Christans and Living Wills
An article by one of our regular contributors here at the Cafe, discusses the moral questions a Christian might encounter in drawing up a living will, or in acting on a loved one's desires expressed in one.
Originally published in Raleigh News and Observer.
By Greg Jones
Q: What is the Christian view of the following provisions in a living will?
* Withdrawing artificial hydration.
* Withdrawing artificial nutrition.
* Withdrawing life-prolonging measures.
Are any or all of the above considered to be killing or suicide?
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There are, to be sure, a variety of responses to these questions in global Christianity. I have found a great deal of similarity among the various denominations -- ranging from Southern Baptist to Roman Catholic. In my own, the Episcopal Church, our General Convention in 1991 resolved to encourage the use of living wills, which might include provisos to withdraw hydration, nutrition or extreme life-prolonging measures in limited circumstances. The key issue for us resides in our understanding from God's revelation of a few key truths.
First, we believe that all human life is sacred and that God's commandment "Do not kill" is authoritative. Second, we recognize too that death is part of the cycle of our natural life. As Ecclesiastes says, "There is a time to be born, and a time to die." Third, we proclaim that in the birth, death, Resurrection and ascension of Jesus Christ, God transforms our earthly deaths into eternal lives. As Paul writes, by Christ "has come the resurrection of the dead."
With these three points before us, we do not believe it is morally acceptable to intentionally kill someone who suffers from an incurable illness. Our covenant in baptism to honor the dignity of every human being encourages us to seek palliative treatments for those in pain.
And, if the time has drawn near, we want to allow people to die with dignity, without artificially prolonging the act of dying. This might include the removal of hydration and nutrition or other artificial measures.
Because the decision to remove life-sustaining systems still has a tragic side, it is a decision that must ultimately rest with the patient or his/her surrogates. The decision is best made in prayer, with family and friends, to the merciful God who suffered and died as the Christ and who by grace restores us to wholeness.
During life we each actively seek alimentation and hydration. Artificial seems a strange word to use here. (Because I am using two languages to think about this theme?) Perhaps passive alimentation and hydration is more accurate. And because they are passive, they are extreme and invasive. However, I do not see a real difference in passive alimentation, hydration, respiration or filtration. Whether we turn off a heart/lung machine, withdraw a feeding tube, or stop dialysis, death usually results. The only real difference for one of us is how much time passes once the invasive support is halted and death results. What happens with our loved ones is that death may occur a few minutes after shutting off a heart/lung machine, but take a number of days for death to follow the termination of the other forms of passive support. A number of days for them to feel guilty and want to second guess their agreement to follow our decision.
I think that it is good to have these instructions, and multiple legal copies in the hands of various confidants. The more information we provide our loved ones left with final decisions regarding us, the easier for them to know what we truly would choose for ourselves. And also perhaps avoid the kind of squabbling that could arise among our loved ones who may have opposing ideas about what would have been our desire. We should also impress upon them in these instructions that they are truly carrying out our decision for ourselves, and that they have our permission to carry out our desires.
Many of us with ties to the indigenous cultures of the Americas, know the stories of various tribes where the elderly would purposely leave the village/family to take the responsibility for their end-of-life decisions off the hands of their loved ones.
Posted by David Allen |dah • veed|![[TypeKey Profile Page]](http://www.episcopalcafe.com/lead/nav-commenters.gif)
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January 10, 2009 3:07 AM
This is certainly important, and General Convention has spoken to it more than once.
As one who has occasion to teach about this periodically, I encourage folks to take three steps. The first, and the hardest, is to have the conversation with those we love, to share what we want, and to learn what they can live with. It is the hardest step, but the most critical; for without a document, it is what those we love know about us that will shape decisions.
The second step is to get directions down on paper. That may include a Health Care Treatment Directive, or a Durable Power of Attorney for Health Care, or both; but it becomes helpful to everyone to get it down on paper.
The third step is to spread copies of the paper around. One's doctor should have it, as should one's attorney. Family members should certainly have it. I'm aware of churches that keep them on file for parishioners. Above all, don't keep them in the bank safe deposit box. The documents have to be where someone can get to them at 2:00 a.m. on a Sunday morning; for all too often that's when we in health care need the information.
Marshall Scott
Posted by mscottsail![[TypeKey Profile Page]](http://www.episcopalcafe.com/lead/nav-commenters.gif)
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January 10, 2009 7:27 PM