Some Thoughts on Feeding, Hydrating, and Caring for Helpless People

The Christian community is against killing helpless and vulnerable people. We are called to stand for those who are unable to assert their ‘personhood’ for themselves (due to brain damage, other debilitating ailments, level of development, or what have you). We are to stand against the murder of ‘the least of these’ as they are growing in the womb. We are to vehemently protest the disposal of severely disabled people that provide no utilitarian ‘use’ to our society at all (as we rather arbitrarily understand 'use'). That we would see these basic commitments to life and its preservation as 'up for debate' or 'morally complex' is a sad commentary on the state of our society. We are called to ‘spend ourselves’ (Isaiah 58:10): our money, time, energy, technology, and any other resource available to fight for life and care for the lives of all human beings. This is the call of Christ. This is the testimony of Scripture. This is a protection and provision of our Constitution. And this fundamental commitment is in fact what we are dealing with today in much of the discussion surrounding Terri Schiavo’s medically sanctioned starvation. We can shake our heads and lament the ‘complexities’ of this situation, or we can see it for what it truly is.

“Wasn’t Terri in a persistent vegetative state?” (Actually, there is no real ‘consensus’ on what a PSV is, and we are Christians who are called not to obey the ‘consensus’ of a secular community anyway.) That is entirely the wrong question. The question is, “Do we deprive people of basic care such as nutrition and hydration due to severely diminished brain capacity?” The answer to this question is ‘no’ regardless of the question of Terri’s persistent vegetative state. Terri was alive, and would have continued living with basic care offered her by her parents and others in the medical community. We are not to allow our children, friends, family, and neighbors to die of thirst. This is such a fundamental axiom of human existence and Christian civilization that I am appalled that it is up for debate.

"But isn't a feeding tube an extraordinary measure of care?" Our medical community is able to sustain life through feeding tubes simply and rather affordably. Yes, not long ago, and still in many parts of the world today, one in Terri's condition would suffer and die without a feeding tube. But, she does not need to suffer and die in such a way. We can easily provide a basic regiment of care that would afford her, and many like her, a rather comfortable life, however 'diminished' her brain capacity might be. To withhold such care would lead to, indeed cause, her death. This is not within the purview of our legal system, or medical community.

Regarding Terri’s (and many others in hospitals and nursing homes everywhere) ‘diagnosis’. "Wasn't she brain dead?" Let us remember, the brain is a very complex, powerful, mysterious and misunderstood organ. When I hear neurologists report of the ‘facts’ regarding Terri’s condition, I have to chuckle at the hubris of our medical community. The ‘facts’ often touted on MSNBC by medical professionals are anything but. There was not a ‘consensus’ regarding the nature of Terri’s thoughts, perceptions, feelings, personhood, or ‘viability’. And these are questions not merely about tissue and biochemistry. There is a metaphysical, philosophical, and theological dimension to these questions that I am afraid many of our ‘medical professionals’ are unable or unwilling to attend to. If anyone from the medical community spoke out against such a ‘consensus’, as they did, they were labeled ‘fundamentalists’ or ‘extremists’.

Terri was very much alive. It was not a life that we would choose for ourselves, or the ones we love. But, we are not the ones who choose such things. That is the sovereign work of God. Terri was severely brain damaged, she was severely disabled and in need of constant care and attention, to be sure. But these realities do not change the fact that she was alive. She displayed this fact for all the world to see in living and fighting for life for two weeks while medical care professionals sat by refusing her water and basic nutrition. To withhold such basic elements of human care and compassion is to cause suffering and death, it would not have ‘prolonged’ it. It should burden our national conscience that a mother and father were forbidden to even wet a cloth and ring it into their dying daughter’s mouth. This is a travesty. It is inhumane. It is grotesque. And it is clearly immoral.

