(upbeat music) Today's email is from a friend of ours, a listener named Matthew, who lives in San Antonio. He's thought up a creative way to get us into the tricky thicket of end of life decisions. Here's what he wrote. Pastor John, thank you for this podcast. I know from listening to the podcast for years, you are very hesitant to speak to specific end of life decisions because they require so much wisdom from medical professionals and because every life is so different.

But we have nearly endless medical advances we can take advantage of now to prolong life. So I'd like to ask my question strictly within a hypothetical that I made up. Here it goes. Imagine a 40-year-old middle-class Texan, a regenerate Bible-believing Christian man married to a godly Christian woman for 18 years.

He's diagnosed with aggressive terminal cancer and has two options before him, neither of which he likes or favors, but one of which he must choose. One, if he does nothing, he lives a relatively normal life for one more year. Two, with aggressive treatment and three surgeries, he will live for four years and those years will be less than pleasant.

He has modest life insurance. His gracious employer will continue to employ him and pay his salary plus one year after he passes. So two years or five of income. He has two kids, 16 and 12, and it's unclear if they're believers. What, if any, biblical principles would inform your own choice between these two options?

- Okay, as I have reflected on this hypothetical, but sounds very plausible, very real. I'm sure it's happening multiple times every day like this. I have seven observations, seven, you can call them principles if he likes, to take into account facing these two scenarios that he laid out. First, I would pray and I would ask my friends to pray in either the one-year scenario or the four-year scenario.

I would ask them to pray for my healing. I would not ask that probably if I were 85, because in this fallen world, the death of an octogenarian is more or less normal. That is, it's God's plan that we die rather than live forever in this age. But at 40, death is much more unnatural and intrusive, and therefore it is more fitting, it seems to me, to seek God for the miracle of healing.

And that decision to pray for healing does not dictate whether I choose to get the aggressive treatment or not, because God can heal me without it and he can heal me through it. So the choice to pursue aggressive prayer for healing does not decide which option I go with.

I would pursue prayer in either case for healing. Number two, I would keep clearly in mind that both scenarios, the one-year and the four-year scenarios, are human probabilities, not certain destinies. If you choose the one-year scenario, you might feel miserable the entire year instead of good. If you choose the four-year scenario, you might feel better, in spite of all the surgery and chemo, that you ever dreamed you could for four years.

You are only dealing with human probabilities, and when you stir in prayer, you are opening yourself to the fact that God may turn the one-year scenario into a four-year scenario, and he may turn the four-year scenario into a one-year scenario. Prayer is the glorious wild card, and God may answer in dozens of ways we don't expect.

So when I say that both scenarios are only probabilities, I am saying that not only may humans be wrong, doctors may be wrong, but God has infinite options at his disposal for how you spend those years. That's number two. Number three, I would remind myself that both death and suffering for the Christian can be for our good.

They are evil in themselves in the sense that they are contrary to God's original perfect design, but in God's providence, both death and suffering serve his children. Death serves his children by introducing them into immediate fellowship with Christ, which Paul says is far better, and suffering, like Paul's thorn in the flesh, can serve us by keeping us humble and deepening our reliance on the Lord Jesus and enabling us to glorify his power in our weakness.

And not only that, but facing death joyfully, square in the face, may be a compelling witness to our family, our children, and to others and bring them to Christ. Or suffering, endured with deep, joyful, tearful confidence in Christ, may be a compelling witness to our family and others. So it's important not to play off against each other death and suffering as though one is intrinsically more likely to be a blessing than the other.

We don't know that. Either one may be a greater blessing than the other in our lives and in the lives of our family. Number four, both the one-year scenario, feeling good and dying early, and the four-year scenario, feeling bad and living longer, both could be used by God for the salvation of our children and the strengthening of the faith of our wives and the magnifying of Christ among medical professionals and church members and lost neighbors.

We cannot predict with any certainty whether our willingness to face death early or our willingness to suffer long will have the greater force in commending the all-sufficiency of Christ to sustain us. We don't know. God could use either one to save our children and others. Number five, neither the one-year scenario nor the four-year scenario need be presumptuous as though we were taking God's prerogative into our own hands by choosing.

We will need God's help in both scenarios. Satan will threaten us in the short scenario with fear and anger and worldliness in how good we feel. He will cause us to focus on the onrush of the day of our death coming next year, and he will tempt us to be bitter and angry, and our faith will not survive without the sovereign help of the grace of God.

And if we choose the long scenario, more life, more misery, Satan may have a field day causing our bodily and mental weaknesses to make it almost impossible for us to do the kind of spiritual warfare we have to do in order to persevere to the end. We will not make it to the end through this suffering without the sovereign grace of God sustaining us and carrying us.

Number six, in both scenarios, I would mobilize a team of trusted and loved Christian friends who would pledge, as much as they're able, to walk with me through either scenario to the end. I have in mind not only daily prayer for me, that my faith not fail, and that the pain not overwhelm me, or the absence of pain not result in my worldliness, but I also have in mind that these friends would feed me the word of God regularly.

Emails, mail, texts, phone calls, visits. Man shall not live by bread alone, but by every word that comes out of the mouth of God, and that's especially true as we walk up to the edge of eternity. I will need the word of God. Like 1 Thessalonians 5, 9, God has not destined you, John Piper, for wrath, but to obtain salvation through our Lord Jesus Christ who died for you so that whether you wake or sleep, you might live with him.

I need somebody to look me in the eye and say that to me in the name of God. And finally, number seven, I will keep in mind that neither of these choices is a choice to hate life or commit suicide, or allow anyone else to perform euthanasia on me.

Life is a glorious thing now and after death, and best of all, after the resurrection in the new world with Jesus. But I will cherish the gift of life now, and I will seek not to waste it. One year or four years, whether I'm feeling good or feeling miserable, whether death is tomorrow or years away, I will seek to treasure Jesus Christ above all things and bring as many people with me as I can into the everlasting enjoyment of his presence.

- So carefully set forth, thank you, Pastor John. And Matthew, thank you for the carefully worded scenario put in a way that makes it easier for us to address, namely by making it hypothetical. That's really helpful. If you have such a question about end of life decisions and how to think through them with biblical reasoning, send that question to us.

Go to our online home at DesiringGod.org/AskPastorJohn to send it our way. I am your host Tony Renke. We'll see you back here on Wednesday for a personal word from Pastor John as we near the end of 2021. 2022 is nearly upon us, it's crazy. Wow, we'll see you then.

(upbeat music) (upbeat music)