More prayers to the Gulf

Just wanting to send more prayers to the Gulf; reminds me of Florida last year. I sure hope it stops after 'Rita'

Just found an article that discusses ARDS and the issues that the Terri Schiavo case raised.

It is interesting because it addresses what I fear will happen any time a patient is intubated. All of those people who decry the horrible quality of life one will have on a vent, assuming the end result will always be what is now called a 'Terri Schiavo' situation

It is the reason why I do not have any advanced directives, since I feel that if I had when I had ARDS, it would have made it too easy to 'pull the plug' without doing what they did to help to save my life.

Today's Christian Woman, September/October 2005

Lessons from TerriHow the death of a brain-damaged Florida woman can help Christians prepare for end-of-life decisions. by Lindsey O'Connor

Terri Schiavo's fight for life riveted our country last March. The 41-year-old brain-damaged Florida woman classified as "persistently vegetative" became the "face that captured a nation." For many, her death was a state-sanctioned murder with frightening implications; for others, it was a victory for dignified death with choice.

Terri's story hit my family in a powerful way. The issues raised by her life—and her death—were more than headlines to us.

At age 41, I gave birth to my daughter, Caroline, on August 30, 2002. But a uterine rupture led to two surgeries and transfusions of 20 units of blood and blood products that night. I developed Acute Respiratory Distress Syndrome and a roller coaster of life-threatening complications: collapsed lungs, pneumonia, a blood infection, kidney failure, blood clots, and heart problems. In the weeks that followed, I hovered near death, and my family agonized over decisions regarding extraordinary measures and Do Not Resuscitate orders. I walked into the hospital on August 30, and came home just before Christmas on a walker and oxygen.

Terri's ordeal reminded me of my family's pain and of that scary place between awareness and not, the horrors of ventilators, the inability to eat or speak, the long struggle to breathe, and the misery of multiple tubes—their removal and their reinsertion.

The Challenge of the ComplexitiesEvery day Christian families face agonizing end-of-life decisions for their loved ones away from the glare of national news coverage. For example, my friends Angie and Fred struggled with knowing when to stop Fred's aggressive experimental cancer treatment and begin hospice care. My mother-in-law, Mary, was terminally ill with an estimated five years of quality time left, but when she was hospitalized with a life-threatening complication with internal bleeding and scarce hope for recovery, our family tearfully agreed to discontinue her ventilator support. She died soon after.

Here's where scientific complexities lead into a moral gray zone. Are tube feeding and hydration medical treatment, or morally required sustenance? Do we have to keep people in a persistent vegetative state (PVS) alive indefinitely? Is there a difference between a feeding tube and a ventilator? How do you determine the line between "prolonging death" and "sustaining life"? What treatment would or wouldn't you want if your death were imminent, or if you were in a coma or PVS?

Christians, including physicians and ethicists, have varying views on these subjects. Some say feeding tubes and hydration are basic sustenance to feed the hungry (Matthew 25:42-45). Others say they're medical interventions that can be ethically removed.

What happened to Terri Schiavo challenges our thinking as believers on many fronts. "The culture of death we're encountering in the U.S. and abroad," said Dorothy Timbs, legislative counsel at the National Right to Life, "defines people in a utilitarian ethic—whether their quality of life satisfies some subjective standard instead of measuring its intrinsic value."

According to Joni Eareckson Tada, founder of Joni and Friends International Disability Center, "When the courts ordered the removal of Terri Schiavo's feeding tube, they removed the safeguards surrounding thousands of Americans like her with significant disabilities. Her court-ordered death has emboldened right-to-die advocates and added fuel to the physician-assisted suicide movement sweeping the country."

What is the role of the courts, the legislature, and the executive branch? And theologically, what answers to these questions does our faith in Christ provide?

Look to Scripture for Wisdom About Life … and DeathEveryone has a worldview that influences their views on life and death (secularists included). As Christians, our beliefs are formed primarily by God's Word, which tells us "You shall not murder" (Exodus 20:13), and asserts we bear God's image (Genesis 1:26), thus giving human life dignity and sanctity.

Yet God's Word also teaches that earthly life is not our highest good, so we don't have to eke out every second at any cost. Bioethicist Marilyn Coors, who's a Christian, says, "Life is a good, but not an absolute good to be preserved at any cost. Our immortality is in heaven, not earth. We also can't avoid suffering at all costs. We need to make decisions based on these values and acknowledge that life entails suffering. We'd never choose suffering, but there's good that can come out of it."

