Families too often face the question in the worst of circumstances — standing in a hospital intensive-care unit or emergency room, with a loved one lying in a bed facing death.
Decisions need to be made: Do you pursue all measures and treatments in the hope one will stave off death? Do you somehow allow death to come sooner if that loved one is tired of the pain and suffering?
The Rev. John Pless, an assistant professor of Pastoral Ministry and Missions at Concordia Theological Seminary in Fort Wayne, hopes a recently published booklet he wrote will help pastors and lay people with those difficult end-of-life decisions.
“What I tried to do in the book is to provide pastoral perspective for pastors who will be counseling people,” Pless said of “Mercy at Life's End: A Guide for Laity and Their Pastors.”
He also foresees it being a useful resource in Bible studies or other religious education.
The 24-page booklet is available for free downloading at www.lcms.org/life. A link on that web page also will take you to the website of Concordia Publishing House (www.cph.org), where printed paper copies of the booklet can be purchased for $2 each. A price discount is available for people ordering a large number of copies.
Pless, who teaches pastoral theology and theological ethics at the local seminary, said he started working on the booklet off and on about three years ago.
The seminary is part of the Lutheran Church-Missouri Synod (LCMS) denomination. The synod's Commission on the Sanctity of Human Life asked him to write a resource guide on end-of-life issues that would be accessible for both pastors and lay people.
While he hasn't faced an end-of-life question with a family member, Pless did help families with the issue while serving as a parish pastor for 17 years at the University of Minnesota in the Minneapolis-St. Paul area.
Advances in medicine now make it possible to save and extend lives in ways not possible previously, Pless said. At the same time, they also make it easier to end a life.
“The mandate we have as Christians is always to care,” he said. But that may not mean the patient or family members need to pursue additional treatment or heroic measures.
Pless said he had three main goals while writing “Mercy at Life's End”:
*Provide a biblical frame of reference on death and the proper Christian response.
Death is the last enemy defeated by Jesus Christ through his resurrection, Pless said. Christians don't view death as something under their control; it's under God's control.
Causing death or aiding it in coming would be murder, he said.
*Deal with the mythologies of death.
Many people view death as just part of the circle of life or that it means the person has gone to a better place, Pless said.
“We miss the emphasis on the Bible,” he said, which says the existence of death is the result of humans' sin.
*Provide pastors and lay people with talking points.
“What are the good questions to ask when death appears imminent?” he explained.
Those questions include seeking a second opinion about the loved one's prognosis from another doctor or health professional. Pless also suggests people ask whether the patient's vital processes have begun to shut down; whether pressure is being applied toward death, such as for organ donation; and whether halting treatment would be done to hasten death or because continuing it offers no realistic hope of recovery.
In addition, families should ask whether their loved one will continue to receive nutrition and hydration after treatment or life support is stopped, he said.
Mainly, however, Pless hopes “Mercy at Life's End” will help lay people and pastors think about end-of-life issues before they face them.