INTRODUCTION

The proper medical care of those who are dying or about to die, is rooted in fundamental precepts regarding the origin and destiny of mankind. There are only two possibilities:

1, Humans and their universe are the products of an accidental evolution. This being the case, humans may consider themselves as the master of their own destiny.  Consequently they can determine if and when they die.  Without consulting any outside Being or force, they can decide if and when other humans die.

 2.  Each human was designed and created with a specific purpose by God.  Therefore no one can do anything regarding their own or another’s destiny without considering human design, consulting the Creator and understanding His purpose for humans.  Regardless of to whom you might attribute the design, to interfere with His purposes might upset the Creator and provoke possible retribution.  I suspect those in palliative care who favour euthanasia feel anxious about that possibility.  This might help explain why they are so often and so loudly adamant about being right in their recommendations.

The best scientific evidence indicates that the precision of the universe is far too great for it to have been an accident. The most recent data collected by the Wilkinson Microwave Anisotropy Probe (WMAP)[1]so clearly agrees with theoretical calculation that is little doubt that there was a hot big bang so recent, [13.7 billion years ago] that evolution to humanity could not have occurred and so precise it could not have been an accident.  The creation of humans occurred in a period of time far too short for any random alignment of atoms to achieve construction of such magnificent celestial and earthly human bodies. The only conclusion by the most eminent astrophysicists and biologists is that there must have been a designer. Then the question is who and why?

It seems equally obvious that the Designer created humans not as playthings but as creatures with enough wit and wisdom to provide him with intelligent transaction and the capacity to choose to go his own way.  Christians believe God created humans to have friends. Though it appears He seldom interferes in the affairs of humankind, He has an intimate knowledge of and concern for each and every person. Christians believe He constructed the universe so that not only the physical laws but the moral laws are immutable. Breaking either set has its inevitable uncomfortable consequences. It is in this context that we must consider not only the dying but those who ostensibly care for them, for one will affect the other for good or for evil.

PRINCIPLE #1: HUMANS  WERE  CREATED

Humans Were Created to be Friends of God.         He only wants human friends who chose to be His friends. To choose there must be choice.  The choice must be between God and some equally attractive alternative.  God not only uses choice to determine who become His friends but He uses choice to make those friends become better friends by being more mature.  Many of these choices are hard, not because God likes to see humans struggle, but because He knows that struggling in the crisis of difficult choices, they mature.  He wants mature, interesting, well battled friends.  Who wouldn’t?  And maturity has little to do with having good looks or a good brain.  In the context of the dying, questions about when life ends, how to assist the dying, what choice an individual has in their own time and method of death are difficult questions that humans have struggled with for centuries. In that struggle, they have matured and possibly come a little closer to the truth.

Humans Were Created Tripartite      From conception humans all have a body, a soul and a spirit, for they were formed in the image of their Maker, who is in an intimate union of three similar parts. A human is created when a particular sperm, a unique egg and an individual spirit God gives humans, (2) come together. Thus the definition of who is alive and who is dead is determined by whether or not all three portions are together. When the spirit fuses with the egg and sperm, which as far as we know happens at conception, that person is a complete human. Humans have an undying spirit and when the spirit departs from the body, what we see is no longer a human.  In the context of this discussion this is critical.

The best and most conclusive way to decide when a person is dead is to determine when the spirit leaves the body.  When the spirit of a person has departed, the body can be considered a body that has been vacated and no longer needs to be kept alive. This for many people, should be an observable event.  There needs to be closer study.  We must learn how best to detect when the person is no longer in their old home.  At that point the old house can be torn down and its good timbers used in some other needy place of someone’s abode.

Drive and Determination      Humans were created with a determined drive to be, to endure and to become all that God intended for them. God gives humans a great potential and a blueprint which innately drives them to become all that they were designed to be. With a little effort, people are able to read their blueprint.  Their blueprint is indestructible. The subconscious knowledge of their blueprint persistently pushes them to seek experiences, role models, guidance and materials appropriate for the area in which they are developing. Since the world was perverted, no one has the opportunity to completely become the person they should have be. Some who were brought up in homes with self-sacrificing loving parent may get close.  With the force of their God given drive to become who they should be, children will persist under the most awful conditions in their search for ingredients and experiences to fulfill the promise of their blueprint.  That is why beaten and starving children in concentration camps, can still find energy to play football, even if it is with a skull.  That is why exhausted and despairing adults can sing old hymns in the salt mines.  And so the first and most important grief of any dying individual is for the Person I Should Have Become, (PISHB).[3] {Deeply Damaged}

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Because humans were created for eternity, they still have a sense of eternity in the core of their being. Thus they will naturally struggle to keep living and resent any push toward the grave.  Any apparent desire to die or to be dead is unnatural.

Human Status   Humans were created a little lower than God, (4)[Ps. 8:5] This gives each person, regardless of their size, age, sex, intelligence and “quality of life”, a dignity everyone should recognize and respect. It also gives people an appreciation of how far humanity has fallen from their original state.  How great is the tragedy for the dying person and for all humanity, that we rejected God’s initial plan to walk together in an amazing garden and gradually get to know and appreciate the most incredible Person there ever was or ever will be.  More than anyone, a dying person realizes the utter stupidity of choosing instead the “knowledge of good and evil”( 5).  Were it not for Christ everyone would die in despair.

