Comfort on the Deathbed (Or: A Pastor’s Most Important Resource)

Simon Goulart was a Reformed theologian and pastor from France who served in Geneva in the middle of the 16th century.  His preaching and teaching were solidly biblical, clearly doctrinal, and very applicable.  One example of this is his biblical comfort he gave to Christians on their deathbed.  Scott Manetsch gives a good summary of Goulart’s pastoral care:

As Christians approach death, Goulart recognizes, they are frequently tempted to doubt God’s promised salvation and despair of their future hope.  In this spiritual drama, Satan is especially active.  Goulart’s discourse ‘Remedies Against Satan’s Temptations in our Final Hour’ enumerates the stinging accusations and doubts that Satan launches against God’s children as they struggle on their deathbeds.  The voice of Satan accuses: ‘You are a miserable sinner, worthy of damnation.’  ‘Your sins are too great to be forgiven.’  ‘How do you know that the promise of the gospel pertains to you?’  ‘Are you certain that your repentance and faith are genuine?’  ‘How do you know that you are among God’s elect?’  In response to each of these attacks, Goulart provides the faithful Christian a ready answer, drawn from the pages of Scripture.

For example, when Satan questions the believer’s election, the Christian responds: ‘All true believers are sheep of Jesus Christ, elected in him to eternal life.  Psalm 23 says that ‘The Lord is my Shepherd.’  And Psalm 100 says ‘Know that the Lord is God.  It is he who has made us, and we are his; we are his people and the sheep of his pasture.’  So too, Jesus Christ says in John 10, ‘My sheep hear my voice.’  I have heard this voice and heeded it.  Thus, I am one of the sheep of this Great Shepherd, who has given his life to bring me into his sheepfold, having rescued me from your jaws, O roaring lion.’

Clearly, Goulart believed that God’s Word was to serve as the pastor’s most important resource in caring for Christians on their deathbeds.  Scripture is like a ‘pharmacy’ for wounded souls, he asserted.  It offers a ‘secure harbor for agitated consciences.’

The above quotes were taken from Scott Matnetsch, Calvin’s Company of Pastors, p 297-298.

Shane Lems
Covenant Presbyterian Church (OPC)
Hammond, WI, 54015

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End of Life: On Refusing Treatment (Meilaender)

 Tragically, it happens: we are diagnosed with an illness or condition that means death is inevitable sooner rather than later.  To knowingly face death is one of the hardest things in life, and it leads to some very difficult choices.  Should we undergo treatment(s) trying to prolong life?  Or should we forego them and perhaps better enjoy the short time we have left?  This isn’t a black-and-white ethical area.  There are various factors that lead Christians to different decisions in this area.

I like Gilbert Meilaeander’s wisdom here.  In chapter seven of Bioethics: A Primer for Christians he talks about refusing treatment.  The entire chapter is very much worth reading, but since I can’t put it all here, I’ll summarize:

“On the one hand, we ought not choose death or aim at death.  But on the other hand, neither should we act as if continued life were the only, or even highest good.  It is not a god, but a gift from God.  Thus, we should neither aim at death nor continue the struggle against it when its time has come.  ‘Allowing to die’ is permitted; killing is not.”

“If I commit suicide (an am of sound mind), I intend to die.  I aim at my death or choose death.  But, of course, there might be occasions when, if I refuse a certain treatment, I will also die.  Are they therefore morally equivalent?  Is treatment refusal the same as the forbidden suicide?  Although they could sometimes be morally equivalent – I could refuse treatment so that I will die – they need not be.  To see why we must think about the aim and the result of the action.”

“[For example] a soldier may charge the enemy, knowing that he faces almost certain death in so doing.  He does not thereby commit suicide.  He does not choose to die, even though he foresees that death is the likely, perhaps almost certain, result of his action.  …Dying is not part of his plan of action, just its very likely result.”

“This distinction between an act’s aim and its result is crucial to bear in mind when we consider decisions to refuse or withdraw treatment.  The result of such decisions may be that death comes more quickly than it might have.  Nevertheless, the fact that we ought not aim at death for ourself or another does not mean that we must always do everything possible to oppose it.  Life is not our god, but a gift of God; death is a great evil, but not the ultimate evil.”

“There may come a time, then, when it is proper to acknowledge death and cease to oppose it.  Our aim in such circumstances is to care for the dying person as best we can.  …Because life is not our god, we need not accept all burdens – no matter how great – in order to stay alive.  …Treatment may be refused or withdrawn when it is either useless or excessively burdensome.  In either of those instances, refusal of treatment is not the forbidden suicide or euthanasia.”

