Extending Life Without Quality of Life

Extending Life Without Quality of Life

One of the challenges produced by the progress in medicine is the question of the role of doctors when a patient nears the time of death. In the old days, doctors had a code that said they would “do no harm,” which resulted in extending life without quality of life.

I had a personal experience with this issue when my disabled son Timothy was in the hospital after contracting COVID from a care worker. Doctors told me that Tim would never recover, but they had to give him a standard COVID treatment. Tim did survive but was not allowed to have any contact with family. He could not talk, was blind, could not stand or sit up, and could not feed himself. Eventually he was placed in a nursing home where I was allowed to visit him, and I did weekly. Although he could hear me, he was unable to respond. I read to him, tried to feed him, and ensured his stuffed animals were around him. After more than a year in the nursing home, he died.

The question in a case like Timothy’s becomes whether a doctor should be allowed to assist in dying when the apparent result was extending life without quality of life. Laws in Belgium, the Netherlands, and Canada allow doctors to administer euthanasia. The next step in these countries is to allow physicians to provide medical assistance in dying for the mentally ill. Canada has delayed the implementation of that option for physicians until 2027 to allow doctors and facilities time to adjust to this new law. Peter Singer, the DeCamp Professor of Bioethics at Princeton University, has advocated for euthanasia for virtually any cause.

For Christians, the issue is especially relevant. The New Testament in 1 Corinthians 3:16-17 says that God’s Spirit lives in our bodies and that the body is sacred for that reason. I Corinthians 6:15-17 uses that view to explain why prostitution is a sin. As modern medical science has advanced to the point of extending human life, it has also found ways to eliminate pain, but my son never showed evidence of suffering from pain. The problem remains of extending life without quality of life.

Euthanasia involves the same issues as abortion. Singer would empty prisons, nursing homes, and mental facilities by applying euthanasia to the people there. The fact is that much of the money spent on medical treatment is spent during the last year of life. Think of the savings if we were to eliminate everyone deemed to be within a year of dying. Do we really want to live in a culture that uses death as a means of removing a person who is inconvenient or difficult to sustain? But isn’t that what abortion is all about?

— John N. Clayton 2024

Reference: “Canada again delays assisted dying for the mentally ill” on BBC News for February 1, 2024.

Life After Death – A Concept Common to Humans

Life After Death – A Concept Common to Humans

Humans from the earliest times have believed in life after death. One of the unique human properties is that we alone believe in a continued existence when our physical life has ended. Most animals simply abandon a dead member of their species. There has been some attempt to claim that elephants, whales, and apes exhibit mourning and stay with the body of a deceased member of their group. However, many researchers agree that interpreting their actions as mourning is not justified. Humans tend to view animal behavior in our image, a process known as anthropomorphism.

As science discovers more fossils of ancient humans, the pattern of preparing a deceased member of the group for another existence becomes apparent. Anthropologists are interested in a South African cave system burial site. There they have found 28 skull fragments and six teeth of what appears to be a child with human characteristics 35 feet (10.6 m) below ground. The bones do not seem to have been washed into the cave or dragged in by scavengers or predators. Researchers gave the specimen the scientific identity of Homo naledi.

Lee Berger of the University of Witwatersrand in Johannesburg reports that this fossil shows strong evidence of a “ritualized body disposal” of the specimen, which they nicknamed “Leti.” Ancient burial sites have almost always indicated that others prepared the deceased for life after death. Sometimes the body is mummified, and sometimes jewelry or weapons are left with the body. There are even cases where an animal or mate was buried with the deceased.

There is a scant reference to life after death in the Old Testament. In 2 Samuel 12:23, David expressed faith that he would see his deceased baby in the future. Job said that after his body had been destroyed, he knew he would see God (Job 19:25-27). Daniel saw a “man clothed in linen” who told him he would “rest” and then “at the end of the days” he would rise and “receive his allotted inheritance” (Daniel 12:13).

The New Testament is full of references to life after death, especially in the teachings of Jesus Christ. The war between good and evil is rooted in the understanding that death is a product of this physical world and Christ has conquered it. (See 2 Timothy 1:10; Revelation 20:14 and 21:4.)

Human spiritual nature is unique because God created us in His image. Our soul allows us to think beyond this life and anticipate an eternal, time-independent relationship with God. That concept has been present in humans from the very beginning and is still present today. Our spiritual nature allows us to express ourselves in art, music, and worship. It also gives us the hope of eternal life in an existence beyond anything this world has to offer.

