How Do You Decide?

[Biblereader]

http://wings.buffalo.edu/faculty/resear ... dnr-p.html

What does a DNR mean, exactly, and is it morally, biblically ok?
Where, exactly, in the bible, does God talk about this?

When do you draw the line, if there is a line to be drawn, about how
much medical care you should get about something?

How does a family member decide about signing a DNR paper?

IF you have had experience with this, and don't mind talking about it, please
post.

 

[handy]

My dad has signed a DNR. If he begins to choke because his esophagus has closed, or if his heart fails, we will do nothing to resuscitate him. Even when it gets to the point of his esophagus closing so that he cannot take in nutrition by mouth, he will receive no IV's to add nutrition into his body. Now, a DNR isn't the same thing as not hooking someone up to feeding and hydration tubes. I believe that the term that was in the living will my Dad has signed was "no heroic measures". But, what it boils down to is that the diease will run it's course and Dad will die, without any medical interference in the process.

The morality of this comes via the circumstances. My dad is dying of inoperable cancer. Performing CPR on him would only serve to cause him much pain and (if it works) prolong the death process rather than to restore him to life. He is already in the throes of death now, even though he is sits in his chair and talks with us. His body isn't going to get better. Prolonging his life, pushing it beyond what would be the natural course of events, would only be cruelly keeping him in what has become a prison, and a painful one at that.

Modern medical science can do a lot, both good and bad. Because of the advances in medicine, many people are alive today that would have had no hope even 30 years ago. However, it can also be bad, prolonging a life for no other reason than to keep a heart pumping or lungs working, even when there is no hope for any other outcome than death.

There are biblical principles to apply here. We cannot cause a persons death, that is murder. But, although we don't really have specific texts that would cover the situation that dad is in, I think that it is just as immoral to prevent the natural death of someone as well, by artificial means.

The first weekend that I stayed with my parents, when we first learned that he only had a few weeks to live at best, my brother and sister-in-law were there as well. That night, Dad's esophagus closed up, because he had eaten solid food. (He now only drinks Ensure and water.) That night, as he was struggling because he couldn't swallow his own salivia, we realized that if he began to choke to death on his own spit, or if the esophogus wouldn't open up again, we couldn't do anything about it. We realized then, that most likely what my father will die of will be dehydration and starvation, brought about because his body will be completely unable to take in nutrition anymore. This struck both of us, because both my brother and I were quite vocal about Terri Shavio, I had even called some Congressmen regarding her case. I still feel that deliberately with-holding the nutrition and hydration from Terri Shavio was morally wrong, because what was wrong with her was not otherwise life-threatening and her parents were wanting to continue to care for her. The difference with my dad's case is that even if we put nutrition and hydration into his body via IV, the cancer will progress to the point that his stomach will be unable to metabolize the nutrition and he'll die anyway. As he is in constant pain now, it would be morally wrong to put him through that.

Of course, another huge difference between Dad and Terri Shavio is that he made a fully conscience and informed decision based upon the facts of what he is now going through.

So, I guess the thing to consider about DNR's is this: Will resuscitation serve to restore life, or simply prolong a natural death?

 

[Drew]

I, like many of you sadly, have also dealt with a loved one lingering at death's door. And there is a sense indeed in which death is a merciful release in such cases. And I agree with the principle of a DNR, with the important qualification that there is little or no hope of recovery.

However, as Chrsitians, it is important that we do not collude with the world's view about death. The world will tell you that death is "natural", a "part of life", a "thing to embraced", etc. Now perhaps there are some good motivations here. But the Christian needs to remember that death is far from "natural" - every death is a repudiation of the goodness of God's creation.

So while we need to be merciful to those who are suffering, we need to view death as an enemy, a thing to be overcome and defeated, not embraced. And God, at great personal pain, has indeed defeated death.

So what does that mean for us? One thing it means is that we should participate in the war against death. While we already know the outcome - that at Jesus return, resurrection will restore us - we need to at least act in a manner that mimics what God has done.

