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Matters of the Body Matter

One distinctive of Jesus’ ministry has always been engaging in healing. As Matthew 9:35 summarizes, Jesus went about teaching, preaching, and healing. Our bodies are important. Pursuing health honors our Creator, as Paul reminds us:

  • “Honor God with your bodies” (1 Corinthians 6:20).
  • “Offer your bodies as a living sacrifice, holy and pleasing to God–this is your true and proper worship” (Romans 12:1).


We resonate with the apostle Paul’s hope that “Christ will be exalted in my body, whether by life or by death” (Philippians 1:20). But what does this entail in today’s high-tech age where technology offers new ways to create a new life or sustain an old one?

  • Anything made by people can be misused. We can overtreat as well as undertreat.
  • It’s helpful to identify and rule out both these forms of mistreatment as part of determining what faithful medical decisions near the end of life look like.

Overtreatment: Idolatry of Technology (Never Say No)

There are two biblical truths that get us into trouble when they’re taken out of medical and biblical context.

  • The first is that life is precious.
  • The second is that death is an enemy.


From the first chapter of the Bible onward we learn that human life is precious
 because all people are created “in the image of God” (Genesis 1:26-27).

  • People have a special connection with God and are intended to be a reflection of God.
  • Accordingly, no one should end a person’s life (Genesis 9:6).


Not surprisingly, death is portrayed as an “enemy”
 (1 Corinthians 15:26).

  • It separates people from their world and loved ones.
  • It exists in God’s creation because of sin (Romans 5:12).


These truths could easily imply that everything possible should be done to extend human life and thereby defeat death. However:

  • Medically, sometimes a dying process is at hand regardless of the treatment given. In such a situation, treatment cannot significantly extend life; but it can add suffering.
  • Biblically, death is a defeated enemy (1 Corinthians 15:55-57). We are not in a desperate battle to defeat it.


In short, we must be careful not to overtreat just because technology exists
.

  • Barring special circumstances, we normally should not cause suffering by adding the burden of treatment when an unavoidable dying process is underway.
  • Human dignity demands as much–the dignity rooted in creation in God’s image (James 3:9).
  • To never say no to treatment technology is to engage in idolatry of technology.
  • We need not worry that stopping a treatment will catch God by surprise and prevent a miracle.


To see a several-minute video on overtreatment (Never Say No), select here.


Undertreatment: Death without Dignity
(Assisted Suicide; also confusingly known as “Medical Aid in Dying” [MAID])

As noted above, there are many biblical reasons to support, not end, life.

  • Death is an enemy and so is not to be encouraged or facilitated.
  • People are not to kill anyone created in God’s image–even themselves.
  • Contrary to contemporary thinking that we can do whatever we want, people’s lives and bodies are not their own (Jeremiah 10:23; 1 Corinthians 6:19).
  • Life may be hugely difficult to endure, but that does not make ending it right.


Consider the good example of Job
.

  • His body was in such terrible shape that he preferred death (Job 7:15).
  • Yet the Bible celebrates him because he was willing to choose God’s way–life–instead.
  • In his words, “Come to me what may, why should I put myself in jeopardy and take my life in my hands” (Job 13:13-14)–as those choosing assisted suicide do.


Consider also the bad example of Saul
.

  • In 2 Samuel 1:9-10, a man comes to David and says that because Saul was suffering terribly, he assisted Saul’s suicide at Saul’s request.
  • Reflecting a godly perspective on life, David—horrified—punishes him (2 Samuel 1:15).


We naturally think we should avoid suffering and weakness at all costs.

  • However, God allows them so we will depend upon God (2 Corinthians 12:9).
  • God allows them to teach us so we can encourage others who suffer (2 Corinthians 1:4).


Those committed to loving God and people will not reject a life of suffering. To see a several-minute video on undertreatment (Assisted Suicide), select here.


Death as Doorway

Christ is God’s image (2 Corinthians 3:18; Colossians 1:15).

  • Being created “in” (meaning “according to”) God’s image means that Christ is our model—and that includes our death as well as our life.
  • Christians can “live, even though they die” (John 11:25) because Christ did.


