A Practical Approach to End-of-Life Issues
Presented by Rev. Robert R. Fleischmann

II. Begin with Faith

The challenge of training fellow Christians in the way they should go is a life-long endeavor to create the Christian mindset. This mindset includes moral absolutes but goes much further. It is a mindset that often begins with the frequent law motivation experienced as children learning the difference between right and wrong. It is a transforming process with the goal for obedience not to be out of fear, or a mere sense of duty but rooted in a love for God who gave his Son as the ultimate payment for our sins.

Throughout this training process, we seek to educate people to leave behind their humanistic old man which asks, “What would I like to do?” and practice the sanctified life of the new man which asks, “What would God have me to do?” When you walk into the hospital waiting room to counsel your members facing a life challenge, you will have to ascertain the status of their internal battle between the old and new man.

To help me in this process I have developed two models which I call the world and the Christian model. Let’s begin by examining the world model.

Individual Rights

In the world model, the highest good is individual rights. It has become the battle cry of nearly every anti-Christian effort in life issues. Abortion advocates argue for the right to choose. Medical directive statements appeal to the person’s perceived right to self-determination in medical care.

Thirty years ago we were much more accepting of our doctor’s advice. Today, the doctor is called upon to provide much more of an explanation of what he wants to do, and then he must wait for your consent. The increase in medical litigation combined with the public’s increased desire to control all aspects of life have proven to be quite challenging for the medical profession.

We cannot be self-righteous in this regard. It is a spirit that is clearly in the hearts of many of us. Few of us take pleasure in being told what to do, and how to do it, and when to do it. Who of us has not taught a Bible Class and have found ourselves challenged on points that, even just ten years ago, could be taught without challenge. People want more control. They want to control their destiny, and to make their own choices, be them right or wrong.

Such was the case with Sue Rodriguez, a 43-year old mother from Victoria, Ontario. She experienced her quality of life diminish from the effects of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. She argued for the right to assistance in committing suicide. In an interview on the CBC news program called “Witness”, she said, “I just feel that I would like to have control of my destiny . . . I want to ask you, gentlemen, if I cannot give consent to my own death, whose body is this…who owns my life?”

It is this spirit of individual autonomy which touches many of our members. When this happens and our members seek the pastor’s counsel we quickly discover that they are not looking for direction to do what is right but the affirmation that their decisions in the matter are right. Inevitably conflict arises.

Common Good

But even the most ardent libertarian recognizes that individual rights have their limits. In The Humanist Manifesto II, the libertarians proclaim, “We believe in maximum individual autonomy consonant with social responsibility.” What is confusing, however, is how one defines a matter to be “consonant with social responsibility.”

In that same Manifesto, the authors advocated birth control, abortion, euthanasia, and suicide. Their closest attempt to satisfy the tension between individual rights and social responsibility came in their section on sexual behavior. There they write, “While we do not approve of exploitive, denigrating forms of sexual expression, neither do we wish to prohibit, by law or social sanction, sexual behavior between consenting adults.”

When I first read this document in the middle 1970s it seemed radical at best. Today, it is a shocking creed reflecting current social trends. Fortunately, at least for the moment, society as a whole is interested in hemming in individual rights in the interest of the common good. For that reason, there are laws that somewhat prohibit the reckless exercise of individual rights. You cannot just punch someone in the nose because you feel like it. You cannot take what does not belong to you.

Common Law

How a society then seeks to preserve individual rights while protecting the common good is defined by the legal process. In the model, there are two basic pedestals upon which society maintains this order. The one pedestal is an appeal to common law. Simply put, common law is, in a way, a form of fatalism. It is predicated upon the notion that society is innately good and is evolving to being better in its character.

When appealing to common law jurists attempt to ascertain a long-standing value in the history of mankind. If, for example, hundreds and thousands of years of history reveal society’s intolerance for thievery, one can then define rights with regard to possessions within the confines that any form of thievery is wrong. The underlying notion is that in the end, how it comes out reflects how it is supposed to be.

