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Making End-of-Life Decisions

            There is one role in life for which each of us is an understudyóthe role of the dying person. Eat the best you know how. Exercise frequently. Do everything you know to do to maintain and even improve your health and you will still die. The mortality rate for humans is hovering at 100 percent, where it has been, with the sole exception of +Jesusí resurrection, since the beginning of time.

            For the two of you still reading this column after such a cheerful start, I write about the certainty of death knowing that we are an Easter people who can sing alleluia at the grave. Christians say death is not the final answer. As that is true, is there then a particularly Christian response to health care issues that arise at the end of life? How can we decide about what treatment is appropriate? When is it permissible, or even a good idea, to withhold treatment?

I believe that a Christian response to end-of-life issues depends on hitting the balance point between upholding the sanctity of life and acknowledging the sovereignty of God. We uphold the sanctity, or holiness, of life knowing that life itself is a gift from God and should be honored. We acknowledge Godís sovereignty by putting our lives in Godís hands. If life is preserved at all cost when a return to health is not possible, then we are make life into an idol and place our trust in medical solutions alone rather than in the God who gives life.

Many cases will arise in which the choice is between prolonging life at any cost and allowing a disease to take its course by not pursuing certain treatment options. Direct means of euthanasia are not compatible with scripture, though there may be times when withdrawing care is a viable option. This does not directly end life, but leaves the patientís life in Godís hands.

The key question is whether a given treatment has a reasonable chance of improving a patientís health, or relieving suffering. If a treatment option will prolong life, but result in increased suffering to a patient, then a Christian response could include withholding that treatment.

One case in the headlines recently was that of Terry Schiavo, a Florida woman who suffered a cardiac arrest in 1990. She required artificial nutrition and hydration to support her life and has remained alive through this treatment. Last October, her husband won a court case over her parents and was allowed to withdraw this treatment. More than 34,000 emails caused Florida Governor Jeb Bush to intervene through a legislative act that gave him that authority. Treatment was reinstated and undoubtedly preserved her life.

Schiavo is diagnosed as being in a Persistent Vegetative State, but that diagnosis in itself is problematic as one cannot be certain if a vegetative state is permanent. There have been rare cases when a patientís condition improved somewhat after years in a vegetative state.

On the other hand, there are cases when withdrawing artificial feeding and hydration may be a moral choice. If there is no hope that prolonging life through these extraordinary means would result in eventual improvement in health, then discontinuing treatment is an option to be considered. I am not close enough to this particular case to feel qualified to make a decision, but I do want to hold out that it can be a moral Christian choice to withdraw medical treatment that sustains life when there is no possible return to consciousness.

Even touching on a case shows how difficult it is to make end-of-life decisions on your own. A team approach is best. You should have a pastor and Christian friends with whom to discuss treatment options and consider the appropriate response. Hospice is an organization uniquely qualified to assist in putting together a team to control pain and discomfort while making these decisions.

Hospice staff and volunteers are gifted at caring for patients and their families in the last months of their lives and they well know their way around the decisions many of us may face for ourselves and those we love. Hospice will also work with you and your minister or the Hospice chaplain in making these decisions. Hospice care neither hastens death nor unduly prolongs life.

One Christian response to end-of-life issues is to talk through your own wishes concerning end-of-life treatment with family or others who may be called upon to make a decision if you were incapacitated. Pray about what directives you might be able to give in advance and prepare a living will.

A living will gives health care professionals your wishes in the event they face making end-of-life decisions when you are no longer capable of communicating your wishes. There is nothing unchristian about letting others know what you have prayerfully decided is the right course of action for you. As each state is different, you will want to make sure that your living will is in a format acceptable in the State of Georgia.

(The Rev. Frank Logue is pastor of King of Peace Episcopal Church in Kingsland.)           

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