Sermon August 23, 2015 – Death and Dignity

Scripture Lessons: Ecclesiastes 3:1-13 and Romans 14:7-9
Pastor: Rev. Kim P. Wells
Summer sermons based on topics requested by the congregation.

Henry Pitney Van Dusen and Elizabeth Van Dusen led exciting, vibrant lives. Van Dusen was a Presbyterian clergy person who rose to become the president of Union Theological Seminary in New York City. He was instrumental in founding of the World Council of Churches. Van Dusen was a premier leader on the religious scene in mid 20th century America. The April 19, 1954 issue of TIME Magazine featured Van Dusen on the cover. In 1970, Van Dusen, suffered a severe stroke. Elizabeth Van Dusen suffered from debilitating arthritis. In 1975, they fulfilled a suicide pact they had made taking overdoses of sleeping pills to kill themselves. They left a letter for their three sons, relatives, and friends. It read:

To all friends and relations,

We hope that you will understand what we have done even though some of you will disapprove of it and some be disillusioned by it.

We have both had very full and satisfying lives. Pitney has worked hard and with great dedication for the church. I have had an adventurous and happy life. We have both had happy lives and our children have crowned this happiness.

But since Pitney had his stroke five years ago, we have not been able to do any of the things we want to do and were able to do, and my arthritis is much worse.

There are too many helpless old people who without modern medical care would have died, and we feel God would have allowed them to die when their time had come.

Nowadays it is difficult to die. We feel that this way we are taking will become more usual and acceptable as the years pass.

Of course the thought of our children and our grandchildren makes us sad, but we still feel that this is the best way and the right way to go. We are both increasingly weak and unwell and who would want to die in a nursing home.

We are not afraid to die.

We send you all our love and gratitude for your wonderful support and friendship.

[http://www.people.com/people/archive/article/0,,20065057,00.html, “A Joint Suicide—and the Right to Choose a ‘Good Death’”]

The action of the Van Dusens caused a stir in 1975 and was covered in People Magazine. I am sure it would cause a stir today. While there has been some progress, I don’t think we have made the strides related to issues of death and dying that the Van Dusens were hoping for when they wrote, “We feel that this way we are taking will become more usual and acceptable as the years pass.” There has been much progress in Europe but euthanasia is not widely accepted in the US.

Medical science has catapulted forward. Bionic joints and limbs are no longer the stuff of TV. Diagnostic procedures scan the inner workings of our bodies and even our cells. The medications and treatments that are available seem nothing short of miraculous. Operations using scopes and robotics seem right out of a science fiction novel. The progress in medical science is beyond the imagination.

But the conversations about end of life issues, available treatments, and euthanasia have not kept pace with medical science and technology. Because someone can be kept alive does not mean that they want to be kept alive or should be kept alive. Ethics boards at hospitals and the courts are being kept very busy dealing with the situations that arise because there has not been a comprehensive societal conversation about the issues involved.

With the progress in medical science and the availability of treatment in hospitals and health care facilities, dealing with death has become more and more separated from daily life. It used to be your loved ones got old and died at home. Or got a disease and died in the bed at home attended by family, neighbors, and loved ones. Now often people die in the hospital or a health facility attended by staff who are virtual strangers to the patients and their families.

With the radical advances in healthcare, medical staff are oriented toward curing an illness, treating a condition, and prolonging life. There is the sense that when person dies, the medical profession has failed and they do not want to fail.

And the cynical side of me says that what’s driving medical care and health decisions today is not ethics or compassion but money. Follow the money and we can see why we have the system we do. Healthcare is one of the biggest industries in America. And the key players leave no stone unturned and are no more upstanding than the tycoons of the oil industry. Florida’s governor is a case in point. Money is the motivator behind much of what is done in the name of the healing arts.

Death and dying are big business. Death and dying are a scientific frontier. Death and dying are also matters of ethics and faith.

The beautiful verses from Ecclesiastes remind us that death is simply part of the natural order of the universe. It is built into the divine fabric of creation. Everything that is living will die. That means you. And that means me. Death is a natural part of life just as the sun rising and setting, the cycle of the seasons, and the tides. Part of our cycle is death. We are born. We die. Death is natural. It is as natural as being born.

