Jeff Gill
Death Has a Way of Getting People's Attention
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When I was serving a pulpit ministry, in any church I served my
practice was to include in the sermon, every year and a half or so, a
suggestion to think about your own particular end.
The sermon context would change depending on circumstances and the
Holy Spirit, but the constants were, for me, two-fold. I'd tell
people what a blessing it always is for families to find, or better
yet to know right along, that a plan or even just an outline for the
service the way you wanted it was written down somewhere (and an
obituary written by the decedent is always a bittersweet pleasure to
read).
And along with providing outlines to pick up in the back for planning
your memorial service, I would also make available the most current
forms for living wills, medical powers of attorney, and "do not
resuscitate" orders. DNR orders, by the way, can say what you DO want
done along with what you don't want.
I've been known to mention that having a will is a very, very good
idea, but not with the same pastoral insistence that the message
about preparing for your demise has carried. In general, there are
all kinds of things that I think are sensible, like being insured,
wearing a bike helmet, or keeping an emergency kit in the basement.
But those aren't close to the core of my faith as I understand it and
feel called to preach it.
But acknowledging that we will, inevitably, die (insert Rapture
qualification here, but c'mon, no one's supposed to count on that
one) is something that surely every responsible Christian and most
other faith traditions can accept. And to acknowledge, mind, body,
and spirit, in the times and seasons we find ourselves, means we
should let our families know if we do or don't want the bronze,
electrum-plated coffin or the pine box, ashes or embalming, hymns
sung or (gulp) Jimmy Buffet played.
A Christian witness in this day and age also, I believe, requires
that we give our closest ones a few advance directives on how to
navigate the turbulent waters of dying in MediWorld 2009.
So am I bothered by some of the stuff in the various floating
(bobbing, twirling, occasionally submerged out of sight) plans for
health care reform? Well, that gets tricky both personally and
pastorally.
If Medicare is going to start reimbursing doctors for spending time
talking to patients about end-of-life decisions, which they do not
currently, then I say "Amen!" That is a vital part of a healthy
doctor-patient relationship, and if Medicare et alia creates various
incentives and disincentives, then simply making end-of-life care
conversations reimbursable is a positive step.
On reading the language used to do this, though, I see a great deal
of "the doctor shall" and "the doctor will" language, and it does, in
fact, seem to lean very hard towards leaning on doctors to lean on
patients to choose the speediest possible demise. Matter of
interpretation, you could say, but I hear that in the wording, and
say not "Amen," but "Whoa."
Add in all the rhetoric over families supposedly asking for pointless
and extreme medical interventions for hopeless cases – yes, I've seen
a few, it does happen – and the implication that care for the very
ill elderly is keeping the country from caring for children, and
quite frankly I get angry.
I've been in too many ERs and waiting areas, pastoring in three
states, where a sick elderly person, incapacitated, has a cousin or
nephew rush in from two time zones off, and quite frankly, they want
this done and over, and want the closing stages sped up with all due
haste – and not infrequently, with indecent haste. Sometimes, not
even the elderly, but simply a person who has no immediate family or
spouse to speak for them. As a pastor, i (rightly) have no voice or
vote at all. Even if i know what i've heard from the person, now
unconscious in that bed. If it isn't in writing, then the impatient
relation's plan becomes reality.
The plural of "anecdote" is not "data." I'm told by some medical
folks, but mainly political partisans, that the problem I describe is
a blip, but "unnecessary care" is a crisis. Could be.
Meanwhile, I continue to say – make your wishes known. Accept your
mortality, and write down your intentions, for the service, for your
remains, and before any of that, for your care. If you want zero
interventions, God bless you and support you and put it in writing.
If you want them to start your heart a couple times more before they
throw in the towel, you'd better write that down, too. God be with
you in getting that care as well.
Jeff Gill is a writer, storyteller, and supply preacher around
central Ohio; tell him your funeral plans at knapsack77@gmail.com.
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