End of Life Decisions
“Whether we live or whether we die, we are the Lord’s.” (Romans 14:8)
In 1992, the ELCA Church Council adopted a Social Message on End of Life Decisions. Twenty five years later the issues remain, as medical technology is able to prolong life longer and longer, and as “right to die” groups promote competing values.
The message raises a number of pertinent questions:
+Which decisions about dying are morally acceptable to concerned Christians, and which ones go beyond morally acceptable limits?
+Which medical practices and public policies allow for more humane treatment for those who are dying, and which ones open the door to abuse and violation of human dignity?
+Is it ever morally permissible to withhold or withdraw artificially-administered nutrition and hydration?
+What is morally responsible when patients and health care professionals disagree on what will benefit the patient, or on whether the expected benefit is worth the risks and burdens?
+Is it ever morally permissible for a physician deliberately to at or authorize an action to terminate the life of a patient?
These are questions that were debated in 1992, and are debated in 2017—in our homes, in our churches, in our legislatures.
The message outlines Christian convictions that can guide us:
+ Life is a gift from God, to be received with Thanksgiving.
+The integrity of the life processes which God has created should be respected; both birth and death are part of these life processes.
+Both living and dying should occur within a caring community.
+A Christian perspective mandates respect for each person; such respect includes giving due recognition to each person’s carefully considered preferences regarding treatment decisions.
+Truthfulness and faithfulness in our relations with others are essential to the texture of human life.
+Hope and meaning in life are possible even in times of suffering and adversity –a truth powerfully proclaimed in the resurrection faith of the church..
“Christians face end-of -life decisions in all their ambiguity, knowing we are responsible ultimately to God, whose grace comforts, forgives, and frees us in our dilemmas.” While the statement acknowledges the many unknowns in end-of-life situations, it does offer advice in several instances.
On the question of allowing death, it affirms that patients have a right to refuse unduly burdensome treatments. It also counsels that when nutrition and hydration are discontinued, the person still needs medical, pastoral and family care, including relief from suffering, physical comfort and assurance of God’s enduring love.
On the question of refusal of treatment, the message balances the health care professional’s obligation to inform patients of their options, with the patient’s right to consent. “A patient’s refusal of beneficial treatment does not free health care professionals from the obligation to give basic human care and comfort throughout the dying process which may follow. Family, friends, and pastor need to accompany the person and share the promise of God’s faithfulness in life and death.”
On the issue of physician-assisted death, the position is clear: “As a church we affirm that deliberately destroying life created in the image of God is contrary to our Christian conscience.” This position is relevant in our society today, as legislatures consider physician-assisted suicide.
In the years since 1992, advance directives have become more common, and churches can help people prepare for death and the decisions around it.
“In the midst of often agonizing end-of-life decisions, we are reminded of the God-given mystery of both life and death. May the Holy Spirit grant to us all loving wisdom and confident hope in the Gospel’s promise of eternal life.”
Jessica Crist, Bishop
Christians in South Korea and North Korea collaborated on this prayer of hope and resurrection.
National Council of Churches in Korea (NCCK)
Korean Christian Federation (KCF)
Lord, you who have defeated death and risen,
In this season where we remember the joys of resurrection,
Thank you for showing the marvels of life this spring through the vitality of green life.
Yes Lord! This world was created beautifully in God’s eyes,
Who also sent his one and only Son, Jesus,
To save those who have sinned against You.
Lord, You have shown us how to live as God’s children,
And Your Spirit has led us not only through life, But also through history.
The sorrows of the 70-years ethnic separation,
Still lingers since the time of our North/South division.
We have lost the hopes of ‘becoming one with God’,
And have sought after earthly goods instead of peace.
Pity us, Lord.
Clear away the pain-filled memories of separation,
And also the rusty barbed-wires.
Help the North and the South fulfill a life of harmony and peace,
As the farmer readies himself to till new land and plant new life,
Prepare us Lord.