The reading from Romans reminds us that we need to have no fear of living or dying, because either way, we are in God’s hands. God’s love is with us. All shall be well. And the epistle writer says this at a time when Christians were being persecuted for their faith. They may very well be killed for their beliefs. They’re reassured that they are in God’s hands, in life, in death, and in whatever lies beyond. Whatever your views on life after death, the Christian faith teaches that we have nothing to fear in death.

Yet we have become a society that fears death. The topic is distasteful. Like, don’t bring it up at dinner, for heaven’s sake. And we have come up with all kinds of euphemisms for it – passing, going to heaven, gone on. You can’t just say, “He died.” You have to say, “He passed.” “She’s gone on to her reward.” “She is no longer with us.” “He cashed out.” “She expired.” “He departed.” “He flatlined.” “She got her wings.” “He perished.” We can’t just say, “She died.” It’s almost antisocially gauche.

Our discomfort with death is also evident in our idolization of youthful appearance. We do all we can to preserve our youthful looks and physique. Our fixation on youth is prominently manifested in the skyrocketing business in cosmetic surgery. We don’t want to look old. We don’t want to feel old. Because getting old means being closer to death. Well, yes. That’s the way life works. From the moment we are born, we are moving in the direction of death. That’s life.

There it is, the universal outcome. The great leveler. We will all die. That we can be sure of. Not much else. So death is something that should be accepted and talked about. But we really don’t like having those conversations. For the most part, we don’t want to talk about death though we talk about everything else – just turn on a TV or laptop.

I suspect that part of our fear of death and discomfort with talking about death is rooted in our feelings about life. Are we living true? Do our lives have meaning and purpose? Do we feel valued? What is the quality of our relationships? I think our feelings about these kinds of issues influence our attitudes about death and talking about death. In my experience as a pastor, I have seen in numerous situations that people who are grounded and solid are much more comfortable talking about death. They want to have those conversations about end of life issues. They know it is important. Talking about death is just an extension of talking about life. It is a continuation of being who we are and expressing our values, morals, and faith. And, maybe most importantly, they know that such conversations are a gift to their families and loved ones. Making their wishes known about end of life issues greatly reduces the burden on loved ones making decisions in difficult circumstances. So how we deal with death and dying is often a reflection of how we live and look at life. If we are foundering in life, we may also find ourselves foundering around the decisions that inevitably accompany the process of dying which we all will face, one way or another.

We really do have many choices related to death and dying. There are decisions about what treatments to have or not to have. There are conversations about the cost, expense, and the financial implications of death and dying. There are issues to do with comfort and pain relief. There is what to do with the body. Cremation. Embalming and burial. Organ donation. Giving the body to science. There are decisions about feeding tubes, ventilators, and what to do when the body may function but the brain is essentially dead. There are considerations about quality of life versus quantity of life. And, there is the almost taboo topic – physician assisted suicide – which is now legal in 4 states, Oregon, Vermont, Washington, and Montana, with New Mexico in line to follow. In Oregon, the law is called the Death with Dignity Act.

Euthanasia, or choosing to end life, is not something that is new. Humans have used this approach with animals for eons. Of course we put an injured animal out of its misery. Of course we compassionately end the life of a pet rather than prolong its suffering. This kind of approach can be applicable to humans as well. People may choose to end their lives rather than live with prolonged suffering. The ancients supported this option: Plato was against it at first, but eventually changed his mind. Socrates made no objection to taking the hemlock. Seneca the Stoic said, “As I choose the ship in which I will sail and the house I will inhabit, so I will choose the death by which I leave life.”

There were also those in the ancient world that were against euthanasia. Pythagoras among them. He believed that we are “the chattels of God and without his command we have no right to make our escape.”

And, more recently, the Catholic Church has weighed in. In 1957, Pope Pius declared, “The removal of pain and consciousness by means of drugs is permitted by religion and morality to both doctor and patient, even if the use of drugs will shorten life.” [Euthanasia quotes from http://www.people.com/people/archive/article/0,,20065057,00.html, “A Joint Suicide—and the Right to Choose a ‘Good Death’”]

We live in an era of choices. We choose where to live. We choose where to go to school. We choose what to wear. We go into the grocery store and have a startling array of choices of things to eat. We choose what to do with our lives. We choose what to watch on TV. We choose what to post on Facebook, Twitter, Instagram, and other social media sites. We choose our friends. We choose our entertainment. We choose our hobbies. Choices. Choices. Choices.