In Christian circles, this is similar to what we teach about the natural law written on man’s heart. Concerning that, the Apostle Paul wrote, “Indeed, when Gentiles, who do not have the law, do by nature things required by the law, they are a law for themselves, even though they do not have the law, since they show that the requirements of the law are written on their hearts” (Romans 2:14-15 NIV).

Reading this passage alone suggests a validity to the notion that common law is a reliable measure of right and wrong. Christ, however, observed, “Because of the increase of wickedness, the love of most will grow cold” (Matthew 24:12 NIV). He reflected the sad historical truth that man’s moral character does not improve but declines.

This is an important distinction when legal scholars argue about whether there is a consistent prohibition against abortion, homosexuality, prostitution, and suicide. If the conclusion is that common law allowed such things is it therefore right to allow it? By society’s standards, it is!

Statutory Law

Common law, however, does not answer all of the questions. For that reason, statutory laws are appealed to. These are laws derived by legislatures through the will of the majority of the legislators. Perhaps the most contemporary example of this is the current and proposed regulation of the Internet community. To some degree statutory laws are the specific and contemporary application of common law principles. But when those principles are unclear and the issues are complex, statutory laws often reflect the current opinion of a majority of legislators which may change over time.

Religious Community

I needed to challenge your patience with this explanation of the world model because it is a model often borrowed by members of the religious community. In our counseling sessions with members, it appears in many forms but once recognized it helps you understand better how they may be approached.

For example, members of the religious community may imitate statutory laws by acknowledging on the one hand that Scripture does not directly mention contemporary issues. On the other hand, however, they adopt a legalist position on those issues. On countless occasions, people will call me simply wanting to know the WELS position on an issue. They usually don’t know the role of and use of Biblical principles and so will settle for proclamations. They often appeal to “what my church teaches” or “what my pastor says” but rarely have the patience or desire to understand the principles behind the applications. They are more concerned about the rule than the reason.

The danger of this legalism is the generalization of statements relating to life issues. Some in our circles have the perception that you never refuse food and water in the hospital setting. While this is correct most of the time there are those circumstances where the continued administration of food and fluids agonize and perhaps accelerate the dying process because of the body’s inability to process these elements.

The religious community attempts also to appeal to the “ends justify the means” mentality often represented in society’s common law approach. As society looks at the end result of history on an issue and assumes it reflects what is right, so also are Christians tempted to do that.

For example, there is an Easter dinner, and the family has gathered around when Grandpa all of a sudden falls over from a stroke. You lay him on the floor, call the ambulance, and rush him to the hospital. If you are like most families, you do not pre-plan what you will do when Grandpa has a stroke at the dinner table. It catches you by surprise. So when the medical staff comes out asking Grandma a bunch of questions she gets overwhelmed, throws up her hands, and exclaims, “If God wants Grandpa, God will take him. If he is supposed to live then God will save him. So do nothing and we will leave it in God’s hands.”

It sounds like a godly decision. In fact, mentioning the name of God sounds very spiritual. But when there are reasonable options to pursue it reflects a desertion of Christian responsibility to simply wash your hands of making the decision.

Consider this parallel. How many of you, when your children were growing up, decided not to teach them to look both ways before crossing the street? After all, if you are consistent in leaving matters in God’s hands, you will trust that if God wants them to live they will make it across the street, if not, they will not. Parents recognize they are stewards over the lives of their children. So also are we stewards over Grandpa’s life. You make the best possible decision, which may be to do nothing. But, to do nothing as an alternative to making a responsible decision is wrong.

In Scripture, we have a demonstration of this erroneous thinking in two different places. In Acts 5:34ff we are told of how the religious leaders wanted to end the work of the Apostle Peter and his co-workers. At that point, Gamaliel displayed fatalism when he observed that if God was against them they would fail like others before them. But if God was for them, they cannot be stopped. As is characteristic of fatalism, sometimes the result is right and sometimes it is not. In this instance, the work of the apostles prospered until the Church has become what it is today. Therefore, it appears fatalism works.

But, when you approach the cross of Christ on Calvary and the soldiers challenge him to come down from the cross and then they will believe in him, he didn’t come down. That did not negate Jesus as the Savior. You see, the danger of fatalism, as with the danger of common law, is that it allows sinful man to establish the criteria for what is right and wrong. As we teach concerning the natural law on man’s heart, it becomes clouded by sinfulness. Our consciences are not reliable indicators of what is right or wrong.