Help us first open our firmly closed hearts,
So that we can embrace each other with tenderness.
Let us sow the seeds of tolerance, love and service,
And with God’s blessings,
May that land bear much fruit,
And bless our people with a life full of joy and harmony.
God of life,
Help the churches of the North and the South,
To defeat this cold death-like reality.
God of peace,
Help us work together with one united mind,
To fulfill the dreams of unification.
Help us remember the days when the North and the South once were one,
To better live into a world of harmony and peace.
God of life,
In this season of resurrection where we await the signs of spring,
Help us see the hopes of new life,
Sprouting in the cold barren land.
God of justice,
In this land where Your glory awaits,
Let the rivers of justice flow,
Bringing forth Your plans for us.
In Jesus name, the one who has defeated death and risen again,
Am I a stone, and not a sheep,
That I can stand, O Christ, beneath Thy cross,
To number drop by drop Thy blood’s slow loss,
And yet not weep?
Not so those women loved
Who with exceeding grief lamented Thee;
Not so fallen Peter weeping bitterly;
Not so the thief was moved;
Not so the Sun and Moon
Which hid their faces in a starless sky,
A horror of great darkness at broad noon--
I, only I.
Yet give not o’er,
But seek Thy sheep, true Shepherd of the flock;
Greater than Moses, turn and look once more
And smite a rock.
Last week I joined a group of 30+ ELCA Bishops, and advocates from the ELCA and LCMS and LIRS to meet with members of Congress on issues related to refugees and immigrants. Part of a visit to Washington DC, if you are a Montanan, is the Wednesday morning Coffee with the Montana Senators. While at the Coffee, I met many other Montanans. Some were there to lobby for their cause, others were there to be tourists and see the cherry blossoms. I ran into people from our congregations, board members of camps, old friends. And as I told people why I was there—to speak on behalf of refugees—I discovered a lot of sympathetic Montanans in that group.
We were asking our Senators for 2 things: The first is welcome. Historically, the United States has been a leader in protecting the most vulnerable. Ours is a country built with immigrants and refugees. As people of faith we are called to welcome the stranger. Lutherans have been involved in resettling refugees since 1939, and we work closely with the US Government, who provide security checks for all refugees.
We are asking the Senators to expand the number of refugees in 2017 to 75,000, up from the 50,000 requested by the Administration. (In 2016, there were 85,000 refugees resettled in the United States.) There are over 65 million displaced people in the world today—the highest number since World War II. Over 21 million are registered refugees.
The second thing we are asking is for protection. We are asking our representatives to support compassionate policies that provide immediate protection for Central American children and families, and faithful solutions to the conditions that cause people to flee. Children and families from Guatemala, El Salvador and Honduras continue to flee from their homes because of violence and persecution.
We are asking our representatives to stand against legislation intended to deter people from seeking protection in the United States, and we are asking them to stand against policies that separate children from their families. We ask for policies that help protect families in Central America, addressing the root causes of forced migration. And we ask for non-punitive hospitality when they do arrive.
This is not a partisan issue. It is a matter of faith. In Washington, DC, we were joined by other Christians, Jews and Muslims advocating for protection and humane treatment for people who are forced to flee their homes.
We have a deep scriptural tradition that calls us to welcome and protect. The ELCA AMMPARO (Accompanying Migrant Minors with Protection, Advocacy, Representation and Opportunities) program (www.elca.org/AMMPARO) has put together a 40 day set of scripture readings that highlight care of the stranger. I encourage you to make this part of your Easter devotions—from Easter to Pentecost! You can find it here.
There are many ways that we can help refugees, in addition to advocating with our governmental leaders. Several communities are working with organizations to be prepared to do refugee resettlement. Your congregation can also become a Welcoming Congregation (www.elca.org/resources/AMMPARO). And you can get involved with Lutheran Immigration and Refugee Services (www.lirs.org).
Jessica Crist, Bishop
Bishop Jessica Crist
Bishop of the Montana Synod of the ELCA