An article by Joel Belz in World magazine, July 18, 2009 (with slight editing). Note that this article was written sixteen years ago, so the dollar amounts have increased significantly; but the issue is the same, the debate has continued, and we are all sixteen years closer to the time that each of us may have to make some decisions about death. Joel Belz lived another fifteen years, dying in 2024 at the age of 82.
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Even at the age of 88 my friend Bess Gilmore is sprightly, direct, and efficient. So when she called the other night, I wasn’t surprised that she got right to the point.
“Joel,” she said, “the doctor tells me that I’ve got cancer. And I’m not upset about it. In fact, I’m thinking maybe this is the vehicle God is designing to take me to heaven.”
I’d spent a good part of that day reading up on some of the competing ideas that Congress, the Obama administration, and others are suggesting for the revamping of our nation’s healthcare system. But in all that I’d read, nothing approached the boldness or simplicity of what Bess Gilmore was suggesting. Maybe, I thought, there’s something profoundly important here that we’ve been leaving out of the national healthcare discussion.
Worldview matters. If you live your life preoccupied with getting sick, fearful of getting old, and terrified of dying, those concerns will radically affect your thought life, your schedule, your budget, your diet, and yes, even your voting inclinations for all of your later years.
If, on the other hand, you understand that sickness, aging, and dying are part of the order God has designed for humans ever since the fall of humankind, then a somewhat more casual response is altogether fitting. It might even be appropriate to respond to the Lord’s call by asking, “What time are you picking me up?”
I don’t mean to be flippant about an altogether serious matter. I do mean to suggest that an extraordinary opportunity may exist for God’s people to offer a powerful witness right at the core of this huge national discussion. What if thousands of aging American Christians found a thoughtful way to say together in reasonable unison: “We’re not scared of old age. We’re not terrified by illness. We know we’re going to die. Our goal is not to resist the inevitable. Our goal is to show others that God is good even in the middle of what some people regard as weakness and adversity.”
The practical ramifications are huge. Half of the current annual bill for America’s health care is for people 72 and over. As the population continues to age, that figure will go higher and higher. And someone, sooner or later, will have to step in and make some choices about who gets what treatment. It might be a doctor, an insurance claims adjuster, or a Medicare bureaucrat. What’s less and less likely is that the choice-maker will be you.
Time for personal disclosure: Since being diagnosed 18 months ago with a case of “aggressive” prostate cancer, I’ve consumed something like $55,000 worth of medical services. For that, I’ve received marvelous care, a vast reduction in the cancer, and a good prognosis. Because my own father died of prostate cancer, I know enough to take it seriously. But I also know I could not have written a check for $55,000. Without the blessing of good insurance, would I have chosen to go into debt to pay for that service? But now I have to face up to the fact that partly as a result of my costly experience (and millions more), the price of my own and my co-workers’ insurance has just gone up 21 percent.
So I ask myself: Does the time come, not for the “system” out there, but for me personally, when I need to be prepared to say, “This ought to stay in God’s hands-not mine”? And if that is the case, how will I recognize when such a time has come?
Age matters. What’s “tragic” for a young father of 35 isn’t tragic for a 68-year-old geezer like me.
The disease matters. Some issues are not life threatening, and the pain and discomfort do need to be treated. And some issues are more life threatening than others. How much cost is reasonable when the chance of recovery is small?
Cost matters. It’s easy to say that you can’t put a value on a human life. But a $55,000 choice isn’t the same as a $550,000 choice. What if the bill were $5 million? (And decisions are being made; budgets that provide millions of dollars to give a 90 year old another eight months, may be denying preventative care for hundreds of infants.)
And we’re all different. Some of us, like Bess Gilmore, are longing for heaven. Others have a few things they’d like to take care of first. We all desperately need godly wisdom. Our faith in Jesus and his promise of our resurrection from the dead must guide our approach to this issue from which not a single one of us is exempt.
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I have two precious memories of my parents as they were facing death.
Memory #1 — After seventeen years in a wheelchair following a stroke, my mother was also beginning to experience some dementia, of which she was painfully aware. She was tired of her worn out body and, like Bessie, was looking forward to heaven. One day on the way to a doctor appointment, she said to me (for the fourth time), “Why are we going to the doctor again?” I replied, “The doctor wants to do some tests. She is just keeping an eye on a few things for you.” She responded with a bit of irritation in her weak voice, “Well, if you and the doctor weren’t watching me so close, and you would all just let nature take its course, I would be done with this misery and be in heaven by now.” With a lump in my throat, I said, “I know, Mom, and I understand. Remember, you did sign that “Do Not Resuscitate” form, so when it is time for Jesus to come and take you home, we won’t interfere to stop Him. But you do have some things going on that are not life threatening, but will make you pretty uncomfortable in the meantime. So that is all we are doing today.” “All right, then,” she said, “but leave it at that.”
Memory #2 — Earlier this year, it was getting to be one thing after another with my father’s health. He couldn’t sleep, he had no appetite, he had no strength, he had urinary and bowel problems all the time (‘troubles with my exhaust system’ is how the old mechanic would put it), frustrations with his eyes, ears, and teeth, etc. etc. One day, the doctor in his assisted living facility said, “I would like to order a few tests for you. Would that be all right?” “No, no, no,” Dad said. “No more tests. I am 93 years old. We can’t be fixing everything. We have to leave an opening for something to get me.” A few months later, much to his relief, something did ‘get him.’ He died in his sleep, after having the wonderful opportunity to say good-bye to everyone in his family, always adding, “I will see you in heaven.”
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P. S. In none of this am I recommending or supporting any form of suicide, assisted or otherwise. God’s commandment “Thou shall not kill” prohibits that solution. There is, however, no commandment from God to pursue every possible medical intervention; installing every available medical device, taking every accessible drug approved (or not approved) by the FDA, or remaining on life support when there is no hope of recovery.
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Luke 2:29-30 (KJV) — Lord, now lettest Thou Thy servant depart in peace, according to they Word, for mine eyes have seen Thy salvation.
I Corinthians 15:55 — “Where, O death, is your victory? Where, O death, is your sting?”
Philippians 1:21 — For to me to live is Christ, and to die is gain.
Psalm 23:4 (KJV) — Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me.
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Send Thy comforting Spirit, Almighty God, that in our hearts we may have that peace that passes all understanding. Grant to us a quiet mind and a patient waiting, so that death may lose its sting and the grave may lose its victory; and that we, in calm joy, may walk all he days of our appointed time until our great change shall come. In the name of our Risen Lord Jesus. Amen.
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