Couples finally pursue end-of-life decisions

Pastor Morrie glories in eternal life and whatever role he can play in assuring that his flock gets there. Unfortunately, that often means a front-row seat for some agonizing departures; some physical, some man-made.

“You have to face the reality of it,” said the pastor, Maurice N. Hansen. “We are really here for such a minute amount of time.”

Helping people with the reality of death and dying has been a passion of the Dana Point, Calif. pastor for more than eight years. That’s how long it took him to compile “Final Details,” an impressive collection of end-of-life forms and helps for individuals.

Released last year, the workbook was selling up to five copies a week on Amazon.com. That was until earlier this year when national media coverage on Terri Schiavo and her family’s ongoing legal battle over her health—and ultimately death.

Schiavo, described by court-appointed doctors as in a permanent vegetative state, died March 31, nearly two weeks after a judge ordered her feeding tube removed at the request of her estranged husband. Terri’s family, trying desperately to save their daughter’s life and resume therapeutic treatment, challenged the decision through the courts and Congress.

At its peak this spring, Hansen’s book was selling up to 50 copies a day.

“People are really starting to talk about this,” he said, adding that he’s been on about 80 radio programs nationwide during the past six months or so.

“Terri Schiavo has been a great deal of help for a lot of people, even more than her family realizes,” Hansen said. “Terri’s done a wonderful service for people.”

Dr. Gene Rudd, associate executive director of the Christian Medical & Dental Associations, a national organization representing more than 17,000 doctors and dentists, said his group’s Web site, including downloadable end-of-life directives, has had an unusually high amount of traffic because of Schiavo.

“It has been spinning fast in terms of people getting free advance directives,” Rudd said. “There’s been tremendous interest. Christians have long thought, ‘it’s not going to happen to me.’’’

Rudd and his colleagues welcome the attention, especially if it prevents another high-profile tug-of-war that splits families.

“These issues are as old as time, except for our technology, (which) is making it much more likely to affect people,” the CMDA executive said.

His organization was among many lobbying in support of Schiavo’s right to live, saying the removal of the feeding tube and the court order not to feed her manually, or give her water to ease dehydration, was immoral.

“When removing a ventilator … You don’t take the oxygen out of the room,” he said. “We’re not getting rid of a burdensome treatment, we’re getting rid of a burdensome patient.”

Vital process
Both Rudd and Hansen said preparing for end-of-life decisions is a critical matter that needs to be done openly and early.

“It’s a process,” Rudd said. “We recommend they start with praying, seeking guidance.

“There’s no way you’ll ever have enough information to cover every scenario that could happen to you. That’s when you sit down with someone you trust and someone who understands your value system.”

Hansen’s book is an excellent resource to help couples get started.

“It’s not to be morbid, but it’s to bring you closer together,” the author said.

It contains directions for a living will and a directive for physicians. Other forms include those for donor consent, quick references for insurance, investments and funeral planning.

“This is the check list for checking out,” he said, repeating a slogan bequeathed to him by a friend. “If you really love your family and really care about them, you really need to let them know what you want.”

Filling a void
Hansen said he began compiling the information more than eight years ago because he found existing information too complex and confusing for many lay people.

“Nothing tears families apart more than when someone dies and there are no details,” he said.

Hansen and his wife spent about six hours using the workbook to compile their information. Sometimes something as simple as a birth certificate can be hard to locate, which can hold up a variety of post-mortem details.

“Every time I have to bury people, I have to scrounge around for information,” the pastor said.

Although it can be used by anyone, the workbook is designed for Christians and includes useful Scriptures.

His advice came in handy for one woman shortly after the death of her husband, who had been married twice before. As his widow made arrangements, she was inundated with conflicting burial demands from the previous wives and her mother-in-law. Fortunately, the widow had a written set of directions from her husband that clarified his wishes.

“Without that directive she would have had a real dilemma,” he said. “Everyone quieted down on this.”

Hansen said he believes the most important document in the book is a directive for guardianship of surviving children. On two separate occasions, Hansen found himself in the center of ugly custody clashes between grandparents after the kids’ parents were killed in auto crashes.

When to let go
While filling out such forms can be emotional, it’s much more straightforward than trying to determine when and if its appropriate to terminate treatment. Most experts hesitate to establish a uniform standard.

“It has to be between you and God,” Hansen said. “No one can make that decision for you.”

Personally, Hansen has decided he does not want to be kept alive “taking up space” with artificial means; he’d rather be in the arms of his Father.

“It’s not a terrible thing, it’s a beautiful thing if you really think about it,” the pastor said.

Rudd agreed that each individual and family must consider all the options based on the context of their faith.

“As Christians we are to be God-honoring in all of our decisions and that comes from knowing the Scriptures,” he said.

Whether or not a decision is made to remove a feeding tube, Rudd said either decision can be God-honoring when it’s approached with prayer and discernment. It’s not a hard-and-fast principle that must apply to everyone, but rather one that needs to be made at the bedside, Rudd said.

“God calls the shots on these things, we just need to be still and listen,” Hansen suggested.

By not making the decision in advance, Rudd said Christians risk relinquishing the most intimate moments of their health and homegoing into the hands of strangers, or even family members who do not have the patient’s personal interests at heart.

“They are not understanding our worldview and our values and considering that in making a decision,” Rudd said. “The most immediate next of kin may not be the best one to make that decision.”

Sound stewardship
Rudd cautions, however, that Christians are also called to be good stewards and that sometimes means ending frivolous and futile care. He said wiping out an entire family’s assets for another round of chemotherapy when the first 10 didn’t work, is also an ethical and moral challenge. The doctor calls it being heavenly minded enough to know when it’s time to let go.

“As Christians we are to be stewards of time and life and we are to make the most and best of both of them,” he said. “The problem is when the family starts to put on the pressure.”

If the facts are fuzzy, he said, we are commanded to error on the side of life.

“A critical point in caring for a person is when we are not going for a cure, we are going for care,” the doctor said.

For more information on the book, call 1-866-706-5960 or log on to finaldetails.net. For information about CDMA, visit cmdahome.org.

Published by Keener Communications Group, xxxx 2005

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