Welcomed  into Their Family     Each human was designed to develop within the context of a family. This begins with being welcomed by their whole family in whatever state, size, condition or place the little one may be. When they are welcomed, it means they are welcomed as they are, when they are, where they are. It is more than unconditional acceptance. It should be a glad celebration of a new person who is now part of everybody, adding a new dimension to their developing personality and a new opportunity to love. The family by welcoming a new child as soon as they are aware of his or her existence, extents their hospitality and protection for the duration of this new person’s earthly life.  The family has the privilege and responsibility of welcoming their child in the name of Jesus, ( 5)Lk:   ] for that is a welcome to earth extended by Creator God to this particular child.  It is a vitally important, one time event that needs to be formally recognized as such.  The family also has the responsibility and privilege of welcoming this child in their family’s name and in the name of each individual by each individual. A few days after birth they can take a good long look at him/her and discern his name is Josiah or her name is Sabine. As they have welcomed Josiah or Sabine, so the family must say goodbye and then commit their spirit back to his/her Creator.

Inception then Conception        Humans began with a concept in God’s mind. The inception of an idea in God’s mind became the design of the human blueprint.  Following that came conception in which a human couple played the easy but necessary role of sexual intercourse which God used to create an absolutely unique, once in an eternity individual.  Since humans were created with a God given spirit, they are indestructible.  Although their blueprint may become so faded or rusty, it is barely discernable to many aging people, still it never entirely fades from their subconscious minds.  With a little effort elders can be aided to remember who they started out to become.  It is usually a very painful process but until they see their blueprint they will never know who they should have become.  When they get a clear image of the glorious person God intended them to be, at any time in their life, they will be able to grieve the PISHB.  Having grieved the loss of the Person I Should Have Become, it is so much easier when they are dying to say goodbye to others.

Commanded To Love      Humans are commanded by God to love Him and each other. When they are loving, they are most healthy. The command applies to everyone, from conception to death. This means that even the old and infirm are expected to reach out in some manner to try and meet the needs of others. In doing so they are more likely to have a purposeful and healthy life to the very end.  By focusing on others, even the dying are less self-centered and thus every inconvenience and pain is lessened.  Self centered people are much more aware of their disorder and deterioration. They struggle to keep themselves in comfort mainly for their own sakes.  This is counterproductive.  They will only hurt and fail more rapidly.  Those who reach out to others even as they sink, do so with greater ease and the assurance they have fought a good fight for their Lord in obedience to His command to love.

Humans were created with what appears to be excessive genetic material. Since God doesn’t waste energy or matter, one has to conclude that genetic material will be used in the magnificent, indestructible new ‘body’ with which they expect to be “clothed” (6) when they die.

Two Births     Humans are originally developed in the fluid of the amniotic sac. Thus they are born out of water. Since they are born with a fundamental defect that results in their continuous struggle against death, they are inadequate to live in the atmosphere of heaven’s power and brightness which would instantly destroy them.  Their spirit must be enlivened, their soul renewed and their body recreated. This can only happen after the spirit is reborn by God’s Spirit, ignited with His flame which results in an inherent desire to seek God and obey Him always.

# 2.   CREATED TO LAST     [much missing here]

Struggle To Resolve Conflict    Because eternity is in their hearts, humans resist dying.  They are constantly attempting to maintain a homeostasis to combat entropy that utilizes energy most efficiently to ensure their earthly longevity. For this reason, they have an inherent desire to resolve conflict. Conflict between humans and conflict within humans use energy without purpose which accelerates their demise and destruction in entropy.  They will try to resolve conflicts usually initiated in them as mistreated children by: thinking and thinking, “until they drive themselves crazy” or talking and talking “until they drive their friends crazy” or by recreating the essential key conflicts that contribute to family tragedy to the “third or fourth generation”,(7). Dying occurs when entropy is winning.

To Protest Disfigurement, Dismemberment, Dehumanization and Death.      Every human at any age they are dying, desires to shout, “I am too young to die!” It may appear, that as they age they more readily accept death, but this only indicates that their existence is becoming intolerably conflicted or painful. Though I have seen thousands of suicidal patients who ostensibly wanted to kill themselves, I have never met anybody who wanted to be dead.  Given even the promise of some amelioration in their condition or circumstances, people will hope again and on that hope build a renewed life, be it ever so short.

Life Preserving Instincts      God created humans with an instinctual wisdom that helps guide them to healthy interactions and behaviour. God does not trust human wisdom, philosophy or religion. When humans respond appropriately to their God given instincts, they are more likely to cooperate in their individual and mutual survival.  They are more likely to know what is good for them.  As an example there is an instinctual avoidance of anal intercourse and thus those who prefer that way of expressing their affection.

