LIFE AND DEATH, POWER OVER---Does God decide when life ends?
GOD
WILL DECIDE WHEN LIFE WILL END:
WE
SHOULD NOT 'PLAY GOD'
SYNOPSIS:
Many religious people believe that Godchooses
when a human life will end.
Usually this view has not
been worked out in explicit detail,
which would give guidance
about end-of-life medical care.
But this objection to any talk of
the 'right-to-die'
should be taken seriously.
For people who believe in God,
how does their faith affect their
decisions concerning medical care?
Do religious people uniformly
make different choices at the end of life
based on their religious
beliefs?
And do different religious traditions advise different
end-of-life choices?
OUTLINE:
1.
WHAT IS THE PRACTICAL MEANING OF "GOD WILL DECIDE"?
END-OF-LIFE DECISION-MAKING IN RELIGIOUS PERSPECTIVE
A. Do Nothing but Pray.
B. Prayer plus Limited Medical Treatments.
C.
Prayer plus All-Possible Medical Care.
2.
ALLOWING ALL RELIGIOUS PEOPLE
TO MAKE THEIR
OWN MEDICAL CHOICES
3.
MEDICAL PROFESSIONALS SHOULD NOT 'PLAY GOD'
4.
SAFEGUARDS TO PROTECT RELIGIOUS BELIEVERS
GOD
WILL DECIDE WHEN LIFE WILL END:
WE SHOULD NOT 'PLAY GOD'
by James Leonard Park
1.
WHAT IS THE PRACTICAL MEANING OF "GOD WILL DECIDE"?
END-OF-LIFE DECISION-MAKING IN RELIGIOUS PERSPECTIVE
The assumption that God 'calls the shots' at the end of life
goes
back as far as there was any belief in God or gods.
Long before
there was any medical care in our modern sense,
human beings were
born and they died.
And often these events were assumed to be
controlled by the gods:
"God gives life and God takes life
away."
When people died, it was said
that
"God took them" or that they "went to meet
their Maker".
Whatever we individually might believe about
such matters,
we ought to allow other people to have their own
views
as long as their views do not interfere
with the rights
of all to believe and behave as seems best to them.
A. Do Nothing but Pray.
At one end of the spectrum of religious beliefs,
some people
believe that no
medical intervention is appropriate.
Such
believers depend primarily on prayer.
(Or at least they seriously
try prayer.)
When they get sick, they pray for God to cure
them.
When they are dying, they decide not
to use medical care,
because
they believe that all power to heal comes from God.
They will
pray to be saved from death,
but they will accept death if it
comes—as
a decision made by God.
Another, more
secular, way to look at this orientation
is that it allows "nature
to take its course".
Before medical science emerged, this
was the only
option.
The
friends and relatives could sit with the dying,
but there was
nothing they could do to prevent the coming death.
Doing nothing except praying or letting nature take its
course
allowed natural dying to occur.
And some religious
people expressed this as
God
is deciding this life is over.
B. Prayer plus Limited Medical Treatments.
Some people of faith use both
prayer and medical science
when they face sickness and possible death.
Their first
impulse might be to ask for divine intervention.
But next they
call the doctor to set up an appointment.
Or they might go to the
emergency room if necessary.
Perhaps they
say God gave us the intelligence to create medical science.
So, we
are actually using our God-given talents to the best advantage
when
we make reasonable use of whatever medical care is available to
us.
In practice, the people in the middle
group will use medical science
as fully as seems reasonable to
them.
Some might say that doctors are good at setting bones
and
removing cancerous tissue.
But when it comes to subtle diseases
and other problems
that do not have obvious physical causes,
they
might believe that God's
power is
more appropriate.
Different religious
groups pull back from using medical science
at different points in
the process of accepting health-care.
For example, Jehovah's
Witnesses do not accept blood transfusions
or any other
treatments that include significant amounts of blood products.
Here
a religious belief trumps any scientific evidence.
And courts
(when consulted) have usually agreed
that religious people may
refuse treatment based on their beliefs,
just as all people have
the right to accept or reject medical treatment.
Should life-supports be used,
and if so, which forms of life-support are most appropriate
from the perspectives of particular religious beliefs?
How
long should 'tubes and machines' be used?
And if we withdraw (or refuse)
life-support systems,
are we closer to letting
God decidewhen life should end?
C. Prayer plus All-Possible Medical Care.
The most liberal meaning of "let God decide" says:
All
forms of medicine are part of God's plan for human health-care.
These
believers do as much praying as they like,
but they will also
consult as many medical specialists as they like.
