In the final part our series "Do you fear death?", Dan Jarms and Brian Sayers discuss end of life ethical issues. They emphasize the biblical principle that humans are created in God's image, giving inherent worth from conception. They distinguish between preserving life and prolonging death, using personal stories to illustrate. They also remind listeners of the need for family discussions on end-of-life care.
Dan Jarms 0:00
Today on faith matters, we have our final part in our series. Do you fear death? And I have Brian Sayers in here with me to talk about the ethical issues for end of life.
Dan Jarms 0:17
I'm Dan Jarms, and you're listening to faith matters, a podcast to help update you on matters of faith, Bible Church, as well as equip you in matters of the Christian faith.
Dan Jarms 0:36
We're in our last part of our series. Do you fear death? We've talked about what happens when you die. So we've talked about what happens when grandma dies, what happens to her body? We've talked about how to be ready for death as a believer, or encouraging people who are unbelievers to trust the Lord. We've talked about the practical matters of preparing for death. Jim greenup was in and we talked about the Wills Trusts and preparation for good stewardship. And today I have Brian Sayers in with me. Hey, Brian, hello, and we're going to talk about the moral issues of end of life issues, things from how you're going to think through Do Not Resuscitate, a DNR, what you're going to put in your will? Or, you know, your your final wishes for for care. We're going to talk about that a little bit and how to think through that. Or if you're the in the tough situation where you have to weigh in on somebody else's medical care at death. So how do we think through that? So Brian, thanks for coming in, and let's, let's start by framing properly what we understand pro life to mean in the Bible. What does it mean? What does it not mean? Because we can think about it in ways that it doesn't mean that in the Bible. So think about our our basic biblical principles. Why is life precious?
Brian Sayers 2:04
I mean, what Genesis one says is that men and women are all created in the image and likeness of God, and as image bearers, every human being has inherent worth from the time of conception so they reflect God's image. We need to preserve God's image as the best we can in every appropriate, legitimate way, and that's really where it's at. And like in James, the image of God and man is used as the motivation for not even speaking against someone like saying unkind words or harsh words to another person, so we denigrate God's image when we attack it. Yeah,
Dan Jarms 2:46
so that's why there's a death penalty in Genesis nine that was instituted to protect the image of man. So we need to value life. There are some ones I love to refer to both at births and at deaths, and that's from Psalm 139 that we are fearfully and wonderfully made, that we are knit together in in our mother's womb. God knows the beginning of our life, and he set a date Psalm 139, 16. He knows every day of our life. He is sovereign over the span of our life. Those are really precious things. I think of just reading through Deuteronomy 30, and it was about curses and blessings. But God says, I kill and I make alive. He is ultimately the sovereign over that. So we want to live in such a way to represent God, to image God and to see the other people in our life, image God in a way that always leaves him the one who is making the decisions. Although in a real world, we all have to make various, various decisions. Let's think about what it doesn't mean, what pro life doesn't mean? Because I think this is a little bit tricky for people. Then we're going to give some real life examples, Brian from early in life with his daughter who passed away, young me from my grandmother's end of life, and I was asked to weigh in there. We're going to give some of those. But let's talk about what we don't mean when we're talking about pro life.
Brian Sayers 4:22
Well, you mentioned one that pro life does not automatically mean the death penalty is wrong, right? So right? In that case, the value of the life unjustly taken requires the justice of of the life as a penalty. So pro life doesn't mean we preserve every life in every situation so, but that's not typically what people are talking about when we say pro life, but it does inform the fact that, okay, not not every life in every situation. Death is treated equally. So justice sometimes requires other things, but in matters involving people in the what you've said is end of life situations, what we don't mean by pro life is that we must prolong death as long as possible. There's a difference between preserving life and prolonging death, and we live in a an age where medical science, you know, can enable us to prolong death for long periods of time and but that's really all we're doing. Death is inevitable. We're just prolonging the day now again, God is sovereign in those decisions, right? If our days are determined as job 14 five says, then God is sovereign in those decisions. But that doesn't mean all of those decisions are morally and ethically necessary.
Dan Jarms 5:59
Yeah, that's really good. So your categories of preserving life, prolonging death, are really helpful to think about. So let's use two situations. Let's start with yours, at early in life, with your daughter and what you had to walk through. Can you just give us a brief summary of that? Sure.