These are just a few highlights of an excellent chapter that gives some ethical Christian wisdom on when to accept treatment and when to refuse it.  If you have – or are – wrestling with this difficult decision, I very much recommend Meilaender’s contribution in Bioethics.

Shane Lems
Hammond, WI

Paralyzed by Fear? (Stott)

Our Sovereign God: Addresses from the Philadelphia Conference on Reformed Theology The 1977 publication Our Sovereign God is a nice collection of articles from J. M. Boice, R. C. Sproul, J. I. Packer, John Stott, and so on.  The book is actually a collection of the addresses from the Philadelphia Conference on Reformed Theology from 1974-1976.  This is a good resource to own.  Here’s one excerpt from John Stott’s address called “The Sovereignty of God the Son:”

“Many Christians are paralyzed by fear: fear of the unknown, the occult, circumstances, people, demons, the number 13.  For example, many high-rise hotels in America do not have a thirteenth floor.  The floors at numbered 10-11-12-14-15-16, because citizens are too superstitious to sleep on the thirteenth floor.  They do not seem to have the intelligence to realize that it is still the thirteenth even if you call it the fourteenth.”

“How can we be paralyzed by fear if the very things of which we are afraid are under the feet of Jesus?  Jesus is Lord.  What are you afraid of?  It is under his feet.  How can we dread death?  How can we think of death as anything but a trivial episode, a transit lounge between life here and life in its fullness, if Jesus the Lord has destroyed death and him who has the power of death, that is, the devil?  It is because of the supreme lordship of Jesus over sin and death that we ourselves can be saved from death.”

John Stott, Our Sovereign God, p. 19.

Shane Lems
Hammond, WI

Death as a Dead Thing (Athanasius)

In one section of On the Incarnation by Athanasius (b. 297) he talks about the victory we have in Christ over death.  This is a nice meditation that reminds us of the truth that death cannot separate us from Christ.

For of the destruction of death, and of the cross having become the victory over it, and of its no longer having any power but being truly dead, this is no slight proof but a very certain index; namely, that by all the disciples of Christ it is contemned, and they all make an attack against it, and no longer fear it, but by the sign of the cross and by faith in Christ trample upon it as a dead thing.

For formerly, before the Divine sojourn of the Savior, even to saints themselves death was terrible, and all mourned those who died as perishing (Cf. Job 18:14; Ps. 55:4, 88:10 ff., 89:47 f.; Isa. 38:18). But now that the Savior has raised His body, no longer is death terrible, but all who believe in Christ trample on it as naught, and choose rather to die than to deny their faith in Christ. For they know full well that when they die they do not perish, but indeed live, and become incorruptible through the resurrection.

For as, when a tyrant has been utterly vanquished by a true emperor, and is bound hand and foot, all who pass by jeer at him, smiting and abusing him, no longer fearing his rage and cruelty, because of the victorious emperor; so also death having been conquered and branded as infamous by the Savior on the cross, and bound hand and foot, all in Christ who pass through trample on it, and as witnesses to Christ deride death, scoffing at it, and saying the words written against it above: ‘Where, Death, is thy victory? where, Hades, thy sting?’ (Hos. 13:14).

Athanasius of Alexandria, Athanasius: On the Incarnation of the Word of God, trans. T. Herbert Bindley, Second Edition Revised (London: The Religious Tract Society, 1903), 91–93.

Shane Lems
Hammond, WI

The Christian and Death-bed Guilt (Newton)

Some Christians struggle with their guilt, sin, and unworthiness more than others.  Quite a few Christians have a roller coaster experience with guilt.  For awhile their guilt almost disappears and they very much feel the comfort of being forgiven and loved by God.  But other times their guilt brings them grief because they can’t feel God’s forgiveness and love.  John Newton does a great job of talking about grief over sin and comfort in Christ on the death-bed.  This is an excerpt of a letter to a friend in 1774.

We have had trying and dying times here: half my time almost has been taken up with visiting the sick. I have seen death in a variety of forms, and have had frequent occasion of observing how insignificant many things, which are now capable of giving us pain or pleasure, will appear, when the soul is brought near to the borders of eternity. All the concerns which relate solely to this life, will then be found as trivial as the traces of a dream from which we are awakened. Nothing will then comfort us but the knowledge of Jesus and his love; nothing grieve us but the remembrance of our unfaithful carriage to him, and what poor returns we made to his abundant goodness. The Lord forbid that this thought should break our peace!

