End of Life Issues: Medicine

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Romans922

Puritan Board Professor
Another thread got me thinking about this (and I mean no disrespect to anyone who might disagree with me or who has just made decisions about this) issue of the end of life and the use of medicine to bring comfort.

Sometimes in the use of using the medicine to bring comfort it places the person receiving the medicine in many different scenarios (because of the medicine that is bringing comfort):

1) coma (spelling?)

OR

2) Not aware of one's faculties

3) there could be more but I am unaware


If such medicines at the end of life to bring comfort cause a coma or cause one no longer to be aware of their faculties, should such medicines be used?

If possible, shouldn't we be aware of what is going on? Shouldn't we want to have control of our faculties as we near death (if possible)?
 
From Prov 31 (hcs)

6 Give beer to one who is dying,
and wine to one whose life is bitter. (I)

7 Let him drink so that he can forget his poverty
and remember his trouble no more. (J)
 
The pain from things like bone cancer can become so excruciating that medication is a necessity.
 
Palliative care shows respect for the sanctity of life and mercy for the suffering of the person. Both of these are Godly aims and worthy of practice.
 
Pain management is proper use of what God has allowed us to develop and not violating his law or ignoring his grace. I know someone who recently died from cancer. The use of narcotic pain medicine made her doze off easily in her chair, but she still was alert and conversational with visitors to the end. You can keep your mind, keep your dignity and keep your suffering to a minimum if the drugs are administered properly.
 
Would you prefer excruciating, intractable pain to comfortable oblivion? Come on. Do to others what you would want done.
 
I have been only at half a dozed deathbeds, so I am boy no means an expert on the subject. All 6 times (all cancer but one), strong drugs were used to ease the pain. What struck me about this fact was, in all but one instance, the sick one, while not lucid on many things was very lucid when it came to the gospel. One striking case involved a man (81 yrs) who was in a deep medicated condition. He was not responsive to even the voice of his wife in that condition. Yet, when I was visiting his deathbed, and began to read the Psalms to him, he was noticeably brought from what appeared to be unconsciousness, to semi consciousness. After reading to him for over a half hour, once i believed he was going back to a deep sleep, I said, "Len, I am going to go now. I will be back in a few hours". To which he, with eyes closed yelled "No", and shook his head. I then stayed for another half hour reading the word to him. He died that same evening.
This is only an anecdote, I know, but it demonstrated to me that someone can be seriously medicated, and still have their hearts warmed and confirmed by the Word. I will not forget that evening.
All that to say that I don't believe it is wrong to medicate at "near death".
 
Would you prefer excruciating, intractable pain to comfortable oblivion? Come on. Do to others what you would want done.

Personally, it is different for me, that is why I am asking.

I would want to feel pain. To feel a glimpse of what my Savior felt because of my sin. I'm sure it would be sanctifying.

But I say this as a young man, so...
 
My grandfather was mostly out of it near the end, but when I read Bible verses to him in Dutch, I could see his lips moving - he was reading along in his head! I would definitely second Pastor Lewis' experience on this, anecdotal though it may be.
 
Would you prefer excruciating, intractable pain to comfortable oblivion? Come on. Do to others what you would want done.

Personally, it is different for me, that is why I am asking.

I would want to feel pain. To feel a glimpse of what my Savior felt because of my sin. I'm sure it would be sanctifying.

But I say this as a young man, so...

I have lived with chronic pain for several years. There is nothing sanctifying about it. It is a steady reminder to ask for mercy. Why would you want to attempt to bear something Jesus took on, for you? The above comment seems rather self-righteous from my prospective.
 
Would you prefer excruciating, intractable pain to comfortable oblivion? Come on. Do to others what you would want done.

Personally, it is different for me, that is why I am asking.

I would want to feel pain. To feel a glimpse of what my Savior felt because of my sin. I'm sure it would be sanctifying.

But I say this as a young man, so...

I don't say this to be disrespectful, but I wonder how much pain you have experienced. Its an easy thing to say that you want to feel pain when you are free of it.

I also wonder if its a little dangerous to want to "feel Christ's pain." First of all, I don't think its possible. Second, it seems like its an easy road from that to self-flagellation.

Edit: Cross posted with Rich. Oops...
 
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Comparing unnecessary suffering to Jesus bearing the sins of the world in his flesh is mixing apples and oranges:2cents:
 
Would you prefer excruciating, intractable pain to comfortable oblivion? Come on. Do to others what you would want done.

Personally, it is different for me, that is why I am asking.

I would want to feel pain. To feel a glimpse of what my Savior felt because of my sin. I'm sure it would be sanctifying.

But I say this as a young man, so...

Brother, in all sincerity, that comment kind of weirded me out.

To feel pain would increase sanctification? That is one of the oddest views of sanctification that I think I have ever heard.