While the victory of death has been achieved by God and God alone, I believe we are called to enact that victory in the present as much as we can. And for those of us who are not medical researchers, we should give money to medical causes, take care of our bodies, and generally seek to preserve and promote life.

I once read a brochure in a funeral home which, while perhaps well-intentioned, advised adults to tell children that death is "natural", a "part of life", etc.

This is not the way of the gospel. Jesus agonized on the cross to give life - to fight and secure a victory over this greatest enemy of God's good creation.

24Then the end will come, when he hands over the kingdom to God the Father after he has destroyed all dominion, authority and power. 25For he must reign until he has put all his enemies under his feet. 26The last enemy to be destroyed is death

The "world" will tell you that this belief of the Christian is simply a way for people to deal with fear of the certainty and finality of death. I suggest that in the scriptures we see a long, complex, highly inter-connected plan of redemption from death that is so compelling in its richness and subtlety, so unexpected and yet so coherent, that we need to take this message to the world so that God can rescue more from needless despair.

 

[lovely]

Before my late husband died, we filled out papers at the hospital with their counselors within a half hour or so of our arrival. While the children and I were driving to the hospital, I was begging God to save his life, and determined to fight this terrible thing. When they asked me, I told them to take any means necessary to save him, and I never questioned that choice. I felt as if we were doing battle at that moment, and I was going to fight for my husband's life. Later in the chapel, while he was having surgery, I could only pray God's will be done in the matter. I found out he was dead within minutes of that prayer.

I guess my point is, without even thinking I fought for life, it was in me to do that, but the reality while praying was that he wouldn't die a moment before he was supposed to, and I really had no power over the matter. This actually brought me comfort, really, because I knew that God, in His goodness, was doing what was best.

Pray, and ask the Lord to guide you, biblereader. I don't know what legal things are involved with these DNR orders, but I do not believe that I could ever have one. I want my family to fight for my life, as I plan to do, but to let go when it's appropriate and trust the Lord to take care of the matter...I believe the Holy Spirit will lead them.

I agree with Drew, though, it is not natural. It's a grievous thing, it's a consequence of sin, and it causes a great deal of pain even when the one who dies is a believer. We can rejoice because they know the Lord, but there is definately a season of mourning to follow.

The Lord bless you.

 

[DavidLee]

I have witnessed the deaths of several family members. Some of them lingered and endured "heroic" measures before slipping into death. I had no control at the time but I saw the pain that seemed to consume everyone involved.

For the believer, death is not something to be feared or struggled against.
Jesus said:

“Jesus said to her, “I am the resurrection and the life; he who believes in Me will live even if he dies, and everyone who lives and believes in Me will never die. Do you believe this?â€Ââ€Â
(John 11:25-26 NASB)

Paul said:

“But when this perishable will have put on the imperishable, and this mortal will have put on immortality, then will come about the saying that is written, “DEATH IS SWALLOWED UP in victory. “O DEATH, WHERE IS YOUR VICTORY? O DEATH, WHERE IS YOUR STING?â€Ââ€Â
(1 Corinthians 15:54-55 NASB)

And:

“For to me, to live is Christ and to die is gain.â€Â
(Philippians 1:21 NASB)

I know you did not ask out of simple curiosity and you have my deepest sympathy. I want provide some comfort if I can, but it's hard to convey in text, apart from the word of our God.
He is able to guide you, as you no doubt already know.

For me (and only me, I cannot impose my view on another), the DNR would be an acknowledgment of the divine sovereignty of my creator. If my own prayers and the prayers of my family cannot persuade God to restore my body to physical health, then I do not want mere men to subject me to measures that keep my family and friends from having to say goodbye, if even only for a season.

I pray God's blessings on you and your loved ones. May He bring clarity of thought to you in peace.

 

[Vic C.]

