A Practical Approach to End-of-Life Issues: Facing the Changed Quality of Life

Close up hands of helping hands elderly home care. Mother and daughter. Mental health and elderly care concept

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

IV. Facing the Changed Quality of Life

Perhaps the most challenging issue to face when counseling on end-of-life issues is the changed quality of life. It seems characteristic of the sinful flesh to measure life by what is lost. In fact, losses in this world illicit the greatest emotional response. This is a society that measures gains and progress. It has little tolerance for losses.

This is a culture that has elevated to the highest good those ideals of life, liberty, and the pursuit of happiness. Anything that would compromise those ideals usually brings frustration, depression, and a sense of futility.

Derek Humphry, the founder of the Hemlock Society, made this same point a few years ago on an episode of Nightline. He was part of a panel discussion on his book, Final Exit when he observed: “We are not just talking about stabbing pain. We are talking about dignity, pride, self-control, quality of life. Something doctors, for all their good in the world, cannot involve themselves in. We are masters of our own fate. Doctors help us as best they can. But we are masters of our own judgment and fate.”

When our members receive a diagnosis announcing a continued decline in the quality of their life they instinctively think of it in worldly terms. They measure the freedom they will lose, and the pleasures that will no longer be theirs. It is our role as pastors to remind them that despite its varying degrees of quality, life has a quantitative, absolute, or intrinsic value.

When presenting this perspective I am quick to observe that Scripture readily acknowledges that life comes in many and varying degrees of quality. We have stories of the blind, the lame, the deaf, and the ailing. Concerning the infirmities of aging the psalmist wrote: “Do not cast me away when I am old; do not forsake me when my strength is gone.” (Psalm 71:9 NIV) God is not ignorant that the quality of life changes.

I also point out the subjective nature of evaluating the qualities of life. In John’s Revelation for the congregation of Laodicea he writes: “You say, ‘I am rich; I have acquired wealth and do not need a thing.’ But you do not realize that you are wretched, pitiful, poor, blind and naked.” (Revelation 3:17 NIV) What I perceive as a low quality of life another may perceive as a high quality of life. And as is obvious from this passage, what some perceive as a high quality of life may in fact be a low quality of life.

This point must be emphasized for two reasons. First, I may be inclined to observe someone’s condition and decide that I would not want to live like that and therefore, make decisions for that person reflecting a spirit of futility. Secondly, even if my own physical condition has me bedridden and in some pain, I may be far better off than a counterpart in a third world country where the luxuries of medication and a comfortable bed are rare or non-existent.

After having illustrated God’s acknowledgment of varying qualities of life and that our determinations are often very subjective, I then demonstrate God’s absolute value for human life. For that testimony, the familiar gospel, in a nutshell, speaks clearly with the testimony that “God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.” (John 3:16 NIV) God did not love just the attractive, the wealthy, or the healthy. He loved the world.

Scripture further reveals that God is impartial in his love: “Then Peter began to speak: ‘I now realize how true it is that God does not show favoritism.'” (Acts 10:34 NIV) And as God is impartial in his sacrificial love for all human life, so also should we be impartial. James warns us, “But if you show favoritism, you sin and are convicted by the law as lawbreakers.” (James 2:9 NIV)

The principles of helping and being a friend to our neighbor apply whether he is in peak condition or with a horribly diminished quality of life. We may lament the loss of many worldly pleasures that come with a declining quality of life, but the principles to preserve and protect life apply nevertheless. The principle, therefore, is that God demonstrates in his word that while there may be different qualities of life, he extends to all human life an absolute value, being the object of his love and plan of salvation.


The above article is part 4 of Rev. Fleischmann’s 10-part paper. Click here to view the complete outline.

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