March 30, 2009
More on Faith and End-of-Life Care
Do American Christians believe that 'Death has been swallowed up in victory'?
Mark Galli points out a study that confirms my own anecdotal evidence through interviews with Christian doctors--particularly those in hospice or working with the elderly: Christians are surprisingly aggressive in attempting to forestall their own death through the use of medical interventions.
This is surprising because the basic belief of the Christian faith is that Jesus Christ died and rose from the grave. And as Paul says in Romans, Christians have the life of the God who rose Jesus from the dead. Because of this death-defeating life, the Christian believes, as the Bible repeats, "Death has been swallowed up in victory. Where, O death, is your victory? Where, O death, is your sting?"
This fearlessness toward death, especially as taught by Paul in I Corinthians 15 and given evidence in his life, is not at all apparent in the decision making of many, many Christians (according to the study Mark cited) who use medical technology to fight death.
In research for my book on the Christian art of dying well (due out from InterVarsity Press next year), I found at least two reasons why Christians in particular pursue aggressive medical interventions at the end of life.
The first is a transference of pro-life values from the beginning to the end of life. "We're so pro-life," one doctor told me, "we're anti-death." Over and over again, he sees patients defend their desperate decisions by appealing to their pro-life beliefs.
The second reason why Christians pursue aggressive medical treatment at the end of life is related to the health and wealth idea of claiming a promise of God. Another hospice doctor--and a Christian--told me that he regularly hears patients who have entered hospice say they refuse to claim whatever illness threatens their life. By refusing to claim it, they deny its existence. Or by claiming a verse or passage that promises healing (even "Death has been swallowed up in victory", many Christians believe they will be the first since Elijah to be taken directly to heaven--a gift even Jesus was denied.
Of course, both these explanations are cover for a deeper issue: the fear of death. And while Christians have a hope in Jesus' defeat of death on the cross, their fear is not unique and perfectly understandable.
But the problems with such fear leading to aggresive medical treatment at the end of life are two-fold. First death is always made more difficult by refusing to come to terms with its arrival. Aggressive treatment not only provides the (often false) hope of a cure, but is typically exhausting and therefore doesn't allow a patient the time or energy to make peace with life's end. Without this acceptance of death, the dying process is often physically difficult, painful, and lengthy. And for family members, such a difficult death makes the grief and mourning process more painful and thornier to work through.
The next problem is related. Through the 19th century, Christians practiced various forms of the good death. While some details changed, the basic belief is that Jesus' death and resurrection is a model for the Christian's death and expected resurrection. Dying well therefore required 1) a willingness to die, 2) an expression of the Christian hope in the bodily resurrection and everlasting life with God, and 3) a farewell to one's family and community often accompanied by last words. This pattern was consistent throughout Christian history until the 20th century.
The 21st century, because of a range of medical and social issues, makes it a good time to try to recover the lost art of Christian dying. (My book and perhaps future CT articles explain this further.) But these values are best learned before a patient needs to make the decision to enter hospice or pursue curative treatment. And they are best taught by a church community that offers hope in the resurrection after death--and not the promise of health and wealth right now.