byFaith | Fall 2013
By Alan Dowd

For weeks and weeks, the pastor came to the altar and began his sermon with an update about a gravely-ill member of the congregation and a prayer that the Lord would restore the man back to full health. I didn’t know the man—it was an enormous church—but I knew he meant a lot to the church, and I knew the doctors and the family were doing all they could to keep him alive.

Then, one Sunday morning, the pastor climbed the altar stairs and said something I’ll never forget. “Isn’t it funny how our prayers for a loved-one sometimes change?” he began, his voice cracking. “What starts as, ‘Lord, heal him!’ turns into, ‘Lord, please take him home.’ Well, it’s time to pray that prayer.”

There is wisdom in this—in knowing when to change the pleadings of the heart, when to let go, when to say goodbye. But it’s hard to do—and not just because we want to hold on, perhaps selfishly, to someone we love. It’s hard because science and medicine—to their credit—make it hard. Every day, the best and brightest among us use their God-given talents to hold back what Paul called “the last enemy,” death. Their default bias for life is a good thing. Oftentimes it gives life a chance—a chance simply to be born, a chance to survive some horrible accident, a chance to beat cancer or heart disease, a chance at a second chance.

But there are times when the struggle against our last enemy merely—and painfully—delays the inevitable. At those times—the times when our prayers change from “heal him” to “take him”—what does God want us to do?

Shouting at Death

Those of us who have prayed those schizophrenic heal-him-take-him prayers are in good company. David did the same thing. At first, he fought hard to keep his dying baby boy alive. Hoping the Lord would be “gracious…and let the child live,” David “pleaded with God for the child…spent the nights lying in sackcloth on the ground…fasted and wept.”[1]

But when God’s answer became clear, David let go. “He will not return to me,” the broken king grimly said of his son. Yet David believed in the resurrection, holding out hope that one day, “I will go to him.” One day, David would be reunited with his boy.

Jesus, too, dealt with death during his life on earth. In fact, death was all around Jesus, stalking him, mocking him, lunging at him.

It pays to recall that Jesus was under a death sentence from the moment he was born. Herod’s mad death decree erased uncounted baby boys in and around the town of Bethlehem. But Herod’s henchmen were not finished; they murdered John, the one who officially introduced the world to its savior. Later, Jesus had firsthand brushes with death in Nazareth, when a mob tried to throw him off a cliff, and in Jerusalem, when religious leaders tried to stone him.[2]

Moreover, when Jesus unleashed his healing power, the sick and suffering and dying flocked to him. Before long, as a sign—a proof—of his authority over death, he was raising the dead back to life.

Let’s look at three of these resurrection miracles.

“My daughter has just died,” Jairus pleaded to Jesus. “But come and put your hand on her and she will live.”[3]

When Jesus arrived at the girl’s deathbed, he held her hand and shouted across the great chasm[4] separating this life from the next: “Little girl, wake up!”  The response came “immediately,” and “the girl stood up and began to walk around.”

On another occasion, Jesus watched as a funeral procession made its way through town. “A dead person was being carried out—the only son of his mother, and she was a widow,” Luke’s account tells us. In other words, death had left the woman completely alone.

“When the Lord saw her,” Luke writes, “his heart went out to her.” He told her, “Don’t cry.” And then, touching the casket, he declared, “Young man, I say to you, get up!”

Notice again the use of an exclamation point. Jesus is issuing an order. He’s shouting at death. It’s as if he is angry at death, contemptuous of it.

As with Jairus’ daughter, death obeyed. Life flooded in.

Finally, there’s the story of Lazarus. John tells us he was gravely ill. As his condition worsened, Mary and Martha (sisters of Lazarus) turned to Jesus for help, sending word that Lazarus was dying. The problem was, Jesus was in another city, and he wouldn’t return for another four days.

By the time Jesus arrived on the outskirts of Bethany, Lazarus was dead and buried.

“If you had been here,” Martha said, after racing to meet her savior, “my brother wouldn’t have died.”

Her next sentence underscores that her words weren’t meant to wound Jesus, but rather to acknowledge his authority and power. “I know that even now God will give you whatever you ask,” she cried.

Jesus was “deeply moved” by Mary and Martha’s sadness, this time to the point of weeping.[5] Through his own tears, he made Martha a promise: “Your brother will rise again.”

He prayed to the Father, turned toward the grave and with “a loud voice”—there it is again, an exclamation point falling like a hammer onto death—shouted, “Lazarus, come out!” 

And the dead man, now alive, walked out of the tomb.

Temporary Housing

The main message of these miracles is that death has no power over the Author of Life. Jesus—straddling the expanse of eternity and the box of time—could see beyond the little girl’s deathbed, beyond the widow’s heartache, beyond her son’s casket, beyond Lazarus’ grave and Martha’s tears, to a place where all of them were fully and truly alive.