Do you think then that since sanctification is to be desired & sought after, that christians aught to seek out pain? Should we cause ourselves pain? Were the Flagelents more "sanctified" then others of their time?

I really hope that I misunderstood what you meant.
 
Another thread got me thinking about this (and I mean no disrespect to anyone who might disagree with me or who has just made decisions about this) issue of the end of life and the use of medicine to bring comfort.

Sometimes in the use of using the medicine to bring comfort it places the person receiving the medicine in many different scenarios (because of the medicine that is bringing comfort):

1) coma (spelling?)

OR

2) Not aware of one's faculties

3) there could be more but I am unaware


If such medicines at the end of life to bring comfort cause a coma or cause one no longer to be aware of their faculties, should such medicines be used?

If possible, shouldn't we be aware of what is going on? Shouldn't we want to have control of our faculties as we near death (if possible)?

Perhaps something of my experience may be of benefit.

My first love, and wife of nearly 20 years, died after fighting cancer for more than three years. She had during that time many times of prayer, seeking God's face, seeing her life in the light of it being near certain that she would die, and then certain ... barring extraordinary providence ... that she would soon be with her Lord. On the last full of her life, somewhere about 8 or 9 in the morning, the pain she was suffering was literally unbearable. She started with quite moaning, but as the day passed, she was in such pain that she was literally screaming in pain almost continually, even with more pain killers than what would allow her to be fully conscious. That went on all day until almost 11:00pm. Then her doctors finally found a combination of pain killers that induced coma, and her screaming stopped. About 3 hours later, she passed from this life into the arms of her Lord.

I can see absolutely no benefit for her to experience such pain. Truth be told, I cannot see how that has worked for the good of either her, the children, me, her family, or anyone else ... even though I know from faith that God works all things (including her time of pain) together for the good of those that love him. Job never learned why he suffered (as far as we know) and I do not believe I will ever know why she suffered.

Am I grateful that such drugs exist and do I think they should be used?
 
Andrew,

A few comments about your "sanctification" post above.

1. Your stated view is contrary to the " 2nd greatest commandment". We may not desire evil to befall our neighbors. Unmedicated pain is by definition an evil that may befall one.

2. Your stated view is also contrary to the express teaching of scripture as found in Prov. The word of God teaches us that we are to medicate those that are in physical (& mental!) pain.

3. Your stated view also reduces the sufferings of Christ to a "mere" human pain.

4. Your stated view also elevates the nature of ordinary human pain to the level of the sufferings of Christ.

5. Your view allows that a person may increase their sanctification by violating one of the commands of God. cf WSC Q. 69. What is forbidden in the sixth commandment?
A. The sixth commandment forbiddeth the taking away of our own life, or the life of our neighbor, unjustly, or whatsoever tendeth thereunto.

5. Your view assumes a definition of sanctification contrary to that agreed to by orthodox christians. cf WSC Q. 35. What is sanctification?
A. Sanctification is the work of God’s free grace,[97] whereby we are renewed in the whole man after the image of God,[98] and are enabled more and more to die unto sin, and live unto righteousness.

6. Your view sounds very much like that held by notorious heretical groups in the history of the church. [ame=http://en.wikipedia.org/wiki/Flagellant]Flagellant - Wikipedia, the free encyclopedia[/ame]
 
Would you prefer excruciating, intractable pain to comfortable oblivion? Come on. Do to others what you would want done.

Personally, it is different for me, that is why I am asking.

I would want to feel pain. To feel a glimpse of what my Savior felt because of my sin. I'm sure it would be sanctifying.

But I say this as a young man, so...

I've only experienced severe pain once in my life, and I'll assure you that there was not one thing sanctifying about it. Being told that further treatment would involve surgery under general anesthesia was quite welcome. And I don't want to even imagine what it would have felt with without the iv, oral and local painkillers that I was on at the time.
 
Maybe a couple of different perspectives, from a Christian and medical standpoint. In response to Andrew's initial post, I believe there's more to analgesia (narcotic or otherwise) than coma or being unaware of one's faculties. The proper use of narcotics (maximum case scenario) for severe pain, whether it be for a terminal end-of-life condition or not, can often leave folks better rested and MORE alert--chronic use of narcotics often leads to less euphoria, hence the escalation of dose when used for the euphoria, not pain relief (i.e. standard Keith Richards-ish heroin use). Overdose is a different issue, but again chronic narcotic use raises tolerance so OD becomes a bit less likely. Properly supervised and administered narcotics can help folks continue to lead their lives to a degree not possible without them, for as long as possible; and when normal life is no longer possible, can be a source of tremendous rest and relief for both patient and family, and actually improve what "quality time" might be left.
Other issue: is pain, of itself, sanctifying? I'd suggest "no". Becoming more holy makes us sinners suffer on many levels--as separation from our cherished idols is difficult at best--often physical pain isn't one of those levels. As the Puritans were apt to point out, all of the scourgings and other extremes the Catholics of their time were wont to put themselves through accomplished nothing of themselves; self-denying at any level is only beneficial for us when informed and instructed in Christ's school, not our own, or anyone else's. And as well pointed out elsewhere, if we think that the pain we suffer in life in any way can be equated with, compared to, added to, or whatever else to Christ's suffering on the cross, we're wrong; if our pain helps us sympathize with our savior, helps us better understand our sinful condition, etc then perhaps even its horrors can be redeemed to God's purposes for our lives.
 
