Strange Bedfellows

Understanding where someone is coming from is important to understanding if you’re headed to the same place or not.

Francis Shaeffer, in his book The Church at the End of the 20th Century, warned that the Church needed to be very careful about who it aligned itself with, and why.  It might be possible that the interests of the Church and the interests of those driving societal change might coincide from time to time, but that we shouldn’t mistake that for a true alliance.  Rather, we need to discern it for what it is, a temporary meeting of the minds that will be discarded once it is no longer beneficial or in keeping with where those driving societal change are headed. 

I think that’s the case with this article.

I agree with the overall thrust of the article.  We have entered a very unhealthy era where death must be cheated at all costs – quite literally.  It’s really a logical outgrowth of secular humanism and rationalism – if this life is all we’ve got, it has to be hung on to at all costs, regardless of the reasonability of such efforts.  Better to live a few days longer in the sterility of a hospital than to die a few days earlier in the comfort of home. 

And I agree with the argument that end of life situations should be treated as such and given the dignity and humanity of occurring in some place other than an ICU ward.  I base this in a Biblical understanding of the inherent dignity and worth of all people, because all people are created by God and in the image of God.  And because I believe completely that we are created by a loving God that can be known and trusted, I don’t need to fear death.  I don’t run to embrace it necessarily, I don’t treat my life cheaply or contemptuously – but when it comes time for me to die, I can accept it without fear and with dignity, knowing that my Savior has triumphed over death.  This attitude, incidentally, is likely to result in a lot less money being spent to keep people alive until the last possible moment.  But this is an incidental issue to me – not the key issue.

But for the author of this article, saving the money is the key issue.  If we want a State sponsored health care solution (which we don’t), we have to make it cheaper.  One way to make it cheaper is to quit spending all this money on keeping people who are dying alive a few days longer.  This coincides with a side-effect of my Biblical world view – right?

No, not at all.

The author’s decision that we need to change our approach to end of life care is driven by economics.  We reduce human life to dollars and cents, to a cost-benefits ratio where we determine what is beneficial, and what cost is too high.  Or more accurately – someone else determines those lines.  People who have a budget to keep.  People who have costs to watch.  People who are held accountable for economics.  The decisions aren’t and won’t be made in terms of human dignity, but in terms of money saved and allocated into other areas.  Once we set up this standard as the means for evaluating what is reasonable care or not, the scale is likely to shift increasingly backwards in time.  The issue is likely  to move from being whether or not to prolong artificial breathing and heart stimulation for a patient, and move to whether or not we seek to eliminate the cancer from someone in their 60’s, since the productive part of their life (by our capitalist, consumer society’s standpoint) has passed.  Much better to spend that effort/money on someone younger who will end up repaying it through taxes paid out over a long period of time.

Dollars and cents are not the issue, and if we are led down that path, we’re going to very quickly dislike where it leads us.  Make no mistake – all of this technology and equipment to provide this sort of life-giving care is not going to disappear.  And while the policy-makers may determine it’s not a good investment to use it on you and I, someone who is able and willing to pay for extraordinary care is going to receive it.  The bottom line is likely to be a huger disparity in the quality of care – or care or no care – between those on a State system and those who have the money to negotiate their own treatment options. 

So it sounds good on the surface.  And there is a convergence of attitudes.  But the author and my Biblical faith are arriving at this confluence from two radically different origination points, and we’re headed towards two desperately different destinations.  Make sure you’re on the right train. 

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