Flawed theology and end-of-life decisions

“Maybe she’s just being punished because she never knew Jesus.”

“What if God had a plan for her life that will never happen because of her decision?”

“She’s missing out on the richness that can be experienced from suffering.”

These comments and others like it have appeared on my Facebook newsfeed regarding an article about a 29-year-old woman who is facing a terminal illness. Rather than wait for the inevitable suffering and decay from her prognosis, Brittany Maynard is electing to die on her own terms this November 1st.

A few years ago, I would have agreed with many of the above sentiments. I would have argued that ALL life, no matter how damaged or painful, is worth the struggle. I would have insisted that all suffering is character-forming. Sanctifying.

It’s not that I don’t still believe these things. But at that time I had yet to witness the agonizing death of a loved one from cancer. I had yet to experience The Struggle up way too close and far too personally.

I wonder how many people making those comments have personally dealt with the raw ugliness of cancer and its consequences. As much as I believe in the sanctity of life, I also believe in the validity of personal, educated choices. And Brittany’s choice to end her suffering on her own terms no longer strikes me as morally abhorrent.

But what about miracles? What about God’s plan?

This isn’t the first time I’ve encountered flawed theology about suffering. I find it unbelievable that some Christians would suggest the upright and faithful followers are immune; that God will always step in and prevent it.

Have we forgotten what God allowed to happen to Jesus? If God allowed his own son to be tortured and crucified, it’s pretty obvious that God has a very permissive attitude about physical pain and suffering. We can’t know the reasons. But we know it’s allowed to happen.

Furthermore, I highly doubt God’s plans for our lives can be easily impeded by our choices. If he is truly all-powerful and omnipotent, he already knew what Brittany was going to do since before she was even potty-trained.

How do we define ‘quality of life,’ anyway?

This answer varies, depending on the person. I’m certainly not suggesting that people with disabilities, depression, or other ailments should just kill themselves to be spared more pain. When there are options, there is hope. It’s not illogical by any means for a woman with Brittany’s condition to make this decision about ending her life. Unlike depression, cancer cannot always be managed. A fatal prognosis changes everything.

If you have never personally watched someone you love cripple day by day from a terminal disease, you have no right to judge this woman. I watched cancer kill my father slowly over the course of 13 years, and then rapidly over a period of 11 days this summer.

There were some precious moments we had together as a family at his bedside, but overall, there was nothing beautiful about my father’s death. There was pain, there were shouts and whimpers we couldn’t understand, there was tossing and turning, eyes rolling back into his head, the stench of rotting body parts, and overall, helplessness. I found myself feeling guilty as a daughter for wishing that death would hurry up and take him already — not because I wanted my father to die, but because I wanted his suffering to be over.

Suffering wasn’t supposed to be God’s plan. There was no suffering in Eden, there is no suffering in heaven. There can sometimes be a dignity in suffering that is beautiful and inspiring, but this is not universal in all cases of suffering.

These end-of-life decisions are never easy. There may be no ‘right’ answers. If this ever happens to you, by all means, pray…and then make a decision using the reasoning God gave you.

Trust that Brittany made her choice with good judgment and input from her doctors and those closest to her, with wisdom and maturity.

Pray for Brittany and wish her well. But do not judge what you would or would not do unless, God forbid, you find yourself in her shoes.

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20 thoughts on “Flawed theology and end-of-life decisions

  1. Dan McDonald says:

    I cannot in my own conscience condone suicide, but neither can I in my own conscience make the choice for another or begin to imagine I understand all that someone goes through in their own bouts with pain and suffering, nor can I imagine what one day I may think in a state of far greater pain. So today I think one word for this situation “compassion.” Compassion or if stated in a phrase, “Love covers a multitude of sins.”

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  2. Caroline says:

    I was diagnosed with stage IV cancer at the age of 37. It was only found at that time because I was finally in enough pain that I couldn’t function normally. I do not like to take narcotic pain killers because I feel worse after taking them than I do before. I was riddled with tumors and the ones in my vertebrae caused back pain that was always present. I got no relief from physical therapy, massages, etc. and I could not sit, stand, lay down, etc. and not hurt. I was only sleeping a few hours at night because of the pain. I discovered that ZzzQuil did a great job of helping me get sleep without any of the side effects or addiction issues that I knew would be there if I got a prescription for sleeping pills. Then there was the added pain when the bulging disks would sent of sciatica. There were also random fevers. I’d feel like I was getting the flu and would run a fever around 100, which would last for about an hour. The night sweats were do bad that I’d have to change pajamas once every night. Right before chemo started, my liver started to hurt because of the tumors. A few years before this, I had issues with untreated epilepsy (non-convulsion seizures) and spent over a year with what is very similar to the early stages of Alzheimer’s and I could also sleep 16-18 hrs a day. I never once asked why any of this happened to me because it can happen to anyone. I do know what it is like to have poor quality of life and I know what it is to be in constant pain. I want the option to die without having to hang or shoot myself. I may not decide to do it, but I’d rather have the choice than to live for months and months on morphine, not able to care for myself and slowly die in what would be near isolation.

