Medical Decisions and the Heart

The woman prayed for the morning glow.

Rev. Robert Fleischmann, National Director, Christian Life Resources

No, this is not an article about heart surgery and transplants. Rather, this article addresses the attitude of the heart when making medical decisions.

Heart = Motive

When difficult medical decisions have to be made we like to have clear, direct answers. Unfortunately, many questions regarding medical decisions do not offer clear answers.

This is in sharp contrast to other controversial medical issues such as abortion. While many in the world argue for the right to kill an unborn child, Scripture is clear on the matter. Passages like Psalm 51:5 clearly testifies to life being present at conception. The fifth commandment and passages like Genesis 9:6 clearly speak against killing. It is, therefore, an obvious and logical deduction that we are not to be killing human beings. As these principles relate to abortion, we are not to kill unborn human beings.

When wrestling with whether to pursue a course of action in medical treatment, however, the application is not always as clear…but the principles always are. How these principles are applied in different circumstances can be, nevertheless, difficult to ascertain.

Motive Is the Key

When we talk about the attitude of the heart we are really talking about motive. When there is a lack of clear application of principles in Scripture a Christian is not free to make decisions without thought or sense of responsibility. The Christian should ask the “3 Ws”:

  • Why am I making this decision?
  • What do I intend to accomplish with this decision?
  • For whom do I make this decision?

Motive Is Critical

The writer to the Hebrews wrote, And without faith it is impossible to please God, because anyone who comes to him must believe that he exists and that he rewards those who earnestly seek him (Hebrews 11:6). Even when actions are correct to the letter of the law, it is the heart (motive) that determines its ultimate acceptance by God.

We see this practically illustrated when we consider the question of financial support for the Lord’s work. God’s Word is clear that we are to support the Lord’s work. God’s Word, however, does not establish a set amount for our offering. When it comes to determining the amount, however, the appeal is to motive. The Apostle Paul wrote, Each man should give what he has decided in his heart to give, not reluctantly or under compulsion, for God loves a cheerful giver (2 Corinthians 9:7).

A Christian financially supports the Lord’s work in a manner that reflects his heart. The amount is not the focus but the attitude. Attitude determines the amount. Motive is the primary determinant of what is the correct amount of the offering.

Motive Is Soul-Searching

Determining motive is a deeply personal endeavor. While others might judge your actions, only you and God know your heart. That is why it is often called soul searching. At best, others can help to prick your conscience by causing you to ask the hard questions. In the end, though, only you will know the answer to why you make a decision.

Motive, therefore, is a deeply personal thing. It reflects heartfelt convictions.

Best Intentions are Not Perfect Intentions

As we try to understand that our best intentions are not perfect intentions. Isaiah reminds us, All of us have become like one who is unclean, and all our righteous acts are like filthy rags; we all shrivel up like a leaf, and like the wind our sins sweep us away (Isaiah 64:6). The Apostle Paul illustrated the same point when he quoted from a number of Old Testament references: There is no one righteous, not even one who understands, no one who seeks God. All have turned away, they have together become worthless; there is no one who does good, not even one (Romans 3:10-12).

I had a seminary professor who once observed that even our most sincere and tear-shedding prayers are tainted with sin. In other words, at best, we are not perfect. This sad reality suggests that we are rarely able to provide the objective evaluation of our motives necessary to consistently make the right decisions. It is this imperfection that compels us to earnestly search out Scripture and the counsel of strong Christian friends. Scripture keeps us focused on the will of God as the supreme guide for our life. Our Christian friends help us to ask the hard questions and aid us in arriving at the correct answers.

Those Who Decide

Over the years I have counseled countless people in making medical decisions. Many who have faced crucial life and death situations have inspired me with their deep faith and desire to serve God. Throughout the decision process, they have been keenly aware of their sinfulness and have earnestly searched for guidance in making what had truly been a God-pleasing decision.

There have been others whose motives have clearly not been correct. I have not encountered too many of these people, but their purpose had been altogether clear. When they wanted input from their pastor or me it had usually been in the hope and expectation that we would provide counsel consistent with the decision they had wanted to make. If the counsel had been different they dismissed us as being unrealistic, uncaring and often implied that Scripture was invalid in their case because of modern technology.

By far the most common group of people I counsel are not so transparent in their motives. It is unclear whether they are wrestling with the facts, with family pressure or with personal questions. I categorize myself in this category when facing personal decisions. I often feel like the Apostle Paul who said, So I find this law at work: When I want to do good, evil is right there with me (Romans 7:21).

To wade through the doubts, facts, and apprehensions we must focus on some fundamental teachings of Scripture:

Blessings Are Not Rights

When raising children we see how easy it is to confuse right and blessings. Consider what happens when a child is told it is time to leave the toy section in the store. Some children immediately throw a tantrum. In their immaturity, they do not see the opportunity to peruse the toy section as a blessing or a privilege but assume it to be a right.

As we grow in our schooling we are reminded time and time again that this is the land where we have the right to life liberty and the pursuit of happiness. If we remain spiritually immature, we will surrender to the secular notion that these things are indeed our rights. They are, in fact, blessings that come from God. Life is God’s gift (Deuteronomy 32:39), not our right. Liberty is something we enjoy as a blessing, but it is not a right to be claimed by everyone (Ephesians 6:5). Happiness is a blessing that God grants to some and withholds from others (Romans 5:3). It, too, is a blessing, not a right.

