'Don't Plead With Me Not To Die'

I ended my last blog with this question: What does God expect you to do when a loved one is clearly dying: to encourage them to let go or to plead with them to "not die"?

This is a difficult question to answer perhaps because we can't acknowledge the "horse on the table" (or the elephant in the room, as one responder suggested). Or perhaps we just don't know the answer. I don't presume to know what is in the mind of God, but I know from watching families grapple with this, and watching some plead for their loved one not to die and others giving "permission" for their loved one to die while letting them know that they love them and will miss them, that neither is easy. But, when we can let someone go, somehow the break seems cleaner. The grief starts sooner and the healing includes being at peace with loving the person enough to let them go as well as perhaps enabling them to die with the knowledge that their loved ones have said it was "ok" to die.

Medical technology has made so many wonderful things possible for us, including enabling us to live longer and perhaps to live with a quality of life that is acceptable for us. But, as A Word to the Church on End of Life Care: Theological, Spiritual and Ethical Reflections, points out, "There is no indication in scripture that God prefers longevity over quality of life"?[1] And, in Genesis, Adam and Eve ate from the tree of the knowledge of good and evil, not from the tree of life. God says, "The man has now become like one of us, knowing good and evil. He must not be allowed to reach out his hand and take also from the tree of life and eat, and live forever." (Genesis 3:22, emphasis added)

So, if God did not mean for us to live forever and did not indicate that longevity beats out quality, doesn't it make sense that when someone is dying the expectation would be to encourage them to let go since we are all eventually going to die? And, as Christians, we know that God is with us not only whether we live or die, but while we are dying.

Several years ago, one of my students responded to a question that I posed to the class about who they would not want present with them while they were dying. She said, "I don't want anyone around me who is begging me not to die. I don't want anyone who is negative. I only want those who are going to encourage me to die because when I am dying, it is when I am supposed to be dying. And, besides, I am going to be with God. So help me along in that process. Don't plead with me not to die." I asked her if she had let her loved ones know this and she responded, "They will as soon as I can get home and tell them."

One of the comments made to my last blog reads: "Our love for our family dictates that we talk about what we want at the end. We have to love them enough to take those end-of-life decisions off their shoulders and let them know what to do." Not surprisingly, I agree with "Cindbird" and encourage you to tell your family what you want. In support of Cindbird's and my stance on this, a recent study in The Annals of Internal Medicine, found that there is an important reason to tell your loved ones what your wishes are as to how you want your body treated as you near the end of life. Wendler and Rid found that those who were selected to be the surrogate decision maker by default (the surrogate decision maker laws, which may be different in each state, specify who makes the decisions when a patient has not signed an advance directive naming someone to make those decisions) "... described that role (the role of being a surrogate decision maker) as being profoundly burdensome, and self-reports of feelings of guilt and self-doubt about whether they made the right decision were present in a substantial minority of patients."[2]

Your loved one will be dealing with the loss of you in their life. Don't make it more difficult for them. Let your love lead you to having these conversations about how you want your body treated and also whether or not you want them to encourage you to let you die or implore you to fight on.

[1] Bruce Epperly and John Mills, A Word to the Church on End of Life Care: Theological, Spiritual, and Ethical Reflections The United Church of Christ Science and Technology Taskforce, 2009 [cited 4/13/2008. Available from http://www.ucc.org/science/pdf/microsoft-word-end-of-life-care-with-theological-ethical-spiritual-resources.pdf, 5.

[2] David Wendler, Annette Rid. "Systematic Review: The Effect on Surrogates of Making Treatment Decisions for Others." Annals of Internal Medicine, Vol 154, Issue 5, 336-346.