And the reason we are given for this grotesque immorality? Hearsay. Her husband (and at least one other) heard her say she wouldn’t want to live in such a state. But, with all due respect, so what? We are not called to honor such requests. Are we called to kill all who don’t wish to live in some diminished capacity? My wife and I have both agreed that we will not kill each other, even if one of us pleads or requests that the other do so. And we certainly wouldn’t do so through the slow and painful process of starvation and dehydration. God’s command is clear: we are not to take the life of an innocent person. This is a fundamental teaching of the Scriptures. This is the cornerstone of a free and just society.

As a Pastor I will not be a party to anyone’s requests to be killed, no matter how ‘legal’ this request is. Let me ask you, shall we obey God or man in such a matter (Acts 4:19)? What exactly is the ‘right to die’? The ethical implications of asserting and honoring such a right are frightening. How far do we take this? We must recognize that in the case of Terri Schiavo, this ‘right to die’ required that our medical professionals, whom we trust to ‘do no harm’, deprive her of basic care. And we must state over and over again that Terri Schiavo was not dying! She was declared functionally dead (arbitrarily and disputably) because of her severely diminished mental capacity. We must reckon with the horrors of these distinctions regarding life or death based on mental capacity, cognition, or awareness. The fact remains that she was alive! And alive for a good long while until she ultimately died of thirst. She may well have not desired to be alive. Her husband certainly did not wish for her to be alive. We as a society may very well consider such life burdensome. But, it does not give us the right to take it away.

Alex Schadenberg, an ethicist and Executive Director of the Euthanasia Prevention Coalition states the case plainly:

Euthanasia is an intentional act or failure to act which causes a person’s death for reasons of ‘mercy’. If a person is dying or nearing death their body often begins to shut down, meaning the veins and circulatory system are becoming unable to circulate fluids and food. To withhold fluids and food from a person who is dying or nearing death is not euthanasia, but rather accepting the limits of life. Terri Schiavo’s body was not shutting down and she was not otherwise dying. Withholding fluids and food from Terri Schiavo was not an acceptance of the limits of life but rather an intentional failure to act in order to cause her death. This is euthanasia.

David Stevens, M.D., Executive Director of the 17,000-member Christian Medical Association, said the following regarding Terri Schiavo’s death:

Today we grieve, along with Terri’s parents and siblings, for a life unnaturally cut short. Terri’s death reflects a failure of a medical system that failed to insist on a definitive diagnosis consensus, a legal system that failed to deliver due process, and a culture that failed to distinguish between artificially prolonging life and deliberately ending life. Removing Terri’s tube was done simply to remove a burdensome patient. Reliable neurologists determined that Terri was not in a persistent vegetative state, which means her starvation and dehydration led to a slow and painful death.

Let us remember the cultural context of all of this. Thirty years ago, at the legalization of the murder of the unborn, prophetic voices warned of this ‘slippery slope’. Today in the Netherlands physicians are ‘rationally’ considering the ‘Groningen Protocol’ that establishes under what circumstances newborns should be euthanized due to severe disabilities and an undue burden on society(http://www.weeklystandard.com/Content/Public/Articles/000/000/004/983ynlcv.asp).
Peter Singer, Professor of Bioethics at Princeton University’s Center for Human Values at Princeton University, advocates killing newborns up to two months after birth based on the arbitrary ‘choice’ of the child’s parents or the state (http://http://www.geocities.com/Athens/Agora/2900/psai.html. The judicial branch of our government recently ruled, at the highest level, and on the basis of an ‘emerging consensus’ in our community and around the world that teenagers cannot be held morally and legally culpable for heinous capital crimes. We stand idly by while millions of babies are discarded every year around the globe. And this is done with ‘legality’. We are legitimizing homosexuality as a ‘normal’ and healthy behavior. Our society is slowly devaluing life and all that preserves, promotes, and sustains it at every level. We have rejected any universal reference point for truth and morality. The ‘truths’ that govern our society have been upended. We have pursued and achieved as a society that deadly combination Francis Schaeffer warned us of, the combination of comfort and affluence without which life is considered burdensome, painful, and without value. In such a culture, we have no room for untimely or unwanted pregnancies, the elderly, disabled, and profoundly needy. And we certainly have no categories for accepting, living with, and rising above such calamitous conditions as they intrude upon our own personal existence.