# 3. CREATED TO LIVE IN FAMILIES        

For Development and Maturation     All humans were created to live in families; most intensely and intimately during their developmental periods. Scientific evidence supports the Judeo-Christian and almost universal notion that children need to be born to, welcomed into and reared by a heterosexual couple who are mated for life.  Families are more substantial and organic than many people realize.  You cannot choose your family despite what some experts in palliative care believe.(8) [recommendations…  For better or for worse, God chose your family for you.  To many it was not fair. “ Why did I get this alcoholic, poverty ridden, broken family, while Jane got to live in a comfortable, loving family across the street”? Only God knows. But I suspect he thought you could handle it.   Your responsibility to yourself and to them is to literally “make the best of it”.  If God didn’t think you could do it, He wouldn’t have put you there.  And yes, things are equal; for those with greater blessings, have far greater responsibility the discharge of which should result in self restriction and impoverishment in efforts to ensure equality and legality for you.  In this life and later, Jane will be held accountable for her God given benefits and priviledges.

God Marries People with Pair Bonds      Like geese, wolves and ravens, humans are basically monogamous. The pair bonds that unite them are their being joined (married) by God. (9) Matt 19.  This is a bond that only God can make or take apart. For that reason, whenever humans are bonded, they are bonded for life regardless of how often they have formed a pair bond with additional people.  Those bonds are created by 8 distinct mechanisms,(10):

a)     Falling in love

b)     Imprinting

c)      Classical conditioning

d)     Operant conditioning

e)     Exchange of hormones during sexual intercourse

f)       Rescue

g)     Buddy

h)     Social

i)        Spiritual, i.e. one in the Spirit, for Christians  (#9)

Breaking Pair Bonds       The only time that pair bonds are broken is through death. Since the bond is primarily a physical bond (one flesh), that bond, when broken by the death of husband, seriously hurts the body and mind of the wife. It is one of the greatest  psychological pains. For this reason well bonded couples “pine away” for the departed and may die within a short period of each other.  If one survives a traumatic event involving  both, the survivor will usually feel “survivor guilt” and then promote their own demise with a suicide that looks like an accident or by not caring for their health.  Paradoxically this pairing of death is most likely to occur when husband are well and only pair bonded to each other.  It is less apparent in the current day and age when there are few who are not bonded to several others.  Good doctors know of this phenomena and are careful to check up on the survivor soon after their spouse dies.

A Good Parent-Infant Bond is Essential       Parent-infant bonds grow throughout pregnancy, then most intensely during the first 18 hours of extra-uterine life but continue to develope  throughout the child’s life with his parents. The parent-infant bond, like the pair bond, lasts an earthly lifetime.  The child who is not well bonded is statistically more likely to be abuse and neglected.  There are many factors that interfere with good bonding.  One of the most prevalent is abortion, (12) [Ney…..The breaking of a parent-infant bond through death is excruciatingly painful. Grieving of a parent for their child or the child for their parent is so intense that many try to avoid it through denial, distraction or quick pseudo-Christian rituals.   Yet it is a natural and normal process, the progression of which is easily recognized.  If allowed, uncomplicated grief spontaneously resolves.  The grieving person completes the cycle and “wakes up” to new hope and an ability to form new attachments.   Grief can be only be facilitated by removing the impediments.  It cannot be hastened or encouraged.  In normal grief there is no need for grief counselors; just family and friends who intuitively know when to be near and when to leave alone.  Too often professionals get in the way

Fraternal Bonds are Very Desirable      Children are readily bonded to each other. That bond is especially important when there is a high likelihood of children losing one parent or another. Thus, in North America where there is about a 50% likelihood of marital disruption, children are increasingly bonded to each other.  Consequently they are very resentful if parents destroys a sibling through abortion. Fraternal bonds are also found among those in good, close company e.g. platoons during war, small, effective manufacturing companies, etc. God made is so for mutual nuturing and support.

Spiritual Bonds among Christians      All those who are children of God are brothers and sisters of each other. Under normal circumstances, they will care and often die for each other. It’s small wonder that the death of one church member brings out a good portion of the congregation to the funeral.  Each nearby spiritual brother and sister needs to grieve, join in committing the dead person’s spirit to their Lord and then help to bury the body by throwing shovels of dirt onto the corpse.

God’s Purpose for Bonds           God creates human bonds for the survival and civilizing of his human creation. Thus every child from conception, is necessary for the survival and civilization of the whole species. In this regard, each person has an equal and necessary contribution to the developement of every other human. Every child requires a family in which to be nurtured and guided so that they become an effective contributor to the welfare of the human species. Every family requires the nurture and protection of the wider group, particularly the elected government.  A child is naturally held by “one cup inside another” and leaving out one holder is very detrimental.  This is why I teach those who man pregnancy crisis centers to always try to involve the father of the preborn baby; even if he is a most unlikely looking specimum of a man.  

Consequences of not Being Welcomed          Every child, regardless of size, shape, color, intelligence, time or place was designed to be welcomed into a family. No member of the family was ever to have the power to discard any child that ever came to them. If and when they destroy a child by abortion, eugenics or mistreatment, there are severe consequences to the whole family.   When that effect is multiplied many times by the same effect in many families, it produces a disastrous consequence to the survival of the whole species.  We are now witnessing this in economic downturn arising from the population implosion.

