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“Light in the Shadows”: Meditations While Living with a Life-Threatening Illness

God, give us grace to accept with serenity the things that cannot be changed, courage to change the things which should be changed, and the wisdom to distinguish the one from the other.
-- Reinhold Niebuhr

    Perhaps we have been lulled into thinking that modern medicine will make sickness and death optional. We have antibiotics to fight off infections, feeding tubes to nourish those who cannot eat, and mechanical respirators to breathe for those whose lungs have failed. We even have a standing order against death-Cardiopulmonary Resuscitation (CPR). Many believe CPR can restart any heart that stops, yet we know there are large categories of patients for whom the procedure is rarely effective.

Once, everyone knew that when breathing failed, or a patient stopped eating, or when a heart was silenced, death was at hand. At times today, these conditions can be reversed and life restored by the use of heroic treatments and machines. Because they are occasionally effective does not mean such extreme measures are always required. For many patients, these conditions cannot be reversed. In earlier years, we might have said, "God had called a person home" when the heart and breathing stopped. Today, some think that this need not be the case.

People occasionally tell me that they cannot order the removal of a respirator or feeding tube or withhold CPR because to do so would be "playing God." They genuinely fear that making a decision to allow a natural death would be assuming God's role-choosing the timing of a death. But isn't it curious that we might feel we are "playing God" when we turn off a machine and not feel the same fear when we turn on a machine? What greater message could God give than for a heart to stop, for breathing to fail, or for the ability to eat diminish? I am not saying that we should never use machines. They can benefit some patients greatly.

My friend, Sr. Carol Taylor, R.N., Ph.D., points out that to use medical procedures inappropriately is to shake our fists at God and to shout, "I will not accept the fate every other human before me has had to face. Although it remains clear that the use of aggressive medical procedures will not stop me from dying, I will do it my way." To relinquish control is difficult, because we have been working our whole lives to gain mastery over our world. When we use medical interventions that offer no hope of recovery, we may be shaking our fist at God and saying, "I am in control here."

Although sometimes it is not totally clear when to withhold or withdraw a medical procedure, I will try not to force my own will in a situation when all the signs point toward letting go.