Man, this is one emotional topic for sure. It emphasizes just how personal a decision like this must be. It's a scenario that I may be facing in the near future. It's one that can tear a family apart or bring them closer together. I will want to do as God's will me to do and above all respect God's will no matter what.

Mom has undergone the removal of part of a lung two years ago to combat cancer. Now she may be dealing with colon cancer in the near future. So, I'm sure quality of life will come up. Dad, well he's 76 going on 50, so I nor my sister know how we may react... unless his health takes a serious turn.

I feel much the same way as David does above and I pray above all else that God is there every step of the way, guiding in wisdom as only HE can do.

 

[handy]

There has been so much that has been said here that is so right. Drew is right, God didn't create us to die. He created us for life. But, while not wanting to get into a disagreement over semantics, death is natural to our earthly bodies. Perhaps, for the sake of this discussion, we can use the word 'normal' if 'natural' seems too much a compromise with sin. However, as long as the Lord tarries, we will experience earthly death at some point or another.

The thing is, what does the believer do about it? Is it more of a testimony to fight death as something that is not part of God's creation? Or, rather, is death something that a Christian can and should face without fear, because Jesus did indeed conquer death on the cross? In Ecclesaties, we are told that there is a time to live and a time to die, and we are also told, I believe in one of the Proverbs, that God has numbered each of our days. Since we are in the position of 'seeing through the glass darkly", and since death is such a grevious time, it's hard for us to know when to fight for life and when to let go and let His will be done.

For the believer, one thing that cannot be underestimated is how the Holy Spirit works in and through this time. And, it is to the Spirit first and foremost that we must go to gain the wisdom, strength and comfort we need to get through these times. We can be sure the Spirit will indeed work within our hearts to allow us to see His will.

Death isn't pleasant. Jesus wept when Lazarus died and He also wept when it was His time to die. But, because of His work on the cross, we Christians do have the blessing of being at peace with death, even though we wish it didn't have to occur.

I know that this time for Dad is temporary. His body is degraded to the extent now that he is losing even basic dignity abilities (dressing himself, bathing and going to the bathroom by himself). But, only for now, only for this moment. I am convinced in this time that the victory that Christ bought for us on the cross is not to prolong life in a diseased, pain-filled body, but rather the assurance that God has done what was needed to bring us to the new heaven and the new earth in our resurrected and imperishable body to live eternally with him.

To get back to the matter of DNR's it is very important to understand the legalities of them. There are pros and cons as there are with all choices we face here on this earth. One of the bad things about modern medical science is that they can keep a body alive. When Dad's throat closes completely, (and under normal circumstances would die within a few days) we could hook him up to IV's and have nutrition and hydration pumped into his body and have him last for months. Is this the "godly" thing to do? One peace that the Holy Spirit has provided Dad and all of us who are with Dad at this time is that it isn't, and that we are to simply let Dad go. It's what his desire is, and it is what we know (and we are all Christians and we are all united in this) to be God's will for Dad at this time. However, if Dad hadn't signed the DNR, then the choice would NOT be his. He would have to be under a doctor's care and the doctor as well as the hospital that he would have to be in would be required to do whatever they possibly could do and who knows how long he would linger under those circumstances. Of course, different states and even different hospitals within a state have differing policies. If one is going to refuse a DNR, then it is very important to discuss with both your doctor and the hospital staff what would happen, because the choices are pretty much all theirs, rather than yours at that time.

Death comes at each one of us in an individual way. There are times to live and to fight tooth and nail and throw everything we can to push death off. And, there are times to realize that it is time to let go. It isn't a question of 'right' or 'wrong' or even 'godly' or 'ungodly'. It's a matter of what one is facing, and what decisions one can make and when one can make them. Ultimately, it is all in God's hand's. But, God has a long standing habit of allowing we humans to live with the consequenses of our actions. So, whether and when to sign a DNR is a question that can be answered by only one way and that is by praying to the Spirit for wisdom.