Often as people face declining health they feel as though they have been denied their right to be healthy and happy. How often isn’t it said, “When you have your health you have everything.” But health is not everything. It is nice to have. It is a wonderful blessing to be able to enjoy life to its fullest with good health. But it is a blessing, not a right. To be denied perfect health at some juncture in life is no more unjust than to be denied great riches, countless friends or a mansion for a home. We accept these blessings as God chooses to dispense or withhold them.

The same is true with health. Should God choose to deprive the blessing of good health we do well to imitate the spirit of Job when he said, Naked I came from my mother’s womb, and naked I will depart. The LORD gave and the LORD has taken away; may the name of the LORD be praised (Job 1:21). We sin when we see the futility in life because we do not have the health we desire for life.

The Secret of Being Content

The Apostle Paul most explicitly referenced to the secret of contentment when he said, I am not saying this because I am in need, for I have learned to be content whatever the circumstances. I know what it is to be in need, and I now what it is to have plenty. I have learned the secret of being content in any and every situation, whether well fed or hungry, whether living in plenty or in want. (Philippians 4:11-12)

Consider how contentment is handled throughout Scripture:

Be still before the LORD and wait patiently for him; do not fret when men succeed in their ways, when they carry out their wicked schemes. Refrain from anger and turn from wrath; do not fret — it leads only to evil. (Psalm 37:78)

Keep falsehood and lies far from me; give me neither poverty nor riches, but give me only my daily bread. (Proverbs 30:8)

A man can do nothing better than to eat and drink and find satisfaction in his work. This too, I see, is from the hand of God, for without him, who can eat or find enjoyment? (Ecclesiastes 2:24-25)

Each one should remain in the situation which he was in when God called him. Were you a slave when you were called? Don’t let it trouble you — although if you can gain your freedom, do so. (1 Corinthians 7:20-21)

But godliness with contentment is great gain. For we brought nothing into the world, and we can take nothing out of it. But if we have food and clothing, we will be content with that. (1 Timothy 6:68)

Bringing It All Together

When a decision must be made and God’s Word does not provide direct application, look to where Scripture is clear. Scripture teaches that life, happiness, and perfect health are blessings from God to be given or retrieved as he sees fit. Scripture also teaches the important role of contentment which compels us to accept life as God provides it.

In light of these principles, we never make decisions to reject life because we do not like its quality. The problem is not with the life but with our own unwillingness t be content with that quality of life.

For the same reasons we do not reject care or treatment simply because we will not like the quality of the life that is left. Life is a blessing for which we are a steward. To suggest that we provide care and concern only when that blessing exists in abundant form is contrary to all the principles of stewardship we learn from Scripture.

Finally, do not forget God’s authority over life and death. Never forget the promise of eternal paradise in heaven earned for you through Christ. When all indications clearly suggest that God is withdrawing the blessing of life, it would be wrong to take aggressive measures to oppose God’s intention.

In each medical decision, there is a judgment that has to be made. We make those judgments understanding who we are: children of God and a slave to his law which calls for happy obedience. With each decision, the silent prayer should always be spoken, not my will but thine be done.

It was for such difficult judgments that Solomon prayed for a discerning heart (1 Kings 3:9). David prayed for such wisdom thusly, Show me your ways, O LORD, teach me your path; guide me n your truth and teach me, for your are God my Savior, and my hope is on you all day long (Psalm 25:45). I am your servant; give me discernment that I may understand your statutes (Psalm 119:125). And the Apostle Paul prayed, And this is my prayer: that your love may abound more and more in knowledge and depth of insight, so that you may be able to discern what is best and may be pure and blameless until the day of Christ, filled with the fruit of righteousness that comes through Jesus Christ — to the glory and praise of God (Philippians 1:9).

In summary, when you face a medical decision for which you cannot find clear biblical direction the following is suggested:

  • Seek the counsel of your pastor
  • Seek the counsel of a trusted friend or relative
  • Ask yourself, “Am I remembering that life and good health are blessings and not rights?”
  • Ask yourself, “Am I remembering that the secret of contentment is not in physical or material gain but in what I have in Christ?”
  • Ask yourself, “Am I remembering that the ‘why’ in making this decision is to reflect God’s concern for human life?”
  • Ask yourself, “Am I remembering that the ‘what’ to my decision is to be consistent with God’s will?”
  • Ask yourself, “Am I remembering for whom I make a decision is first for God and then for others?”

These are sometimes hard questions to ask when pitted against love for life, family and things of this world. But, as you search your heart, it will help you to determine your own motives.

Examine yourselves to see whether you are in the faith; test yourselves. Do you not realize that Christ Jesus is in you — unless, of course, you fail the test? And I trust that you will discover that we have not failed the test (2 Corinthians 13:56).



  1. Deborah Racine : February 7, 2020 at 11:00 am

    This was very helpful as we comfort or make decisions for those at the earthy end of their journey. 🙏🙏🙏

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