No; faith in his name may forbid our fear, though we shall see and confess we have been unprofitable servants. There shall be no condemnation to them that are in him: but surely shame and humiliation will accompany us to the very threshold of heaven and ought to do so. I surely shall then be more affected than I am now with the coolness of my love, the faintness of my zeal, the vanity of my heart, and my undue attachment to the things of time. O these clogs, fetters, vales, and mountains, which obstruct my course, darken my views, slacken my pace, and disable me in service! Well it is for me that I am not under the law, but under grace.

As Newton looked ahead and thought about his own death, he knew his own heart well enough to realize that he would probably grieve because his service to Christ was so weak and imperfect.

But Newton understood sovereign grace.  The last line of this quote isn’t a sad concession, but a strong confession that all of his hope in life and in death was that God is gracious to sinners.  “Saved by grace” is not just a slogan.  It is comforting gospel truth in life and in death.  It’s true whether the Christian feels it or not.

I think we can all say this with Newton:

“Well it is for me that I am not under the law, but under grace.”

This quote from Newton is found in volume 2, page 201 of his Works.

Shane Lems
Hammond, WI

No More Chemo

Bioethics and the Christian Life: A Guide to Making Difficult Decisions Cancer destroys (too) many lives.  Most of us know someone who has struggled or is struggling with some form of cancer; some of our readers are perhaps dealing with it right now.  In this context, the question sometimes arises: should I undergo or forgo chemotherapy?  This is a tough question to answer for everyone involved.  There are no easy answers and it takes biblical wisdom, prayer, and counsel to come to a conclusion.  I appreciate David VanDrunen’s notes on this in his book, Bioethics and the Christian Life.  The following specifically has to do with the choice to forgo more chemo when it is an end of life issue.

“Actively bringing about a person’s death – by drowning, lethal injection, or whatever – is quite simply not the same thing as deciding not to intervene when something else is bringing death upon a person.  One of the most important reasons why this is the case is that death is a force that exists independent of human agency.  Despite the pretensions of modern medical technology, human beings did not invent death nor can they eliminated it.”

“…Another consideration that may help us to appreciate the moral distinction between killing and letting die is the fact that with the former we are necessarily aiming at death as our goal while with the latter this is not necessarily (and usually not) the case.  To kill – that is, to actively take someone’s life – is by definition to choose death, whether this be done out of wicked or merciful motives.”

“To let an ill person die (ourselves or another), however, may well be to choose not death but one form of life over another.  A person’s choice to forgo an additional round of chemotherapy when her cancer is evidently a terminal case is probably not a choice to die.  The fact of death has already been decided, apart from the cancer victim’s will.  Instead, the choice to forgo more chemotherapy may be a decision to live a somewhat shorter life than the chemotherapy might make possible, but a shorter life that is free from the debilitating burden of chemotherapy and that enables the person to enjoy her remaining life far more – to finish projects, to spend time with loved ones, and to get her house in order.  It is not necessarily a choice between life and death, therefore, but a choice between one kind of life and another kind of life (210-211).

VanDrunen goes on to say that we always make choices about various kinds of life – some choices even increase the chance that our lives will be shorter.  For example, by choosing to drive a car each day, our lives might be shorter than if we would not drive.  Also, if someone chooses to be a firefighter, he knows his life might be shorter than if he’d become a school teacher, “yet no one would claim that such a career decision is a choice of death over life” (Ibid.).  This discussion may not answer all our questions, but it does help when we come face to face with end of life situations.

If you want to learn more about Christian bioethics – beginning of life and end of life ethics specifically – I highly recommend this book: Bioethics and the Christian Life.

shane lems

“O Death” by Chrysostom

I ran across these great words by Chrysostom (d. 407 AD) in Marva Dawn’s book, Talking the Walk.  They can also be found in Chrysostom’s “Catechetical Address.”

Let no one fear death,
for the Savior’s death has set us free.
He who was held prisoner by death
has annihilated it.

By descending into death,
he made death captive.
He angered it
when it tasted of his flesh.

Isaiah saw this, and he cried:
Death was angered when it encountered you in the lower regions.

It was angered, for it was defeated.
It was angered, For it was mocked.
It was angered, for it was abolished.
It was angered, for it was overthrown.
It was angered, for it was bound in chains.

It received a body and it met God face to face.
It took earth and encountered heaven.
It took that which is seen and fell upon the unseen.

O Death, where is your sting?
O Grave, where is your victory?

Christ is risen and you are overthrown.
Christ is risen and the devils have fallen.
Christ is risen and the angels rejoice.
Christ is risen and life reigns.
Christ is risen and not one dead remains in the grave.

For Christ, being risen from the dead,
is become the first fruits of those who have fallen asleep,
and to him be glory and honor, even to eternity.
Amen!

– Chrysostom-

rev. shane lems
covenant presbyterian church (OPC)
hammond, WI