"Life or Death: Who Decides?"
(2 Corinthians 4:16-5:9)

Today I'm departing from the topic I had scheduled to preach on to address a topic that has consumed the media the past couple of weeks, the issue of life or death and who decides, an issue brought to light by the Terri Schiavo incident.

I don't intend to address her particular case in great detail since we don't have all the facts of her situation, although I will offer my perspective on her situation based on what we do know.

Terri's case does raise questions about the broader topic of euthanasia, a practice perhaps better known as "assisted suicide," and this is the issue I will address this morning in some detail.

People are faced with decisions regarding life and death everyday, and in each scenario the decision of what to do is a difficult one, and is based on specific circumstances surrounding each case, such as: age of patient, quality of life, faith tradition, legal issues, finances, living wills, and so forth. Many of you have already been faced with such decisions in your life, and more of us will be over time.

So to begin, let me define a couple of terms so we're all on the same page. Euthanasia literally means "good death." Now while this word could be used to describe different concepts, the way we use the word today has come to mean "mercy killing." And by mercy killing I mean to take another person's life, either at their request or without their consent, in order to stop his or her suffering.

The issue of euthanasia is also often times discussed in conjunction with two additional concepts: "the right to die" and "death with dignity."

Legal and political positions have been discussed and argued, as they relate to euthanasia, particularly over the past couple weeks. So today I want to address the issue from a biblical, theological, and pastoral perspective, a perspective that gets little public attention.

Now, one of the decisions many have encountered, or will encounter, is the issue of using life support, or not using life support, to maintain a persons life. The question we're confronted with sometimes is, does implementing a DNR (a do not resuscitate order) or removing life support constitute a form of euthanasia, or at least in some way is it contributing to our loved ones death in an un-Christian like way?

Most ethicists, Christian and otherwise, do not consider the decision to withdraw life support from individuals who are dying and who can no longer sustain their own life apart from artificial means to be euthanasia.

When we withdraw medical life support from persons who are dying, it's the disease or physical condition that eventually takes their lives. These individuals would not live without extraordinary medical means. And the use of extraordinary medical means is not generally deemed to be ethically required in terminal situations.

The withdraw of life support is usually considered morally acceptable under the following conditions: " All treatments likely to restore health have been exhausted " The patient is already entering the death process; meaning he or she will die without life support " Life support is only postponing the inevitable, because it's been determined the patient will not recover " And the patient does not desire to be kept alive by artificial means preferring "to let nature takes its course" if you will.

In the latter case it's helpful to have this desire written in an advanced directive, or at a minimum your wishes known by your family. If nothing else the Terri Schiavo case has highlighted the importance of having an advance directive.

An advance directive, or living will, is also good to have so that the burden of using or not using extreme medical measures does not fall on the shoulders of someone else. An advance directive specifies what you want done medically, and what you don't want done in certain situations, and the form is easy to fill out. Watching someone die is hard enough without having to make these kinds of decisions on their behalf.

So to summarize this point, removing life support may hasten death, but it's the physical condition of the patient that results in death. Therefore, removing life support or the refusal to implement life support is not euthanasia.

I also call your attention to the bulletin insert which includes the United Methodist Church's position on the "Faithful Care for Dying Persons," which is included in our Social Principles.

Now the act of euthanasia is supported by some, claiming they wish to only end the pain and suffering of an individual, citing that we euthanize animals when they're in pain or are suffering, so why not humans. Isn't it more humane to release someone from suffering through death, then to have them experience the ordeal of living in a manner that some say is less than humane.

This was the position of Dr. Kevorkian. Many of you might remember him as the doctor who helped others basically commit suicide. We now call this "assisted suicide."

I can remember seeing pictures and short video clips of how Dr. Kevorkian helped others die in the back of a van or in a rented cabin. The patient was alone, hooked up to a suicide machine, all they had to do was push a button, and the drugs that would end their life were released, and slowly flowed into their body.

When I stop and think of all the folks I've been with as they neared death, they were at home, in a nursing center, or in the hospital surrounded by their loved ones, surrounded by people who cared about them, and were in the presence of God. In some cases they too planned their deaths by wanting to be at a certain place as they were dying, deciding on hospice care over life support, and so on, but they weren't left alone and they were being cared for with compassion. These folks strived to live as long as possible, trusting that God would determine when it was time for them to die.

When I've visited with folks who were dying, a question I was often times asked was "Why won't God just take me?" My response has usually been "I don't know, but perhaps God has more work for you to do." And I believe this to be very true. You see, even when we're in poor health we can still serve God, just by being a faithful witness to God's love and grace to all those that come and visit us. Some of the most powerful and faithful witnesses to God's grace, love, and eternal promise that I've been a part of have been with those individuals who are dealing with severe medical issues and are facing death.

