"End of Life Issues" and birthday celebration

Sunday 1 November 2009 was a big day in our community. Nicholas is now a year older. This is a week after Tendai celebrated his birthday. We also had an adult birthday and Cleo's name day. This was a good occasion for us to sing "Many years," one of my favorite custom of the Slavic churches. Lisa and I sang it a week earlier for her mother who is around 87 years old. We were at Never on Sunday Restaurant where a group of my Catholic friends and I frequently gather for breakfast.

Because of the presentation by Tim, his whole family was here and it was a treat seeing them. Gladys was here for the second Sunday in a row after the Festival and I hope that she will eventually become a member of our family.

Now, Tim's presentation:

Fr. John read from the Gospel of John, chapter 5:

24Truly, truly, I say to you, he who hears my word and believes him who sent me, has eternal life; he does not come into judgment, but has passed from death to life.

25“Truly, truly, I say to you, the hour is coming, and now is, when the dead will hear the voice of the Son of God, and those who hear will live. 26For as the Father has life in himself, so he has granted the Son also to have life in himself, 27and has given him authority to execute judgment, because he is the Son of man. 28Do not marvel at this; for the hour is coming when all who are in the tombs will hear his voice 29and come forth, those who have done good, to the resurrection of life, and those who have done evil, to the resurrection of judgment.

30“I can do nothing on my own authority; as I hear, I judge; and my judgment is just, because I seek not my own will but the will of him who sent me.

Tim has five children. The starting and ending point is the same, Christ is risen from the dead. Death is the final enemy. Christ has defeated it but we are still subject to it. God gave us death as a gift. The worst thing in the world would be living for eternity and continuing to sin. The Church teaches us to seek a good death. A temptation is allowing machines to get in the way of our meeting with God.

Tim is not a doctor nor a nurse and he does not practice medicine. The United States Constitution gives every person the right to make medical decisions. It is not absolute and unrestrained. You do not have the right to commit suicide or euthanasia.

There are three conditions for dying. One is a terminal condition. The second is the end stage condition. Your body systems have shut down and the disease has put you in a place where the only thing keep you alive is medical intervention. The third situation is a persistent vegetable state. A person in a coma is an example. We have all heard stories of people who have come back. A fire fighter in North Carolina was in a coma for 15 years. He was able to identify all his nephews and nieces by the sound the voices.

In these situations you have the right to decide what medical assistance you will receive. The law said that you can discontinue every form of medical intervention. If you can’t swallow, putting food into your stomach is not ordinary care.

For the first four years of his life, John had to be kept alive with a feeding tube. Now he is part of the Ukrainian dancers.

Both we and the Roman Catholics believe in the resurrection and that Christ has destroyed death. But their teaching leads to a frenzy hanging on to life. We have a grater willingness to surrender to the will of God.

They were the first to raise the question of whether we should hook up somebody and keep him alive just because we could do it. Just because you can does not mean that you should. You need to make sure that everybody knows what you have decided. Tim said that he has a Swedish body.

Maryland law and federal law require that doctors and hospitals tell you that you have the right to decide. It is a living will. The Maryland state document is not very good and effective. It does not allow for the appointment of an agent. The appointment, if it is in writing, is binding on your doctor and hospital.

Tim prefers documents drawn up by an attorney because ye is one and writing yoru own document is like playing quarterback when you don’t know the rules. It is good to talk to somebody who spent time doing this stuff.

DNR [Do Not Resuscitate] orders can only be entered by your doctor. This is a medical order.

When should you administer the feeding tube and when should you remove it? This also applies to other intervention. All of this planning is done for the purpose of creating life and providing a better whole on life and not prolonging dying. Some times we can’t know that until we try. Tim’s documents are so that medical intervention can be started to reverse a decline. When you can’t reverse the process, you stop.

Once you are over 18 or 21 years of age, you have more cells dying than new ones. In many decisions we just don’t know. Cal Orens’s brother was in a car accident. After several months they decided to turn off the machines but one sister said no. Several months later he was up and walking around.

Tim is always available through phone calls or e-mail. Talking to an attorney helps to draw up the document for the first step. Talking to your priest is a better first step. We are not all cookie cutting people. First talk to Fr. John and then to him. If you are under a life threatening situation, talk to your doctor first. It is imperative to decide who will make those decisions for you.

Orthodox truth is universal truth for everybody There is value in suffering. If we suffer, God has a purpose in life. Our relationship with God is not depending on our organs. We should not embrace death just to get around suffering.

Now we have medicine for bone marrow cancer. The reason for the bent and twist in our life is sin.

Can a directive be set up with cost in mind? Nursing home won’t unplug you when you run out of money. That is what Medicare is for. The law respect the situation of the family and the spouse.

One of the hallmarks of our culture is independence. People are saying that they don’t want to be a burden on their children. We don’t want to say “I need you.” You can cut off artificial means but not the others. Activities of daily living have to be attended to. If you tell the nurse not to come back and Adult Protective Services finds out, somebody is in trouble. If a patient is abusive, the nurse calls Adult Protective Services and somebody from APS and a sheriff will show up and the person will be put into protective care.

Julie had a friend who said that she wants to die only once. Don’t bring her back.

Mary Ann found an Orthodox advanced directive on line but she can’t remember where.

Tim does not like to create “Christian wills”. Judges do not like to figure out what the teachings of the early Church Fathers are.

You don’t want somebody who will substitute his will for your will to be your administrator.