 

[Drew]

IFor the believer, death is not something to be feared or struggled against.
Jesus said:

“Jesus said to her, “I am the resurrection and the life; he who believes in Me will live even if he dies, and everyone who lives and believes in Me will never die. Do you believe this?â€Ââ€Â

I certainly think the text you cite supports your assertion about fear, but I do not think Jesus is teaching us not to "struggle against" death.

I think that we are indeed called to that struggle, subject of course to perfectly legitimate decisions to not prolong life where there is poor quality of life and little or no hope of recovery.

When we as Christians "struggle" against death - whether it be by supporting medical research or by speaking out against abuses of the concept of mercy killing - we are sending the world an important message: Death is an enemy to be fought as an enacting of the victory over this enemy that has been secured by God.

God has defeated death. But when we struggle against it in little ways, we - at least symbollically - align ourselves with God. Death is the enemy of His beloved creation. It is something to be fought. The world needs to know that death is not "natural" and "part of life". And when they see us "fighting the fight" they may well be moved to ask: " Why are you doing that?".

And the next step should be obvious.....

 

[Carol Lowery]

I pretty much feel the way David and Vic do....it's such a painful subject for anyone. I lost my 12 year old son to a drunk driver as he was crossing the street, and short one week of a year my husband to a drunk driver that ran him off the road a mile apart from each other. But I wouldn't have wanted someone trying to keep my child or my husband alive with the injuries they suffered to their bodies. My husband/son would have been a vegetable, brain matter came from his nose and left ear from the empact. I could not have allowed anyone to try and substain a life that no longer existed as they knew it consciously, and prolong the life in a death state with no hope of recovery. Man/doctors can be cruel in some situations in substaining a dead life....there was nothing that could even be used as a donor on either one of my loves. I would have like to been able to bless/give life/sight/heart/main organs to another, but that choice was just not there for me under the circumstances of their injuries/death. I too am a donor....if I can bless someone with sight from the eyes I no longer use....then let them be bless to see their family too....it's better than letting them go to waste by deaths process to the body.

Kudos HIM,
Carolpsalm91<><

 

[Vic C.]

The thing is, what does the believer do about it? Is it more of a testimony to fight death as something that is not part of God's creation? Or, rather, is death something that a Christian can and should face without fear, because Jesus did indeed conquer death on the cross? In Ecclesaties, we are told that there is a time to live and a time to die, and we are also told, I believe in one of the Proverbs, that God has numbered each of our days. Since we are in the position of 'seeing through the glass darkly", and since death is such a grevious time, it's hard for us to know when to fight for life and when to let go and let His will be done.

Oh Dora, you just brought a tear to my eye and a quote and a few songs to mind. I won't quote Turn, turn, turn because that is too obvious. ;-) There is a Billy Graham quote that came to me:

My home is in Heaven. I'm just traveling through this world.

... and that brought to mind a Dolly Parton song; "Travelin Through".

Like the poor wayfaring stranger that they speak about in song
I'm just a weary pilgrim trying to find my own way home
Oh sweet Jesus if you're out there, keep me ever close to you
As I'm travelin', travelin', travelin', as I'm travelin' thru

I guess it's a bit more comforting knowing if the one dying knows the Lord. We know He has overcome the world and death was swallowed up in victory through His dying for us. The real dilemma is, how do we convey that understanding of death to the unbeliever? If I could only know I could prolong death long enough for just one more testimony and witness. IF...

"And I am not frightened of dying, any time will do, I don't mind.
Why should I be frightened of dying? There's no reason for it, you've gotta go sometime."
Pink Floyd

 

[Drew]

My home is in Heaven. I'm just traveling through this world.

At the risk of coming across as confrontational, I suggest that this statement is incorrect theologically (at least without making it clear that Heaven is a temporary stop only), and the error it contains is precisely part of the problem of how the church represents the gospel to the world.