Giving Glory to God

In contrast, the Christian model is entirely different than the world model. The highest good for the Christian is to glorify God. We are told, “So whether you eat or drink or whatever you do, do it all for the glory of God.” (1 Corinthians 10:31 NIV) Christians are not concerned about what preserves their autonomy and gives them authority. They always are asking themselves, “what can I do to give God glory?”

Word of God

In order to give God glory, it is only logical that one must know what it is that glorifies God. That is where God’s Word comes in. As I quoted the Psalmist earlier, “Your word is a lamp to my feet and a light for my path.” (Psalm 119:105 NIV) As you glorify God when you minister with his word so also do your members glorify God when they appeal to you for guidance from God’s word.

Faith

One does not glorify God or seek out his word, however, unless he has God’s greatest gift, the gift of faith. Faith is that incredible God-instilled working force in our lives that leads us to do the ultimate in illogical things — to believe in a Savior we never met and to be certain of the eternal home of heaven which we have never seen. How true are the words of the writer when he said, “Now faith is being sure of what we hope for and certain of what we do not see.” (Hebrews 11:1 NIV)

When we as pastors console our members at these emotionally-charged times it is incumbent upon us to guide them so that they work not from emotion or tainted human logic, but with God’s gift of faith. It is only those decisions rooted in faith that are the “right” decisions. The writer to the Hebrews explains, “And without faith it is impossible to please God.” (Hebrews 11:6a NIV)

We must remind our members that they are more than just the wife or husband; son or daughter; mother or father of a critically ill patient. We must help each member see himself as a child of God. As a member wrestles with making medical decisions they do so first as a child of God who faces life and death with the faith that gives the ultimate and eternal victory.

Biblical Directives

As members work from the position of faith they seek out their pastor as the expert on God’s word. It is that

word of God which contains a wealth of biblical directives clearly reflecting the will of God. We are told, “This is love for God: to obey his commands.” (1 John 5:3 NIV)

These directives are more than just timeless moral codes. These “commands” include fundamental principles that guide us today in our lives of sanctification. You may not find the terms “abortion” or “nasogastric tube” in the Scriptures, but you will find principles that speak to these and other medical concerns.

Example of Jesus

The other guiding standard is the perfect example of Jesus Christ. James wrote, “To this you were called, because Christ suffered for you, leaving you an example, that you should follow in his steps.” (1 Peter 2:21 NIV) There is, of course, the presumption, that you have learned from Scripture about the life of Christ. This must be more than a superficial knowledge. With a full knowledge, however, it would be a good thing to ask, “What would Jesus do?” when facing many difficult decisions.

Society

At times the world also likes to play with the Christian model. On the granite walls of the U.S. Supreme Court building in Washington, D.C. you will find carved the Ten Commandments. They are joined with other moral codes of various cultures. In the eyes of secular society the Commandments represent a code of ethical conduct that may be good for a society to emulate — much like the ethical codes of other cultures.

In the same manner, there is still a secular institution that allow the picture of Christ to be hung in a prominent location as long as it is joined with other great men. Nativity sets are allowed on public property in some communities, not for its spiritual significance, but because it represents one of the traditions of Christmas.

In both cases, society lacks the fundamental component of being rooted in faith. When Christians obey God’s will and decorate with Christian images, it comes from a heart of faith, not merely a holiday spirit or a civic sense of moral responsibility.

As our members face the various challenges of life issues we must help them think like Christians and not people of the world. We accept Paul’s statement as truth that “the sinful mind is hostile to God. It does not submit to God’s law, nor can it do so.” (Romans 8:7 NIV) That being the case, it is the natural tendency of all of us to resort to the world view of life. It is when this battle rages internally between the new and old man that we pastors must come in with the reinforcement of Scripture to appeal to their faith. As we help our members wrestle between making right and wrong decisions our first principle to remember is that truly right deeds and decisions can only be made from a heart of faith.

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The above article is part 2 of Rev. Fleischmann’s 10-part paper. Click here to view the complete outline.