End Of Life Decision Making
a ministry of the Christian Family & Children's Center
email: info@champion.org
As medical advances continue in our society, people and medical professionals are having more and more situations arise that cause us to look at decisions around medical care in the end of our lives. These decisions are confusing, and carry many difficult choices and questions that force us to address tough issues and sort thorugh complicated decisions about what God wants for us. New Horizons has prepared the following document that is designed to help you talk about these things with those who you care for and who care for you. We would encourge you to use this as a point of reference to begin talking about these things in terms of planning. Please take long hard looks at life decision, and feel confident that the Author of Life is in charge. There is a real difference between agressively ending life, and managing the dying process. Often God is honored in allowing Him to be in charge of the decision making around death, and for us to manage our end of days by managing pain and producing comfort.
End of Life Decision Making Discussions
This page is intended to help family members and individuals discuss the potential treatment issues that may arise in the end of life decision making process. Most medical professionals do not desire to make these decisions for an individual, but would rather give input and information about the treatments and let a patient decide. Assuming that a family has made a decision to make a durable power of attorney for health care, the individuals involved in decision making (and particularly those required legally to make actual decisions) should have an information base to help guide those decisions. This fact sheet is designed to do just that by helping individuals and their families communicate about these kinds of medical decisions. By doing that, when the time comes they are better prepared to make decisions being assured that to the best of their ability they understand the wishes of the individual. It is not designed to be a complete list of all possible options, just a place to begin.
The first step in the process is to understand the complicated nature of end of life treatment decisions. Although each circumstance is difficult, almost always decisions involve many variables such as:
What are the emotional and physical pain of the treatment?
What are the emotional and physical consequences of not taking the treatment?
Will the treatment extend my life? If so, how long?
Will the treatment make my last days more comfortable and more able to be who God has created me to be?
Is there any aspect of the treatment or lack of treatment that would be actively taking my life? (There is a difference between euthanasia (the taking of life) and allowing the normal dying process to continue without delay).
Each of these treatments and scenarios are different for everyone. Please prayerfully consider the issues and discuss with family members your understanding of God's will for your life. We would encourage you to remember the following truths in your planning process:
1. Remember that the Lord has promised to never leave you or forsake you. This is true in death as well. In fact there are several scriptures that suggest that this time in life is seen very specially by the Lord. We hear story after story of individuals who experience the Lord in a very powerful way during these times. Truly He is with us through the valley of the shadow of dealth. We need not fear evil.
2. The Lord is truly capable of being in control of your dying as well as He was in control of your living.
3. As stewards of our lives, we are called to be managers of the dying process, not decision makers about the time to die. Life and Death belong only to the Lord. Let's focus on how to manage pain and comfort, focus on our relationship with the Lord, and be with our friends and family.
4. We encourage you to face the dying process squarely just as you have the rest of your life. Make honest decisions based on God's Word and your understanding of His will for your life. The Lord will honor that.
5. Remember that to allow the normal dying process to proceed is not necessarily euthanasia when you are only prolonging the dying process.
6. Ask the Lord for his Presence and his Wisdom.
This is not a legal or a counseling document. It is only intended to be a discussion starter.
Types of Procedures
1. CARDIOPULMONARY RESUSCITATION
The use of drugs and /or electric shock to start the heart beating and the use of artificial breathing.
2. MECHANICAL BREATHING
Breathing by a machine, normally by inserting a breathing tube down the throat
3. ARTIFICIAL NUTRITION AND HYDRATION
Nutrition and fluid given through a tube in the veins, nose or stomach
4. MAJOR SURGERY
Removing organs or parts of organs such as the gall bladder or part of the intestines
5. KIDNEY DIALYSIS
Cleaning the blood by machine or by fluid passed through the abdomen
6. CHEMOTHERAPY
Drugs to fight cancer, some with physical side effects
7. MINOR SURGERY
Removing some tissue from the body, such as an infected toe
8. INVASIVE DIAGNOSTIC TESTS
Procedures such as using a flexible tube to look into the stomach
9. BLOOD OR BLOOD PRODUCTS
The giving of blood or plasma
10. ANTIBIOTICS
Drugs to fight infection
11. SIMPLE DIAGNOSTIC TESTS
Procedures such as blood tests or x-rays
12. PAIN MEDICATIONS,
Drugs given to suppress pain. Sometimes given in higher doses (which is sometimes necessary to reduce significant pain) has the potential risk of suppressing the nervous system and could indirectly (but does not necessarily) shorten life
SITUATIONS AND SCENARIOS
SITUATION ONE: If I am permanently unconscious and in the opinion of my physicians, I have no known hope of regaining consciousness no matter what is done, then my wishes regarding the use of the various medical procedures would change in what ways?
SITUATION TWO: If I am in a coma, and I have a small likelihood of recovering fully, a slightly larger likelihood of surviving with permanent brain damage, and a much larger likelihood of dying, then my wishes regarding the use of the various medical procedures would change in what ways?
SITUATION THREE: If I have brain damage, brain disease or some other conditions which cannot be reversed and which makes me unable to recognize people and speak understandably, and I also have a terminal illness, such as incurable cancer which will likely be the cause of my death, then my wishes regarding, the use of the various medical procedures would change in what ways?
SITUATION FOUR: If I have brain damage, brain disease or some other condition which can not be reversed and which makes me unable to recognize people and speak understandably, but I have no terminal illness, and I can live in this condition for a long time, then my wishes regarding the use of the various medical procedures would change in what ways?
Please let us know if you have found this document helpful, or if you have found it needs additional things. We would appreciate your input!