ETHICAL CHOICES AT THE END OF LIFE

By PPL Vice-President Jack Sharpe, Esq.



“For the Spirit God gave us does not make us timid, but gives us power, love and self-discipline. So do not be ashamed of the testimony about our Lord or of me his prisoner. Rather, join with me in suffering for the gospel, by the power of God. He has saved us and called us to a holy life—not because of anything we have done but because of his own purpose and grace. This grace was given us in Christ Jesus before the beginning of time, but it has now been revealed through the appearing of our Savior, Christ Jesus, who has destroyed death and has brought life and immortality to light through the gospel”

(2 Timothy 1:7-10)


As an attorney that has done a sizable number of estate plans that include end of life directives or living wills, I have a wealth of data as to how people react to end of life decision-making. Although I am able to discuss the boundaries of these decisions, most people have their minds made up on most issues and they are remarkably similar among all faith backgrounds, including those whom I cannot determine or do not know their backgrounds. Most people want to have life end quickly without intervention, including food and water.


Early in my days as a PPL Board member, we were discussing end of life issues, and our then executive director, Terry Schlossberg, stated her hope that when it came time to exercise the power for her mother, that she would not have to “act in a way that was unethical.”

I have reflected on that statement often over the past 20 years, and have considered it professionally, as well as personally as I was an agent for my parents and was faced with these decisions. We actually had to make end of life decisions for my mom as to whether we would continue with IV nutrition after she stopped eating.


The basic worth of human beings is not found in their gifts, abilities, wealth, social status, or any other thing. Though there have been those societies throughout history that did "suppress the truth in unrighteousness" (Romans 1:18), the Bible teaches us that God's law is written on the hearts of all mankind (Romans 2:15). So, with all decisions involving decisions about life or death, we should start with Scripture. I am not going to attempt a theological exposition of end-of-life issues, but I think the familiar passage from 2 Timothy 1:7 and the less familiar verses that follow shed great light on how we ought to approach the issues. It raises four theological concepts that ought to shape our thinking. First, the Spirit God gives us should not have us act out of fear. Second, suffering is not bad in itself, especially as it can promote the gospel. Third, God gives us grace for a purpose. Fourth, and finally, Christ Jesus has destroyed death and brought eternal life through the gospel.


In making end of life choices, we ought not be motivated by fear. It has no place in our thoughts. Fear can motivate in two ways: fear of death can make us take extreme measures to hold on to life or fear of being a burden or of lingering can make us end life prematurely. We see this play out in the push for euthanasia. We need to remove fear from our thinking on these issues.

Closely related is the desire to avoid pain. We tend to think that living in a state of permanent coma is a painful existence, and it is natural to avoid pain. In 1990, PPL held a weekend symposium addressing those issues from a variety of perspectives. One of the lasting conclusions from that weekend was the realization that with the advent of palliative care, end of life suffering is not a necessary experience. But, apart from that, suffering, and the witness of the sufferer, makes a compelling case for the gospel. As Paul invites us to join him in his real suffering, we should look at suffering as an opportunity to show others the gospel in our suffering or in our care for those suffering. So, we should not assist death merely because of our desire to avoid suffering.


Grace is the provision that allows us (and our loved ones) the opportunity to endure suffering and to witness to God’s grace through any end of life suffering we or they may experience. If God is sovereign (and He is), then He guides us through the end of life to serve His purposes. “And we know that all things work together for good, for those who love God and are called according to his purpose.” Romans 8:28. Based upon the grace, we should not play God, but allow him to work for good in all things. Allow God to make the sovereign decisions over our lives and do not rush to end life.


Finally, end of life is a passage. It is not the “end!” Christ Jesus has destroyed death. Therefore, we ought not to make an idol of this physical life and hang on to it as we are in control. Scripture treats death as such a passage. There is a time for us to die or “go the way of all the earth” and “rest with our ancestors” (I Kings 2:1-10). But based on Scripture, we are not in control of that time. We should then live and plan accordingly.

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