End-of-Life Medical Intervention — or Not?
00:00:00.000 | (upbeat music)
00:00:02.580 | Today's email is from a friend of ours,
00:00:06.160 | a listener named Matthew, who lives in San Antonio.
00:00:09.560 | He's thought up a creative way to get us
00:00:11.920 | into the tricky thicket of end of life decisions.
00:00:15.720 | Here's what he wrote.
00:00:16.640 | Pastor John, thank you for this podcast.
00:00:18.160 | I know from listening to the podcast for years,
00:00:20.680 | you are very hesitant to speak
00:00:22.560 | to specific end of life decisions
00:00:24.720 | because they require so much wisdom
00:00:26.320 | from medical professionals
00:00:28.340 | and because every life is so different.
00:00:30.480 | But we have nearly endless medical advances
00:00:32.660 | we can take advantage of now to prolong life.
00:00:34.720 | So I'd like to ask my question strictly
00:00:36.640 | within a hypothetical that I made up.
00:00:38.880 | Here it goes.
00:00:40.160 | Imagine a 40-year-old middle-class Texan,
00:00:43.400 | a regenerate Bible-believing Christian man
00:00:45.600 | married to a godly Christian woman for 18 years.
00:00:48.180 | He's diagnosed with aggressive terminal cancer
00:00:52.760 | and has two options before him,
00:00:54.720 | neither of which he likes or favors,
00:00:56.240 | but one of which he must choose.
00:00:59.080 | One, if he does nothing,
00:01:00.960 | he lives a relatively normal life for one more year.
00:01:04.320 | Two, with aggressive treatment and three surgeries,
00:01:07.040 | he will live for four years
00:01:08.340 | and those years will be less than pleasant.
00:01:10.860 | He has modest life insurance.
00:01:12.940 | His gracious employer will continue to employ him
00:01:15.080 | and pay his salary plus one year after he passes.
00:01:18.280 | So two years or five of income.
00:01:20.780 | He has two kids, 16 and 12,
00:01:22.800 | and it's unclear if they're believers.
00:01:25.480 | What, if any, biblical principles
00:01:27.200 | would inform your own choice between these two options?
00:01:31.740 | - Okay, as I have reflected on this hypothetical,
00:01:35.840 | but sounds very plausible, very real.
00:01:39.480 | I'm sure it's happening multiple times every day like this.
00:01:44.160 | I have seven observations, seven,
00:01:46.600 | you can call them principles if he likes,
00:01:49.740 | to take into account facing these two scenarios
00:01:54.960 | that he laid out.
00:01:56.820 | First, I would pray and I would ask my friends to pray
00:02:01.820 | in either the one-year scenario or the four-year scenario.
00:02:06.800 | I would ask them to pray for my healing.
00:02:09.760 | I would not ask that probably if I were 85,
00:02:12.920 | because in this fallen world,
00:02:16.280 | the death of an octogenarian is more or less normal.
00:02:20.400 | That is, it's God's plan that we die
00:02:23.640 | rather than live forever in this age.
00:02:26.400 | But at 40, death is much more unnatural and intrusive,
00:02:31.400 | and therefore it is more fitting, it seems to me,
00:02:36.860 | to seek God for the miracle of healing.
00:02:40.780 | And that decision to pray for healing does not dictate
00:02:44.560 | whether I choose to get the aggressive treatment or not,
00:02:48.780 | because God can heal me without it
00:02:51.720 | and he can heal me through it.
00:02:53.920 | So the choice to pursue aggressive prayer for healing
00:02:58.120 | does not decide which option I go with.
00:03:02.320 | I would pursue prayer in either case for healing.
00:03:04.880 | Number two, I would keep clearly in mind
00:03:08.520 | that both scenarios, the one-year
00:03:10.800 | and the four-year scenarios, are human probabilities,
00:03:15.520 | not certain destinies.
00:03:18.000 | If you choose the one-year scenario,
00:03:20.520 | you might feel miserable the entire year instead of good.
