Cancer Blog #30
By Brian Zimmerman
Begun on July 31, 2021
Email: dyingman1@yahoo.com
My Dying Words
Entry #30
March 22, 2022
[Act 20:7-12 NASB95] 7 On the first day of the week, when we were gathered together to break bread, Paul [began] talking to them, intending to leave the next day, and he prolonged his message until midnight. 8 There were many lamps in the upper room where we were gathered together. 9 And there was a young man named Eutychus sitting on the window sill, sinking into a deep sleep; and as Paul kept on talking, he was overcome by sleep and fell down from the third floor and was picked up dead. 10 But Paul went down and fell upon him, and after embracing him, he said, “Do not be troubled, for his life is in him.” 11 When he had gone [back] up and had broken the bread and eaten, he talked with them a long while until daybreak, and then left. 12 They took away the boy alive, and were greatly comforted.
[Act 9:36-43 NASB95] 36 Now in Joppa there was a disciple named Tabitha (which translated [in Greek] is called Dorcas); this woman was abounding with deeds of kindness and charity which she continually did. 37 And it happened at that time that she fell sick and died; and when they had washed her body, they laid it in an upper room. 38 Since Lydda was near Joppa, the disciples, having heard that Peter was there, sent two men to him, imploring him, “Do not delay in coming to us.” 39 So Peter arose and went with them. When he arrived, they brought him into the upper room; and all the widows stood beside him, weeping and showing all the tunics and garments that Dorcas used to make while she was with them. 40 But Peter sent them all out and knelt down and prayed, and turning to the body, he said, “Tabitha, arise.” And she opened her eyes, and when she saw Peter, she sat up. 41 And he gave her his hand and raised her up; and calling the saints and widows, he presented her alive. 42 It became known all over Joppa, and many believed in the Lord.
The topic of death and modern medicine is obviously of great interest to me – someone with a terminal disease. Do MD’s have the right to take a life (euthanasia)? Legally they might be granted that right, but morally, should they be extended that right? Do they have the moral right to help a person commit suicide? And, when can they “pull the plug?” My opinion on these questions is derived to a large extent from a book called “Medical Ethics” by the theologian, John Frame. What follows in this entry is, however, my opinion, not necessarily his, so don’t blame him for these thoughts. I strongly recommend, though, that anyone who has questions about this area, should read his short book (only 122 pages) (I believe it’s out of print, but it still can be found pretty easily if you Google the ISBN 0875522610). Short as it is, it is an excellent and surprisingly comprehensive overview of questions in this area. So, let me give my very simplified view focused on the issues I raised at the beginning of this entry.
From the way I framed the questions above, I’m sure you can surmise my answers: no, MDs should not (even if legally they can) have the right to euthanize patients. God alone, as we saw in a previous entry, has the right of life and death. He has delegated the right in certain specific situations, but suicide is not one of them as it violates the 6th commandment (“Thou shalt not kill”). In fact, a basic medical ethical principle is this one: first, do no harm. Further, the ancient Hippocratic Oath forbad euthanasia as well as abortion.
In modern life, of course, things are more complicated. There is the question of how we decide if someone is dead, which I won’t get into (see Frame for his helpful discussion of making a pronouncement of death based on brain death, or the stopping of the heart or breathing). The passage I quoted at the beginning may give some impression that Eutychus must have passed out if he was revived, but I think from both vs 9 and vs 12, we can be certain that the fall killed him. Thus, what Paul did wasn’t a revival, but a resurrection (like Lazarus). The Bible seems to indicate that people over thousands of years tended to see the time of death primarily as stopping breathing. But, in this passage, there is no criterion of death mentioned. Eutychus’ death must have been obvious to all, with no hope of revival. Thus, Paul’s act was not just merciful, but miraculous.
