Managing the Tough Decisions – Discussing End-of-Life Options with Loved Ones
Julie rushed to the hospital after hearing about her Dad’s stroke. Upon her arrival, Julie was greeted by David, the social worker, who immediately escorted her into a private room. David gave Julie a full update about her father’s condition and then said, “Your Dad doesn’t have a medical directive, and we need to make some decisions. Can you help us with some of these issues?”
No one wants to be in Julie’s situation. We prefer to think that we won’t be confronted with these complicated end-of-life issues. This situation can become even worse when we do not know a loved one’s wishes regarding life-prolonging treatments. Should consent be given for a feeding tube? What about authorizing a resuscitation order? What about a nursing home? Is hospice a viable option?
Sound complicated? It doesn’t need to! Three key issues should be addressed when dealing with end-of-life discussions:
No one relishes the idea of talking about death and dying with a family member. Is there really ever a “good time” to talk about such dire issues? Let’s face it: these topics are generally avoided until a loved one is faced with a serious medical emergency. In most cases, people just hope they will never have to deal with these issues, deciding they will only answer such questions when they are actually confronted with them. Yet talking about end-of-life issues is vitally important and should not be avoided.
Remember, these discussions are meant to share each others’ thoughts about death and dying, not answer all the specific hypothetical questions. In general, parents should initiate the talks. Be sure to discuss any fears that family members might have, such as issues of suffering or being left alone. Take this slowly and open the door for continued discussions. After the initial conversation, it can be easier to revisit the topic and talk more candidly about additional concerns.
Times of emergency are also times of heightened emotions. It is wise to take time to discuss end-of-life decisions before a crisis occurs. Talking before a medical crisis can help you and your loved ones prepare for any difficult decision that might need to be made – one which might otherwise be clouded by emotion. Parents are familiar with caring for their children but don’t want their children caring for them.
Parents might fear becoming a burden, and children don’t want to see their folks become incapacitated. Everyone has a fear of extensive pain and the dying process. Those concerns and a lack of proper communication between parties can cause confusion, conflict or an all-out incapacity to make sound decisions. Although the emotional aspect of these end-of-life situations cannot be avoided, it is imperative to begin the advanced planning process with loved ones when they are healthy. You can also talk with your pastor or call CLR to receive clear and godly information as you work through the decision-making process.
A third issue to consider is the balance between glorifying God and acting on the behalf of a loved one. These do not have to be in conflict with each other, yet they often are.
To keep a clear understanding of one’s purpose in these situations, remember these two points:  God alone has authority over life and death (Deuteronomy 32:39; 1 Samuel 2:6); and  we are responsible for providing care for others (Genesis 9:5,6; Luke 10). As long as God decides that life should continue, we do not have the right to intentionally take that life. When God decides to take a life, we are not responsible for prolonging the dying process.
To help in addressing these three issues, CLR developed a unique medical directive. Our directive, called a Power of Attorney for Health Care – Christian Version, is a legal document that also includes an important Christian witness component. It is suggested you order one of these documents, fill it out and then share copies with your loved ones. When you provide a copy of this directive to your family members, you have the opportunity to also discuss your wishes and overcome the avoidance issue. If, at some point, you are declared incompetent, your family can rely on your medical directive to guide their decision-making in order to work through any difficult issues that might arise – when emotions are particularly heightened.
Above all, your medical directive becomes a wonderful witness of your Christian faith and shows your confidence in God’s decisions regarding your health and life. What a great blessing for your family as you remind them of your confidence that “I trust in you, O LORD; I say, ‘You are my God.’ My times are in your hands” (Psalm 31:14,15).