00:03:25.520 | If you choose the four-year scenario,
00:03:29.540 | you might feel better, in spite of all the surgery and chemo,
00:03:34.480 | that you ever dreamed you could for four years.
00:03:37.880 | You are only dealing with human probabilities,
00:03:42.160 | and when you stir in prayer,
00:03:46.120 | you are opening yourself to the fact
00:03:48.200 | that God may turn the one-year scenario
00:03:51.640 | into a four-year scenario,
00:03:53.380 | and he may turn the four-year scenario
00:03:55.440 | into a one-year scenario.
00:03:57.200 | Prayer is the glorious wild card,
00:03:59.820 | and God may answer in dozens of ways we don't expect.
00:04:06.020 | So when I say that both scenarios are only probabilities,
00:04:11.800 | I am saying that not only may humans be wrong,
00:04:15.800 | doctors may be wrong, but God has infinite options
00:04:20.800 | at his disposal for how you spend those years.
00:04:24.080 | That's number two.
00:04:25.120 | Number three, I would remind myself
00:04:28.480 | that both death and suffering
00:04:30.400 | for the Christian can be for our good.
00:04:34.260 | They are evil in themselves in the sense
00:04:38.320 | that they are contrary to God's original perfect design,
00:04:43.480 | but in God's providence,
00:04:45.760 | both death and suffering serve his children.
00:04:50.760 | Death serves his children by introducing them
00:04:53.960 | into immediate fellowship with Christ,
00:04:56.980 | which Paul says is far better,
00:04:58.620 | and suffering, like Paul's thorn in the flesh,
00:05:04.040 | can serve us by keeping us humble
00:05:06.960 | and deepening our reliance on the Lord Jesus
00:05:09.920 | and enabling us to glorify his power in our weakness.
00:05:14.620 | And not only that, but facing death joyfully,
00:05:20.400 | square in the face, may be a compelling witness
00:05:23.840 | to our family, our children, and to others
00:05:26.960 | and bring them to Christ.
00:05:29.120 | Or suffering, endured with deep, joyful, tearful confidence
00:05:36.960 | in Christ, may be a compelling witness
00:05:40.000 | to our family and others.
00:05:42.700 | So it's important not to play off
00:05:45.520 | against each other death and suffering
00:05:49.040 | as though one is intrinsically more likely
00:05:52.140 | to be a blessing than the other.
00:05:53.740 | We don't know that.
00:05:55.400 | Either one may be a greater blessing
00:05:58.480 | than the other in our lives and in the lives of our family.
00:06:03.020 | Number four, both the one-year scenario,
00:06:07.300 | feeling good and dying early,
00:06:10.020 | and the four-year scenario, feeling bad and living longer,
00:06:14.260 | both could be used by God for the salvation
00:06:18.540 | of our children and the strengthening
00:06:21.140 | of the faith of our wives and the magnifying
00:06:24.140 | of Christ among medical professionals
00:06:26.880 | and church members and lost neighbors.
00:06:29.520 | We cannot predict with any certainty
00:06:32.940 | whether our willingness to face death early
00:06:36.060 | or our willingness to suffer long
00:06:38.940 | will have the greater force in commending
00:06:41.860 | the all-sufficiency of Christ to sustain us.
00:06:45.200 | We don't know.
00:06:46.780 | God could use either one to save our children and others.
00:06:51.420 | Number five, neither the one-year scenario
00:06:56.240 | nor the four-year scenario need be presumptuous
00:06:59.740 | as though we were taking God's prerogative
00:07:02.760 | into our own hands by choosing.
00:07:05.620 | We will need God's help in both scenarios.
00:07:09.540 | Satan will threaten us in the short scenario
00:07:13.020 | with fear and anger and worldliness in how good we feel.
00:07:18.020 | He will cause us to focus on the onrush
00:07:23.180 | of the day of our death coming next year,
00:07:26.040 | and he will tempt us to be bitter and angry,
00:07:29.900 | and our faith will not survive
00:07:32.520 | without the sovereign help of the grace of God.