Christ died but defeated death by being resurrected to eternal life in a glorious new body
.

  • Christians after death live forever in a new body in God’s image (1 Corinthians 15:49-52).
  • Though an enemy, death is defeated and becomes a doorway (1 Corinthians 15:55-57).
  • God uses it to usher believers into a wondrous eternal future (1 Corinthians 2:9).


We can’t gain that future by being good–only by being forgiven (Ephesians 2:8-9)
.

  • There’s a price to pay for our sin–for our self-centeredness and neglect of God.
  • But God paid the price by becoming the person Jesus Christ and dying on the cross.


God calls us to
:

  • admit our wrong (1 John 1:9),
  • receive God’s gift of forgiveness by faith (John 1:12), and
  • commit to following God’s will as an expression of repentance (Romans 6:17).


Forgiven people can be content to die according to God’s timetable
.

  • There’s no need to use medical technology to squeeze out a few extra breaths.
  • Life, living with and for Christ, is great; but to die is gain (Philippians 1:21).


How to recognize when to pursue treatment and when to stop is discussed below. To see a several-minute video on Death as Doorway—and on the relevance of the gospel—select here.


Faithful Decisions: When Enough is Enough

The Good Samaritan is our norm: We should provide life-sustaining care (Luke 10:30-37).

The basic inclination of a godly person should be to “choose life”–meaning physical as well as spiritual life (Deuteronomy 30:19-20).

However, near the end of life, ending treatment doesn’t necessarily mean intending death.

As the Bible recognizes in other contexts, if someone does something that has the effect of ending another person’s life, the intention is key (Exodus 21:12-14); death shouldn’t be intended.

For example, if a person will die soon with or without treatment, and treatment adds a burden to dying, then one can decide to forgo treatment for a reason other than intending death. The person will die soon due to the illness, not due to anyone’s action or inaction. Forgoing a treatment may be an appropriate answer to the right question: “By what God-honoring means can the person’s suffering be lessened as they unavoidably die?”

The biblical model for verifying intention (Joshua 20:1-5) offers wisdom for end-of-life medical decisions: It’s wise to involve others in verifying that a decision to end treatment is made for a valid reason and not with the intention to end life sooner.

Determining medically if treatment should be continued comes first. Then one can consider if enough personal funds, insurance, and/or other public or private resources are available to pay for that treatment.

If they aren’t, new resources may appear once it becomes known that treatment is needed.

In many cases, no one knows whether a person will be dying soon or not. To end their life-sustaining treatment would be to wrong them by intending their death. But in many other cases, it’s fairly evident that a person will be dying soon. For example, they may have advanced cancer and bodily organ systems are shutting down. Dying may take days, weeks, or even a few months to complete; but it’s inevitably soon. In such a case, ending burdensome treatment is not intending death–it’s caring for the dying.

Decisions become more difficult when it’s not clear if a treatment will actually sustain life. People differ as to how much suffering they will risk to gain an uncertain benefit. When it’s likely enough that a treatment will not succeed in sustaining life, one may forgo it–not if the intent is to bring on death but because treatment is too burdensome.

In such a case, one can only prayerfully weigh the possible benefits and burdens of treatment and pursue treatments whose benefits are greater than their burdens by the largest margin. How probable, long-lasting, and important each benefit and burden is should be considered. Whether or not treatment continues, symptom relief must continue. We are to bear people’s burdens (Galatians 6:2) by

  • relieving people’s suffering–e.g., by reducing their pain–and
  • respecting people’s dignity–e.g., by caring for their bodies.

Advance Directives

Every adult should have a written advance directive.

There may come a time when we lose consciousness or an illness impairs our ability to think.

Having a written document–an advance directive–will then be important. It will identify the person we want to make medical decisions for us. It can also identify the values we want to guide their decision-making for us.

If we live only for ourselves, we’ll probably never get around to making an advance directive–there’s always something else more interesting to do. But if we care about those around us, who will have to decide for us, we’ll make one now.

Grieving families often overtreat or undertreat those who have no advance directive.

King David didn’t want to leave his son Solomon guessing about his plans for the Jerusalem temple.