The nice sounding phrase “the first right of every child is to be wanted”, is a most pernicious philosophy.  Every child’s first and only undeniable inherent right is to be.  Everyone has a God given right to exist, regardless.   For most people in most countries, wantedness has become the determining factor in deciding which child lives and which dies. That criteria is now being applied to other apparently less wanted people:  the handicapped, wrong sex, inconvenient and the elderly. Since wantedness has becomes the criteria by which people live and die, nobody is safe. Almost everyone is left wondering how much they are wanted or popular for they then must live according to the ethic of wantedness.  They must expend most of their energy to stay liked and likable, rather than courageously facing extremely difficult issues alone and unpopular.

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 Guilt Complicated Grief        If any member of society, the family in particular, in fact or in fantasy, actively or passively contributes to the death of another member, they feel a biologically determined guilt.  The closer the relationship, the greater the guilt.  This inherent guilt greatly complicates grieving. The guilt-complicated grief  [GCG] frequently results in pathological grief which often becomes a very difficult to treat depression.   This is mainly why, family should never aid or abet the death of any family member.  This is partly why physicians must never aid or abet the death of any patient.

Government Interference      Ever since there was government, there has been a tension between the family and the society governing group, competing for the body and souls of the young. Presently the government is winning and families are abdicating.  This is occurring  primarily because families are so burdened with paying taxes for government funded daycare, education, medical care, etc. they feel they must work outside the home. As the family abdicates, the government takes over more of their responsibility, constantly reminding the electorate that they must do so because the “some parents are so irresponsible”. The family, on the other hand, with very few exceptions, abdicate all too readily because they are hoping if they work long and hard enough, there will be enough money left over after taxes to buy themselves exciting pleasures. As the government and its agencies burgeon which are invariably split into specialized groups, competing with each other for greater recognition, constantly demanding more funding, and insisting they have a right to grow at the expense of the family because there is such a need for their particular service. This is especially true when family accommodation, structure and behaviour makes it harder to care for their elderly. The government and its agencies, with the private sector competing, builds empires of palliative care.  The government for power and the private agencies for money, demand greater funding.  The end result of this vicious cycle is that although more funds are spent on the elder, they receive less quality of care and are more resented.

Family Grieving is Necessary      Grief is a natural and necessary process. It begins and ends reasonably smoothly if there is no interference.  Those who ostensibly facilitate grief by outlining the invariable stages, or insist people need grief counselling, or measure the amount of a person’s grief, often do more harm than good. Grief is also interfered with by the prescription of antidepressants.  When a sad, slow moving, poor sleeping  and withdrawn patient requests help of their family physician, too often they are diagnosed as depressed rather than grieving and are given antidepressant  medication.  Grieving requires that people acutely feel the breaking of their bonds. While they are on antidepressants, there is a vague sense of wellness when all is not well. Medicated grieving people seem to “doing much better”.  It is concluded by the family and the patient themselves that they coped so well they can now get on with their lives.  The grief is not completed and thus the need for the antidepressants may go on indefinitely.  If they try to stop the medication they experience a rebound effect or the painful consequences of the seratonin depletion syndrome which further convinces them they are truly depressed and must continue medication for the rest of their lives.

Must Detach Before You Are Able to Attach Again          In the early 1970’s, Lewis (13) recognized that until mothers detach from a stillborn child, they have difficulties bonding to the next. We found the same phenomena with other pregnancy losses, particularly aborted babies. Grief therefore is necessary for new attachments.  When a husband or wife dies, the ability to make new attachments is necessary for the family, especially when they are young. Anything that interferes with the detaching process (grief), interferes with later attaching process, which interferes with the growth and development of the family.  Death breaks the pair bond and grieving is the process of letting go and healing.  The young husband or wife should marry again for the sake of their children, if for no other reason.

Seven Prerequisites Of Grief      The natural beginning and normal progression of grief requires:

a)     Recognizing that the person is irrevocably dead. This means that people need to hold the body as it becomes cold and stiff or touch and stroke it after there are no more signs of life.  Children need to be able to poke their grandparent to make sure she/he does not respond.  Otherwise it seems so cruel to the child that gramma who looks so good lying in her coffin in her pretty dress and all made up by the undertaker, has the lid of the box closed on her and then covered with earth.  It is sometimes why small children are so angry at funerals. There needs to be some authority to definitively pronounce that person as completely dead.  Since Christians recognize the person is dead when their spirit leaves, there needs to be more than one person, who can with a high degree of certainty, ascertain when the spirit has departed and authoritatively inform the family.

b)     The person must be humanized in the minds of the family, in order to be grieved as a human. It’s no good saying, “That stupid alcoholic is gone.” They must be able to say, “That person with alcoholism is dead.” To rehumanize the person, they have to be welcomed as part of a family, if they weren’t before. The preborn baby must be individualized, characterized, humanized and welcomed into a family. This means each stillborn, miscarried or aborted preborn baby must be given an identity, sex, physical and personality characteristics and then named.  It is so remarkable how when given an opportunity to visualize the dead preborn baby as they would be at this time if the had lived, family members independently describe such similar characteristics.

c)      Before the person dies, good goodbyes must be said or written.  A good, goodbye is mutual, there is no unfinished business, and that the departing and those left behind need to express their respect and appreciation for each other.

d)     Contributing.  If anybody has in any way, in fact or in fantasy, passively or actively contributed to the death of the person, they must face that wrong, seek forgiveness and reconciliation.

e)     Care by family. Humans function best in the context of an extended family. This means that older people should be given semi-independent living, and a meaningful role in the welfare of the family as long as they live. Many years ago, the New Zealand government provided permission, ways and means for people to build on their city lots, a granny cottage where the old folks could live but where they were within sight and earshot so they could be responded to if there were episodes of acute distress. In a similar way, people should die at home. This requires periodic relief by others and a visiting nurse during the most stressful times.  Good evidence indicates that when there is a visiting nurse, the family are much more determined to care for a dying family member.