There’s a secondary message of these stories. Think about what Jesus didn’t do: He raised the widow’s son, but he didn’t raise the widow’s husband. He promised that Lazarus’ sickness would not end in death, and he awakened Jairus’ daughter from “sleeping.” But he didn’t promise Lazarus or Jairus’ daughter that—once called back from the other side of eternity—they wouldn’t taste death again. Similarly, he didn’t stay death’s hand at Bethlehem or Golgotha.

In other words, by pulling back the curtain on eternity—for a moment—Jesus wasn’t saying to Jairus or Mary or the widow or us that this life is so important that we should cling to it or prolong it indefinitely. Quite the opposite, he was saying that this life is a shadow of what he is preparing, “a mist that appears for a little while and then vanishes,”[6] that death is not an end but a beginning, that believing in him is the key to real life—eternal life.

This shouldn’t be difficult for followers of Christ to understand and embrace. “For we know that if the earthly tent we live in is destroyed,” as Paul explained, “we have a building from God, an eternal house in heaven, not built by human hands.”[7]

Ponder that imagery. Paul was a tentmaker.[8] So he knew well the difference between a tent and a house. One is temporary, rudimentary, weak and can barely stand up to the elements. The other is permanent, strong and sturdy and safe, complete, a refuge. One represents the very essence of being away from home; the other is home.

This earthly tent is perishable, decaying and can be downright ugly, but it covers something that endures—something that’s eternal and glorious and beautiful.[9]

Bright Lines

A few important caveats are in order as we wrestle with these life-and-death issues.

First, there are times for heroic measures, times to struggle against our last enemy. Doctors and pastors can guide us through this murky territory. In this regard, it pays to recall that Paul—the Spirit-filled evangelist—and Luke—the physician-turned-follower of Jesus—worked together and healed together.[10]

“I don’t think there is a rule or formula that covers making these choices,” says Professor Bill Davis, who teaches bioethics at Covenant College and has served on hospital ethics panels. “As with many choices requiring wisdom, the most important thing we can do is obey James 1 and pray that the Lord will give us wisdom,” he explains. But he is quick to add, “It is impossible not to rely heavily upon the physicians’ recommendations. Only the medical personnel—and especially the doctors—can speak confidently about the medical likelihoods regarding benefits and burdens” of a particular course of care.

I remember how my dad leaned on pastors and doctors when his dad was in the hospital. My grandfather actually was preparing to leave the hospital after treatment for a series of mini-strokes. It was a Friday night, and the doctors expected him to be discharged before Monday. But Grandpa Dowd fell headfirst onto the hard hospital floor that evening. He was fine for a few minutes. He thought it was just a bump, but it was much more serious. An emergency CAT scan revealed a hemorrhage on Grandpa’s brain. 

In the span of just a few minutes, Grandpa Dowd had gone from packing his bags for home to emergency brain surgery. There was no debate or delay about whether or not to operate. Grandpa was healthy, and the doctors moved rapidly to do what needed to be done to save him.

After the five-hour surgery, the doctors allowed us to see him. But we couldn’t touch him. So we prayed over him—a priest, a pastor and all the people he shared his good name with—that the Lord would restore Grandpa back to health. My prayer was that the Lord would bring Grandpa back so his wife and five sons could say a real goodbye, hold his hand, hug him and hear his happy voice again.

What Jesus did for Mary and Martha, he did for us. At first, Grandpa just smiled and used sign language to communicate. (He had two sons who were deaf, so it came in handy.) A few days later, the bandages came off, his eyes opened, and he talked. He was as sharp as ever. He hugged and laughed and cried. He and I watched a good chunk of the NCAA tournament together that spring in his hospital room. He was Grandpa, and he was alive again.

All five sons were able to say what they needed to say. And Grandma was able to share that precious gift of time with her best friend. But Grandpa’s body was weakened by the trauma, the surgery and the hospital stay itself. Slowly, his body began to shut down. It was then we began to pray that “Lord, take him home” prayer. And Jesus answered that prayer later that spring.

Through it all, from the extraordinary measures taken after his fall to the difficult decision to authorize a “do not resuscitate” order as Grandpa’s earthly tent gave way, my grandmother, my dad and my uncles listened to the doctors and the pastors—and did what was right for Grandpa.

That brings us to a second end-of-life caveat: It’s not cold or uncaring for doctors to tell a family, “It’s time to say goodbye.” And it’s not selfish or unfeeling for a family to allow their loved-one to pass from this life to the next. A “do not resuscitate” order is not a death sentence. Resuscitate, after all, means “to revive from death.”

As Davis puts it, “Declining treatment that might forestall a disease or dysfunction that is killing someone, is not causing death.”

However, there is a bright line between allowing life to end naturally and “mercy killing”—just as there is a difference between, say, choking someone and removing a device that artificially keeps a person’s lungs working. The former takes a life; the latter merely allows life to take its own course.

