The Old Testament taught us that earthly life is not the end of our existence. Our soul returns to God (Ecclesiastes 12:7). Daniel describes two separate eternal dwellings after earthly life (Daniel 12:2). Jesus reflected those truths when he spoke about Judgment Day (Matthew 25:31-46). Even in death, we live (John 11:25-26).
Jesus comforts us with his promise that he has prepared our eternal home (John 14:1-3) and that death is not to be feared (Matthew 10:28). The psalmist went as far as to state that the condition of the dead who died in faith was “precious” (Psalm 116:15).
A medical directive (aka “medical directive statement”) is a legal document intended to guide others on how to provide for one’s health care if he or she becomes unable to make those decisions on their own.
A medical directive does not take effect upon the creation of the document. It only takes effect after two doctors examine the individual and declare him/her unable to understand or communicate. For this reason, it is recommended to complete a medical directive statement in advance of a medical emergency.
A Medical Directive typically comes in one of three forms: as a “Living Will,” a “Power of Attorney for Health Care,” or a combination of the two.
Living Will: A legal document that provides specific directions about one’s health care in the event a person can no longer communicate those wishes. A living will addresses one’s end-of-life medical treatment preferences. As a stand-alone document, it does NOT designate a health care agent to make those decisions when the individual cannot do so on his or her own. Rather, a living will gives the health care provider the power to interpret the patient’s instructions articulated in the Living Will document.
Power of Attorney for Health Care (POAHC): A legal document that appoints someone to make medical decisions for the person (called the Principal) in the event the Principal cannot do so on his or her own. That designated person is called a health care agent, proxy, representative, or surrogate. A second agent can be appointed in the event the primary agent is unable or would no longer be willing to serve.
IMPORTANT NOTE: Some states combine both forms into one document to include preferences regarding one’s treatment and designation of a person as the health care agent.
“Power of Attorney for Health Care”; “Durable Power of Attorney for Health Care”; “Advance Directive”; “Advance Directive for Health Care”; “Health Care Directive”; “Health Care Proxy”; “Medical Power of Attorney”; “Living Will”
The best time to create a medical directive is before one is needed. It is good for any adult at any age to create and sign a POAHC directive – at a time when a person has a clear understanding of the options. The directive can be changed or canceled at any time.
If the POAHC includes a personal statement of medical wishes, a periodic review of the document is recommended. It should be updated when major events change in an individual’s life, such as the diagnosis of a serious illness, divorce, or the death of a loved one or someone who was named as an agent in the medical directive, thus affecting the content of the document.
NOTE: Federal regulations require every health care facility and program that receives Medicare and Medicaid funding to inform all adult patients about medical directives. The federal law does not require individuals to complete any form of advance directive nor does it require a person to complete any type of advance directive as a treatment requisite. Yet, most hospitals, nursing homes, home health agencies, and similar programs provide patients with medical directive information at the time of admission. It is advised to bring a completed medical directive in hand.
It is further suggested to provide a copy of the completed medical directive statement to health-care personnel for placement in one’s medical record.
The CLR Power of Attorney for Health Care – Christian Version document not only permits designating a health care agent, but it also provides guidance on a person’s health care wishes before he or she becomes incapacitated. Most importantly, it serves as an important Christian witness tool to our salvation through Jesus Christ and thereby provides clear and God-pleasing direction for such care within a state-recognized document.
ANSWER: We recommend every adult sign a medical directive statement regardless of his or her current health situation or age.
The first benefit of such a statement is that it allows a person to provide direction for medical care in the event he or she is no longer able to make such decisions. Understandably, these directions must be somewhat general, because it is impossible to predict what malady will be faced.
The second benefit is that it allows a person to designate a health care agent to make decisions when the stated wishes of the document are too vague for the circumstance. If you do not have a statement a patient’s family often must guess about the kind of care the patient would want.
If family members disagree among themselves the situation becomes complicated, contentious, and sometimes can only be settled by an ethics committee or through legal action.
ANSWER: Your attorney is correct in stating that you have the legal right to make your own medical decisions. You are also right in stating that God is the ultimate authority over life and death. The challenge for you is to apply your faith when making medical decisions. Your right to make medical decisions does not remove God’s ultimate authority over your life. Your role is to make decisions that are consistent with the directives of God’s Word. In other words, use your legal right to make life-sustaining decisions until there is evidence that God is bringing your life to a close. When it is clear that death is imminent, then accept his will and receive comfort care until death.
Any preparation for death requires faith. Scripture defines faith as, “Confidence in what we hope for and assurance about what we do not see” (Hebrews 11:1). These examples of faith come to mind: Abraham willing to sacrifice his long-desired only son; Moses leading an entire nation out of Egypt and across – or more like “through” – the Red Sea; and a virgin accepting a miraculous pregnancy at the word of an angel.
For many – and perhaps most – death is our first big test of faith. Even believers become uncertain during those times.
These are the four most common fears:
Fear #1: Destination
A Christian knows that after death we are in heaven. Yet, as death nears, we in weakness and doubt might ask, “Can I be sure?” When it comes to faith, certainty is not found in evidence that we can see, handle, dismantle, and reassemble. Faith accepts what our reason wants to reject.
Christians long for something better. The seed of faith reminds us that earthly is not the endgame. The best is yet to come. Jesus made it happen. Yet, doubts may fabricate a second fear.
Fear #2: Accountability
During the final moments of life, we may fear accountability – the past finally catching up with us. Despite knowing God’s forgiveness of sins, we might dread the thought of being held accountable (Romans 14:12).
The forgiveness of sins through the life, death, and resurrection of Jesus Christ is a historical fact. He who knew no sin became sin for us (2 Corinthians 5:21). Christ’s death on the cross was a complete payment for all of our sins – whether in thought, word, or actions.
Fear #3: Pain
One of the fears at the end of life is that the path to death might be painful. Nearly all physical pain today can be managed. It is common for pain specialists to advise finding a different doctor if a patient’s pain cannot be controlled.
Fear #4: Survivors
Universally, those with a heart for others fear the welfare of those they leave behind upon death. A husband or wife worries about how the surviving spouse will get along. Younger parents worry about the continued care of their children. Heads of small businesses worry about the employees who counted on them.
Death, however, brings that concern to an end. Even in our care for others, we need to realize we were simply God’s servants in carrying out his will. God’s concern for our loved ones will continue after we are gone.
If you study Scripture, you will discover that God provides both assurances and directions for us to address the four most common fears. To do so requires a desire to love as we have been loved and to make sacrifices for the benefit of others. It’s our way to prepare others and ourselves for our day of departure and the ultimate reunion in heaven because of what Jesus did for us.