Living Wills and Related Matters


Dick Blackford
The following letter was sent to Truth Magazine and the editor asked if I would reply. It deals with a difficult subject, but one that has become quite relevant to our time.

Brother Willis, could someone please discuss in Truth Magazine a Christian having a Living Will, defining medical care in the event of a terminal illness or condition? Can we choose only comfort measures, specifically only pain control as the only treatment for ourselves? Do the Scriptures deal with this in any way? Also, please discuss how a Christian handles the death of a loved one or himself. My brother has terminal brain cancer and I feel, because I hate the whole situation, and can’t seem to get a grip, that my faith is weak. My earthly love does not want to let anyone go — are we not supposed to feel this way? Thanks for any thoughts. (name withheld)

Christians often find themselves with conflicting emotions and difficult questions, as expressed in the above letter. These are real problems that don’t easily go away. I fully recognize I don’t have all the answers, but will do what I can to offer some helpful thoughts. Our sympathies are certainly with our brothers and sisters in Christ who face these perplexing situations.

Most states have two documents that allow one to make legally valid decisions about future medical care. These are called “Advanced Directives” (AD). The two types of ADs are: 1. A Living Will Declaration (LW),  2.A Health Care Proxy Designation (HCPD). The purpose of these directives is to let medical authorities know if you do or do not want to receive certain types of treatment or if you wish to name someone else to make health care decisions for you in the event you are unable to do so. At the time of injury or illness it may not be possible for you to express your will on these matters so the AD allows you to do it in advance, while in your right mind and without the emotional distress. No one automatically has an AD. It is entirely up to you whether you want to prepare such documents. If questions arise about the kind of medical treatment you want or do not want, ADs can help solve these important issues.
Living Wills
A LW is a document which tells your health care provider whether or not you want life-sustaining procedures if you are in a terminal condition or permanently unconscious state. It is called a “living will” because it takes effect while you are living. It is not to be confused with  your “will” or living trusts, which are financial documents that determine the settlement of your belongings after your death. It only deals with medical issues. You do not need an attorney to complete a LW. It must be signed by you and witnessed by two adults.

Life-sustaining procedures are not expected to cure a terminal condition. In such cases, they only prolong dying. Examples are respirators which help you breathe, kidney dialysis which clears your body of waste, and cardio-pulmonary resuscitation which restores your heartbeat. Keep in mind that we are only speaking here of a terminal condition.

Health Care Proxy Designation
An HCDP is a legal document that allows you to appoint another person to make medical decisions for you should you become temporarily or permanently unable to make those decisions. It also must be signed and witnessed. A more thorough discussion of these two ADs can be obtained from your local hospital.

Should We Seek To Save Our Lives?
The whole tenor of the Scriptures is on saving life. God wanted Adam and Eve to live and not die and he sent Jesus to abolish death (Gen. 2:17; 1 Cor.15:22). Hezekiah prayed that he would not die and the Lord allowed him to live fifteen more years (2 Kings 20:1-5). When the Philippian jailer was about to take his own life, Paul hastened to prevent it by yelling, “Do thyself no harm” (Acts 16:28). Epaph­roditus was “sick nigh unto death.” The desire of Paul, Epaphroditus, and others was that he be spared (Phil.  2:25f). We don’t know whether Timothy’s ailments were life threatening but he was instructed to take care of his health (1 Tim. 5:23). His treatment was for his oft infirmities, not merely to mask the pain. The good Samaritan used medical treatment on the wounds of the man who had been beaten and robbed (Luke 10:33, 34). This was done in view of saving his life, for he had been left “half dead.” Jesus recommended a physician for the sick, in view of their being made whole (Matt. 9:12). Luke, as a physician, was in the business of saving people’s lives.

Questions Asked
Can we choose only comfort measures — specifically, only pain control as the only treatment for ourselves? Do the Scriptures deal with this? We are extremely sympathetic toward those suffering excruciating pain. If I have correctly understood the inquirer, she is asking, “May one (if terminally ill) refuse extra-ordinary measures to sustain life and choose only comfort measures?” I fail to see that it would be wrong to let nature take its course. Machines are not going to cure a terminal illness. For millenniums, dying naturally was the only choice for terminal conditions prior to the invention of the machines.

There is a big difference in allowing yourself to die naturally than in injecting something into the body to cause death. The latter is murder (or suicide, if on oneself). While the pain seems unbearable we have to believe that “God is faithful, who will not allow you to be tempted beyond what you are able, but with the temptation will also make the way of escape, that ye may be able to bear it” (1 Cor. 10:13).

