Sermons

In Life and In Death

John Wilkinson                               Third Presbyterian Church  September 25, 2005                            Romans 8:31-39

Over the Columbus Day weekend, Third Church is venturing out: an all-church weekend getaway at Camp Asbury near Letchworth Park. This is for all ages of every family configuration, young and old, single and not. It will be a wonderful weekend of recreation and community building. We will spend some time in games, in workshops, in worship, but there will also be plenty of time to enjoy the beauty of the outdoor world and to relax and rejuvenate. I do hope you will consider attending. Today is the last day to register…

***

INTRODUCTION
The brief, 41 year life and sad death of Terry Schiavo on March 31 served as a kind of prism through which we might consider a thousand other things. Her death was neither the commencement of, nor the conclusion of debates, sometimes quite heated, that have political, legal, medical, ethical and theological ramifications. Whatever I say today will not serve as the last word, therefore, but perhaps as a first word in what I hope may become for this community of faith a conversation with important public and pastoral implications.
Though the death of any child of God matters greatly, that Terry Schiavo died was not the newsworthy item. Nor, particularly, was the manner in which she died. As we will note later, Americans die sadly and much too early every day. We read the obituaries every day and realize, when looking at the ages of the deceased, that some die at a ripe old age and some do not. What was unusual, of course, was the public nature of her death, the protracted legal battle between her husband and her parents, the role of the legal system, the participation of politicians, the presence of religious figures.
The Christian Century reported that “Repeatedly, Florida courts and state-appointed medical experts found that Terri Schiavo was essentially brain-dead or in a ‘persistent vegetative state’ from which she would not recover and that, though she left no written directive or ‘living will,’ previous statements she had made to her husband and other family members and friends indicated she would not want to be kept alive in such a condition.” (“Schiavo Drama Feeds Political Frenzy,” April 19, 2005)
It was, you remember, a painful ordeal to observe. May she rest in peace.
POLITICAL
That we live in an increasingly conflicted world is something of an understatement, and in many ways, the Schiavo saga gained a type of public momentum entirely out of proportion. It was unseemly, reflecting a polarized red state-blue state reality. "Culture wars" is the term, and it now seems that any issue with any moral or ethical implication is politicized in the worst kind of way. A partial list would include public education curriculum and the “intelligent design” debate; the battle over who may marry or who may adopt; matters related to choice; stem cell research; prayer in schools; the display of religious symbols, including the Ten Commandments, in public places like courtrooms and legislative halls; the death penalty; nominations to the Supreme Court. Name an issue and there you will find an ideological battle and hear loud religious voices.

It is wearying and discouraging, particularly in the manner in which religion is used as a wedge rather than an instrument of reconciliation and civility. We are called to be more than we are demonstrating. Our nation’s history demands better and our children’s future will require it. And we who are people of faith have much to contribute to every issue, including the matter of setting the tone of how debates will be engaged.

But it seems to me at least that the political process did not serve Terry Schiavo well, nor her family, nor particularly the issues surrounding her life and death. The doctors had spoken. The judges had spoken. And though I can understand her parents’ deep desire not to let go, even when that desire seemed to conflict with her husband’s, I could not quite understand the role of the politicians in all of this, when the system that we have established had done its job, as complex and messy as it was. To “win” in this case was not to win, but to acknowledge our brokenness, as the private became public, and I fear that acrimony will continue for this family, perhaps forever, and that reconciliation will be near impossible to achieve.

The issues are complex, and I would choose not to dwell on the political too much this morning. Whenever we come to a difficult ethical issue, even one with political implications, we do have resources through which we may have useful discourse and by which we make hard decisions.

For people of faith, for we who live in the Reformed and Presbyterian world, we begin always with scripture, to which we will turn in a bit. We look at our theological history. We examine what prior church committees and councils have said. We Presbyterians have said quite a bit on these matters in the last 20 or 30 years. We issued a fine report in 1995 called “In Life and In Death We Belong To God: Euthanasia, Assisted Suicide, and End-of-Life Issues.” Other reports include “The Covenant of Life and the Caring Community” (1983) and “The Nature and Value of Human Life” (1981) as well as a host of reports on health care. These reports do not tell us what to believe – that would be rather un-Presbyterian. But they do raise important issues and suggest ways to frame the questions.

There are the legal questions – what is the proper role of government, legislative and judicial? Some are ethical – what are the right questions to ask, how do we engage in discourse, who participates and who decides?

MEDICAL
And, of course, there are medical questions. I know there are medical professionals in the room – physicians, nurses, teachers – upon whom we should call as we are having this conversation. I am not a doctor (nor do I play one on TV!). But by nature of my work, I am around them a lot, and in hospitals, and with people facing end-of-life decisions all of the time, personally and professionally.

And the world is changing. The way that medical care is delivered is changing, as is the context in which it is delivered. The possibility of litigation. Access to the Internet. Health care costs. The rise of alternative therapies. Patients’ rights. Increased life expectancy. The fact that every year witnesses an increased percentage of deaths that occur at hospitals rather than at home. The role of palliative care and the increased presence of hospice care, whether at the hospital itself or at some other location. And, of course, the spectacular advances in research and the availability of extraordinary technology has made this a different world altogether.

Even the simple question of when death occurs is now asked and answered differently, moving from when the heart or lungs cease functioning to when the brain does – a piece of information that we could not know a generation or two ago, let alone do anything with.

In fact, and this may be quite an uninformed statement, it seems that medical science has outpaced our society’s ability to understand the accompanying issues of medical ethics.