Resist Government Intrusion   The family must resist temptations to earn and spend at the expense of caring for each other. They must resist the apparently kind intrusion of the government with its many offers of help. This should be increasingly easy now that the government is struggling to find sufficient funds.  Yet governments seem to have very deep pockets when they see fit.  As the population declines, so does the economy. In a world now facing almost universal exponential fertility decline and population implosion, the government will need to make severe cutbacks in social, educational and medical services.  They will begin with those most vulnerable, the elderly and the handicapped.

Commanded to Procreate                God’s first command to humans was to populate  and care for the earth,(14). Gen 2  Power-hungry people insisted the greatest scourge was population explosion long after it became apparent that the real problem was implosion. The same type for the same reasons are now alarming the world’s people with cries of global warming caused by human waste and CO2.  They ignore the evidence that there have been wide variations in global temperatures in earlier times.  There was such global warming in the 16^th and 17^th centuries the Vikings were farming  in Greenland. (15).  There never was population explosion.  There was selfishness that kept people with too much from sharing with those who had too little.  There were fears that precipitated huge expenditure on armaments instead of developing the technology to colonize the planets and beyond.   Our God, with limitless knowledge and capacity, created an apparently limitless universe, which surely invited humans to have a countless numbers of their kind,(16) God’s promise to Abraham. Instead they began fiercely competing and killing each other.  If they cooperated they could easily be populating space. Even a small portion of money spent on armaments would suffice.   When they cooperate and encourage each other’s exploration and galaxy colonization, they would be at their civilized best.

* Welcome, sendoff, commit, spirit, touch body, bury and grieve.

Automatic Revulsion toward decay.    In order to survive individually and as a species, humans must avoid disease and decay. For that reason there is an automatic revulsion to bodies that are diseased, and degenerating. It takes a great deal of determined love for a young couple to clean and care for their parents’ feces smeared and wasted bodies. For that disagreeable task, they need good role models of those in the congregation who have done it before.  They should have ample opportunity to discuss their conflicting feelings of love, respect and revulsion with others who are encountering the same struggle, for if they don’t express, they will repress these conflicts which may surface as reluctance in caring for their children when they become soiled.

A Need To Struggle           Zoos have found that animals are healthier and survive longer when they are caged, prey and predator side by side. The lion is alert to the possibility of a warm meal and the antelope is constantly on the defense. Humans will live longer and their minds will stay sharper when they struggle, not only to fend for themselves but also to care for others. In the family, older people need a meaningful role contributing to meals and entertaining the young.  Even if they cannot get on their feet, there is something useful they can do.  To be useful gives meaning to life and with meaning, small pains and disabilities are much better tolerated.  The most pathetic sight is to see older people in homes being reasonably well cared for yet quickly deteriorating because they are no longer struggling to look after themselves and help those who are slightly more infirm.  If there should be a home for the aged, and there should be very few, there should be no elevators. This requires people to go up and down stairs or ramps to get from dining room to bedroom.  It may take 30min. per floor or more but the exersize is what they badly need. They may need to help propel each other up the ramp in a wheel chair.  They may expire with the effort.  Yet Christian elders would prefer to die while trying to assist someone than lying in bed, dependent on those they don’t easily trust.

Attributional Effect      Whenever any otherwise expected or automatic activity is paid for, it loses value and people become less interested in doing it. When family members are paid to care for their own, they have less natural inclination to do so.  Why?  People reason, “if one has to be paid, surely it must be an onerous, unrewarding activity”.  The more people are paid for caring for their family, the less they want to do it and the more they will demand remuneration.  I have been on the advisory board of Kids First for many years, assisting this pioneering body pressure the government to equalized taxes so one parent can stay at home to raise their children.  I strongly advised them not to seek government funding to pay for parenting because of the attributional effect.   When poorly informed government want to improve care by family by paying family members, they are astonished to realize it isn’t working. They tend to conclude the best way to fix that problem is to pay them more, thereby compounding the problem.  They eventually give up, leaving the family to provide care for their dependent and dying when they are least likely to do so. There certainly should be recognition for home care heroes and support for the rank and file who routinely provide for the needs of their elderly, but it should be done with names in the paper and certificates of appreciation, not with money.