For us, though, there may be decisions that Eutychus’ family were spared. For instance, we may have to think about life support. To me, life support should be supplied with the expectation of recovery, otherwise it should probably be removed. Comfort care (also known as hospice) for pain, breathing, etc., should be provided, as should nutrition (food and water). But, letting someone die from their disease or condition is not the same as killing them. Prolonging life may be good in one sense as life is a gift from God. But, prolonging life is not an absolute good to be desired in all circumstances. A person may choose to avoid treatment to extend their life, even to avoid economic hardship for their family, but, again, that is not the same as suicide, which is self-murder, i.e., taking a life that otherwise would normally continue, being stopped only because we murder someone (or ourselves) to end it unnaturally (using means such as lethal injection or by denying them oxygen or nutrition). As we can see in the case of Tabitha (Dorcas), the loss of a life, as I discussed in a previous entry, may impose a great burden on those who are left behind to mourn them. In light of that burden, I think Peter then agreed to raise Tabitha back to full health. In my case, my greatest motivation to live, as I’ve seen a number of times with other couples in my home health practice, is my wife’s desire not to suffer my demise. But, as for me, as I’ve discussed before, and for any believer, I believe that we should always be ready and willing to die, even gladly but for the pain it may cause those who remain, if God should so call us to do. We shouldn’t see a terminal diagnosis as an absolute evil nor should our family and friends, though death itself is unnatural and an evil, as is the suffering and sorrow it causes us. Those who treat impending death as an absolute evil cause much trouble for the medical community and for those of the family and friends involved in that situation. I’ve seen it many times.
Other issues like comatose and terminal patients, as well as criteria of death (as I mentioned above), are discussed by Frame in more detail and far more clearly and better than I can do here.
MEDICAL UPDATE: I wanted to give a quick medical update on my situation. I went to the ED (emergency department) very early Monday morning (March 28) (I let my wife sleep as long as possible before waking her) with a variety of symptoms: nausea/vomiting, diarrhea, severe chills, mild muscle cramping/aches in my legs. I knew those could all be symptoms of something called an Addisonian crisis, which can be life threatening, if left untreated. So, again, to prevent my possible death, I went to the ED. At first they thought it could be an infection (such as Clostridium difficile (C diff, it’s normally called), a normal bacterium that lives in our gut, but can sometimes act like a two year old and get totally out of control, and is the dickens to get back under control. They thought that as I had a low grade fever (100.6), but I thought it very unlikely. In the end, they decided I was right, that I had what they called adrenal insufficiency. That’s a more general term for a deficiency of the hormone produced by the adrenal gland called cortisol. You may have heard of it termed the stress hormone, as our body produces more of it when we’re under stress. Unfortunately, I’m a chronic steroid user, and am forced to be to permit me to take one of my chemo drugs, Opdivo, an immunotherapy drug, whose side effects are so severe in me that I can tolerate it only by taking a steroid to dampen down my immune system response to it. That not only lowers my immunity (so, I’m immunocompromised), but also impairs the production of cortisol by the adrenal gland as my body tends to see the prednisone I take as a form of cortisol. Anyway, so the treatment was to give a cortisol replacement in large doses, the replacement being another steroid called hydrocortisone. Don’t ask me the difference between prednisone and hydrocortisone as I don’t know, but there are some differences I do know that. As soon as I got the first big dose of hydrocortisone, most of my symptoms dampened way down and I felt much better. They gave me several more large doses (100mg), and then cut it in half, as you need to taper the dosage down with steroids to permit the body to adjust to the drop. Steroids have serious side effects so you can’t just stay on large doses. The diarrhea wasn’t helped, though, and I had 10 bouts of it in less than 24 hours and so was afraid of dehydration, which is also a serious problem, so I requested and they gave me Imodium, which fixed it. I left the hospital on Wednesday, feeling much better. I’m home now and it’s Friday (April 1) and I’m feeling much better, almost normal (if you can call my situation or me normal. Ha!) Thank God for His help in the medical intervention and for the many prayers and encouragement of my friends, and the special care of my wife.
Next: I have several entries planned, but I haven’t decided which one to go with next. Sorry about that!