Andrew,

One more thing here. If you are in fact at the end of your life, you need not worry about pain being sanctifying ... as soon as you pass from this life to the next, you will in fact be fully, completely, perfectly sanctified. The brief time before you die will be of little consequence, and the difference between a day (or week, or even month) of pain and the sanctification that will occur at the instant of death is so great that I have no doubt the pain one might suffer will be of little consequence.

While you are here, of course pursue sanctification, but leave strong drink to those in pain.

Brian
 
From Prov 31 (hcs)

6 Give beer to one who is dying,
and wine to one whose life is bitter. (I)

7 Let him drink so that he can forget his poverty
and remember his trouble no more. (J)

Having looked at the context of these passages in Proverbs, and having read Mr. Henry's commentary on them, I don't think they are commending liquor (or drugs) for the purpose of alleviating pain.

Rather, they teach the exact opposite- they are condemning drunkenness, idolatry and the seeking of escape from the lot in life one is given (by God) as a very "low" form of behavior, not at all fitting for kings, let alone for God's people.

http://www.ccel.org/ccel/henry/mhc3.Prov.xxxii.html?highlight=proverbs,31#highlight


Matthew Henry
Commentary on the Whole Bible, Vol. III

.....

2. Against drunkenness, v. 4, 5. He must not drink wine or strong drink to excess; he must never sit to drink, as they used to do in the day of their king, when the princes made him sick with bottles of wine, Hos. vii. 7. Whatever temptation he might be in from the excellency of the wine, or the charms of the company, he must deny himself, and be strictly sober, considering, (1.) The indecency of drunkenness in a king. However some may call it a fashionable accomplishment and entertainment, it is not for kings, O Lemuel! it is not for kings, to allow themselves that liberty; it is a disparagement to their dignity, and profanes their crown, by confusing the head that wears it; that which for the time unmans them does for the time unking them. Shall we say, They are gods? No, they are worse than the beasts that perish. All Christians are made to our God kings and priests, and must apply this to themselves. It is not for Christians, it is not for Christians, to drink to excess; they debase themselves if they do; it ill becomes the heirs of the kingdom and the spiritual priests, Lev. x. 9. (2.) The ill consequences of it (v. 5): Lest they drink away their understandings and memories, drink and forget the law by which they are to govern; and so, instead of doing good with their power, do hurt with it, and pervert or alter the judgment of all the sons of affliction, and, when they should right them, wrong them, and add to their affliction.
 
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Scott, you are mistaken.

Mr Henry does not specificly address the issue of giving strong drink to those in pain. He skips that to focus on the warning to kings to avoid drunkeness.

These issues are entirely distinct from one another.

If you intend to champion teetotalism from the scriptures I would suggest that you begin with a passage that does not commend the use of wine & strong drink as a benifit.
 
From Prov 31 (hcs)

6 Give beer to one who is dying,
and wine to one whose life is bitter. (I)

7 Let him drink so that he can forget his poverty
and remember his trouble no more. (J)

Having looked at the context of these passages in Proverbs, and having read Mr. Henry's commentary on them, I don't think they are commending liquor (or drugs) for the purpose of alleviating pain.

Rather, they teach the exact opposite- they are condemning drunkenness, idolatry and the seeking of escape from the lot in life one is given (by God) as a very "low" form of behavior, not at all fitting for kings, let alone for God's people.

Commentary on the Whole Bible Volume III (Job to Song of Solomon) | Christian Classics Ethereal Library


Matthew Henry
Commentary on the Whole Bible, Vol. III

.....

2. Against drunkenness, v. 4, 5. He must not drink wine or strong drink to excess; he must never sit to drink, as they used to do in the day of their king, when the princes made him sick with bottles of wine, Hos. vii. 7. Whatever temptation he might be in from the excellency of the wine, or the charms of the company, he must deny himself, and be strictly sober, considering, (1.) The indecency of drunkenness in a king. However some may call it a fashionable accomplishment and entertainment, it is not for kings, O Lemuel! it is not for kings, to allow themselves that liberty; it is a disparagement to their dignity, and profanes their crown, by confusing the head that wears it; that which for the time unmans them does for the time unking them. Shall we say, They are gods? No, they are worse than the beasts that perish. All Christians are made to our God kings and priests, and must apply this to themselves. It is not for Christians, it is not for Christians, to drink to excess; they debase themselves if they do; it ill becomes the heirs of the kingdom and the spiritual priests, Lev. x. 9. (2.) The ill consequences of it (v. 5): Lest they drink away their understandings and memories, drink and forget the law by which they are to govern; and so, instead of doing good with their power, do hurt with it, and pervert or alter the judgment of all the sons of affliction, and, when they should right them, wrong them, and add to their affliction.

