Futile care

Sooner or later your family will have to make some hard medical decisions about the care being offered to a loved one whose condition seems hopeless. Perhaps you’ve been through that already. The most likely scenario involves the decision process around a frail and elderly person for whom a complicated and expensive medical procedure might offer a few more weeks or months of life. Do you put a 94-year-old person through hip surgery, for instance? Or open heart surgery? Even more traumatic is the tension over what to do when the patient is a small child or infant and the doctors say that treatment is futile. What do you do? How does your faith guide your decisions?

Perhaps you’ve heard of Baby K (later identified as Stephanie Keene). She was born with a partial brain—most of the cortex was missing, though she had a functioning brain stem. She was eventually allowed to die in 1995, but only after intense public debate. A current case involves little Charlie Gard, who has spent his entire life in intensive care in a London hospital. He has mitochondrial depletion syndrome, which prohibits the cells in his body from being properly nourished. He can’t breathe on his own, can’t move his arms or legs, can’t hear, and is often wracked with seizures. Doctors, lawyers, courts, and the parents are presently wrangling over whether to perform some experimental procedures on the little guy that have an 11-55% chance of enabling him to smile and look at something. The doctors say that when care is futile, further treatments are inhumane and ineffective and will just prolong the suffering. Charlie’s parents disagree.

Who decides? In the case of adults, we’d all agree that the individual should have the last word, unless he or she is judged not to be mentally competent. In the case of children, we’d all agree that parents should make the decisions. The elephant in the room is the staggering amount of money that indefinite 24/7 intensive care costs. If the parents were paying for the care out of their own (deep) pockets, nobody would object. But does every person have a right to unlimited medical care? How much of the unreimbursed costs for Charlie’s care will Great Ormond Street Hospital get stuck with? Should people whose medical outlook is hopeless be allowed to consume resources indefinitely?

Interestingly enough, Britain, with its single payer health care system (admired by the left-wingers in the U.S.), rations care at times like this and allows the courts to make the hard end-of-life decisions. In the U.S. the parents make the call.

How does our faith play into these decisions? Biblical Christians resist abortion-on-demand because they believe that even unwanted children have a right to be born and have a shot at life. However, Christian parents of children with severe illness or severe disabilities don’t have to demand massive intervention to squeeze out a few more weeks or months of life for a child for whom treatment is believed to be futile. We have the comforting promises that the gospel of Christ is for children too, even infants. We cannot only speak God’s words to our little ones, not only commend them into our Father’s care in prayer, but we have the amazing promises of Baptism, a washing of water and the Word, which objectively brings God’s grace to the recipient regardless of how much the little individual understands.

Since we have every expectation of living forever with that child, we can let go more easily, just as Martha told Jesus that she knew her late brother would rise again. Jesus said, “I am the resurrection and the life” (John 11:25). We don’t have to obsess over a life that is ending. We can rejoice at a life that is just beginning.

Pastor Mark Jeske has been bringing the Word of God to viewers of Time of Grace since the program began airing in late 2001. A Milwaukee native, Pastor Jeske has served as the senior pastor at St. Marcus, a multicultural congregation on Milwaukee’s near north side since 1980. In addition, he is the author of six books and dozens of devotional booklets on various topics.

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