Brian Sayers 6:21
So our first daughter, who died when she was three, shortly after her third birthday. She had complications at birth. Had cerebral palsy, severe cerebral palsy. She was quadriplegic, cortically blind, deaf, really was never cognitively more than an infant. So she was just like a giant infant by the time she she passed away, and at one point, I think, just before her third birthday, she she needed a surgery to relieve some tension in the tendons in her legs. Because, you know, you know people with cerebral palsy, their their muscles get super tense, and her legs were criss crossing. We couldn't keep a diaper on her anymore, so they had to relieve that tension. So in the process of, you know, prepping for the surgery, the doctors are like, here's a do not resuscitate form. Do you you want to sign this? Do you? What do you want us to do if the off chance of her heart stopping on the operating table happens, etc. And I was a, it was a very low probability, given the nature of the surgery that they were doing with her. But so there were faced with a, it was, it was, I mean, we were both kind of taken by surprise by the request, and so we thought through that and prayed through that, and thought not, not because even in her hand, and even in her severely handicapped state, she imaged God. We certainly believe that with our whole heart. And yet, if God, in His providence, would have made her heart stop on that operating table. We felt like her passing into glory and being in his presence was the far better option. And so again, we weren't trying to just preserve her life at any and every cost in any and every way, nothing came of that. She went through the surgery great, she came out fine, and she she basically just passed in the night some months later, but, but we were forced to think through that issue, yeah, like, if, if her her body were to fail or to stop in that moment, what are we going To bring her back to right a life of of I don't even know how I would say it. I wouldn't say a life of unconsciousness. But in a sense, cognitively, that's, that's what appeared to be the case. I think the Lord loves her and somehow fellowships with her, even in that state. I don't know how that works, yeah, but she's with him in glory now. So tough decision. But again, we're not trying to preserve life in in every way, in every situation. You got to ask that question, I think, what are they? What are they coming back to? If you Yeah, do resuscitate them.
Dan Jarms 9:17
Let's, let's pause because on that, I want to come back to come back to that, because that's going to be a quality of life question. Yeah, my my situation, about two of them with family members. The first one was with my grandmother, who was 91 she had colon cancer. She had colon resected and a bag and a colostomy, you know, probably in her late 80s. She lived with that for a few years. It came back at one point, she's in ICU, and her bowel ruptures, and she's 91 and her bowels are just really thin, so the doctors asking. Yeah, he's not really asking, but he's kind of asking, What do you want us to do? And he's he's asking a question, what is she going to come back to? Now, if you're a believer, that questions a little easier, because, like, well, to go on to glory sounds great. If it's an unbeliever, then you're like, I don't know, maybe we should keep her back every possible minute so that we could share the gospel with her. And I was somewhere in between, like I have some confidence that my grandmother finally trusted Christ near the end and the last few years of life. However, it wasn't going to change anything about her body. So they could have sewed up the colon and they could have repaired it, but it was going to happen somewhere else, and she might not serve. She might not even survive the surgery. So this is the this is the dilemma. So he's asking her, she's 91 and her whole bowel is ready to burst everywhere. So I can fix this one, but not really like we wouldn't even recommend the surgery, because she it's gonna be so painful, she's not likely gonna make it. We recommend that you let her go. So that's that's different. When you talk about the quality of life for your daughter or my grandmother, we're not talking about somebody who can no longer snow ski, and they loved to snow ski. You know, there, there's a movie that was out a couple years ago. We didn't know what it was about. We started watching it thinking it was a romantic comedy. Me Before You I think it was. But in the end, it was about a guy who'd had a motorcycle accident, and he could no longer do the things that he loved. He was perfectly cognitively able to work or to enjoy people, but he just loved his old life and he didn't love his new life, and in the end, it convinced you he should have his way and want out. That's not what we're talking about where it's it's the body's just not going to work, or not going to work for long. That's part of why medical professionals are going to ask you, when you walk into the hospital as a patient, I don't remember the name of the form, polstice form or the DNR form, whatever it is, but what are your wishes in case something happens? And a pro life stance would say we don't have to do everything in our power to prolong life, but just because it's going to be hard later doesn't mean we say no. We need to ask the question, what are you going to come back to what's the likelihood? So there's some real things to weigh out, and you're not anti life. If you say, at some point I want to stop the cancer treatment, at some point I want to stop I don't need to be revived. At some point I don't want a ventilation tube put in. You know, when we think of life support, there's no such thing as life support. There's a ventilation tube, there's, you know, a heart monitor. There's something that keeps you going. But the quote, unquote, life life support, it's not really that that much of a thing. And then you want to have compassionate care, so be help the person be comfortable with it. At the end, any thoughts on those categories?
Brian Sayers 13:23
I mean, I think the hardest part of that is that phrase quality of life, because we, you know, we hear people who use that as a justification for assisted suicide and and not not preserving life, but actually speeding up death, yes, right, right, or initiating it all together. So I think we would shy away from that phrase because of how it's how it's used, but when I think of our daughter and quality of life, what I'm thinking is not my quality of life. Oh, I don't want to love her, take care of her anymore. I'm exhausted. That would have been selfish. No, we were thinking, Boy, what a joy it would be for her to enter into the joy of her master, you know, like the Bible says, and yeah, and be in His presence and have her body, you know, perfect, resurrected, that you know, the hope of her being in heaven, leaping and dancing and praising God like the Yeah, the healed cripple. So that's what we're thinking.