To be sure, we are not to hasten someone’s death without cause—that is murder—or decide that someone is unfit to live—that is euthanasia—or allow someone to bring about his or her own death—that is suicide. But we must recognize that “There is an appointed time for everything,” as Solomon explained in one of the Bible’s most beautiful passages. There’s a time to be born and to live, and there’s “a time to die.”[11]

“The Christian pursuit of holiness,” as Tristram Engelhardt, a physician and professor of philosophy at Rice University, and Ana Iltis, a professor of bioethics at Wake Forest University, conclude, “prohibits using medicine in an all-consuming pursuit of health and postponement of death; the attempt to save life at all costs is thus forbidden.”[12]

“The Bible does not value extending our earthly life over every other consideration,” Davis adds, pointing to the example of Stephen and other martyrs, who are “praised for choosing a shorter earthly life that included testifying to Christ’s Lordship over a longer earthly life without that spiritual good.”

Those of us who believe in the sanctity of life often quote from Psalm 139 to make our case: “You knit me together in my mother’s womb,” David gasped. “Your eyes saw my unformed body.” But we sometimes overlook another passage from this life song: “All the days ordained for me were written in your book before one of them came to be.” In other words, we are allotted a finite number of those days. The days in this world, in these temporary bodies, in these “tents,” are supposed to come to an end.

A third caveat: Our actions and decisions in end-of-life situations should be humane, honoring and humble.

Humane

Engelhardt and Iltis note that a great deal of controversy exists, even within the Christian community, “about the appropriateness of withdrawing artificial hydration and nutrition at the end of life and for people in a persistent vegetative state.”

An injunction from Proverbs 3 quiets the controversy for me: “Do not withhold good from those who deserve it, when it’s in your power to help them.” To deprive a human of water and food—no matter his or her state—is to hasten death. We water our lawns. Why would we do any less for people, even dying people?  It pays to recall that even on the cross, Jesus was offered a drink—and by his executioners no less.

Honoring 

End-of-life decisions should honor and respect the dying person’s wishes, so long as they are in line with scripture. “The family may not be emotionally ready to say ‘goodbye,’ and yet if the one dying would not choose the longer life of pain, distress or spiritual deprivation, the family should honor what the patient would want,” Davis advises. 

More importantly, end-of-life decisions should honor and respect the Author of Life. Genesis tells us that God created man in His image and blessed humanity with a part of Himself—“the breath of life.” By taking on this temporary tent and entering into our humanness, God made an unequivocal statement about the sacredness of human life. To dishonor or degrade human life at any stage is to dishonor and degrade the Author of Life.

Humble

If we don’t approach life and death with a humble attitude, they will certainly humble us. We cannot defeat this last enemy—no matter how many vitamins we take, miles we run, Big Macs we avoid, medicines we ingest, surgeries we have—but Christ can. Indeed, Christ already has. “I am the resurrection and the life,” he promises. “The one who believes in me will live, even though they die.”[13]

That promise should give us the peace to recognize those moments when the struggle against our last enemy doesn’t really extend life, but rather just delays it.

Sidebar: The Limits of Life

Not long ago, Dr. Ken Murray let the world in on a little secret. Most physicians “make sure that, when the time comes, no heroic measures are taken” to extend their life. The reason: Because they understand “the limits of modern medicine,” Murray explained in a Wall Street Journal essay, “they know exactly what is going to happen” at the end of life.

Hence, almost two-thirds of doctors have “an advance directive specifying what steps should and should not be taken to save their lives should they become incapacitated.” Only 20 percent of the general population has such a document on file.

“It is an enormous blessing for the person dying to have left an advance directive concerning end-of-life care,” says Covenant College professor Bill Davis, Ph.D., who teaches bioethics and advises hospital ethics panels. Davis emphasizes the importance of “clearly identifying an ‘agent,’ a person empowered to speak for the one dying when medical decisions are needed” and “talking through” end-of-life situations with the agent.

“My own advance directive,” Davis explains, “instructs my wife to decline medical treatment that will extend my earthly life unless it will maintain or restore my ability to receive the Word of God (read or preached), to pray and to partake in the Lord’s Supper.”

Dr. Carolyn McClanahan encourages people to “plan to die like a doctor.” The first step is “a change in how life and death are viewed”—an “understanding that we all get sick and die.” When a person grasps that, she argues, “death isn’t so scary.”

The next step, according to McClanahan, is to prepare your loved-ones financially and emotionally long before you’re on your deathbed. “Good financial planning gives people great peace in end-of-life situations,” she explains.

“When everyone is healthy,” she adds, “talk about how you want to be taken care of, what type of funeral you want, and how you want people to celebrate your life.”

[2] See Luke 4:29, John 5:18, John 8:58

[3] Matthew 9:18

[4] Luke 16:26

[5] John 11:33-35

[6]James 4

[7]2 Corinthians 5

[8] Acts 18:3

[9] 1 Corinthians 15

[10] See Acts 27-28

[11] Ecclesiastes 3.

[12] Tristram Engelhardt Ana Iltis, "End-of-life: the traditional Christian view," The Lancet, September 17, 2005

[13] John 11