— John N. Clayton © 2021

Reference: Science News 12/4/21, page 15.

Physician-Assisted Death

Physician-Assisted Death

One of the facts of life is that eventually, we will all die. Many of us have seen people endure enormous pain over a long period before death finally came. I am thankful that my wife Phyllis and my son Tim did not go through months of intense pain before passing on. Medical science has made great progress in extending life but has not been as effective in relieving pain. That is part of the reason we have seen a movement for legalizing physician-assisted death.

New Jersey passed a “Medical Aid-in-Dying” law two years ago, and last year 33 terminally ill people in the state ended their lives. Since 2016, California has had “The End of Life Option Act.” New York has a “Good Death” Act moving through the legislative process. The movement to legalize physician-assisted death is not confined to America. Holland was perhaps the pioneer of physician-assisted death in Europe. Columbia became the leader in South America back in 1997. The “Colombian Pain Institute” administers euthanasia for “intense physical or mental suffering due to an injury or incurable illness.”

The Week magazine for October 22, 2021 (page 8) carried a report demonstrating the difficulty of legalizing physician-assisted death. In Colombia, a 51-year-old woman named Martha Sepulveda has ALS and was scheduled to be euthanized. She would be the first person in Colombia to receive physician-assisted death without a terminal prognosis. However, the Colombian Pain Institute concluded that “her condition had improved” so she is no longer qualified for the procedure. Now she has a lawyer fighting for her right to die because she “is not willing to continue to live.”

Christians have concerns in this matter. In 1 Corinthians 3:16, we read that our body is “the temple of God and that the Spirit of God dwells in us.” The next verse tells us not to defile the temple. This concept is continued in 1 Corinthians 6:15-20, which teaches why a Christian should not be involved in prostitution. In ancient times, death came more quickly than in today’s world with modern medicines. Therefore, a person near death today deserves special attention and Christian compassion. In Proverbs 31:6-7, we read, “Give strong drink to those who are ready to perish, and wine to those who are of heavy hearts.” When David was near death, he was chilled, and a woman came to warm him not for sexual purposes but to relieve his discomfort. (See 1 Kings 1: 1-4).

The doctors I know are horrified at the prospect of deciding to end someone’s life. It is hard to assess the collateral damage of someone saying, “I choose to die rather than blessing others, especially my family.” In many cases, financial concerns are a significant motivation for ending life, and there are horror stories of involuntary euthanasia in Holland. Christians should lead the charge to develop medical steps to relieve suffering and pain. Financial problems should not be an issue in a wealthy country like the United States.

From an atheist’s viewpoint, death is the end, and physician-assisted death is merely the solution to suffering. However, I continue to be reminded of my son’s last words to me before he died. He said, “Dad, I am going to see Mom, and I will actually be able to see her and be with Jesus.” These words were from a blind, mentally challenged, COVID-ravaged young man who had battled muscular dystrophy, cerebral palsy, and schizophrenia all of his life. He was ready to move on to something better.

— John N. Clayton © 2021

Tim Clayton’s story was told by John N. Clayton in the book Timothy: My Son and My Teacher available HERE.

The organization Compassion and Choices has been a leader in the movement to legalize physician-assisted euthanasia.

The Design of Death

The Design of Death

It may sound strange to talk about death in a positive way. The truth is that the design of death is part of the creation. The second law of thermodynamics, in simple terms, says that in a closed system, things move toward a condition of disorder. That principle is built into the fabric of the physical universe. It allows the diffusion of resources, the circulation of air, the transfer of energy from one form to another, and multiple other physical processes. It also means that our human bodies are in a constant movement toward decay.

The Bible contains a statement of this law in Isaiah 51:6: “Lift up your eyes to the heavens and look upon the earth beneath: for the heavens shall vanish away like smoke, and the earth shall wax old like a garment, and they that dwell in the earth shall die in a like manner.” Thus, the design of death applies to the universe and everything in it.

Is our death just a piece of collateral damage to the second law? For those who are Christians, death is not the ultimate tragedy. My son Tim lived his whole life with multiple handicaps, including muscular dystrophy, blindness, cerebral palsy, and schizophrenia. Despite those handicaps, his life was full. When COVID-19 took away his ability to swallow, talk, sit up, stand or walk, he could still hear and communicate with me. For him to be unable to die would have been insanely cruel. Isaiah 57:1-2 describes this well: “For the righteous man is taken away from calamity; he enters peace; they rest in their beds who walk in their uprightness.”

