Reflections from the Front: End-of-Life Care
In the past sixteen months three members of my immediate family have died. Heart Disease, Dementia and Cancer claimed the lives of my father, my mother and my wife. If it were not for the resurrection, we would be totally bereft. As it is, we grieve, “but not as those who have no hope.”
In their last days, with each family member, we made the decision to not pursue all possible treatments at any cost, but instead only reasonable treatments, that would help mitigate pain and suffering, and whose benefits clearly outweighed the likely downsides to treatment. In regard to specific decisions, however, this may be easy to say, but not so easy to do.
Particularly for the Christian who continually prays for God’s miraculous interventional healing, it is tempting to continue to push, based on the possibility that God will intervene “soon”, if we have faith, and don’t give up the fight. Deciding when to transition care from a cure-orientation to a palliative care approach, can, at times, be especially difficult when the patient and the whole family are not at the same place at the same time. The person who perhaps prophetically realizes that God’s healing may not come on this present earth may be perceived as being less committed, less loving, and less faith-filled. Perhaps; but perhaps they have an insight from the Lord.
Dr. John Dunlop, Internist and Geriatrician, recently wrote an outstanding, yet easy-to-read book– Finishing Well to the Glory of God, (2011, Crossway Books, Wheaton, Illinois,) covering just these issues. I highly recommend his book, which I found personally helpful. I would also recommend the website: http://www.cancer.gov/cancertopics/factsheet/Support/end-of-life-care
Discussions in the abstract, quoting probabilities of life, death, pain and disability can be almost mathematical. For populations these predictions have been found to be relatively accurate. For the patient or family member directly in front of you, they are much less helpful. When your time comes to deal with these issues as a provider, friend, or family member, I recommend Dr. Dunlop’s book, appropriate, accurate medical data, continuous prayer, and reliance on the Holy Spirit to help you walk through this minefield. I also recommend patience and love for your family circle members who aren’t where you are and a spirit of humility, forgiveness and grace as you make tough decisions.