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