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Narcissistic Greed       The advertising media has convinced people they should spend much money in the pursuit of fun. This requires them to keep earning even when it takes them away from their family.  It has become an North American expectation that we should have so much time off, so much leave and so many hours away from the demands of family life. This encourages a nascent narcissism which has no bounds once it can be justified.  The justification is, what is good, usually implying fun, for you, is good for your family.   Whenever these expectations for fun and recreation are frustrated by more difficult care, family become resentful of the social or moral expectations that arise when any family member implicitly demands their care by just being old or dying.  For this reason, some people will stop going to church rather than face a group of people who by asking, “how is your old mother doing in her new old people’s home ?” imply they should be looked after by their family

Fear Of Aging             As older people are treated more shabbily, so the middle aged become frightened of aging. At one time when the elderly were esteemed, respected and consulted for their wisdom, there was even a desire to become old. But now they are shunted off as a “burden to society” with “little quality of life”. The increasing fear of aging results in a greater demand on medical services by the middle aged, who constantly fear their health is deteriorating.  As health care costs rise, the aging and dying have disproportionately less spent on them because they are increasingly viewed as non-contributors.

#  4  CREATED EQUAL

Essentially Equal       Humans were created essentially equal. Depending on how people are measured, some will fall short (literally and figuratively) in the estimation of   others. Yet no measure has yet been able to assess the quality of human spirits whose wisdom and maturity has little to do with a person’s measured intelligence or physical prowess.  Moreover, since all humans regardless of their capacity or age make a critical contribution to the survival of the species, everyone is a necessary contributer to the welfare of all.  There are no exceptions.  We can all benefit from the contibution of their being alive of everyone conceived.  To think otherwise is to think God makes mistakes.   Most importantly, everyone is created in the likeness of God who has inestimable worth.  As God views Himself and so He sees every person. That likeness is an essential quality.

Derogatory Discrimination     Humans must discriminate one color from another, one race from another, one gender from another, good from bad, etc. It’s when that discrimination becomes derogatory that it is harmful.  On the basis of what they discriminate, many people, especially those with poor self esteem, try to elevate themselves by putting others down.  In doing so their nastiest characteristics show,  To get rid of discrimination would be foolish if not impossible. To discourage derogatory discrimination is admirable. However humans should more wisely look at the root causes of derogatory discrimination because sometimes they are part of survival mechanisms.  Wise Christians will admit they derogatorily discriminate against someone whose moral behaviour is aberrant and destructive. Is it not good that children intuitively derogatorily discriminate against strangers, especially those who are staggering down a road toward them.  Healthy children naturally derogatorily discriminate and avoid those who offer them candy because they might be seduced or abducted.  People with leprosy and those who are mentally bizarre have been avoided for centuries because of real and imagined fears of being contaminated.  The tendency to discriminate against the elder and the handicapped is not reduced by invectives or legislation nearly as well as by helping people understand the roots of their fears and teaching them to love in spite of their concerns for their own safety.

All Talk And Little Action   Almost universally people say they believe in the inherent equality of every human but their avowed belief does not translate into appropriate action. North Americans in particular believe that all are equal, but they seem not to notice that belief should translate into sharing equally.  The difference between what we believe and what we do is the degree to which we are hypocrites.  If we truly believe all others are equal, then we should have equal education, clean water, medical care, etc. If medical care resources were distributed equally around the world, there would be no possibility of heroic end of life care. It would be impossible to have organ transplants for older people if that money were spent on antibiotics and antimalarials where they are really needed.  It wouldn’t even be a consideration.  Many might consider this an impossible ideal, however they either have to stop asserting that all people are equal or they have to behave accordingly, particularly when it comes to the equal distribution of medical care. If they truly believed in equality, there would be no grave discussions by the ethical committee about “are they dead”, or “do they deserve more expensive care”. All those decisions would be foregone by the absolute economic necessity of making sure that medical care was universally distributed.

Organ Replacement     As always, the rich, the powerful and the privileged are able to buy more expensive medical care and do so at the expense of others less well endowed with money or talents to earn money. (17) recent article on email They have little thought of how their demands might deprive others of the doctor’s time etc.  In a free market, they are able to pay such high prices that people in poverty will sell an extra organ.  Governments will condone the removal of organs from the barely living or the recently decapitated as capital punishment. Governments are unable to stop this terrible trade, but individuals can. Families can support each other in saying, “No, they cannot have my kidneys when I am dead, primarily because I don’t trust them not to hurry my demise.” The aged can insert a small paragraph in their will which reads, “I do not allow expensive care for myself when I am dying, but I insist that whatever may have been spent for me, be used to provide antimalarials in Kenya or Paraguay etc.

Empirical Decision      For the Christian physician, the decision of when to stop treating a person [someone whose spirit still resides in their body], should be determined only by economics. Therefore only somebody who is impelled by economic demands should make that decision. Physicians and family never should. Only the hospital administrator, or other government agent who is able to demonstrate that this person must stop having acute care because somebody somewhere else needs it more urgently should say sorry, we cannot afford more treatment for your father.  Otherwise the Christian physician, backed by the patient’s family must only and always treat his patient to the limit of his resources and ability. Ref addendums A & B & C ethical statements.

Rationalizations for Hypocrites          As long as people are allowed to assert they believe all people are equal without doing anything about it, they will learn better and better rationalizations and justifications to support their selfish way of life. Sadly many Christians ignore what Jesus says about priorities.  They loudly and proudly state that their family always comes first.  With this they justify expending huge amounts on the family’s recreation and health care.  Unfortunately, the dichotomy between what they believe and how they behave will erode their own health. This is another example of the reciprocity of effect.  The ethic of mutual benefit always applies.