For a Christian, death removes us from evil and brings us into peace. I look forward to freedom from politics, pollution, illness, global warming, and pain. In 2 Peter 1:15, Peter talks about his death using the Greek term “exodos,” which means to depart. It is the word from which we get the name of the book of Exodus that describes Israel’s departure from Egyptian bondage.

So far in 2021, I have lost my son, my brother, and three of my close friends to death. They were all Christians, so I am happy for them. I take to heart 1 Thessalonians 4:13-14, which tells me not to grieve “as others do who have no hope.” Psalms 116:15 tells us, “Precious in the sight of the Lord is the death of His saints.” The word “saint” here refers to “one set apart” as members of God’s family of believers–Christians.

When I was an atheist, death offered me no future. As a Christian, I see death as an entrance into a far better existence than I have now. We have an instinctive desire to live, and any change we make can be scary. That is especially true of departing this life. Paul said in Philippians 1:21-23, “To live is Christ and to die is gain,” Death can be beautiful, and the design of death is a reality for the world in which we live.

John N. Clayton © 2021

Assistance in Dying is a Difficult Issue

Assistance in Dying is a Difficult Issue

We have had several personal experiences with a person approaching death that brought up the issue of assistance in dying. One of the cases in our family involved a loved one dying in an Asian country. The belief in that country was that life is all there is, so a person should be kept alive at all costs, no matter what. Our loved one was in enormous pain and begging to die, but his Asian wife refused to allow him to receive any drug that might shorten his life. Drugs such as morphine can relieve pain, but they can also shorten life, so she did not allow those drugs.

There is also a medical treatment called palliative sedation, which renders a person unconscious until they die. In the United States, hospice offers palliative care but does not hasten death. Individuals can use VSED, which is “voluntary stopping of eating and drinking.” The decision is difficult, and when the person loses consciousness, family members can override it.

Ten states and the District of Columbia now allow medical assistance in dying. Doctors in those states can prescribe a lethal dose of a drug if requested by the patient or their power of attorney. The states are Oregon, Washington, California, Montana, Vermont, Colorado, Hawaii, New Jersey, Maine, and New Mexico.

Several of our church friends have faced the issue of assistance in dying. Our current issue is our son Tim who is mentally incapable of deciding for himself and is in a pathetic condition. COVID-19 has activated his cerebral palsy complications and especially his muscular dystrophy, so he is bedfast and barely able to communicate. He is making no visible progress, and because of blindness, he has very little quality of life. I read to him daily over the phone. He can only eat pureed food because he can’t chew and swallow hard foods. He is cut off from friends or family because it is virtually impossible to understand his speech.

What do you do in a case like my son Tim? He is a physically strong person, so he may remain in this state for a very long time. Having a doctor inject him with a lethal dose of drugs might seem to be the merciful thing to do, but that is pure euthanasia and assumes he will never make any recovery. Who has that kind of knowledge?

We share this with you to underline the issue of assistance in dying. As our population ages and as medical care advances, this issue will only get more complex. Join us in praying that God will lead us to know how to deal with this new problem facing humanity, which is especially difficult for believers in God.

John N. Clayton © 2021

For two different views on the assistance in dying issue, you can turn to the websites of Compassion and Choices and the National Right to Life Committee.

Who Owns Your Body When You Die?

Who Owns Your Body When You Die?

One of the medical issues of our day is the shortage of organs for transplant. Many people die while waiting for a heart, kidney, or liver, and the problem of finding organ donors is complicated. That leads to the question of who owns your body when you die?

In the United States, there are data banks for almost every organ in our bodies. If someone needs a kidney, their surgeon can go to the kidney bank and see how many people in the database have the blood type and traits to be a donor. Often kidneys are supplied by living donors, so the kidney is moved from one person to another, with both the donor and the one receiving the new organ in the same operating room. Of course, that is not possible for many organs such as hearts.

The government of Switzerland is considering a bill that would make the state the receptor of everyone when they die unless the person officially opts out. When a person dies, their organs will become a “public asset” so doctors could harvest them for transplant to alleviate the shortage. The Swiss medical establishment says that between 50 and 100 patients die in Switzerland every year because of the lack of organs for transplant.

This proposed law brings up all kinds of issues and gives a whole new dimension to the relationship between the state and the individual. Who owns your body when you die? Many times a dying person is in a coma or is pronounced brain dead. Taking their organs would certainly be a form of euthanasia. What about the person who is terminal with cancer but has organs that are unaffected by the disease?