I think the scriptures teach that our ultimate home will be in a restored and transformed physical creation, not in any kind of "Heaven". Heaven is where we "wait" to be resurrected, so don't get too attached to the place - if the writers of scripture are correct, you will only be there temporarily.

Why am I bringing this up in the present context? Because to the extent that we think our final destination is heaven (and not earth), we implicitly devalue the goodness of the physical creation - as if it is something that is going to be thrown away when God wraps up history. The problem with this, in turn, is that it very subtly leads us to be overly willing to escape this "temporary world which will ultimately be done away with".

A theologically correct view validates the goodness of this material world and our lives in it and, I suggest, motivates us to think differently about death and how to treat its approach.

And I hasten to add that this does not mean that I do not empathize with the stories of suffering and the imposition of needless suffering. I am speaking more generally than this - fighting to preserve life of reasonable quality in this world is an act that conforms with God's defeat of death and His vindication of His creation.

 

[Vic C.]

Drew, this is NOT a theology debate. You just did what Dora wanted to avoid and that is arguing over semantics. Take Billy's statement in it's broader context and let it go please. Thanks.

 

[lianna7]

My friend Susan is dying from cancer and she has a DNR also. About 10 days ago while I was visiting her she got unresponsive. She was taken to the VA. hospital and they went by the DNR . They gave her no fluids or nourishment of any kind. For 2 days I watched her as she slept , but she woke a couple times and said hi then out again. Her son finaly got there and I left them alone , within 15 min. he came out and said his mom was awake . Sure enough she was , she was confused because she didnt remember the last day at home or her time in the hospital. As another hour passed she was very choherent and she said ''Im hungry , I would like a hamberg and milkshake. Well the doctor came and ask her what mounth it was and a bunch of other things . He said she was back, and to give her anything she wanted . I have this feeling she came back around because of her son and if he had waited much longer she would have more then likely died. She is now in the Hospic unit at the VA. and she is being kept comfortable , but the DNR is still in affect if and when she goes into a comotose state. I think that people should have the right to decide things like this , I mean do you realy think God would want any of his children to suffer ? Doctors sometimes push the limits to see how long they can keep a person alive who they know will go through horrobile pain . I can't see the logic to that , and feel its crule to do so.

 

[Biblereader]

My dad has signed a DNR. If he begins to choke because his esophagus has closed, or if his heart fails, we will do nothing to resuscitate him.
The morality of this comes via the circumstances. My dad is dying of inoperable cancer.


Sorry to hear about your dad, but, I understand. Medicine HAS advanced, too far in some ways, and to keep a person from dying a
natural death, is prolonging their agony.
My mom signed a DNR, and she died of an aortic aneurysm, plus, she had a spot of cancer on her lung, so, she signed a DNR.

I think medicine has gone crazy, in some cases, keeping people from dying natural deaths.
I also have NOTHING against taking medicines, for heart, diabetes, cancer, all that, but, at some point, the body has to be let go.

 

[Biblereader]

I have this feeling she came back around because of her son and if he had waited much longer she would have more then likely died. She is now in the Hospic unit at the VA. and she is being kept comfortable , but the DNR is still in affect if and when she goes into a comotose state. I think that people should have the right to decide things like this , I mean do you realy think God would want any of his children to suffer ? Doctors sometimes push the limits to see how long they can keep a person alive who they know will go through horrobile pain . I can't see the logic to that , and feel its crule to do so.

I think you're right, she came back around to see her son. God brought her back awake.
I believe God kept my mom alive until I could get to the hospital many states away, so we could say good bye, even though she was sedated.

I think, a person will not die until God allows them to. My daughter said, and she's a nurse, that some people who you think are going to die, don't, and some people who you think are going to live, don't.
It's up to the Lord.
It's a hard decision to make, to sign a DNR. Very hard, and I know someone who suffered from guilt and depression because she had to "pull the plug" on her mother.
She's ok, now, but, boy, DNR is both good and difficult. I was just wanting to know what others felt.
I understand why my mother and mom in law signed DNR papers.

