Anonymous Asks (122)

“When should life support be stopped?”

If you managed to get through those awful presidential debates this year, you will probably remember that on several occasions Joe Biden accused President Trump of all-but-murdering something like 206,000 U.S. citizens, which was the number alleged to have died of COVID-19 complications at that point in time.

Apparently the Democrats thought this was a sound strategy that would resonate with undecided voters, though I very much doubt the average American imagines any president is really capable of doing very much to slow the rate of transmission of a virus once it is out there in the world.

Manufactured Outrage

Feigned or not, Biden’s outrage was palpable: no matter how infirm or dementia-riddled, no matter how compromised with existing co-morbidities, no matter the eventual cost to the taxpayer or the potential unforeseen consequences of locking down a country of 330 million, every possible step must be taken to save every possible second of every possible life. We are owed that duty of care, supposedly, by our elected leaders.

An interesting take, and it reflects the entitled attitude of a generation of Democrat voters — or perhaps the last several generations — and probably more than a few Republicans as well. When your position is that government ought to be responsible for absolutely everything, and that government spending ought to be based on perceived need rather than available funds, it’s easy to answer the question of when life support should be stopped: never ... unless the patient wants to die, in which case, that should be his or her inalienable right, even if he or she is perfectly healthy.

Framing a Very Strange Question

We have come to a truly fascinating place as a society when it has become possible to frame a question in this way, or even use a term like “life support”. In the last century, we have developed machines to filter toxins from the blood, restart a heart that has ceased to beat, provide nutrition and water to the comatose, and even push air into the lungs of a person who is no longer capable of doing it for himself.

These devices have not existed for more than an infinitesimal slice of human history, and other than in countries with socialized medicine, they are only available today to a very tiny and affluent segment of the world’s population because they are costly to manufacture and operate. The subsistence farmer in Ghana whose heart gives out while tilling his field by hand is not getting life support no matter how much his family loves him. For him, the opportunity doesn’t exist. And yet in Western societies, we not only take the existence and availability of life support systems for granted, many of us believe they are our inalienable right.

But you see what I mean about framing the question. Say the words “life support”, and 99.9% of the human beings who have ever lived wouldn’t have a clue what you’re talking about.

Seeking Biblical Principles

Still, we do, so let’s try to apply biblical principles to the question. You will understand that principles are all we’ve got to work with; there are no verses of scripture that speak of life support in the sense we are using it.

Let’s start with this principle: In a fallen world, everybody dies. That’s Genesis 3: “You are dust, and to dust you shall return.” There are a few notable exceptions to the general rule: Lazarus and a few others died twice, and Enoch and Elijah got a pass. You and I won’t unless the Lord’s return is scheduled to occur within our lifetimes, a privilege and a delight if it happens, but not one that has been the lot of the faithful dead in Christ down through the centuries, which, I suppose, is why they get to rise first. But since death is universal, all our efforts to resist it only amount to delays, not victories, and sometimes those delays are very brief indeed. Real victory over death awaits the return of the Lord.

A second principle: A longer life is not necessarily a better life. Dietrich Bonhoeffer pastored German churches in Barcelona and London, wrote a number of important works, and was killed resisting the Nazis at age 39. The Lord Jesus, if we have our dates right, probably saw his 33rd birthday but not his 34th. John the Baptist lived a similar span of years. American missionaries David Brainerd and Jim Elliot and Scottish minister Robert Murray M’Cheyne only made it to 29. William Borden left a fortune to missions when he died of cerebral meningitis at age 25, and a note that read “No Reserve! No Retreat! No Regrets!” Amen to that. On the other hand, godly King Hezekiah begged God for a longer life and received an extra 15 years, then used them to cast his pearls before swine and to father arguably the most evil ruler in Judah’s history. Getting old may turn out to be a blessing, or it may be very difficult indeed. We do not know until we get there. For the Christian, however, the idea that our lives must be preserved no matter what the circumstances or cost is a notion that is difficult to defend.

A third principle: Christians don’t go anywhere until our number is up. David wrote, “In your book were written, every one of them, the days that were formed for me, when as yet there was none of them.” Can you believe there is any power in the universe that can cut that number short, whatever it might be? I can’t. Not genetics, not disease, not enemies or accident or conspiracy. Equally, no power in the universe but God himself can extend a life. When you’re done, you’re done.

A fourth principle: Living is fine, but not at somebody else’s expense. On March 15 or 16 this year, 72-year-old Don Giuseppe Berardelli died after refusing a ventilator so that a younger person could be accommodated. Say what you want about Catholic priests, but that man got something important right. “Greater love has no one than this ...”

A fifth principle: Being with Christ is better, not worse. Actually, what the apostle Paul wrote was “far better”, not just “better”. The only real question is whether we believe him.

The End of Life Support

That should probably do us for principles. So then, when should life support be stopped?

Well, if we are asking what the state should legislate if it is to be moral, that’s a little too abstract for me. Making life support systems available to everyone depends on choices made about taxation levels and spending priorities. Is providing indefinite universal life support a moral aspiration for a nation trillions in debt? You tell me. But it’s also an irrelevant question for you and me: the state will do what the state will do, and we will have very little say in it.

But assuming life support technology is being offered as a feature of our health care system (sustainably or otherwise), if we are asking when a Christian with health care power of attorney for another believer ought to call cease and desist on his or her behalf, I believe that very much depends on the wishes of the patient, assuming they have been expressed. As far as I can see from scripture, the Christian is under no moral obligation to resist the natural processes when his body can no longer carry on without mechanical help. If a friend or relative is ready to go to be with the Lord and only drastic medical intervention is keeping that from happening, I would find it difficult to argue from scripture that he or she should be prevented from declining it.

Likewise, I trust my own health care proxy will respect my wishes if it ever comes to that.