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  3. elysesalpeter says:

    Thank you for your honest post. I have found the people most angry, and hostile to this woman’s choice, to be the most devout at times and I don’t understand it. Her death has nothing to do with God. It has to do with Cancer, pain, and suffering. When someone has not lived through the suffering that occurs with this hideous disease, I don’t believe they have any right to a vocal opinion, chastising her on her choice. Would I love her to live? Of course. But the fact is, she is going to die. She just wants it to be just a few weeks earlier, before she’s living in constant pain that can’t be stifled with medications and before her family will be crushed every single moment watching her die a very slow, painful death.

    Liked by 1 person

  4. Kati Hammar says:

    Well said! I wish more people would admit that we don’t have all the answers and we don’t know why shit happens (pardon the French). I have a disease that is not terminal but is EXTREMELY painful at times, and people who haven’t experienced it really don’t know what that’s like. I don’t know whether or not I think assisted suicide is the “right” choice but I’m certainly not going to judge other people or try to make that choice for them.

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    • Ted Luoma says:

      I also suffer from chronic pain. It is an invisible illness in the sense that people can’t see anything wrong with me. They only see my complaints and the regular grimacing and wincing. I have also suffered from depression since I was a child.

      I don’t agree with Brittany’s decision, but I’m left to consider where doctor-assisted suicide will lead. Will it be strictly for patients whose illness is terminal, or will it eventually extend to people who have illnesses that are not terminal, but leave the patient in agonizing pain? Will the choice be in the patient’s hands or will there be a day when people are exterminated because they are not productive according to societal standards? There was a day when I would have thought questions such as these were ludicrous, but I think that euthanasia could become commonplace.. Time will determine if these are just silly notions, though.

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  5. Dan McDonald says:

    I appreciate your treatment of Brittany’s decision. It seems to me that we speak in different ways about issues of life when trying to speak to a choice that has not been made and when one is made. I am of the conviction that it is not right to take a human life, even my own. But it is one act of grace to speak to try to prevent a person to do an act, and another form of grace to deal with someone who has made the determination to end their own lives. We understand that there is a principle of preserving life including our own lives, but when the deed is done or appears decided beyond our influence then a whole new scenario appears and we begin to hope and pray for God’s mercy. It is one thing to argue that the choice Brittany made may well be a wrong choice ethically, but once that choice is made then our evaluations should give way to asking God’s mercy for each of us have made decisions that may or may not be approved by God. Does this make sense? Because to me that is the important thing you have highlighted regarding Brittany’s decision.

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    • Beth Caplin says:

      I think one of the biggest ethical factors in this situation is how involved doctors should be for patients like Brittany. While I respect Brittany’s right to make this decision, it does go against the goal of doctors to extend the lives of their patients, not end them…or is their job to keep their patients comfortable and suffer as little as possible? These are questions I’ve been unable to answer as I watched my father die. At one point even he discussed the option of taking all his medication at once, but he never did. I think the decision not to was rooted in fear of death than anything else.

      Liked by 1 person

  6. sarahdaltry says:

    I have to agree with the commenter here that not all depression can be handled. I’ve had depression my entire life and I have had several moments where suicide felt like the only option. I don’t keep going because it’s immoral to die or really for any reason except that my cats need to be fed and my husband probably doesn’t want to clean up my dead body. However, that’s not really the point. The point is that people can’t speak for others, because they don’t live their lives. (Earlier this year, I admitted publicly I was suicidal only to be attacked and called a manipulative and whiny liar by people I’ve never met – including a “trained mental health professional,” so believe me, the way people blame and shame and try to justify is definitely something that hits me close to home.)

    I’m not religious in the traditional sense. I don’t go to church. I wouldn’t call myself a practicing anything, but I do have very strong beliefs and faith in something. I think the problem is that many people use faith as another set of rules – and then they make claims of what God would do. First of all, they are not God. Therefore, they don’t have the slightest idea what God would do, so that is just flawed logic. Secondly, I’ve found that a large number of people quote the Bible, yet they haven’t read it. I have read the Bible – several times actually. What I’ve learned in that reading is that there are no clear rules most of the time. There are guidelines, but each story is unique. Not everything is a test to prove we can follow the rules; sometimes it’s an opportunity to develop empathy and compassion. This is an example of one of those times.