All
possible efforts must be made to save the dying from death.
And when the patient dies—despite
all possible medical efforts—
this
is the practical meaning of "let God decide".
People who profess no religious belief
might also expect maximum
medical care.
And the health-care system usually supports
the choice of all
possible medical interventions.
Only when it has become absolutely
clear
from the scientific point of view that this patient will
never recover
do the doctors sometimes say "nothing more can
be done".
Then (and only then) is it appropriate to 'let God
decide'.
And sometimes patients who have
been declared beyond medical cure
do experience a 'miraculous'
recovery.
Religious people might easily thank God for such
unforeseen outcomes.
Thus, it seems that
the spectrum
of religious choices
is
very similar to the spectrum
of secular choices.
People without religious beliefs
might also refuse most
medical treatment (Option A)
and wait for whatever will happen
without medical intervention.
Secular people might try medical
cures up to a certain point (Option B)
and then decide to
discontinue what does not seem to be working.
And secular people
sometimes demand maximum medical care (Option C)—even
care that might seem to be futile or harmful.
2.
ALLOWING ALL RELIGIOUS PEOPLE
TO MAKE THEIR
OWN MEDICAL CHOICES
No effort here will be made to discuss how various religious
beliefs
will have an impact on medical decision-making.
In
open-minded societies with no state-established religions,
all
people have the right to make their own medical choices
—whether
informed by religious beliefs or not.
Organized religions have a right
to attempt to influence the
decisions of their members.
And religious leaders have a right to
join in any rational
discussion
of all issues related to the end-of-life.
Also religious
believers have a right to voteon any public issues
based on their own religious beliefs.
However, all secular systems of law should resist attempts
to
put religious principles into the laws.
Wherever any
form of government has an explicit religious basis,
then the
established religious authorities dohave a right
to force their religiously-based principles on the
people.
And if a hospital is owned and operated by an organized
religion,
the religious authorities have a right to impose their
principles
on all patients cared for on those premises.
But some religious believers are open to using rational
discussion
to
apply religious principles to each bedside situation.
For example,
dialysis for patients who suffer from kidney failure
is well
accepted by religious believers.
And most religious leaders and
their followers
would also consider it reasonable to discontinuedialysis
when the patient is dying despitethis treatment.
Exactly how religious
principles apply to each death-bed situation
will have to be
decided by each patient and/or that patient's family.
If they
believe that their religion rejectsa certain medical treatment,
then they will not
authorizethat course of action.
3.
MEDICAL PROFESSIONALS SHOULD NOT 'PLAY GOD'
Sometimes doctors seem to have God-like powers.
They can
occasionally save people from death
when the objective chances
were slim.
They are encouraged to 'play God' when it means
using the equipment in the emergency room to prevent
death.
But many religious believers hold
that doctors
should never declare a human life beyond
hope:
"Where there's life, there's hope."
Such
maximum use of medical science and technology
holds that we 'play
God' only when we turn off the machines.
God (not the
doctor) should decide the last moment of the patient's life.
If we pay close attention to how the expression "playing God"
is used,
we might observe that it is seldom or never applied
to
situations in which medical science and technology are being
used.
Attaching 'tubes and machines' to the patient is not
called "playing God".
Is
"playing God" only used to describe situations in which
'tubes and machines' are disconnected?
Are we "playing
God" only when we make life-ending decisions?
Such religious questions will have to be worked out
between the
believers and their religious advisors.
The practice of medicine
should respect religious beliefs whenever possible.
But whenmedical principles and religious principlesconflict
(as for example when religious believers demand futile
medical care),
then the medical principles must ultimately
prevail.
However, with respect to
life-ending decisions,
the exact timing of removing life-supports,
for example,
can usually accommodate the religious beliefs of the
patient and/or family.
Using their own religious principles, when
is the best time to 'pull the plug'?
{The following section on Safeguards is the same as used for the worry called:
SUICIDE IS A SIN AND OTHER RELIGIOUS OBJECTIONS.}
4. SAFEGUARDS TO PROTECT RELIGIOUS BELIEVERS The following 12 safeguards make sure
that the consciences of religious believers
are not violated in making any end-of-life choices.
In open societies such as our own,
followers of any religious tradition are free
to apply their own moral principles to their end-of-life situations
in whatever ways seem best to them.
The following safeguards allow ample opportunity
for several different persons
to make sure that religious principles are not violated.
These safeguards are arranged beginning with the safeguards
that
would be most relevant and powerful.