A current very public and visible example of this is the Pope. He served as a powerful witness, as he refused to give into his various illnesses until he was called home by God. The Pope was determined to serve God until God said it was time.

His ministry didn't stop or become ineffective, it's just changed, and this is the case with us as we near death. Our faithful witness to God, and our ministry, doesn't stop with age, illness or the like, it just changes. Some of the most profound and life-changing ministry has been accomplished by folks who were dying.

Now let's discuss what our Christian response ought to be to euthanasia. First, Christians are called to offer compassion and love to the sick. Jesus said this would be one of the criteria used at The Last Judgment. In Matthew 25:36 Jesus said to the people ready to inherit the Kingdom, "I was sick and you looked after me."

Much of Jesus' ministry was spent with people who were physically, mentally, emotionally, and spiritually suffering, and his heart led him to deliver them from their suffering, not by expediting death, but by showing them compassion and healing them.

When Jesus was healing he was demonstrating, in a very real way, both the power and compassion of God. Jesus was illustrating for us what we can expect in God's Kingdom, and he was revealing his divine identity to the people of his day by these signs of grace.

As followers of Jesus Christ we are called to carry on the ministry of healing, offering aid to those who are suffering, are in pain, and those who are facing long and hard struggles. Also, keep in mind that healing is not the same a curing. We can be healed and still not be cured of a specific disease or condition.

The second point I'd like to make is that if we've never been in a situation that has led us to think about death as the only answer to our suffering, or the suffering of a loved one, we need to be careful about judging and condemning others who have.

Looking at this issue from the outside in gives us a totally different perspective, then if we're walking in the shoes of folks dealing with the real issues, of pain, suffering and the like.

Quit frankly, as a pastor and having seen what some have had to go through, I can say I understand why a person might want to end their life because living is just to painful. And I can tell you with all honesty, that although I don't believe euthanasia is an appropriate Christian response to end pain and suffering, my heart goes out to those who are faced with their loved one's own suffering, and want to end their life.

So what are the biblical and theological teachings we can draw from to help us better understand our response to this issue from a Christian perspective?

The first teaching we can draw on is rooted in the principle that the ending of life is in God's domain. In Genesis 9:5-6, we're taught that we're NOT to take another persons life intentionally since we all are created in the image of God, and God alone has the authority, to not only create life, but to take it as well.

When we decide to take someone's life we assume God's authority and we begin to "play god."

Christians believe God has the power to determine when it's time for us to die and when it's not. God can see what we can't. God knows the big picture. God knows how he wants to use us for his kingdom, sometimes this means we're here for a short time, and for others it means we're here for a long time, sometimes perhaps longer than we want.

Christians and Jews both point to Psalm 139:16 where the psalmist declares that, "All the days ordained for me were written in your book before one of them came to be." God has numbered all our days and knows the duration of our life from beginning to end.

The same Psalm says that God is with us even if "make my bed in the depths you are there" (v.8). "Even there your hand will guide me, your right hand will hold me fast," says the psalmist in (v.10). "Even the darkness will not be dark to you; the night will shine like the day, for darkness is as light to you" (v.12).

I'll never forget an experience I had with a woman who died several years ago. I'll call her Peggy (not her real name). Peggy had terminal cancer and was close to death. She was in pain and was ready for Jesus to lead her home.

As I sat with her next to her hospital bed she kept saying, "Pastor why doesn't God just take me." She would say this over and over again. It was hard to witness, but after several hours of conversation and prayer I began to see what God was doing, how God was using Peggy one last time. Peggy had a large family, and during the three days she was in the hospital, one by one they would come to visit her. As they did Peggy gave them each very specific instructions on how to live their lives, how they needed to get their children baptized, how they needed to be more faithful, give their life to Christ, and so on.

As I watched and listened to some of these conversations I was amazed at how God was using Peggy, despite the pain she was in, as a faithful witness up until the very end.

On Peggy's last day it was about 2:00 am and I asked one of her daughters who was at her side if everyone in the family had been by to see her mother. The daughter responded, all but one granddaughter who was traveling up from Georgia.

About an hour later the granddaughter showed up, and as she approached her grandmothers bed, Peggy woke up, recognized who it was and immediately gave her instructions on how to live the rest of her life.

And it wasn't long after her grandchild left the hospital room that Peggy died peacefully.

Clearly when Peggy entered the hospital, God wasn't done with her yet, he had one final task, and that was to give very specific instructions, mostly faith related, to each of her children and grandchildren. And once this task was complete God said it was time.