All of this indeed should cause us to mourn the slow and creeping moral decay of our culture, especially as this decay reaches into our Christian community. But we should rejoice at such opportunities to proclaim God’s truth and demonstrate his love in a dying age. We don’t trust in human governments, in human riches, or human strength and wisdom. Our hope is in his Word, in his unfailing love, and his unconquerable strength. May God have mercy, may his Kingdom come, and may his people be faithful. Cling to the promises of His Word, and be committed to works of righteousness by His grace.

Exodus 4:11 The LORD said to him, "Who gave man his mouth? Who makes him deaf or mute? Who gives him sight or makes him blind? Is it not I, the LORD?

Exodus 20:13 You shall not murder.

Romans 14:7-8 For none of us lives to himself alone and none of us dies to himself alone. If we live, we live to the Lord; and if we die, we die to the Lord. So, whether we live or die, we belong to the Lord.

Matthew 19:18 Jesus replied, "'Do not murder, do not commit adultery, do not steal, do not give false testimony;

Jeremiah 22:3 This is what the LORD says: Do what is just and right. Rescue from the hand of his oppressor the one who has been robbed. Do no wrong or violence to the alien, the fatherless or the widow, and do not shed innocent blood in this place.

Isaiah 45:9 "Woe to him who quarrels with his Maker… Does the clay say to the potter, 'What are you making?' Does your work say, 'He has no hands'? Woe to him who says to his father, 'What have you begotten?' or to his mother, 'What have you brought to birth?' "This is what the LORD says… Concerning things to come, do you question me about my children, or give me orders about the work of my hands?”

Proverbs 24:11 Rescue those being led away to death; hold back those staggering toward slaughter. 12 If you say, "But we knew nothing about this," does not he who weighs the heart perceive it? Does not he who guards your life know it? Will he not repay each person according to what he has done?

Isaiah 58:10 If you spend yourselves in behalf of the hungry and satisfy the needs of the oppressed, then your light will rise in the darkness, and your night will become like the noonday


Isaiah 1:17 Learn to do right! Seek justice, encourage the oppressed. Defend the cause of the fatherless, plead the case of the widow.

CMDA on Schiavo

For now...here is the statement of the Christian Medical and Dental Associations' statement regarding the starvation and dehydration of Terri Schiavo, with which I heartily agree:

Schiavo Death a Failure of Medicine, Law and Culture: CMA Doctor
Washington, DC, March 31, 2005—

The head of the nation's largest faith-based association of physicians today lamented Terri Schiavo's death as a failure of medicine, law and culture.David Stevens, M.D., Executive Director of the 17,000-member Christian Medical Association, (www.cmdahome.org) said, "Today we grieve, along with Terri's parents and siblings, for a life unnaturally cut short. Terri's death reflects a failure of a medical system that failed to insist on a definitive diagnosis consensus, a legal system that failed to deliver due process, and a culture that failed to distinguish between artificially prolonging life and deliberately ending life.

"Removing Terri's tube was done simply to remove a burdensome patient. Reliable neurologists determined that Terri was not in a persistent vegetative state, which means her starvation and dehydration led to a slow and painful death."

If anything remotely positive can come of this tragedy, it will be a fresh awareness of the need for patients to protect themselves by designating a proxy who will stand up for their clear desires in a case of incapacitation."The Christian Medical Association is making available at no cost on its web site (www.cmawashington.org) a guide to end of life health care that includes an advance directive form for patients and their families.

There is a great article on 'advanced directives' I encourage you to check out at the CMDA website: http://cmdahome.org
Just scroll down to 'issues' link and find the articles regarding euthanasia.

Free Will?

“Do you believe in free will, or is every action by man determined and controlled by God?”