The editors of the Christian Century wondered for all of us: “Perhaps the first ethical question is this: Is there a moral distinction between removing a feeding tube and removing other means of life support?” They quoted competing, internal opinions from the Roman Catholic and Southern Baptist communities. The fact that they cannot all agree means that there is serious and important work to be done.

Here is what we Presbyterians said, more than 20 years ago: "While the direction of Biblical ethics is against taking the life of another, it in no way claims that it is necessary to prolong the life--or the dying process--of a person who is gravely ill with little or no hope for cure or remission. Persons who are terminally ill must be able to trust that their dying will not be prolonged by unrequested technological interventions. . . . The existence of specific medical technology does not require that it be used." ("The Covenant of Life and the Caring Community" 1983: 23).

The dominant medical values of doing no harm, protecting from harm and respecting all life become more and more complex as the ways that the terms are understood and play themselves out evolve. Does doing no harm mean prolonging life, or does, in fact, prolonging life really mean forestalling death, which may or may not be harmful?

I hear most often these words from family members: “we just don’t want her to suffer” or “it’s his time.” At the same time, medical advances do not always make the timing of those moments clear. So for a physician, and the families with which she or he is working, just what does constitute fulfillment of medical and ethical obligations? And how do we support, from our particular faith perspective, the asking and answering of that question?

Here we discover that the realms of theology and biomedical ethics are not so far apart, though we often treat them as such. There are moments, and we’ve witnessed them, that the very best medical treatment is to relieve as much pain as can be done and then care for the person, and their family, as death inevitably comes.

PASTORAL
There are pastoral issues to pursue as well. Some have to do with the nature of this community of faith. If, in fact, most Americans want end-of-life decisions left to family members and their physicians, how do we support those families and those physicians as they make those decisions?

Ethicist Dixon Sutherland of Stetson University asks “Do churches do enough to minister to those facing the end of their lives or the lives of their loved ones?” (Christian Century, April 19, 2005) I am not sure that we could ever do enough. But we can do this:

· We can do what we are doing this morning, namely, offering the opportunity for you to sign a health care proxy form, thus making it clearer for your family members later on if you are unable to make decisions for yourself. This is one step in education and empowering; there may be others, and a special word of thanks to our team of attorneys for organizing this effort this morning.

· And we can seek to be true community for one another, the body of Christ.

When I visit a hospital, I often wonder what people do who have no community. Martin Marty writes that “Dealing with persons in comas is part of the regular rounds for pastors.” And it is – comas and many forms of illness. Marty says that “Pastoral care regards the patient in context, and knows that the family will outlive the dying member... The pastor will do all he or she can to help a family find courage to make the right decision, the freedom from guilt that goes with any choices -- all of them always bad -- and then to help them look ahead to the life that is really life. The family can blend back into society and know that they also will be cared for spiritually in tough times.” (“Peace for Terri Schiavo,” Sightings, March 28, 2005)

And such care is not the exclusive territory of ministers, heavens no! We have a committed Board of Deacons, Pam Foye our gifted parish visitor, others who have committed themselves to this work, and, more so, we have each of us, all of us, who are always about the work of care and compassion. It is not easy work, nor always pleasant, nor always clear. But it is always gratifying, because it demonstrates the love of God and God’s care in concrete ways, the healing touch of Christ, and it enables those who are experiencing health concerns or perhaps facing death to do so surrounded by a community of grace that provides a floor for their experience whatever lies ahead.

THEOLOGICAL
Perhaps the action plan for this morning is quite simple and straightforward. Think about these things in the context of community. Do not be put off by the emotional intensity or the grimness of the task or its complexity. Support your family by signing, or at least considering, a health care proxy. Pray for physicians. Pray for all those offering care. Pray for all those facing death.

To everything there is a season, the writer of Ecclesiastes reminded us. This is not fatalistic. That is real life, which includes real death. A baby will die suddenly, inexplicably. A teenager will face a bizarre accident. A sudden and massive heart attack. The rapid ravages of cancer. Alzheimer’s’ worst. Or even this – a beloved one moves through their 80s, their 90’s, past a century, and the body simply wears out.

And through it all, people of faith will make decisions, and, we pray, use their faith and the community from which it springs as a strong resource rather than a weapon or a sedative.

In life and in death we belong to God, we claim in our theology and seek to live out in our practice. Every life is a gift. And every death is not an ending. Some will die before their time. Some will live beyond their time. We are limited in our wisdom and imperfect in nearly every way. Rarely do we face clear choices or make easy decisions, for ourselves or those whom we love. (See Eugene Bay’s sermon of November 7, 1993, “The Christian Faith and Euthanasia”)

But in life and in death we belong to God.

Paul wrote that nothing, not even death, could ever separate us from the love of God. We read what we read this morning at funerals and memorials services. Katherine Grieb, whose book we will read as we study Romans throughout the year, says that this passage testifies to God’s covenant faithfulness in Christ, God’s costly generosity (The Story of Romans, page 81)

Karl Barth offered this word: “As monstrous to us as even those final inevitable contrasts are, [including] life and death…in God they are one…they are at peace, reconciled, redeemed.” (The Epistle to the Romans, page 329)

If God is for us, who can be against us? God, our help in ages past, our hope for years to come, our shelter from the stormy blast and our eternal home.

Let us pray. O God, our source and sovereign, you chart all of our journey and every moment of life is in your keeping. We rejoice that you care for us without merit. You hold us close through all circumstances, whether mountaintops of joy or valleys of sorrow. When we walk in those valleys may we remember that we were not born for death, but for life. Be with us and with all who cry out to you. When the winnowing wind sweeps over us, may we learn to bend and not yet break. And though we are turned about, help our faith remain an ever-fixed mark. In Jesus Christ our Lord. Amen.