Dan Jarms 14:25
Yeah, I think of quality of life. If you're asking the question for yourself, and you're asking the question for a Christian loved one, is, I'm not my own I'm bought with a price. It's, it's First Corinthians, 620, I'm not my own. I'm bought with a price. Is there something that God has me to do still, and that that can be a set of conversations that can be some way to control. Rebuke. It's not just I can't do what I used to do and I hate it, or it's just hard, like I want to get out of hard. But is there something that I still see in God's calling to me, that staying alive is is necessary for so I think of watching some of our dear older saints make it very long into life. And you know, there's, there are older saints who are testimony in hospice care, right? And you know, if you try to speed that up, they they lose out on that testimony, and they're going to still be in glory forever. So thinking about how we can be useful, or how we belong to our Master, and we want to, we want to live as long as he gives us opportunity. And we don't have to use every measure. That's the we don't have to prolong death. You have to use every measure all the time because of there are those factors which are coming back to what you're thinking about, so that that's a way for us to help think about it. I remember then, you know, facing many of these either or kinds of situations, the life of the mother or the life of the child, which is super rare, but I know it's happened at least once in my Christian life, and the family chose the life of the child over the life of the mother. We're going to have the baby. And you know, that's a tough that's a tough decision. And the mom passed within a few days, just like the doctor said she would. It's we've seen those kinds of things. Those are tough decisions. And I think our medical doctors, who we've been discipled by, always try to clarify. Help. Help us clarify, what's the medical scenario, what's the real risk, and then pray that God would make it really clear what that is like. You're praying for a clear decision that it's a really risky procedure or it's a really dangerous situation, and here are the real likely events that are going to come after it. So do you want to do this or do that you want them really clear, and God will help. And there are, of course, good Christian doctors available, you might not get a good Christian doctor, so you might want to call one of your pastors who can refer you to one of our Christian doctors to help you think things through at those really critical junctures. But we were thinking about how to how to reach that all of us should have conversations with our spouses. So if you haven't had a conversation with your spouse, if x happens to me, let me go home. If x happens to me, then keep me alive.
Brian Sayers 17:57
Yeah, yeah. I think another complicating factor here is, well, those conversations are important because we might not agree, yes, right? And then across families, you know one family, the situations we don't know, all the details they may even at the behest of the person who's about to pass make one decision, another family may feel compelled to make another decision that doesn't make one morally and ethically wrong, the circumstances are always going to be different. We shouldn't stand in judgment of those things and and that's kind of tricky, yeah, but I think that's a reality that will bump up against over the years, like, Wow, I can't believe they made that decision. But we need to extend grace, because, and those are the those are the hardest decisions that some of the hardest decisions you'll ever make in life. Well,
Dan Jarms 18:54
in in the last 75 years, you've had the ability to literally keep a heart beating right, regardless of the brain, you have had the ability to keep lungs moving regardless of the brain. So it's not unusual at all to have a person who is brain dead, but they're keeping them artificially alive to harvest their organs, which is often a really gracious choice to allow somebody else a better or prolonged life by giving organs. So those, those things are those things are there to think about.
Brian Sayers 19:30
So, yeah, one of, one of the phrases that I've used in my home talking with Michelle is, you know, when it gets down to those moments Ian, I kind of asked myself, What would this have looked like 100 or 200 years ago, like how long would I survive this? 100 or 200 years ago? I realize modern medicine science has brought us to a place where I don't, I don't, I don't have to die, necessarily. But there's again, there's a part of me that just says I'm not. Are intent on preserving my my life as long as humanly possible. I am really looking forward to heaven, and so it's it's not wrong for me to long for that, for me to die is gain, right? That's what we need to tell ourselves, right?
Dan Jarms 20:17
Hopefully this is helpful for you. May have questions, and we are happy to field those questions and help you think them through. So you can email us at info, at FB, church, Brian or I can either meet and talk about it, because usually you have some issue that you're facing and you're thinking something through, we would be happy to help you. Any of our elders would be able to help you through that, or any of our docs would be able to help you think through that. So if you have any of those, feel free to reach out to us. Thanks, Brian, yeah,
Brian is the Pastor of Counseling & Equipping at Faith Bible Church. He is passionate about the local church, and equipping the saints to effectively serve one another. Before coming to Spokane, he spent 14 years serving God's people as a pastor in rural New England (Vermont & New Hampshire).
View Resources by Brian SayersDr. Dan Jarms is lead pastor at Faith Bible Church in Spokane Washington, as well as associate dean at The Master's Seminary in Spokane. He has been married for over 30 years to Linda, and has three adult children. He earned his B.A. in English at the Master’s College, B.Ed. at Eastern Washington University, M.Div and D.Min in Expository Preaching at The Master’s Seminary. His other interests include NCAA basketball, woodworking, and art.
View Resources by Dan Jarms