I do not like using the term ‘free will’ in the context of a biblical discussion on this issue. The reason is that there is so much imprecision in the usage of such a term. But I do believe in some sort of ‘freedom’ when it comes to the actions and decisions men. Calvin says this,

“Man will then be spoken of as having this sort of free decision, not because he has free choice equally of good and evil, but because he acts wickedly by will, not by compulsion. Well put, indeed, but what purpose is served by labeling with a proud name such a slight thing…But how few men are there, I ask, who when they hear free will attributed to man do not immediately conceive him to be master of both his own mind and will, able of his own power to turn himself toward either good or evil…If anyone, then, can use this word without understanding it in a bad sense, I shall not trouble him on this account…I’d prefer not to use it myself, and I should like others, it they seek my advice, to avoid it.”

What Calvin is getting at is the fact that the term ‘will’ (either thelema, or boulomai in the NT Greek) is rarely used with reference to man. It almost always refers to the eternal and steadfast decrees and counsel of our sovereign God. When thelema (the common word for ‘will’) is used of men, it is used to speak of man’s ability to choose sin and wickedness and his inability to procure grace for himself. Look at Ephesians 1 and 2—in chapter one the word ‘will’ refers to the free and sovereign will of God (vv. 1, 5, 11) and the only description of the ‘will’ of men is in chapter where we find Paul describe man in his ‘gratifying the cravings (thelema- ‘will’) of our sinful nature and following its desires and thoughts. Like the rest we were by nature children of wrath.’ The testimony of Scripture by and large describes man’s ‘freedom’ as tragically hampered by his sinful nature and depravity. This is why, in describing the ‘will’ of men, Paul says this in Romans 9: 16, “It [‘it’ referring, I believe to vv.11-12 speaking of God’s purpose in election] does not, therefore, depend on man’s desire or effort (boulomai), but on God’s mercy.” In this passage we find that man’s ‘will’ has nothing to do with the issue, all is based on God’s mercy.

This is not to say that man is not morally responsible or culpable- the Scriptures testify that he is and that he is subject to punishment and wrath because of his sin. And we must speak of man as being ‘free’ in some respect. Otherwise God is some sort of capricious master puppeteer and we are his robotic craftsmanship. This is not the case. We engage in moral decision making throughout the day, we are responsible to ‘choose’ good and to deny evil ‘choices’. But I never want to assert the will of man as separate and distinct from the omniscience and omnipotence of our sovereign God. Psalm 139 is for me a great testimony to the fact that God is one who knows all things, ordains all things, and sees all things. In that passage, this divine knowledge extends to even the minute details of our lives, he knows our words before they are on our lips. It is, I believe, a tragic flaw in one’s theology of God to assert that the God who has revealed himself in such a way does not have knowledge of who his people are- are that the exercise of his creatures’ will is outside of his control. To be honest, to say that our ‘will’ is totally free and incontingent is to deny the free and incontingent will of God. Basically, you can’t have a God who is sovereign and free and have a creature who is able to make completely ‘free’ choices outside the contingencies that bind him (such contingencies being: his own depravity, his inability and need for grace, his dependence upon God for all things).

So, to make a long answer even longer I would say this: I am careful to use words like ‘free will’ because the common conception of such a phrase usually is very loaded and is often not consistent with the testimony of Scripture. I will say that there must be a sense in which we are ‘free’ in that we are responsible- some call us ‘free moral agents’. Dr. Packer says that the testimony of Scripture presents us with an ‘antinomy’. An antinomy is the phenomenon in physics where we find seeming contradictions in the physical universe (light as both wave and particle, for example). In Scripture, we find a tension between God’s sovereignty (the omniscient, omnipresent, and omnipotent ruler of all he has created) and man’s responsibility. This is a ‘seeming’ contradiction from our limited and sin-stained perspective. But, in fact, from the divine perspective it is not a contradiction, such tensions are resolved in God’s divine and eternal counsel and will one day be revealed to us in glory. Ultimately, I will land on the shore of God’s power and purpose as free and sovereign, because I believe the burden of Scripture is on the shoulders of those who assert that man’s will is totally free and completely undetermined in any sense by God’s election, foreknowledge, and will.

Once Saved, Always Saved?

Do you believe in once saved always saved?