And part of the reason we have so many choices is that we believe that part of living with dignity is having choices. Dignity involves the ability to determine the course of our lives. Dignity is rooted in the right to self determination. This means making choices about our lives.

How do we bring dignity into conversations about death and dying?

Issues around death and dying are extremely personal. These decisions are grounded in our experience, our personality, our character, our ethnicity, our values, and our faith. Death with dignity implies having choices, legal choices, that are respected by the medical establishment as well as by the courts. If you don’t want to pursue physician assisted suicide, then you should not have to. There should be no pressure to do so. But if you do want to pursue that path, it should be open to you, legally and with the sanction of the medical profession. The same is true of the many, many other facets of the care available as life ebbs. These are things to be talked about. Sorted out. Investigated. Prayed over. And our feelings about death and dying may very well change over the course of our lives and as we get nearer the end. And we should expect that and continue to be in conversation.

There are so many issues and options to be considered and the situation will get even more complex as medical science and biology continue to advance. Yet we can still be reticent to talk about these things.

Interestingly, the city of La Crosse, Wisconsin decided that people needed to be talking about end of life issues. And through an intentional process of community education over a period of years it has worked. Here’s the story. In 1991, 15% of the population of La Crosse, WI had some kind of advanced care planning. A program was put in place with the goal of increasing the percentage to 50%. As we learn, that goal was far exceeded.

In 1998 the first La Crosse Advance Directive Study was published. While it was not designed to be an evaluation of the education program, it seemed to have had a profound impact on the use of advance directives. In a review of 540 medical charts, the number of patients who had died with advance directives in place had increased from 15 to 85 percent. When the LCAD study was replicated ten years later [2008], advance directive use had risen to 90 percent.

Today, GHS [Gundersen Health System] offers individualized advance care planning in three stages: First Steps ACP is for healthy adults 55 and over; Next Steps ACP is for patients with chronic, progressive illness; and Last Steps ACP is for frail elderly patients or those close to the last year of life.

[“Advance care planning in La Crosse, Wisconsin,” The Christian Century, Nov 3, 2014 by Jennifer L. Hollis]

The program is called Respecting Choices. Very fitting!

Medicare might not want to pay for you to discuss end of life issues with your doctor, but in the church, we believe that this is very important. We went through a season in the life of this church recently when on a monthly basis one of the chaplains from the congregation was available to work with people doing the paperwork about end of life options and choices. If you would like to do this, we can arrange for one of the chaplains to help you. It is very important for you. It is also a gift to your family and loved ones.

People die every day in ways that are awful. Unethical. Unjustified. Undignified. People die of hunger. People die of poverty and lack of access to medical care, medications, and proper nutrition. This happens in our communities, not just in Africa or some foreign land. People die at the hands of drunk drivers. Unarmed people are killed by police. Civilians are killed in war and violence. People die of cancer caused by pesticides or toxic chemicals or radiation. Things they had no control over. People are killed when the death penalty is implemented. There are all kinds of ways that we are dying, day in and day out, that do not involve dignity. That do not respect the sacredness of human life. That do not involve a full range of ethical choices.

While this is the case, there is still much that we can do to bring dignity to death. We bring dignity to death when we intentionally consider the options that we do have. We can face death with dignity when we have considered our lives and values and faith and seek to approach death in a manner consistent with how we have lived. We bring dignity to death when we make choices ourselves, on our terms, and respect the choices of others. There is more than one right way to die with dignity. What might be right for you may not be right for someone else. We face death with dignity when we are humble and reverent. And, we face death with dignity when we are living our lives fully, abundantly, in service to others and the good of the world.

The Van Dusens, who were mentioned at the beginning of the sermon, prepared for their death, with dignity, on their own terms, with careful intentionality, and grounded in their values and beliefs. They ended the letter to their loved ones saying:

We are not afraid to die.

We send you all our love and gratitude for your wonderful support and friendship.

‘O Lamb of God that takest away the sins of the world
Have mercy upon us

O Lamb of God that takest away the sins of the world
Grant us thy peace.’

Sincerely, Elizabeth B. Van Dusen Henry P. Van Dusen

May we live with dignity and die with dignity. May we see to it that everyone may live with dignity and die with dignity. May God have mercy upon us – for our choices, for avoiding choices, and for dictating the choices of others. And may all know God’s peace. Amen.

A reasonable effort has been made to appropriately cite materials referenced in this sermon. For additional information, please contact Lakewood United Church of Christ.

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