I would tend to disagree. The passage says the king should not drink, that the appropriate reason to drink is for those that are dying. The whole point, regardless of what Mr. Henry says, is the appropriate use is for those that are dying. The context clearly is specifying that drinking to get drunk is not for the king, and the Psalmist contrasts the king with those that are dying. Here there is a clear distinction presented ... yes, we should not desire strong drink as the rule of the day, but if someone is wounded or dying, then they are the perfect use of what numbs the pain. This is clearly what is being said. There is no reasonable way to read it otherwise unless the person is bringing their theology to the passage, not allowing the passage to speak for itself.
 
Scott, you are mistaken.

Mr Henry does not specificly address the issue of giving strong drink to those in pain. He skips that to focus on the warning to kings to avoid drunkeness.

These issues are entirely distinct from one another.

If you intend to champion teetotalism from the scriptures I would suggest that you begin with a passage that does not commend the use of wine & strong drink as a benifit.

The cited passages do not address abstinence, either.

They really address the high standards of behavior for the king, and, by analogy for all believers. In context, I do not understand them as a command to promote drunkeness in order for others, except the king, to eliminate their pain.
:)

It may have been a cultural practice to do that at that time, but in no way do these passages command that.

On the topic generally, our Lord was offered a drug (hyssop) while on the cross to numb what could of been on the most incredible of pain. Although hard for us to relate to- he did not take it. It seems there is something in His example there.

There are valid medical benefits in alleviating pain, but the Proverbs passages used here are about alcoholism, a misuse of something as a contrast with right behavior. They are not dealing with the King abstaining, while the peasant is expected to drown his sorrows in alcohol.

The context of the two verses cited here in Proverbs is high moral character for a king, but by analogy, to God's people.
 
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Palliative care is being considered for me. I will prayerfully and cheerfully take it. The Lord is mine; blessed be His name! He would have me to be comfortable after these many years (nearly four decades now, since I was virtually a kid) of suffering... I am so very grateful that He chose me to be His own. He forgave me; He healed my worst afflictions! The Lord does provide doctors and wonderful ways of alleviating severe, intractable, temporal pain and other miserable symptoms.

There are two things I want nothing to do with (because I've "been there"): bleeding out from a non-existent platelet count, and hemolytic transfusion reactions. Both are horrifying ways to go if you happen to be conscious while they're occurring; they're both possibilities if someone countermands the written instructions I've left.

I see nothing wrong with anyone passing into his or her Savior's arms having taken advantage of sedation, strong analgesics and/or whatever.

Margaret
 
Scott,

Is it the phrase "give him beer" or "let him drink" that you find condemn the practice of giving alcohol to those that are suffering?

:think:
 
It's 11:05 pm here at my house. At 8:30 tonight one of my cousins died after years of suffering from Huntington's. His pain was both physical and mental. Tonight when I saw him lying still in his favorite recliner, no longer struggling to breathe, I only wanted to thank God for his life and for the peace he has entered. If you have a spare moment to pray, please remember his family. We didn't know it would come this soon.
 
Jennie, may the peace of God, & the love of Christ, & the comfort of his Holy Spirit rest & abide on you at this time of your loss.

My prayer is that you and your family will know the peace of God at this time.

Here is the word of God;

2 Corinthians 5
Our Heavenly Dwelling
1For we know that if(A) the tent that is(B) our earthly home is destroyed, we have a building from God,(C) a house not made with hands, eternal in the heavens. 2For in this tent(D) we groan, longing to(E) put on our heavenly dwelling, 3if indeed by putting it on[a] we may not be found naked. 4For while we are still in this tent, we groan, being burdened—not that we would be unclothed, but that we would be further clothed, so that what is mortal(F) may be swallowed up by life. 5He who has prepared us for this very thing is God,(G) who has given us the Spirit as a guarantee.
6So we are always of good courage. We know that(H) while we are at home in the body we are away from the Lord, 7for(I) we walk by faith, not(J) by sight. 8Yes, we are of good courage, and we(K) would rather be away from the body and at home with the Lord. 9So whether we are at home or away, we make it our aim to(L) please him. 10For(M) we must all appear before the judgment seat of Christ,(N) so that each one may receive what is due for what he has done in the body, whether good or evil.
 
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