I have intentionally titled this series, “Death and the Church.” Given the highly individualistic character of Western culture, many complex human issues are viewed as personal concerns to be dealt with in a manner that keeps friends, neighbors, and even family at a distance. The well-known expression “It is none of your business,” epitomizes an isolationism that has become a core value of American culture. Indeed, “individual autonomy” is given first place among bioethical principles in the so-called “Georgetown Mantra.”[1]
We do not want to displace the patient as the primary voice in his or her healthcare decisions, but as Christians, we operate with a worldview that prizes community—in worship, to be sure—but also in the major events that define the human journey: birth, marriage, major life decisions, and death. While Protestants may find a number of disagreements with Roman Catholicism’s sacramental system, the latter is certainly a poignant reminder that the Body of Christ accompanies the Christian’s earthly pilgrimage from womb-to-tomb.
In my two previous essays, I have contended that the church (in our case, the local congregation) needs to deliberately address the issue of suffering and death—as an integral part of the Christian discipleship process. I have proposed that one way this could be practically facilitated is by holding a four-to-six week multi-generational, Sunday school class or seminar. The initial focus of this class should rightly be focused on helping parishioners construct a sound, biblical theology of death that engages and offers wise “balance” to our contemporary culture’s conflicted counsel, asking for example, whether we should hasten death in the face of debilitating illness, or use everything in our technological arsenal to avoid it? It is neither sufficient nor responsible simply to arm God’s people with a few Bible verses on the cessation of life. Rather, what is needed is a thoughtful and robust Christian worldview that is God-centered, reality-bounded, and love-impelled.[2] However, as noted above, this distinctive, faith-based preparation for death should occur in the context of Christian community. Allow me to explain why and how this might take shape.
1) A caring Christian community is needed to keep us anchored in “dying well.”
D. A. Carson notes that in the Puritan tradition, believers were “recognized to be those who knew how to ‘die well.’”[3] In short, this meant that our Christian forebears were more concerned about doing nothing that would dishonor the name of Christ, especially in their suffering. In like fashion, John Dunlop has assembled a helpful list of ten characteristics that belong to a Christian understanding of a “good death,” including a proper use of medical technology as well as a “change in longing from earth to heaven.”[4] Consequently, a good death will both glorify God and draw unbelievers to his saving grace.
However, perhaps the most direct and practical understanding of the good death has come from the noted Jewish physician and palliative care pioneer, Ira Byock, as he characterizes the life well-lived by four statements: “Please forgive me,” “I forgive you,” “thank you,” and “I love you.”[5]
2) A caring Christian community is needed to address the multi-faceted issues facing the dying person.
As a person faces death, it is quite common for the family, caregivers, and the patient to become locked into competing and adversarial relationships often because these parties are focused on a singular aspect of a complex, multi-faceted problem. A “death-educated” parish, on the other hand, recognizes that there are medical, social, and spiritual issues that converge in this difficult situation, and seeks to keep all of these in perspective. This can range from making sure the patient understands the goal of their treatments and the nature of comfort care, to addressing strained relationships within the family, as well as the dying person’s relationship to Jesus Christ.[6]
One very practical way that a Christian community can help its members prepare for death (long before death is imminent!) is to provide some regularly-scheduled instruction on how to construct advance directives. This will involve some explanation of the difference between living wills and durable powers of attorney, and could best be facilitated by a local Christian lawyer or legal expert. (It continues to surprise me how many Christians have failed to do these basic health-care exercises). While one might be reticent in pronouncing one of these documents the genuine, “Christian option,” the latter may actually be theologically preferable due to its inclusion of others in the death experience. In a classic, if not altogether provocative First Things article, entitled “I Want to Burden My Loved Ones,” noted bioethicist, Gilbert Meilaender, observes that when people come to a workshop on advance directive, they may say something like the following:
“I’m afraid that if my children have to make decisions about my care, they won’t be able to handle the pressure. They’ll just argue with each other, and they’ll feel guilty, wondering whether they’re really doing what I would want. I don’t want to be a burden to them, and I will do whatever I can in advance to see that I’m not.”
Despite these preparations, he goes on to suggest:
But still, there is here a serious point to be considered. Is this not in large measure what it means to belong to a family: to burden each other—and to find, almost miraculously, that others are willing, even happy, to carry such burdens? Families would not have the significance they do for us if they did not, in fact, give us a claim upon each other. At least in this sphere of life we do not come together as autonomous individuals freely contracting with each other. We simply find ourselves thrown together and asked to share the burdens of life while learning to care for each other.[7]
Meilaender reminds us that families share together the difficulties of life, especially the many that are not desired or volitional. Because families learn to love and trust each other as well as share a common core of values, we should not be afraid to empower each other to make final medical decisions on our behalf. The durable power of attorney (DPOA) seems to be more amenable towards promoting this noble “burden.” Thus, Meilaender concludes:
It is, therefore, essential that we structure the medical decision-making situation in such a way that conversation is forced among the doctor, the medical caregivers, the patient’s family, and perhaps still others, such as pastor, priest, or rabbi.[8]
In Bonhoeffer’s well-known words, the Christian life is meant to be lived “together.” This requires a community of faith that actively nurtures its members in life—and in death. Such a community would stand in faithful witness and vivid contrast to the broader cultural values of western individualism. When we fall short of “finishing well,” might we consider having a first-order ecclesiology through which we can experience a good death.
Continue reading this series: Part IV.
Resources
[1] The “Georgetown Mantra” refers to four principles for making bioethical decisions that were codified by two professors at Georgetown University: respect for autonomy, nonmaleficence, beneficence, and justice. See Tom L. Beauchamp and James Childress, Principles of Biomedical Ethics, 7th ed. (New York: Oxford University Press, 2013).
[2] See John F. Kilner, Life on the Line (Grand Rapids: Eerdmans, 1992), 13-29.
[3] D. A. Carson, “Wisdom from the New Testament,” in Why the Church Needs Bioethics, edited by John F. Kilner (Grand Rapids: Zondervan, 2011), 201.
[4] See John T. Dunlop, “Bioethics and a Better Death,” in Why the Church Needs Bioethics, 240-243.
[5] Ira Byock, The Four Things That Matter Most: A Book About Living (New York: Simon & Schuster, 2014).
[6] Adapted from Dunlop, “Bioethics and a Better Death,” 250.
[7] Gilbert Meilaender, “I Want to Burden My Loved Ones,” First Things (October, 1991), 12-14. This can be accessed online at https://www.firstthings.com/article/2010/03/i-want-to-burden-my-loved-ones.
[8] Ibid., 13.