The
The red commentsexplain how that safeguard respects religious beliefs.A MEMBER OF THE CLERGY
APPROVES OR QUESTIONS CHOOSING DEATH
The patient and/or family members might consult their
clergy-person.
If this professional religious leader says
that
then that patient and his/her family might decide
not to choose even to consider such a practice
as disconnecting life-supports even when the case is hopeless.
On the other hand, the religious leader might say
that nothing in their faith tells them
that certain medical treatments are mandatory.
RELIGIOUS
OR OTHER MORAL PRINCIPLES
APPLIED
TO THIS LIFE-ENDING DECISION
When the
patient does in fact embrace a certain set of moral
principles,
written statements can be created explaining how those
principles
might apply to the medical decisions at hand.
ADVANCE DIRECTIVE FOR MEDICAL CARE
Each
comprehensive Advance Directive for Medical Care
has a section
for religious beliefs
When the patient has stated the most relevant principles in advance,
then there should be much less confusion at the bedside
when religious or moral principles might have some bearing
on the decisions that must be made.
REQUESTS FOR DEATH FROM THE PATIENT
When the
patient makes a request for death,
he or she might express some
relevant religious beliefs.
What implications do his or her
religious beliefs
have for the patient's request for
death?
INFORMED CONSENT FROM THE PATIENT
When the
patient is asked to give informed consent,
he or she might also
bring religious principles to bear on the decision.
If, for
example, no choices may be permitted that will lead to death,
then
the patient will
that include any of those prohibited options.
Suffering might have some
religious meaning for the patient.
How does
When (if ever) does suffering become meaningless for the patient?
How does the patient's belief-system
deal with protracted, unbearable suffering?
UNBEARABLE PSYCHOLOGICAL SUFFERING
The patient might also be suffering psychologically or spiritually.And this should be taken into account in all end-of-life decisions.
Sometimes the religious beliefs of the patient
will be a causeof psychological suffering.
How will any such conflicts be resolved?
For example, is the patient worried about going to hell?
Can confession and absolution
resolve this form of psychological or spiritual suffering?
STATEMENTS FROM FAMILY MEMBERS
AFFIRMING OR QUESTIONING CHOOSING DEATH
When
family members are asked to create their own written statements,
they
also are free to mention any relevant religious beliefs or
principles.
The family might have a
In case of conflicts about end-of-life decisions,
the patientor the duly-authorized proxiesmust make the final decisions.
But at least all points of view will have been heard
before the deciders go ahead with
whatever seems wisestand most moralto them.
PHYSICIAN'S STATEMENT OF CONDITION AND PROGNOSIS
The physician's summary of the patient's physical conditionwill be the basic factual background for making end-of-life decisions.In most cases, the physician will not express any religious views.
INDEPENDENT PHYSICIAN REVIEWS THE CONDITION AND PROGNOSIS
A second physician will also issue a written evaluation,giving an independent assessment of the patient's condition and prognosis.This also will be taken into account by the deciders,who are free to apply any moral or religious principles they wish.
PSYCHOLOGICAL
CONSULTANT EVALUATES
THE
PATIENT'S
ABILITY TO MAKE MEDICAL DECISIONS
A psychological professional will evaluate the patient's abilitiesto make wise medical decisions.And this consultant should not attempt to override any religious beliefsor other moral principles that the patient and/or the family wish to use.ETHICS COMMITTEE REVIEWS THE LIFE-ENDING DECISION The institution caring for the patient might have an ethics committee
that could be asked to review the plans for the last year of the patient.
And if this committee knows of any relevant religious or moral views,
they should not attempt to overridethese principles.
Rather, the ethics committee should make sure
that all relevant ethical principles are brought to bear
on the final decisions for this life.
If these safeguards do not seem sufficient to prevent trampling on the religious beliefs of the patient,then there are several other safeguardsthat might be brought to bear on the end-of-life decisions.
Created
January 17, 2010; revised 1-26-2010; 1-30-2010; 4-2-2010; 5-21-2010;
1-11-2011; 6-28-2011: 12-22-2011;
1-21-2012 ; 2-21-2012;
3-28-2012; 4-12-2012; 7-18-2012; 9-12-2012;
3-28-2013; 6-21-2013;
10-10-2014; 4-6-2017; 2-1-2018; 8-23-2018; 5-26-2020;
The above exploration of the various meanings of "Let God decide"
is also Chapter 10 of How to Die: Safeguards for Life-Ending Decisions:
"God Will Decide When Life Will End: We Should Not 'Play God' ".
Go to other dangers, mistakes, & abuses of the right-to-die.
Go to
the beginning of this website
James
Leonard Park—Free
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