God can and does use suffering for our good and for the good of others. Suffering is not the enemy of Christians. Jesus suffered before his death, he knew what it was like to face such things, and he knew what it was to pray to God to take away his suffering. Yet at the same time Jesus put God's purposes ahead of his own desire to end his suffering.

Jesus suffered immensely on the cross, but God used that suffering to save the world. As hard as it is to see, suffering does have its benefits. Suffering often turns us to God, and our suffering may also heal relationships and turn others to God. Suffering can deepen our faith and strengthen our soul. And I have been blessed by witnessing both of these gifts as I've sat with some of your loved ones as they neared death.

As Christian's we believe that God will carry us through the valley of the shadow of death, so we need not fear.

There's nothing more inspirational then watching persons of deep faith face death; they face it without fear, and with a sense of anticipation that something better awaits them. In another words they die well. What an inspiration these folks are to others! This was how Peggy lived her final days, and she was an inspiration to me and others who were with her in her final days. I pray I die well, when my time comes.

As Christians our lives are a gift from God, and each day is a part of that gift. The apostle Paul teaches that even our bodies don't belong to us; they belong to God and are given to us as a gift. (1 Corinthians 6:19-20). So to choose to end life before God has chosen our end, is to reject the gift and possibly the Giver of life as well.

The power of Easter, of which we continue to celebrate today, is never felt quite so fully, as it is by a person who is facing death. When the doctors have finished doing all that they can do, the only hope we have, and the hope that sustains us, is that Jesus promised that his followers would spend eternity with him in heaven.

The Apostle Paul points to this truth when he writes in 1 Corinthians 15:51-57: "Listen, I will tell you a mystery! We will not all die, but we will be changed, in a flash, in the twinkling of an eye, at the last trumpet. For the trumpet will sound, and the dead will be raised imperishable, and we will be changed.

For the perishable must clothe itself with the imperishable, and the mortal with immortality. When the perishable has been clothed with the imperishable, and the mortal with immortality, then the saying that is written will come true: 'Death has been swallowed up in victory.' 'Where, O death is your victory? Where, O death, is your sting?' But thanks be to God, who gives us the victory through our Lord Jesus Christ.'"

It is this faith, this sure and certain hope, that allows Paul to also write, "Therefore we don't lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all" (2 Corinthians 4:16-17).

Therefore Christians are to face death and suffering by fixing our eyes not on what's seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal. (2 Corinthians 4:18)

Now let me briefly mention my position on the Terri Schiavo situation, with the caveat there is much information we're not aware of. What we do know is that we don't really know what Terri's wishes were regarding the desire to receive nutrients through a tube. We know it's been 15 years since the feeding tube was inserted. And we know she was breathing on her own and had some response capability. These are three critical points.

Since Terri's medical desires were not known, and since the feeding tube had been in place for 15 years (8 years prior to the first attempt to remove the tube) I'm concerned about the motives of those making decisions on her behalf the past couple of months. Did they act with the best interest of Terri in mind? Did they act as Christ would have? I don't know.

Also I struggle with the idea of purposely withholding food and water from someone who is not in the process of dying from a terminal illness or physical affliciton. In any other situation withholding food would be considered inhumane, illegal, unethical, and not an appropriate Christian response. What really killed Terri, her physical affliction or the fact she was denied food? Was she terminally ill, or just in another state of existence.

I don't view providing food and water as extreme medical care. I view providing food and water as meeting someone basic needs, especially when an individual is not considered terminally ill and is not in the process of dying.

Therefore, I've concluded in my heart, based on what I know of the situation that it was inappropriate to allow Terri to die by denying her food and water, and that her life should have continued. When there is doubt or uncertainty, regarding actions associated with life or death, we should always hold up life as a gift from God, preserve it, and allow people to die when God determines it's time.

So as Christians: " We're to face death and suffering not wanting to end it sooner by suicide or assisted suicide. " We're to face death and suffering knowing that our lives belong to Christ, they're not our own. " We're to face death and suffering believing that in God's good time we will be called home, we don't have to rush the process. " We're to face death and suffering believing that God is the only rightful authority on when life ends. " We're to face death and suffering hoping that God can use us, and our suffering, to let his light shine through us. " And we're to face death and suffering with hope, knowing that the momentary troubles we encounter in this life are preparing us for eternal glory. Amen

Acknowledgement I'm grateful for the thoughtful research and writing done by the Rev. Adam Hamilton, pastor at United Methodist Church of the Resurrection in Kansas City, Kansas regarding euthanasia, and have drawn on his work as I prepared this message.

Read other messages by Pastor Wade