    It’s interesting that you point out that you may have felt the same way if you hadn’t experienced a devastating loss. I think that is the crux of this really. It’s simply ignorance. It is very easy to sit and judge, to tell someone how you would handle a situation, but until you experience it, you have no idea what you would do (I mean you in general, not you personally). This is something that, as writers, we often see even from readers, right? People say, “I wouldn’t have handled the situation that way,” but maybe they would have. And maybe they wouldn’t. But for one woman to choose to die because she would rather be in control of it, would rather not leave her husband in perhaps horrible circumstances and maybe even forced to choose for her, is how she is handling her situation. Perhaps someone else would say, “I don’t care. I am going to keep at it and hope,” but that’s them. And both are right for their own circumstances. We must learn to stop trying to live other people’s lives for them and just live our own as best as we can.

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    • Beth Caplin says:

      I think there’s bravery in both choices: choosing to stick it out until the end, or choosing to die before the real suffering begins. I’m hesitant to make a blanket statement that depression is as fatal as certain types of cancer, though. I don’t think suicide should ever be considered a viable option (and I say this as someone who has struggled with suicidal thoughts before). But I agree with Brittany that her situation is not the same as a suicide. I believe there is hope for people struggling for depression. But there are very limited treatment options for people with certain types of cancer.

      People are certainly entitled to their own beliefs, but Brittany’s story deserves to be taken seriously, and it breaks my heart how quick some people are to judge before they hear it (the discussion on the blog is a lot more civil than what I’m seeing on Twitter right now).

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      • sarahdaltry says:

        I have to respectfully disagree that depression is not the same as cancer. In many ways, it’s worse. Because it’s invisible, people just tell you to shut up and get over it and stop being depressed. As if it’s a choice. Imagine telling a person with cancer to stop being sick.

        Suicide is also the third leading cause of death among young people through the age of 24. I think it’s a serious problem and should not be treated like a choice.

        On the other hand, Brittany’s decision isn’t the same as someone dying from depression or a mental illness. But I don’t think it’s fair to say that one disease is less.

        Liked by 1 person

        • Beth Caplin says:

          I didn’t mean to imply that one disease is less significant, just that the hope of effective treatment can vary. Currently there are more options for treating depression than there are cures for cancer. I have depression myself, so I understand the frustration from people who dismiss it as a ‘feeling’ rather than a disease.

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          • sarahdaltry says:

            I suppose that’s true, since there are medications for it. Although in my experience, nothing really works. But you’re right. It just upsets me because so many people have told me to just stop being sad. 🙂

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  7. mckarlie says:

    Those quotes strike me as reductive, but that’s just my opinion. I grew up with Faith, due to a number of factors I am now agnostic. I believe there is a God I just don’t think he is accurately represented by the Bible, especially the old testament. My version of God is not all powerful and all knowing but all loving and kind and supporting. He doesn’t love you less if you’re gay or straight or democratic or communist. He just wants us all to love and support each other and to have a happy existence. It may be naive of me but that’s how I like to see it. I’ve experienced some really negative events being mentally ill in the Church, I had a friend with mental health issues commit suicide because he didn’t get the help he needed, he was simply told to repent his sin and he would be healed. It never happened. And just for the record I’d like to say that not all depression can be managed, it can be just as unpredictable and bleak as cancer.

    All the best 🙂

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    • Beth Caplin says:

      You’re right that depression looks different for everyone. But I do think that with the right balance of medication, therapy, and support, it can be managed, and many people unfortunately never find that balance.

      Can I ask why you don’t think the bible is an accurate depiction of God’s character? I ask out of curiosity, not an agenda 🙂

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      • mckarlie says:

        We can agree to disagree on whether or not ALL depression can actually be managed, have you been hospitalized before? It’s an eye opener.

        Sure I don’t mind the question at all. A guy in a cave was really annoyed at how the Romans were carrying on, so he started a book on how not to live like a Roman, basically. Then over time a handful of men selected some and disregarded other writings, apparently on God’s command but do I have to point out how sketchy that is all together? It was relative a couple of thousand years ago when it was written, but look at a list of what is actually considered sin and 80% of it is completely nonsensically outdated. Also, there are a lot of contradictions along with the fact that Hebrew and Aramaic don’t translate terribly well into English. There is then the fact that I know people are born gay and do not choose to be gay, some straight people may choose to partake in a sexual act with a member of the same sex but that’s very different to a person choosing their sexuality, yet the Church is against homosexuality and believes it to be a sin. There is no conjecture in my mind as to whether or not people are born gay, they just are. So why would God create homosexuals just to condemn them? Homosexuality occurs all over nature, God created nature. Oh and it can get pretty sexist!

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        • Beth Caplin says:

          I’ve struggled with depression and suicidal thoughts for several years, but no, I’ve never been hospitalized. I’d be interested in hearing more about your story, but since I’m just a stranger on the internet I understand if you’re not comfortable doing that. But if you are, my personal email is on the ‘contact’ page.

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