However, there comes a time when death is inevitable and there is nothing man can do to prevent it (Heb. 9:27). In history, when medical knowledge was limited, people were often thought to be dead when they were no longer breathing. With advanced knowledge we came to learn that, though there was no evidence of breathing, one’s heart might still be beating, indicating life. Our present and best available knowledge is that one is dead when there are no brain waves. A machine may force breathing and blood flow, but present knowledge tells us they are dead, with no hope of reviving. There is no record of anyone without brain waves surviving and going on with their lives. The spirit has departed the body (Jas. 2:26). The decision to shut off the machines can be emotional and difficult. It is then that we have to consider the welfare of the living. The toll on the living can become unbearable physically, emotionally, and financially. Just because a machine can force air into the lungs or force the heart to beat does not mean the person is alive. Such treatment could go on indefinitely. All of us must die. It is time to accept the inevitable. Dying is not the worst thing that can happen to us. Being lost in hell for eternity is the worst.

Please discuss how a Christian handles death of a loved one or of himself. First, we will consider a loved one’s death. Faith in God demands that we accept the fact that all of us are going to die (Ps. 89:48). We die because we have sinned (Rom. 5:12). Death entered the world because of Satan, not God. It is our enemy (1 Cor. 15:26). Grief is natural and expected. Jesus wept at the death of Lazarus (John 11:35). Brethren made great lamentation at the death of Stephen (Acts 8:2). Do not be ashamed to express your sorrow. Bereavement usually comes in stages. There is shock and numbness, emotional turmoil, emptiness in the form of loneliness, depression, and despair, and finally, acceptance.

Despite preparation, it still comes as a shock that our loved one is gone and we become preoccupied. Feelings and emotions such as anger, resentment, guilt, and bitterness may set in. Then comes loneliness. It takes time. Don’t be impatient with it. The Bible does not give any specific length of time for mourning. In many instances though, great and grievous mourning took place (Gen. 50:1-13). Trials will come and they may come in the form of the death of a loved one (1 Pet. 1:12; Jas. 1:2-4). Often, there  is regret that we didn’t do things differently, better, and more. We should do all we can in life while there is still opportunity. We are to bear one another’s burdens (Gal. 6:2). And we should allow others to bear our burdens when they get too heavy.

When people are mourning, they mourn less for the dead than for themselves. The dead are no longer suffering from their injuries or illnesses. It is the survivors who have to live with this loss. One thing that will help you heal from your grief is to serve others. We feel helpless to do anything to help the dying, but by helping the living we also help ourselves. The time to visit the distressed is “in their distress” (Jas. 1:27), not after their affliction when they have gotten over it. Remember that what you do during the darkest hour of your friends and loves ones, even if it seems simple to you, will by far outweigh anything you could give after that time of need is over. We are to “mourn with those that mourn” at the time they are mourning (Rom. 12:15, 16).

Mourning with others can be a learning experience. People who have had a brush with death are often wiser and more in touch with the things that really matter. You can learn a lot from such experiences, or from others who have gone through them. The Bible offers practical wisdom: “It is better to go to the house of mourning than to the house of feasting: for that is the end of all men; and the living will lay it to his heart” (Eccl. 7:2). Going to a funeral will benefit more than going to a party or a restaurant. One reminds us of the future and eternity while the other of the present and temporary. We are put in remembrance of our own mortality, our frailties, the shortness of human life, and the judgment. The Scriptures offer a world of comfort (Ps. 119:50; Rom. 15:4). Some burdens seem beyond human endurance, so cast them on the Lord (Ps. 55:22; 1 Pet. 5:7).

Our Own Death
It is impossible to speak from personal experience, but no need to. The Bible gives timely and relevant admonition. Hezekiah was told to “set thine house in order; for thou shalt die and not live” (2 Kings 20:1). Setting one’s house in order is primarily a spiritual admonition, a time for soul-searching and examination (2 Cor. 13:5). But we also need to make provision for the dispensing of our earthly goods. Hezekiah “wept sore” and prayed. There is no guarantee that God will extend our lives. Whether he does or not, prayer will work wonders (Jas. 5:16; Phil. 4:6). We close this  article with the verse of a hymn:

When sore trials came upon you,
Did you think to pray?
When your soul was bowed in sorrow,
Balm of Gilead did you borrow,
At the close of day.
O how praying rests the weary!
Prayer will change the night to day;
So when life seems dark and dreary,
Don’t forget to pray.
(Did You Think to Pray?, M.A. Kidder).

That “balm of Gilead” is prayer. And our prayers are with you, dear Sister.

P.O. Box 3032, State University, Arkasnas 72467 rlb612@aol.com
Truth Magazine Vol. XLV: 10  p1  May 17, 2001