The Bible tells us in 1 Corinthians 15:50, “Flesh and blood cannot inherit the kingdom of heaven.” That same chapter tells us that we will all be changed (verse 52). The natural body is not sacred. It is the dwelling place of God’s Spirit when we are alive (1 Corinthians 3:16), and our soul is housed in it. But Genesis tells us that our body is “dust to dust.”

The body without the spirit is dead (James 2:26). I had that vividly pointed out to me as I stood beside my wife’s bed when she died. The body was lifeless, cold, and unresponsive. My wife Phyllis was gone and what was left was the house in which her spirit had lived.

The issue here is how much control the state should have over our being. Who owns your body when you die? In Switzerland, at least, the state may be considered the master of our existence, even in death.

— John N. Clayton © 2021

Reference: The Week, May 21, 2021 page 16.

So You Have Cancer: Now What?

So You Have Cancer: Now What?

Typically we review books that deal with apologetics. However, sometimes a book comes to our attention that we believe meets a need even though it does not primarily involve evidence for God and the Bible. We want to share one such book with you here— So You Have Cancer: Now What? By Glen Goree.

I have read many books on cancer and books that deal with grieving when you lose a loved one to cancer. This book was written by a man who has terminal cancer of the liver and a short time to live. I did a lectureship with a congregation in Texas many years ago, where Glenn was the preacher for ten years. He has also been a missionary in Africa and has had a long career as a counselor. Glenn has had a large share of illnesses, including two heart attacks, hepatitis C, diabetes, including having five toes removed, and neuropathy.

The purpose of this book is to help Christians who know their life is about to end. Glenn is candid, outspoken, honest, and fair in what he says. He talks about being angry with God and being outraged. He deals with fear and depression. He discusses God’s grace, forgiveness (including forgiving God), and mercy. He does this by describing his own feelings and then going to the Bible to get help when knowing you are about to die.

Every reader will profit by reading this book since every one of us is terminal. Goree’s approach to grace and God’s mercy alone makes it worth reading.

The book is available from Amazon or Glenn Goree’s website www.glenngoree.com.

— John N. Clayton © 2020

When Is Someone Dead?

When Is Someone Dead?

Yale researchers have restored cellular activity to pig brains hours after the animals had been killed at a slaughterhouse. A new technique for treating heart attacks is to cool the body, but that causes brain function to disappear completely. Certain drugs also cause brain function to cease. The question becomes, “When is someone dead?”

The current medical definition of death is when a person has no eye movement, no pain response or gag responses, and does not attempt to breathe independently. The “World Brain Death Project” reported on these facts and definitions in the August 3, 2020, issue of the Journal of the American Medical Association. Their report carried suggested recommendations for doctors to follow.

Dr. Paul Graham Fisher at Stanford said, “This is only a first step. Complex cultural, religious, and even legal forces thwart a simple and universally accepted definition of brain death.” In 2013 a girl named Jahi McGrath was brain dead after a tonsillectomy. Her parents refused to accept that fact and, with support from religious and civil-rights groups, moved her to New Jersey. That state allows religious objections to any diagnosis. There she spent more than four years on a ventilator, finally dying of liver failure in June of 2018.

We have gotten to the point in medicine where it is not easy to answer the question, “When is someone dead?” From a biblical standpoint, death is when the soul leaves the body and returns to God, but how do you determine that?

When there is no quality of life and no hope of physical recovery, a Christian may desire no heroic medical attempts for resuscitation. If you do not believe in God and the soul, then clinging to life is all you have. The question of when is someone dead becomes much more of a concern. Either way, for those left behind, letting go of a loved one is always hard. But for Christians, accepting death is much easier.

— John N. Clayton © 2020

Reference: Science News, September 12, 2020, pages 2, 8, & 9.

Medical Assistance in Dying

Medical Assistance in Dying

In June of 2016, Canada approved a law called MAID, which stands for “Medical Assistance In Dying.” It became the sixth country in the world to allow the practice, and there are nine states in the United States plus Washington D.C that have followed the Canadian model. Those who work in the field of medical assistance in dying tell us that there are three words they use in dealing with MAID. They are ACCEPT, ADAPT, and be at PEACE.

ACCEPTING the fact that you are going to die very soon is something that most people manage, but for some, it is accomplished more quickly than for others. One’s religious convictions or the lack of them can have a significant impact on when and how we accept death.