In order to fully answer this question, I think I need to comment on this phrase, ‘once saved always saved’, and maybe adjust it a bit. This sort of terminology misses the boat a bit, I’m afraid. It is a summary of the historic Christian doctrine of the ‘perseverance of the saints’. This doctrine teaches that those whom God has effectually called and saved by His grace through faith will certainly endure to the end and in no way fall from this state of saving grace. This doctrine is found in a variety of passages:

John 6:38-40 For I have come down from heaven not to do my will but to do the will of him who sent me. And this is the will of him who sent me, that I shall lose none of all that he has given me, but raise them up at the last day. For my Father's will is that everyone who looks to the Son and believes in him shall have eternal life, and I will raise him up at the last day."
John 10:27 My sheep listen to my voice; I know them, and they follow me. 28 I give them eternal life, and they shall never perish; no one can snatch them out of my hand.
Philippians 1:6 being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus.

As you can see from the definition I have given above, there are a host of theological presuppositions that precede a healthy understanding of the ‘perseverance of the saints’. The doctrine of perseverance is bound up in the doctrine of election (God’s sovereign calling) and efficacious grace (‘efficacious’ meaning that such grace will accomplish its work, it is effectual, dependent on God’s sovereign will, not upon us). I believe in the perseverance of the saints because I believe that ‘saints’ are saints by grace from first to last. They are ‘saved’ by the election of God and not by their own merits or by their own rational processes. To put it simply, the Bible overwhelmingly states that we do nothing to be saved (we exercise ‘faith’- but Eph. 2:8-10 states that this faith is a gift of grace) and so can do nothing to ‘undo’ such a sovereign salvation. Of course there are many that would disagree with my views of election, efficacious grace, etc. (these doctrines are traditionally connected with what we might call ‘Calvinism’).

Though I prefer not to bear the ‘stigma’ of what people understand of Calvinism, for better or worse, I am what you would call a ‘five-pointer’. But I wasn’t born in a ‘Calvinist’ home, I was not reared in a Dutch Reformed or Scottish Presbyterian church.
I am a ‘Calvinist’ because I believe this is what God’s Word teaches.

Note how our Lord speaks of salvation: ‘I shall lose none that he has given me’ and ‘I give them eternal life’ or hear Paul’s words, ‘he who began a good work in you’. All of these (and many others) passages push us to see salvation as the work of God in sinful man. Consider the wonderful truth of Romans 5:8, ‘God demonstrates his love for us in this, while we were yet sinners, Christ died for us’. While we were sinners, while we were lost, God saved us. Hear the Apostle John, ‘we love because he first loved us’ (1 John 4:19). Salvation is initiated, secured, and sealed by God’s grace. And if this is so, we must affirm that such a divinely secured grace can’t be thwarted by the actions of sinful man. You did nothing to gain his saving grace, you can do nothing to lose it.

The problem with the terminology of ‘once saved always saved’ is that it is sometimes employed to remove the necessity of the ongoing sanctifying work of God in the believer’s life. It provides us with a form of ‘fire insurance’. If you walk the aisle, say the sinner’s prayer, etc. then you are given assurance of salvation. I believe that these assurances give people a false sense of security. Our security is placed in the sovereign work of God, and in manifested in His work in our lives.

Let’s consider the testimony of Scripture. Scripture binds up the assurance of salvation and assurance of ‘perseverance’ with a continual conviction of sin, an ongoing life of repentance and faith, and the persevering work of the Spirit to convict of sin and lead toward righteousness.

