, manageable religious life without conflict. Still, I can hope. Huge numbers of clergy for years have spoken yearningly of a need for revitalization of the church and other congregations. The euthanasia debate offers the ideal means for this to occur. I suspect, however, it will occur only to the degree that clergy are willing to take the risk of forcing the issue. I pray for those who do, for they are likely to meet with much resistance. Yet, if things succeed, there will be revitalization and they will have the congre-gation renewed by wrestling with the mystery of death and hence a real God.”