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 # 5   LIVING AND DYING

Definition of Dying     There is no human who is not both living and dying.  From conception human cells are dying and being replaced by others. At some point in their life, the rate of cells dying exceeds the rate of cell replacement.  When medical care is no longer able to facilitate the body’s inherent regenerative processes so that healthy cells are being formed faster than cells are dying, or when unhealthy cells are more rapidly displacing healthy ones, that person is dying. When the battle for life and living, in spite of the best of nurture and medical care, is being lost, that person is dying.

Some palliative care experts state their specialty comes into action to prolong life and ease dying.  Yet the best that medical care can ever do is to prolong life. There are no permanent cures. Everyone eventually dies. Every cure, even those by Jesus are only temporary. So a cure is defined as that point at which medical treatment for that particular disorder is no longer required. There may be other disorders about to arise very quickly.

Part 1 Revised up to this point
Healthiest When Loving        The royal law of love always applies. Christ commanded his followers and his disciples and his brethren to love the Lord their God with all their heart, mind and soul, body and strength, and their neighbour as well as they love themselves.  The great Designer who knows every aspect of His creature, states a rule and a principle that is the best way for that creature to function.  When humans are obey the Royal law of Love, they are healthy. When they become narcissistic, they implode. A good example is the individual who is madly in love. He is so concentrated on his beloved that every day, the sun shines and the birds sing. The man’s heart and mind are so focused on his beloved, his body is in harmony as no other time in his life. There is harmony between body, mind and spirit when people are in love with their Lord. In that state, they are healthier than they can otherwise be. When Christ commands his people to love, it is for the benefit of those they love and for their own benefit. The benefit is mutual and simultaneous.

Healthiest When Beliefs And Behaviour Align             Most people have beliefs and faiths, even though they may aggressively deny they do. They are exerting their faith when they go to bed and fall asleep. Their faith is that they will wake up and they exersize that faith by allowing themselves to become unconscious. They believe they will automatically awaken after about 8 hours.  Otherwise who would dare to allow themselves to become oblivious? They have faith that the world will keep spinning, and each day will dawn more or less on time. Some believe in gods of green paper, and concrete buildings, and tanks. Everyone has a belief that governs their interactions with family, friends and neighbours. When their beliefs and behaviour are discordant, they become unhealthy.  Too often, instead of exerting themselves to act as they believe, they become cyncical and care less about their hypocrisy and so become increasingly unwell.

Conflict Resolution            Although humans survive best when they struggle, they survive most poorly when they have needless conflict, especially conflict within themselves. It is for that reason they are designed with an inherent drive to resolve conflict. (18)ney possible reasons]  They do this by thinking and thinking until they drive themselves crazy, or by talking and talking until they drive their friends crazy, or by reenacting the unresolved conflict until they drive both their friends and themselves quite mad. The reenactment of tragedy is not just perversity; it is adaptive. There is a reason that people recreate their tragedy. It gives them another opportunity to view it, hopefully more objectively, and learn why it happened the first time so they can see it coming and stop it before it is irretreavably tragic.  Sadly very few have the skill to help others understand the roots and reasons for the tragedy as they are reenacting it. (19) hope alive]

Need to be Needed

Some humans have the desire to love their neighbours if for no other reason than to be loved by them. They also have the desire to be needed. In palliative care, this often shows itself as people helping the aged unwillingly and unnecessarily, thereby reinforcing dependent maladaptive behaviours.

Part 1 ends here

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#5. LIVING AND DYING

From inception to conception, through birth, rebirth and bodily death, the human is becoming an increasingly interesting person. God’s plan is to give these humans choice. They began by making very bad choices, and much of their life is spent in doing what Adam and Eve did, which was to choose a quick fix, a simple route to knowledge and power. God’s plan for man was:

1)     To be.

2)     To become all that God intended for him and her. To become the person that he designed them to be. To become mature, interesting in conversation and maturity. God designed the baby to be welcomed into a home where he would be understood, nurtured and protected. God designed people to know him, who is the source of all knowledge. He encourages the pursuit of understanding, and the acquisition of facts. He designed humans to do, to serve and express joy in praise and thanksgiving. Seldom have men approached the intention that God had for them. Many have, by their own choice, and the choices of their forebears, turned away from God, and found disaster and death.

Everyone is Dying               From the very beginning of life, human cells are dying. They are scavenged and re-used, but eventually the death of cells exceeds the regeneration and reproduction of cells, and humans in the prime of their life, begin to decline. They become increasingly susceptible to disease and dysfunction, and dysplasia. Since everyone is dying from the outset, the best that medical care can do is to prolong life. There are no permanent cures. Even Jesus’ miraculous bringing to life again soon ended in the person’s death.

Healthiest When Loving     God commands humans to love him with all their heart and mind and strength, and to love their neighbours as themselves. This royal law of love creates homeostasis, the best condition for a human’s healthy life. Thus when they are loving, their mind and heart are turned to another, their blood pressure drops, their pulse rate is lowered, and they live longer. When they indulge themselves, seek their own enjoyment, pursue their own pleasures, they become increasingly narcissistic. In that state, they begin more rapidly to die.