ADAPTING takes many forms and is frequently a function of how much pain we are in and how much our impending death affects those we love financially. Using MAID to avoid pain or to stop the loss of family finances is a growing adaption many people are choosing to make. A person’s medical and mental condition can affect how they adapt.

For a significant number of people, being able to donate organs to others is part of being at PEACE with one’s approaching death. An ALS (Lou Gehrig’s disease) victim named Fred Gillis said it this way: “ALS, you can’t take this away. We’re going to give life to other people.”

There are a wide variety of problems associated with MAID. The laws in Canada and the U.S. make it very difficult to give organs away if you are terminal yourself. If you have active cancer, you are ineligible to donate organs. If you die too slowly, you are not eligible. Even if you are on life support and you decide to pull the plug, about 30% of the time, the organs become nonviable. If donating an organ hastens your death, there is a “The Dead Donor Rule” that makes it impossible for you to donate organs. Fred Gillis was able to donate two kidneys, his lungs, and his liver when he died in April of 2018. The first 30 MAID donors in Canada gave 74 organs, which meant many lives were spared.

Medical assistance in dying is a tough issue for Christians. God gives life, and God makes it clear that the Holy Spirit lives in us. (See 1 Corinthians 3:16.) The need for organ donors is enormous, and allowing people to find peace as death approaches is also huge. It is hard to be rational when we or someone we love is facing death. It is essential to understand that a person’s death is when their soul departs, not necessarily when the physical organs stop working. As Christians, we must study and intelligently discuss this subject.

— John N. Clayton © 2020

The data in this article is from Scientific American, May 2020, page 23.

End Of Life and God

End Of Life and GodOne of the most difficult personal issues of today is what a person should do when they are very near the end of life, and their quality of life is zero. Medical science has progressed to the point where a person can continue to be alive even though they are in enormous pain and connected to machines with no hope of ever being free of wires and tubes. Most of us do not want to ever be in that situation, but the fact is that many of us will be.

I have a Buddhist friend who maintains that having a difficult time in life at any stage is payment for sin, and we should not do anything to minimize that payment. There are many Christians who maintain that God and God alone should determine the time of our death and that extending or reducing the time of death is wrong.

We are not talking about suicide in the sense of wanting to leave this life because of relationship problems or failures in life. We are talking about cases like a woman named Brittany, who had an aggressive brain tumor. After an eight-hour surgery, doctors told her that they could not get it all and that within six months, she would die. Doctors told her that “her symptoms were going to get much worse with brutal headaches, seizures, a loss of motor and cognitive abilities, a change in her personality, and ultimately she would die.” She did die on her 30th birthday in Oregon where she and her family had moved because physician help in dying is available there.

This case has been publicized by an organization called “Compassion and Choices.” They are pushing for nation-wide acceptance of “physician-assisted compassionate death.” They are using Brittany Diaz as their poster child. There are all kinds of issues involved in a case like Brittany’s. The medical profession has been lax in dealing with pain, and the current opioid crisis has made the situation worse. The potential for abuse in end of life cases is enormous. The expense of keeping a terminal patient alive can bankrupt a family. On the other hand, end of life situations frequently provide for healing among those left behind and also allow a person a final opportunity to be obedient to God. How should Christians deal with this issue?

The first point we need to understand is that death from a biblical standpoint is when the soul returns to God. It is not when the heart stops beating or when the person stops breathing. A person can be dead, and yet their body can continue to do biological functions. The Bible tells us that the body is the “temple of God and the Spirit of God dwells in you. If any man defiles the temple of God, him shall God destroy: for the temple of God is holy, which temple you are” (1 Corinthians 3:16-17). This same principle is involved in 1 Corinthians 6:15-20, where Paul condemns prostitution by again referring to the body as “the temple of the Holy Spirit.” He ends by saying, “glorify God in your body, and in your spirit, which are God’s.”

We are not talking about “pulling the plug” in this discussion. Christians can work with their physicians when death is near to stop the pain and yet allow the person to continue to manage their affairs. Giving enough relief from pain to cause a person to be unable to manage their affairs is rarely the situation, and it is not actively killing the person. Even giving morphine can accelerate the death of an individual by suppressing breathing, but pain killers should be available for every individual.

Each case is different, and each person should make clear what they want to be done when the end of life is near. When God has more work for a person to do, and they are able to do it, physician-assisted suicide should not be forced upon them.
— John N. Clayton © 2019

Reference: CompassionAndChoices.org.