Death: Will of God or human technology?

Julia D. Emblen

To the common dilemmas of doctors' and nurses' decisions on treatment, economists' concerns over costs and lawmakers' concerns with ethics, the Christian adds the question: What is God's will regarding the treatment of my loved one?

I was a nurse, familiar with the use of medical technology. Yet I found I was unprepared to discern God's will in deciding whether or not to withdraw the medical intervention that was being used to treat my husband's respiratory condition. Even after eight weeks of unsuccessful treatment, I agonized over my response when Dr. Scott asked, "Shall we stop the meds and let John go?"

I've found that stories of others' struggles with Christian values have helped me make some of my critical life decisions. With the hope that our story may provide some background for your decisions, I offer it to you.

Personal Experience

After a breathing tube was inserted through his voicebox, John was unable to speak, and he soon became too ill to even communicate nonverbally. The medical team attempted to administer a research drug to restore his lung function. John was nearly asphyxiated in the process of the administration of the drug. When a second attempt produced more asphyxia, they discontinued it. The massive antibiotic treatment destroyed his kidney cells. By the time the kidney cells had regenerated, John's lungs spontaneously developed holes. The available treatment options were attempted without success, and the team of physicians determined there was no chance that John would ever get off the ventilator. This unsuccessful treatment prompted Dr. Scott's question regarding stopping the medications. Withdrawl of these medications would end John's life, unless God miraculously intervened.

My initial thought was that if I made this choice, I would be taking my husband's life. Dr. Scott assured me that he would be the one ordering the withdrawal, not I. I wished I could have had years to consider my decision, to talk with John, to do research, to consider other alternatives. But our time had run out. Because of the anticipated effects of withdrawing certain medications, the decision had to be made that afternoon. Mother and I spent time talking, and I'm sure we must have prayed. Details become fuzzy when the choices are imminently life-threatening. Finally, I had peace about stopping the medications. John died quietly two days later. But I think his death of spirit occurred two months earlier when the high-technology treatment began.

I finally made the decision to stop the medications because I felt that to keep a person, even my beloved husband, alive when he could not live without invasive medical technology, was not in keeping with God's will. I reasoned that if God had willed John to live, He would have allowed the medical technology to restore his lung function.

This decision seemed in keeping with our belief in the stewardship of life, which focusses on serving God and living with Him, not just on maintaining our human life. Stewardship means that we accept our human condition so that when treatment is ineffective and creates excessive burden in terms of physical function, pain and dollars, we can allow treatment to be stopped and/or withheld.

Christian Guidelines for End-of Life Choices

1. Think through the issues ahead of time. Our experiences surrounding John's death would have been easier if John and I had had an opportunity to talk together and mutually plan the desired care. (With only eleven months of marriage, it was easy to block conversation that would cloud our horizon.) If we had talked together to plan what to do in the case of critical illness, I would not have felt such a burden to know the extent of treatment John would have wanted. Because his critical condition prevented him from thinking logically, and because insertion of the ventilator tube prevented him from speaking, my only indication from John was his lack of any expression of pleasure whenever anyone commented to him regarding his progress. After his death, I found a medical history he'd prepared in which he stated that he did not fear death; he only wished for no extended suffering. I regretted that my decisions extended his suffering for two months. My motives were pure: I wanted to try to save my husband's life.

2. Christians do not take life (Exodus 20:13). It is a given that we never intend death. By withholding some extraordinary treatment, one does not intend to hasten death even though it is foreseen that death usually follows. God still is in control and can and often does work His miracles--overriding the expected medical result.

3. It is the terminal disease or severe injury that is the cause of death, not initiating, withholding or withdrawing treatment. Sometimes we confuse the intermediate steps with the cause.

I agonized over each additional treatment that had to be instituted after we had initiated ventilation--surgery to plan more medical intervention, application of a pacemaker when John's heartbeat became irregular, using dialysis when the antibiotics destroyed his kidney function and, finally, stopping all but his medications to relieve pain. I came to realize that we tried all these things to prevent his death. But when this could not be achieved, withdrawing even the life-sustaining medications was not the real cause. The real cause of John's death was his irreversible lung damage produced by the extension to his lungs of his arthritic condition.

4. There is no difference between withholding and withdrawing treatment. Food, fluid and oxygen are universal bodily needs, but the invasive technology required to supply these is not universal.

We had initiated the use of the ventilator "with guarded optimism", hoping that it might be the medical vehicle God would use to save John's life. Without using the ventilator, John would most likely have died that April evening when he became so ill. We had to add artificial food and fluids because John's condition became so critical. All these were used to buy treatment time. When the available treatments proved ineffective, stopping such invasive, death-preventing treatment seemed like the right choice.

5. Christians are concerned with the gift of life as a medium for service to God, not as an end (Romans 6:8; 8:38-39; 12:1). For Christians, death is not to be avoided at all costs. It cannot separate us from Christ. > 6. It is wrong not to try to sustain life, but it may be just as wrong (and possibly cruel) to extend care unconditionally. Using medical technology, we can manage physical pain well. God manages the emotional and spiritual pain of grief and loss, for the dying and for their families (II Corinthians 1:3-5).

I did not believe God was honoured by merely keeping John from dying by continuing to use this extraordinary technical treatment. Because John was a Christian, I knew his life was a gift that he willingly offered to God. At his death, he would be in the presence of the Lord. He had served His Lord well during his life, in spite of years of struggle with painful and stiff arthritic joints. Continuing to keep John's body alive was merely fulfilling a selfish desire of mine to keep him from dying.

7. The Christian community should be involved in caring for the sick and their families (Matthew 22:39). Our community of Christians surrounded us, ministering lovingly to both John and me, offering visits, food, prayer and encouragement. My only regret was that I had had to make a final decision to withdraw treatment so quickly that I did not have time to discuss this with all members of our church community. Because they were not completely informed, some did not understand my choice.

8. Dying persons have obligations to the living--to take responsibility for death, to die in such a way that others will see the sustaining credit is to God, the ultimate Giver of life. During his critical illness, John did not have much opportunity to make choices regarding his death--he became too ill too quickly. If he had had an opportunity to make his own choice, I am sure he would have chosen to go to the Lord much sooner. He did not believe in using resources, including extended medical technology, when they did not serve to treat underlying conditions.

A Final Word

Julia D. Emblen is a member of Bakerview MB Church in Abbotsford, B.C.

Further resources

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