1 Corinthians 15:1-2 Now, brothers, I want to remind you of the gospel I preached to you, which you received and on which you have taken your stand. By this gospel you are saved, if you hold firmly to the word I preached to you. Otherwise, you have believed in vain.
Colossians 1:21-23 Once you were alienated from God and were enemies in your minds because of your evil behavior. But now he has reconciled you by Christ's physical body through death to present you holy in his sight, without blemish and free from accusation-- if you continue in your faith, established and firm, not moved from the hope held out in the gospel. This is the gospel that you heard and that has been proclaimed to every creature under heaven, and of which I, Paul, have become a servant.
2 Timothy 2:11-12 Here is a trustworthy saying: If we died with him, we will also live with him; if we endure, we will also reign with him. If we disown him, he will also disown us
Mark 13:13 All men will hate you because of me, but he who stands firm to the end will be saved.
1 John 2:3-6 We know that we have come to know him if we obey his commands. The man who says, "I know him," but does not do what he commands is a liar, and the truth is not in him. But if anyone obeys his word, God's love is truly made complete in him. This is how we know we are in him: Whoever claims to live in him must walk as Jesus did.
1 John 2:19 They went out from us, but they did not really belong to us. For if they had belonged to us, they would have remained with us; but their going showed that none of them belonged to us.
Ephesians 5:5 For of this you can be sure: No immoral, impure or greedy person-- such a man is an idolater-- has any inheritance in the kingdom of Christ and of God.
John 8:31 To the Jews who had believed him, Jesus said, "If you hold to my teaching, you are really my disciples.

Now, as we read these passages, the believer trembles at such warnings. The Christian should immediately recognize that she is a sinner and does not deserve to be in God’s Kingdom. The redeemed confess their sin and inability, holding fast to the promise of God’s goodness and grace. This promise of sovereign and free grace prompts the heart to serve God, not presume upon grace and continue in sin! “Shall we go on sinning that grace might increase? May it never be! We died to sin; how can we live in it any longer?” (Romans 6:1-2).

The issue is not that the believer will not sin. We still struggle with our sin nature (‘the flesh’). We know that Peter sinned. We know that Paul sinned (Read Romans 7!). The issue is how we deal with our sin. Do we seek to turn from sin toward righteousness? Do we seek to live a LIFE of sin or a LIFE of holiness through the power of the Spirit? Do we respond to our sin with repentance and faith? Jesus knew we would sin. That is why he told us how to deal with one another in our sins (Matthew 18: 15-20). If someone is caught in a sin, they are to be confronted, and they are to respond with repentance. A heart of godly sorrow over sin and a spiritual desire to leave that sin and live for Christ manifests and exhibits the presence of inward and ‘unseen’ grace. To respond to sin by saying, ‘Once saved, always saved’ without a demonstration of confession and repentance is to put our trust in some arbitrary action in the past while ignoring the importance of a present sanctifying power securing our hope in future salvation. Our assurance is found in the current and abiding grace of God available to those who daily confess sin, repent and turn to God, seeking to live for Christ moment by moment.

If one says, “I am a Christian”, then that confession will be accompanied by obedience. This obedience is not PERFECTION but simple trust and an abiding desire to please God. We shouldn’t give you assurances of salvation that are not given in Scripture. If one is saved, then there will be a ‘godly sorrow’ over sin leading to repentance and joy in the power and sanctifying work of the Spirit. Consider the Apostle regarding ‘sorrow’ over sin:

2 Corinthians 7:10-11 Godly sorrow brings repentance that leads to salvation and leaves no regret, but worldly sorrow brings death. See what this godly sorrow has produced in you: what earnestness, what eagerness to clear yourselves, what indignation, what alarm, what longing, what concern, what readiness to see justice done. At every point you have proved yourselves to be innocent in this matter.

The Bible distinguishes a ‘godly sorrow’ from a ‘worldly sorrow’. There is a ‘worldly sorrow’ that recognizes sin and its effects. But it doesn’t lead to repentance and faith. Paul describes ‘godly sorrow’ as producing: ‘earnestness, eagerness…alarm (over sin), longing (for righteousness)’. If the response to sin does not lead to repentance (repentance means ‘turning’ or ‘change’) in one’s heart and a desire for change in one’s life and behavior, then there is no assurance of salvation. The Word of God testifies that such an unwillingness to turn from sin and trust in God’s grace leads to death.

Those who have entrusted their lives to God through faith in the work of Christ will persevere. Such faith leads the believer in a daily commitment to the ongoing gracious activity of the Spirit’s leading in holiness. Such faith provides assurance of salvation by the promise of God’s Word.