Presbyterian pastor Michael Johnston has very personal experience with pastoral care for the seriously ill and dying. He has been in and out of hospitals for the past two years with a life-threatening condition.

Lyle Thorpe's wife, a longtime and active member of a Presbyterian church, died almost alone as fellow Christians watched her physical deterioration and didn't know how to reach out to her.

Freda Stavrou and her family cared for her aging mother in their home, finally keeping a day and night vigil at her bedside until she died. A pastor asked her why the family interrupted their lives in such a major way to care for her parents.

Common to every one of our congregations is the presence of those who are seriously ill and dying. The stories parishioners tell suggest that we in the church have a lot to learn about ministry at the end of life.

What is the pastoral care that people need as they lie dying? What guidance does the Church have to offer to people making decisions about the end of life in the 21st century?

Central Presbyterian Church in Baltimore was host to a consultation sponsored by PPL in October. The consultation explored strategies for the role of the Church at the end of life.

PPL brought together theologians, medical specialists, and practitioners for a discussion with pastors, in an effort to deal not only with the moral and theological questions related to dying but also with the practical realities of the needs of local congregations.

Keynote speaker Nigel M. De S. Cameron, theologian and bioethicist, began the discussion by addressing "prior questions." Often, Cameron said, we find ourselves in intractable disagreement over issues of modern life because we have not begun the discussion at the beginning. For example, before we discuss Oregon's law regarding physician-assisted suicide we need to attend to such prior matters as the meaning of death and what it is to be human, as well as our understanding of the identity and task of the physician.

Questions of the meaning of death and the meaning of our humanity are at the very center of Christian faith. And they are at the heart of understanding the church's pastoral role at the end of life.

The consultation was the beginning of PPL's serious effort at a discussion that is long overdue among those called to pastoral ministry. The objective is to develop resources for local churches based on biblical understandings of the prior questions and the practical needs.

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