Coming to Terms with End of Life Issues

By Jim Stinson, Director of Spiritual Life

“I have decided to expire,” were her exact words. They were offered in response to my observation that she was not attached to the oxygen tank that had been her companion for nearly a year and the question why not? Because we both love repartee and because it felt so tense in her room, I said, “When did you become a license or a library book?” She laughed and said, “I really meant to say, “I have decided to die. I am over ninety years old, have had a good life, and just don’t want to live this way anymore.” After a good listening session and some time in prayer, I left to respond to a call from Bishop Wicke Health and Rehabilitation Center, our skilled nursing and rehab facility on our Wesley Village campus.

Upon getting there I went to see a resident, probably in his sixties, who wanted to speak to me about his decision to forego any further dialysis, knowing full well that doing so will likely bring a more rapid death. After a good visit, I left his room consumed with thoughts about the recurring questions surrounding ‘end of life’ care and the fact that there are no final answers to them. Every situation is different, every person facing them is unique, and one answer for every situation doesn’t satisfy!    

The questions that consume my thoughts in such situations center on who gets to make the decision to stop treatments that are designed to prolong life, rather than to cure disease. What are the factual realities? Is the one making the decision the most appropriate person to be doing so? Are there signs of depression or other signs to suggest an emotional inability to make a truly informed decision? Who gets the final vote?

Conscious, informed decisions, in light of ever-increasing advanced technology, are the most difficult of all to make. Especially is this the case when the person having to make them has been raised in a faith tradition that values life and teaches ‘only God can decide when it is over?’ My friend who had decided to ‘expire’ had one question in the forefront of her mind when she announced her intentions. “Am I going to be in trouble with God for making this decision?”   Weighty! Fearsome! Cause for second-guessing! Probably all of these things!

Believing that God’s love is all-encompassing and believing no one person has all the answers and that the person most involved (providing she is cognitively able to do so) should be the one deciding, my response was to ask other questions, hopefully without bias or judgment “Who put you on oxygen, God or the doctor? Is there a possibility that ‘heroic measures’ are not really heroic, but a way to postpone the natural end? Could your decision be a statement that living and dying are natural events and to be accepted?” Her response was quick and clear after we discussed her answers. “Thank you, in different words, those are my questions. I think I’m comfortable even more now than I was before we talked through your questions.

For any of us caring for or about a person trying to come to terms with end-of-life issues, there is danger in imposing our answer on someone who is in a very different place than we are, both spiritually and physically. Judgment is not our task! Neither is denying the person their own decision-making ability! Our task is empathy and support, trusting any judgment to the one whose love is all-encompassing and never-ending.

About the Author

Rev. Jim Stinson has served as the Director of Spiritual Life for United Methodist Homes since 2002 and ordained pastor of the United Methodist Church since 1963.

Jim frequently writes for our Senior Living Blog and is also the author of a newly released book, entitled, Just Because I Am Old. 

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