00:07:36.420 | And if we choose the long scenario,
00:07:38.720 | more life, more misery, Satan may have a field day
00:07:43.720 | causing our bodily and mental weaknesses
00:07:47.260 | to make it almost impossible for us
00:07:49.040 | to do the kind of spiritual warfare we have to do
00:07:51.700 | in order to persevere to the end.
00:07:53.840 | We will not make it to the end through this suffering
00:07:59.400 | without the sovereign grace of God
00:08:01.160 | sustaining us and carrying us.
00:08:03.400 | Number six, in both scenarios,
00:08:06.220 | I would mobilize a team of trusted
00:08:08.440 | and loved Christian friends who would pledge,
00:08:11.780 | as much as they're able, to walk with me
00:08:14.220 | through either scenario to the end.
00:08:17.240 | I have in mind not only daily prayer for me,
00:08:20.260 | that my faith not fail,
00:08:22.120 | and that the pain not overwhelm me,
00:08:24.420 | or the absence of pain not result in my worldliness,
00:08:28.100 | but I also have in mind that these friends
00:08:30.680 | would feed me the word of God regularly.
00:08:35.460 | Emails, mail, texts, phone calls, visits.
00:08:39.940 | Man shall not live by bread alone,
00:08:42.380 | but by every word that comes out of the mouth of God,
00:08:44.680 | and that's especially true
00:08:46.880 | as we walk up to the edge of eternity.
00:08:49.960 | I will need the word of God.
00:08:53.700 | Like 1 Thessalonians 5, 9,
00:08:56.260 | God has not destined you, John Piper, for wrath,
00:09:01.020 | but to obtain salvation through our Lord Jesus Christ
00:09:04.220 | who died for you so that whether you wake or sleep,
00:09:06.700 | you might live with him.
00:09:08.300 | I need somebody to look me in the eye
00:09:09.780 | and say that to me in the name of God.
00:09:12.480 | And finally, number seven,
00:09:14.780 | I will keep in mind that neither of these choices
00:09:20.420 | is a choice to hate life or commit suicide,
00:09:25.880 | or allow anyone else to perform euthanasia on me.
00:09:29.660 | Life is a glorious thing now and after death,
00:09:34.020 | and best of all, after the resurrection
00:09:36.380 | in the new world with Jesus.
00:09:39.020 | But I will cherish the gift of life now,
00:09:43.500 | and I will seek not to waste it.
00:09:47.300 | One year or four years,
00:09:49.260 | whether I'm feeling good or feeling miserable,
00:09:53.380 | whether death is tomorrow or years away,
00:09:57.360 | I will seek to treasure Jesus Christ above all things
00:10:02.360 | and bring as many people with me as I can
00:10:06.040 | into the everlasting enjoyment of his presence.
00:10:11.040 | - So carefully set forth, thank you, Pastor John.
00:10:13.420 | And Matthew, thank you for the carefully worded scenario
00:10:16.280 | put in a way that makes it easier for us to address,
00:10:18.160 | namely by making it hypothetical.
00:10:19.920 | That's really helpful.
00:10:20.960 | If you have such a question about end of life decisions
00:10:23.360 | and how to think through them with biblical reasoning,
00:10:25.420 | send that question to us.
00:10:26.940 | Go to our online home at DesiringGod.org/AskPastorJohn
00:10:31.300 | to send it our way.
00:10:32.540 | I am your host Tony Renke.
00:10:35.100 | We'll see you back here on Wednesday
00:10:36.180 | for a personal word from Pastor John
00:10:37.600 | as we near the end of 2021.
00:10:40.140 | 2022 is nearly upon us, it's crazy.
00:10:43.580 | Wow, we'll see you then.
00:10:45.360 | (upbeat music)
00:10:47.940 | (upbeat music)
00:10:50.520 | [BLANK_AUDIO]