If only applying these principles were simple! We face the danger of having our biblical views influenced by secular ethics of life and death without realizing it. For example, we have to be careful with the weight we give to autonomy ("it's my life, I'll decide") and the alleviation of suffering ("I wouldn't want to live like that").

Doug Groothuis, professor of religious philosophy at Denver Seminary, points to the biblical counterpoints to these cultural principles. With autonomy, we have individual rights, but our life isn't our own; it's God's, which he gave us. And as to the alleviation of suffering, Groothuis says, "If the alleviation of suffering combined with autonomy are all you have as moral principles, the recipe is moral anarchy."

Seek the Counsel of Other ChristiansOne of the most powerful tools we have to help us make wrenching medical and ethical decisions, besides Scripture, is the counsel of family members, friends, pastors, and even doctors who share our worldview.

On the night my family calls "the death vigil," my husband, Tim, sat with two of our best friends and our pastor. My condition and prognosis were bleak. I had suspected brain damage and was expected to die before morning. As Tim wrestled with continuing the ventilator, their prayerful counsel helped him decide to keep life support in place, even though ethically he could have chosen not to.

Another man I know made the opposite decision for his wife, leaving him a widower with children at home. He made this agonizing yet ethically appropriate decision for some of the same reasons Tim could have discontinued my treatment: unacceptable treatment burden to the patient, coupled with imminent death, to name two. He and others making similar decisions also need support from the body of Christ.

According to Sarah Flashing, a women's ministry director who's on staff with The Center for Bioethics and Human Dignity, "As the central figures in the family—wife, mother, and daughter—women need to know how to apply biblical principles to difficult situations that range from beginning-of-life to end-of-life decisions." As a result, she's driven to help Christian women understand the relevancy of bioethics, and believes women's ministries can be an effective place to educate women on these difficult issues. "Women need to know that bioethical issues are also spiritual issues and of a very practical nature."

Err on the Side of LifeI first saw the video footage of Terri on TV exactly one year after waking from my coma. While the world wondered what it must be like to live like Terri, I had an unusual perspective. I knew what it felt like to be fed by tube, for a machine to breathe for me, to be unable to communicate. Because of this, I empathize with those who want to avoid such suffering for themselves or their loved ones. However, my experience leaves me solidly in the "err on the side of life" camp. There is indeed a "time to die," as Ecclesiastes says, and a time to withdraw or withhold treatment—but only under ethical and theological parameters, without a hint of passive euthanasia.

I've learned the best thing we can do for ourselves and our family is to legally name a trusted medical proxy and discuss with him our thoughts on life-sustaining procedures and long-term care. My husband knows my wishes and is free to interpret them as he and the doctors see fit.
In order for my husband to have that freedom, I've chosen not to write legally binding specifics for end-of-life care in a living will. Words have specific legal meaning, and I could tie my husband or doctor's hands and affect treatment in unforeseen circumstances in a way I never intended.
Similarly, I don't have short-term life-support specifics written in an advance directive and I haven't given them verbally. If I'd said three years ago that I would never want to be on life support, I'd be dead!

Does your spouse or another loved one know your wishes? Do you know your parents'? Have you named your medical decision-maker (power of attorney for healthcare) in an advance directive? Give your loved ones guidance by discussing your theology, philosophy, and wishes in case you're ever incapacitated.

I wouldn't want to live in a disabled state any more than you would, but I know that whatever my state, God can be glorified even as he was while I slept. Tim experienced God's grace, wisdom, and insight as he agonized over heroic-treatment options, issued Do Not Resuscitate orders and rescinded them, and struggled to be assertive in my care while keeping a job and parenting our children. Throughout his nightmare, God gave Tim supernatural wisdom, peace, and a sound mind—just as his Word promises.

My recovery is a miracle. But I didn't come out unscathed. I'm still on oxygen at night—and may be for the rest of my life. I also struggle with some "hidden disabilities" that continue to limit me.
I once said I wouldn't want to live like Terri. But I recently realized I'd said this after I'd regained some health. When I was in the midst of my fight for life, I never once thought, Pull my plugs. My perspective from health and my perspective from the brink were vastly different.
Take it from someone who's been there and back. I hated my "poor quality of life," but it didn't mean I wanted to die. What surprises me most is how shockingly fierce the God-given will to live is. Perhaps that, more than anything else, will guide me in the future.

Lindsey O'Connor is a freelance journalist, former anchor for USA Radio Network News, and author of If Mama Goes South, We're All Going With Her (Revell).