1. We cannot provide simple formulas and conclusions that fit every encounter with heroic measures. On the contrary, we find that it is impossible to give a specific direction for every conceivable circumstance, and we realize that decisions will differ. We can be sure that “God is our refuge and strength, a very present help in time of trouble.” (Psalm 46:1) God has promised to give us wisdom if we will ask in faith. Ministers should be consulted to pray with and for the patient to help him to determine God’s will in the application of heroic measures. Often God will give us the wisdom we need through the counsel of caring doctors. The patient and family should prayerfully and carefully weigh any decision to go against the counsel of the trusted physician since he would be expected to have the best advice in these situations. In many situations a distinction can be made between treatment that will heal, improve or restore the patient to health and treatment that will only prolong the dying process. The patient and family should ask appropriate questions to obtain this information, since for various reasons a physician may not make this distinction when various options of medical treatment are presented. Pastors or other elders should be consult-ed as patient and family carefully and prayerfully consider these options.9 2. Necessary means of preservation of life must not be withheld from the patient. Negative judgments about the “quality of life” of an unconscious or otherwise disable patient have led some to propose withholding nourishment in order to end the patient’s life. Medical treatment that is clearly efficacious to heal, improve, or restore must not be refused. 3. The Bible does not teach that people are obligated morally always to accept treatment that would sustain life artificially. For example, there does not seem to be an absolute moral obligation to undergo chemotherapy or to receive kidney dialysis in certain cases. In the case of irreversible diseases (like certain forms of cancer), the patient may in good conscience refuse treatment that may briefly lengthen his life if he believes that his quality of life would be greatly impaired. A decision to withdraw medical support from a patient is terribly difficult, especially when it seems likely that death will be hastened by that decision. Nevertheless, a decision to withdraw life support is more often based upon better evidence than a decision to initiate life support. These heroic measures are often begun in an emergency situation when physicians must make decisions quickly about patients, but with limited information. Over the next few days, or weeks with continued observation and additional information, however, they may discover that utilization of a respirator or feeding tube would be futile treatment which would only prolong the dying process. Initially these procedures were started when there was some reasonable hope of the patient’s recovery.10 Although heroic measures have been started, they do not necessarily have to be continued. Since there is “a time to do,” it is morally permissible to discontinue life support when doctors agree that there is no hope of recovery. 4. Physicians should be chosen with these principles in mind. It is possible to have your doctor know your desires for each family member. “Do Not Resuscitate” orders are often an appropriate way to avoid heroic measures, because hospitals are required to resuscitate all patients who die suddenly unless such orders are on the patient’s chart.11 5. The advantages and disadvantages of available legal measures should be explored with a trusted lawyer if possible. This action can prevent many of the dilemmas that occur with terminally ill patients. 6. Our Lord Jesus gave us two helpful guidelines. First He enunciated “The Golden Rule:” Do to others as you would have them do to you (Luke 6:31), and the great summary commandment, “Love your neighbor as yourself” (Mark 12:31). Numerous surveys have demonstrated the fact that most people do not want extraordinary treatment for themselves when there is no real hope of recovery. Nevertheless, when faced with a decision on behalf of close relatives or friends, they often want more for others than they would do or want done for themselves. Love for our neighbor demands that ‘in proxy decision making, we should apply the same biblical standards of justice, mercy and faithfulness to others that we want and expect to be applied to ourselves.”12 We encourage spouses and family members to draw upon the biblical and theological principles outlined above as they seek to discern God’s will in regard to heroic measures. After appropriate biblical reflection, we urge that families pray together and openly discuss what they desire concerning the various choices of medical treatment before being confronted with the actual experience of such a decision. We also encourage families to meet with their minister, Christian friends and physician about their concerns regarding care and to become educated about their conditions in order to permit informed decision-making. Sooner or later each one of us, either directly or indirectly, will face decisions regarding our own or a loved one’s medical condition(s |