“So David made extensive preparations before his death” (1 Chronicles 22:5).

We, too, should show that kind of love by preparing an advance directive.

When something is important, God prepares in advance, and so should God’s people.

  • God prepares “in advance” for people’s eternal glory (Romans 9:23).
  • God prepares “in advance” for the good works we are to do in this life (Ephesians 2:10).
  • So the apostle Paul helps prepare a lifesaving gift “in advance” (2 Corinthians 9:5).
  • Similarly, we should make an advance directive to guide life-or-death decisions someday.


Not only are knowledge, wisdom, and work important–but “planning” is also important (Ecclesiastes 9:10). As with all godly plans, advance directives should be:

  • based on godly guidelines (2 Corinthians 1:17),
  • backed by advice from others (Proverbs 15:22; 20:18), and
  • bathed in prayer (Proverbs 16:3).

The Importance of Prayer and Provision

Much of faithful medical decision-making involves judgment–for example:

  • recognizing if the patient’s death will be unavoidably soon;
  • recognizing what forms of medical treatment and symptom relief could help;
  • discerning each benefit and burden of each potentially beneficial medical treatment.
  • discerning the same for each potentially beneficial form of symptom relief,
  • deciding what combination of treatments and forms of symptom relief is best.


Godly decisions depend on the prayers of both the one nearing death and their supporters. The person nearing death

  • Jesus is our model: “He offered up prayers and petitions with fervent cries and tears to the one who could save him from death” (Hebrews 5:7).
  • God can provide healing in response to prayer, even in the face of fatal illness (e.g., 2 Kings 20).
  • God can provide peace in response to prayer as we remember who God is (Psalms 23; 27; 56).
  • Reminded of God’s goodness, we say with Jesus “Not my will but Yours be done” (Luke 22:42).
  • Prayer-filled love for God in our dying, like Jesus’s, can point people to God (see Mark 15:39).


The supporters of the one nearing death

  • Jesus wanted his companions to provide such support: In Gethsemane, Jesus tells Peter he is depending on them to “watch and pray” (Matthew 26:41).
  • A centurion’s dying servant is healed because the centurion asks Jesus (Luke 7:1-10).
  • A paralyzed man is healed because his friends bring him to Jesus (Mark 2:1-12).
  • Paul “received the sentence of death” but tells the Corinthians that his life and ministry continue because “you help us by your prayers” (2 Corinthians 1:9-11).


Another way to help is by our provision
. Rather than just hoping someone’s need will be met, we should help meet it (James 2:15-17).

  • Ensuring they are receiving adequate medical treatment and pain management.
  • Ensuring their spiritual and emotional needs are being met.
  • Ensuring food, transportation, rest, and other needs of their loved ones are being met.


Christians should mainly be known not by what they’re against (e.g., assisted suicide) but by what they’re for–meeting people’s needs so they don’t feel forced to make ungodly choices.


For Further Information

Books

  • Basic Questions on End-of-Life Decisions: How Do We Know What’s Right? (Gary P. Stewart et al., Kregel Publishing Company).
    • A team of Christian leaders provides practical responses to common questions about medical treatment decisions near the end of life.
  • Why the Church Needs Bioethics: A Guide to Wise Engagement with Life’s Challenges (John F. Kilner, ed., Zondervan, especially Part Three).
    • Interacting with a real end-of-life situation, several Christian leaders explain the wonderful resources the church has available to help families with tough decisions.

Videos

  • How Should a Christian View Physician Assisted Suicide?” https://www.youtube.com/watch?v=QfACxjXhVU4
    • Champion of people with disabilities, Joni Eareckson Tada, responds for 10 minutes to questions about assisted suicide and its biblical alternatives.

Websites

  • The Center for Bioethics & Human Dignity: www.cbhd.org
    • Articles and more from a Christian perspective on a wide range of ethical challenges in health care and biotechnology, including end-of-life treatment decisions.
  • Christian Medical & Dental Associations: www.cmda.org
    • Position statements and issue overviews from a Christian perspective on many health-related topics, including end-of-life decisions.

Contact the Lead Team