Thursday, March 22, 2012

Refusing Medical Treatment

My article from this week's Algona Upper Des Moines about treating terminal illness:

Q:  Is a Christian allowed to refuse life-prolonging medical treatment?  Does the Bible require us to use all available means, no matter how unlikely the chance of success, to extend the life of a person who is critically or terminally ill?  How do we know when it is appropriate to proceed with, discontinue, or refuse treatment?

Knowing how to handle a life-threatening medical condition can be a very difficult thing, especially when we are making decisions for a parent or other relative who is not able to express their preferences at the time of treatment, as is often the case in situations where we are faced with questions such as this. 

For the Christian, life is always a gift from God to be honored and protected.  When we make decisions regarding our own treatment or that of a loved one under our care, this is our starting point.  We desire to respect life as God has given it and care for it in a way which honors Him.  We frequently hear this principle applied to life’s beginning at conception, but it equally applies to life’s end. 

Because modern medical technology did not exist during the times when the Bible was written, we do not find extensive guidance on choosing a course of medical treatment.  However, since the Fifth Commandment says, “You shall not murder,” it and its accompanying explanations in the Bible serve as our boundaries in this sort of decision. 

To begin with, actively and intentionally ending our own life or that of a loved one is never an option for the Christian.  The only circumstances in which the Bible does not consider causing a person’s death to be murder are genuine accidents, self-defense, and government’s authority to execute criminals and defend its citizens through war.  Euthanasia, assisted suicide, and any other active and intentional killing of the patient are therefore not an option.

We also do not withhold essential provisions such as food, water, and oxygen from a person for the purpose of hastening their death, nor should a person refuse such things as long as they are able to receive them through normal means.  At the same time, one is not required to go to employ extraordinary or invasive means to receive or provide them. 

When Martin Luther explains the Fifth Commandment, he summarizes the Bible’s guidance in this way: “We should…not hurt or harm our neighbor in his body, but help and support him in every physical need.”  Our goal when making the sort of decisions described here is to help and not harm the person receiving care.  We want to honor God’s gift of life by making our best efforts to heal and save, but also we do not want to needlessly cause or prolong suffering beyond the likelihood of recovery. 

This can be difficult, because we have no way to know with absolute certainty what the outcome will be, so as we make these decisions we are always ultimately leaving the person in God’s hands.  We do our best to serve them with our decisions, and trust Him to guide the outcome for their benefit. 

As we do so, it is important to honor their wishes whenever possible.  If they have expressed to us a desire regarding treatment, we should honor those desires.  When they have not expressed a desire or the decision goes beyond what they have communicated, we seek to always do whatever is best for them—whatever will bring the most help or the least harm in a given situation, and provide them the highest degree of comfort possible in the process. 

When the person receiving care is a Christian, we have an added consolation, because whatever the outcome, it will be for their benefit.  The Apostle Paul said, “To live is Christ, and to die is gain,” and the book of Acts tells us that “through many tribulations we enter the kingdom of God.”  This means that if the treatment is successful, they will spend more time receiving God’s blessing on earth, but if the treatment fails, their soul will rest with Jesus to await the Resurrection on the last day when they will be fully and permanently healed. 

As is often the case, the variety of circumstances is seemingly endless, so every situation will have its own unique characteristics.  Although we have general boundaries within which to proceed, the guidance of doctors and pastors is of immeasurable value when making any particular decision. 

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