© 4.06.05 By D. Eric Williams
I’m not really sure why the Terri Schiavo case made such a stir. There wasn’t anything that unusual about her situation. The fact of the matter is that thousands of Americans are put to death each year in the same manner as Mrs. Schiavo. For instance, Bob, a resident of the nursing home where I am employed as Chaplain died from dehydration and starvation just a couple weeks ago. Like Mrs. Schiavo, he was not receiving artificial life support - just nutrition and hydration through a tube and that for no more than a few days near the end of his life. But, alas, his health deteriorated suddenly and the family decided his quality of life had diminished to the point that it was his time to go. So, acting on the advice of the medical professionals, the family decided to withhold food and water until he died.
To be fair he was going to die soon anyway, or so it seemed. He had a list of health problems as long as your arm and there wasn’t anything that could be done to correct them, so I’m told. Right near the end everything seemed to go to pieces at once and I think the family was simply tired of the long struggle.
Part of the problem was the fact that Bob couldn’t communicate his point of view on the matter. His mind wandered the barren landscape of advanced dementia and it was only occasionally that he brushed the edge of our reality. At those times he would grace his visitor with an observation or two concerning the topic at hand and then again veer away out of human reach. Near the end he stopped talking at all. That of course made it impossible for him to ask for water. An obvious point, but significant nonetheless. You see, the hospice people instruct families to be sure to “give the dying loved one whatever he asks for.” With that bit of advice the medical experts side-step the issue of murder. After all, if Bob had wanted water he could have asked for it. And he didn’t ask for it (so the story goes), because it would have increased his suffering (why adequate hydration would have increased Bob's suffering was never explained to me).
On the same weekend that the hospital discharged Bob and sent him back to the nursing home (sans food and water), another resident returned to our facility from a stay at the hospital. Interestingly enough, Jack was suffering from many of the same conditions as Bob. However, Jack was as sharp as a tack. He was, or I should say, is a favorite of the staff here at the home. He remains a favorite because he is still alive. Yes he’s dying (the doctor told him over a month ago that it was only a matter of days before he died), but because he can speak for himself, he receives three meals a day and snacks when he wants them. As Jack draws near death he is eating less and less, but when he dies it will be from one of the many maladies he endures, not from starvation nor dehydration.
It took Bob more than two weeks to die after he stopped receiving food and water. His vitals remained strong right up until the last few days and he was responsive to voice and touch. I spent a lot of time with the family during those two weeks and I encouraged them to let God decided the time of Bob's passing rather than cloud the issue (I tell myself I was being diplomatic), by withholding food and water. I encouraged them to at least request intravenous hydration for Bob. Yet every time I brought up the issue, I was told that the “doctor said” or the “hospice nurse said” that providing fluids would prolong his “agony” and in fact exacerbate it. The only agony I saw Bob experience in his final days was the torture of a body deprived of its basic needs. Everyone else saw a vegetable in the form of a man that stubbornly refused to quit breathing. The fact that Bob’s family is Christian made the whole experience all the more exasperating.
We really know very little about the human mind. (People who hold to a materialist view don’t believe there is such a thing as a non-physical mind. In their point of view what we call a “mind” is nothing more than a series of chemical reactions or “movements” of the brain. Fortunately most people intuitively recognize that for what it is: pure foolishness). We don’t know what it's like to suffer advanced dementia because no one who does is able to tell us about it. But we do know (or we do if we believe the Bible), that God is the sovereign Lord of the universe and that He works His will in the lives of His people no matter what their physical or mental condition may be. Indeed, I have come to believe that advanced dementia may very well be a place where God performs some of His most powerful work.
Nebuchadnezzar, the Babylonian king who overthrew Jerusalem, destroyed the temple and carried Judah into exile, ruled as the supreme lord of the ancient world. His kingdom was a golden age in the history of God’s dealings with His chosen people (Dan. 2:37-38). Although he recognized Yahweh as a powerful god (Dan. 2:47, 3:29, 4:1-3, 34-37), he arrogantly refused to acknowledged Him as the sovereign Lord of the universe. As a punishment, God afflicted him with some form of dementia for seven years. At the end of that seven year period of insanity, Nebuchadnezzar “lifted (his) eyes to heaven and (his) understanding returned to” him. At that point he began to praise God and acknowledge that God rules over all the affairs of men. In other words, during that time of madness God was teaching Nebuchadnezzar. He wasn’t some hollow creature - a zombie without a mind. He was, however, a man no longer distracted by his physical body. He was a man whose mind was occupied with the presence of God and God’s instruction concerning Himself. That’s why at the end of his seven year madness he didn’t wake up, look around and say “where am I?”
Thus who are we to say that God does not deal with His people in a similar manner when they enter the realm of advanced dementia. Now, please understand me: I’m not suggesting that we should all pray for the opportunity to loose our minds. No more than we should all pray for the opportunity to get in a car wreck. Yes, God does work His purpose in our life through adversity (see my article Count it all Joy), but that doesn’t mean we go looking for it. Nevertheless, when God leads us down the path of tribulation, we should embrace it as a gift from God. That being the case, no one has the right to decide to end another’s life simply because that other’s quality of life is diminished. No one has the right to say that poor health or a lack of cognitive awareness is reason enough to commit murder by starvation and dehydration. The Bible says that it is good for us to be afflicted because it drives us to acknowledge God as Lord (Ps. 119:67-72). Physical illness is one form of affliction that commonly forces one into the arms of Christ and under His yoke. Suggesting that physical affliction is wasted on one who is in the advanced stages of dementia is to say that God is too small to do anything in a difficult case like that. To paraphrase, don’t you think that the One who made the mind knows enough about it to “make contact” even when we can’t?
I agree with the pro-life position which declares that we do not have the right to decide when human life should end. I also agree that all human life has dignity - and that is reason enough to preserve it (at the very least to provide food and water which certainly isn't "taking extraordinary measures to preserve life" for crying out loud). However I think that we need to develop our argument a bit. It’s not enough to say that life is sacred – people want proof that where there is “diminished” life there is value. And the existence of Mind is verification of value. The presence of a reasonable mind even in a “vegetable state” or in advanced stages of dementia cannot be disproved1 – indeed the Bible teaches us that our mind is open to God even when it is not discernable to those around us.
These are the ideas that I tried to convey to Bob’s family but for whatever reason they refused to listen. My guess is that their attitude is not uncommon among Christians today.
Note added 4.10.05: Jack Died in his sleep on Sunday, April 10, 2005. He had confessed Christ as his Lord and Savior and publicly stated his belief in Christ's resurrection just days before. He ate his last meal (chicken, potato salad, vegetables and ice cream for desert), only a few hours prior to his death.