placing our hope where it belongs

Today’s post is the last of a 5-part series, “Making Peace with Mortality,” by Dr. Margaret Peterson, associate professor of theology at Eastern University.

Peterson’s Ph.D. is in theology and ethics from Duke University. She received her first education in end-of-life care twenty years ago, as her first husband was living with and then dying of AIDS. She chronicled that experience in a memoir, Sing Me to Heaven: The Story of a Marriage.

Her second husband and former faculty colleague, Dr. Dwight N. Peterson, with whom she is the author of Are You Waiting for “The One”? Cultivating Realistic, Positive Expectations for Christian Marriage, has been in failing health for some years and entered hospice care (at home) in July of 2012. Peterson blogs daily about their end of life experience at www.caringbridge.org/visit/dwightpeterson.

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Let’s circle back to the news item with which the first post in this series began: the announcement by Medicare of its intention to reimburse doctors for time spent talking with patients about their wishes for medical treatment near the end of life.

This development has been welcomed by physician groups involved in the care of patients at the end of life.

It is opposed by the National Right to Life Committee, on the grounds that doctor-patient conversations about the end of life may result in patients feeling pressure to reject “lifesaving treatment.”

The National Right to Life Committee is not alone in its apparent assumption that more end-of-life treatment is probably better.

At least two recent studies (links here and here) have identified a positive correlation between receipt of intensive life-prolonging medical treatment (defined as mechanical ventilation and/or resuscitation) in the last week of life and “positive religious coping.”

“Positive religious coping” (as measured by an instrument called the Brief RCOPE) means a person affirms statements like “I seek God’s love and care” or “I try to see how God might be trying to strengthen me in this situation.”

In other words: it is particularly pious individuals (most of whom, in these studies, were Christians) who are more likely than others to die on ventilators after unsuccessful resuscitation attempts.

What is going on here?

Why do these sincerely religious people choose brutal end of life experiences for themselves and (in the case of the National Right to Life Committee) oppose reimbursed conversations between other people and their physicians about what the range of options might be?

One possibility is that these folks have conflated Christian faith with a particular kind of modern idolatry described by Stanley Hauerwas in his book God, Medicine and Suffering, when he observes, “Modern medicine has become a god to which we look (in vain) for deliverance from the evils of disease and mortality.”

Too much of our religious language has been co-opted into the idolization of this false god.

We say we have Christian faith, but what we appear to believe is that modern medical treatment is the source of life itself, so that more aggressive medical treatment, even—perhaps especially—of the dying, is by definition more “pro-life.”

We say we have Christian hope, but we appear to equate “hope” with the availability of yet another medical intervention, another treatment, another drug or procedure, that will magically result in the patient’s recovery, or at least in the patient not dying yet.

We say our advocacy of “lifesaving treatment” is motivated by Christian love, but it looks more like the sacrifice of gravely ill people on the altar of the idol of technological medicine.

What would it look like to reclaim the language of faith, hope, and love in service of the God to whom we belong both in life and in death?

What kind of faith, hope, and love might allow us to be people who can beat our swords into plowshares and make peace with mortality?

Christian faith places its ultimate trust in God and not in medicine.

Medicine is a useful tool, sometimes for cure, always for care. But the lord and giver of life is the God of Abraham and Isaac, Jesus and Paul, who is present to us in the hearts and hands of the people who care for us in both life and death.

Christian hope is compatible with the reality of death.

There is such a thing as a good death, and we can hope for one, for ourselves and for our loved ones. We can hope for a death that is gentle, that is humane, that takes place in community, that is marked by reconciliation and gratitude and honest sorrow.

Christian love has room for loss.

We don’t have to prove our love by fighting to keep one another alive forever. We can let go and grieve our own approaching deaths or those of others, and in our grief expect to encounter God’s presence and blessing.

Making peace with mortality is never going to be easy. Peace is seldom easier than warfare.

Is it worth cultivating? Jesus seems to think so. “Blessed are the peacemakers, for they shall be called children of God.