 

[Biblereader]

And I hasten to add that this does not mean that I do not empathize with the stories of suffering and the imposition of needless suffering. I am speaking more generally than this - fighting to preserve life of reasonable quality in this world is an act that conforms with God's defeat of death and His vindication of His creation.

I agree, Drew, fighting to save a life is good. Using machines, operations, medicines, all that, is good, and if the person lives, that's good.
The words" reasonable quality" bother me, though.
It's not up to you to define what a quality life is. Christopher Reeve had no use of any part of his body, except his head, his mind. Conjoined twins may be strange to some, but, their lives are of great value.
All life is of great, eternal value. ALL life. Abortion is wrong, so is euthanasia. So is assisted suicide.
I was talking about what the moral implications are about signing a DNR paper, or, should we just leave it ALL up to God? I take meds, by the way, so, I'm not a Mormon, or whatever that religion is who refuses any and all medical help.
Luke was a doctor. Nothing wrong with doctors or nurses.
I guess I also have a problem with keeping a person alive who actually has no brain activity.
Just to cut out their organs and give them to someone else.
My one reason for not being an organ donor, and I know this will get flack, is, what if my cornea or liver, or whatever, is given to someone who ends up killing someone?


Another thought: what is the origin of the DNR paper? Who thought that up, and why?

 

[lianna7]

Hi Biblereader,
I found a link that explains alot about the DNR and what happened before it was put into affect. Thought you and others might want to read it.

http://www.cqc.state.ny.us/newsletter/i ... thcare.htm

 

[Biblereader]

I pretty much feel the way David and Vic do....it's such a painful subject for anyone. I lost my 12 year old son to a drunk driver as he was crossing the street, and short one week of a year my husband to a drunk driver that ran him off the road a mile apart from each other. But I wouldn't have wanted someone trying to keep my child or my husband alive with the injuries they suffered to their bodies. My husband/son would have been a vegetable, brain matter came from his nose and left ear from the empact. I could not have allowed anyone to try and substain a life that no longer existed as they knew it consciously, and prolong the life in a death state with no hope of recovery. Man/doctors can be cruel in some situations in substaining a dead life....there was nothing that could even be used as a donor on either one of my loves. I would have like to been able to bless/give life/sight/heart/main organs to another, but that choice was just not there for me under the circumstances of their injuries/death. I too am a donor....if I can bless someone with sight from the eyes I no longer use....then let them be bless to see their family too....it's better than letting them go to waste by deaths process to the body.

Kudos HIM,
Carolpsalm91<><

Your horrendous, heart-wrenching experiences brings up another sub topic: How do we all deal with grief?
I've met some people who REFUSE to cry, or even bring up the subject.
Others dwell too much on it, and their lives come to a standstill.
Some cry, when something "triggers" it.
I guess the grief never goes away. I know there are supposed to be stages to grief, but, if a person refuses to go through them, does that mean they're doing something wrong?

 

[Biblereader]

Hi Biblereader,
I found a link that explains alot about the DNR and what happened before it was put into affect. Thought you and others might want to read it.

http://www.cqc.state.ny.us/newsletter/i ... thcare.htm

Thank you, so far, it looks like the DNR was invented, to take the burden OFF the relatives.

 

[Carol Lowery]

I held my grief inside until it broke me.....and it broke me good when it did. I was always the rock everyone stood on and I'm still treated as such for some reason......I'm the one everyone comes to for resolving problems/shoulder to cry on, and prayer. (I'm not complaining) After all these years I've just recently in the last 3-4 years been able to express my experiences without the grief of my loss love ones. Of course I have my private sad days on the holidays and such, but the wonderful memories that I have of both of them out weigh the grief by far. And I'm so blest for the time I did have with them, cause I believe my grief would have been far greater without them in my life or never knowing them......they contributed along the way to who Iam now, and that's what keeps their love for me alive and visa versa.

Kudos HIM,
Carolpsalm91 <><