Humans are healthiest when there is close alignment between what they believe and how they behave in following this law of love. If they believe that all people are born equal, they are healthiest when they make that happen. Humans need to be needed, however they become unhealthy when people are paid to provide care they don’t need. This dependency creates an increasingly wide gap between the giver and the receiver. It was never meant to be this way. It was meant that everybody both give and receive, even the very oldest.

Need to Struggle    Humans are best when they are struggling to survive. The struggle should not be too little or too great. When too little, they become fat and lazy. When too great, they expire in exhaustion. Zoos have found caging prey and predator side by side keeps both the antelope and the lion alert, and in that state they are much better specimens to be viewed by the curious. Even in old people’s homes, humans should be given the opportunity of serving each other, and individually struggling within their capacity to continue life. They need to climb stairs, wash dishes, weed in the garden, knit, and crochet. They need to entertain visitors and tell them stories of the past whereby the young can gain wisdom.

Kept Alive by Instincts      Human reason, human philosophy, human religion could never be sufficient to guide people to wise choices that enable their survival. God put human survival in their basic instincts, to love, mate, propagate and care for their young in families. Too often humans have listened to their own ideas, widely, forcefully propagated by increasingly intrusive media that give them the idea of what is best for themselves. They have lost touch with their instincts that could guide their own emotions and impulses.

Fear of Dying           Humans are born with some sense of eternity embedded in their spirit and mind. Not knowing what might transpire after their body dies, they approach death with increasing dread. Too often unable or unguided in dealing with dread, humans welcome medication that clouds their consciousness and apparently allays their anxiety. However, it has been shown that even with the best palliative care medications prior to death, when autopsies are done on the body they have high levels of catecholamines. This seems to indicate that at the very moment of death the spirit, mind and body are terrified. It still has to be determine whether those catecholamines represent excitement in those who are anticipating being welcomed into heaven as sons of God.

Pride     Those who are arrogant throughout life, who boasted of their mental and physical capacities, tend to be prideful when approaching death. They don’t want any help, direction, comfort or care. They will meet death head-on. This tendency needs to be understood for those who provide any type of palliative care.

Reciprocal Reaction          Those parents who callously chose which child should live and which child should die by abortion now begin to realize that the children who survived will consider them in the same callous regard. They wonder when children talk about quality of life if this means they are not wanted, and like their little siblings, they will dispense with the old, because who wants them anyway. They are sitting upon lots of wealth that could be used to buy cars, boats, cottages or education. Thus old people accept government care rather than home care, where they feel extremely vulnerable to the vagaries of their children’s intentions.  The post abortion survivor is indeed more likely to be dehumanized, and as such, considers other humans with less essential value.

Population Implosion        Only a few wise people predicted at the time when everyone else was cringing in the face of population explosion that humans in fact were destroying the very ecology on which they depended. They were sawing the branch on which they sat. it is becoming increasingly apparent that those who are chosen because they are wanted, to live, have little interest in having children.

As with all types of population statistics, explosion and implosion are exponential. At some point in the curve, humans decline so rapidly they cannot replenish themselves, and as experience has shown, they can die out. The native people of Tasmania were removed from that island, placed in reasonably good living circumstances, but very shortly there were none left.

The government is now realizing they cannot run a free market economy on a declining population. With various incentives, they are trying to now increase the population with the same stupid ideas that they used to limit the population. They are soon finding that it cannot be controlled that easily, that the fine balances that are part of the human ecology cannot be easily rectified.  In fact, they are rectified with greater difficulty in animals whose survival is endangered. All the economic rules that once governed the free market economy can no longer apply, so all predictions are wrong, except that it is quite apparent that things will get worse, much worse, before they get better, if that ever happens.

Government Control         In an effort to reestablish the economy, the government will become increasingly controlling of the buying and selling of every person. There will be pressures on people to populate, as there were in Romania. As in Romania, people may be forced to have children, but then will abandon them. The end result will be increasing numbers of people who are dependent on government largesse. Increasing government control will require increasing legislation, bureaucrats and police, and law courts, etc.

In an effort to promote population in one particular country, there will be subtle and then increasingly crass attempts to increase immigration and adoption that will inevitably result in a splitting of classes, greater inequality, servants and slaves.

Because humans have a limit to what they can earn, consume and spend, there will be increasing efforts to encourage humans to buy, to indulge themselves, and so they become increasingly narcissistic. There will be more discarding of used items that are good in every case except no longer so bright and shiny. This will require increasing storage units, garbage piles, thrift stores.

The Focus Of Dignity        As people’s physical and mental capacity declines, so the focus of dignity shifts from strength and knowledge to wisdom. There was a time when old people were greatly revered for the wisdom they gained, that is their way to interpret knowledge, events, etc. With the increasing use of the computer that makes predictions, the value of the old people’s wisdom has significantly declined. Therefore the old people have little to contribute as they age. Still, they need to be encouraged to tell their stories and inscribe their wisdom, if to nobody else but their individual families. There could be publishing companies that encourage the production of leather-bound volumes for the family history and wisdom.

Dying     As the rate of destruction of individual cells eventually exceeds that of the regeneration, so the body reaches the point where it is losing the battle against death in spite of the best available treatment. At this point, care is truly palliative, aimed at making the rest of life most meaningful and most comfortable.

Lasting Image         The vision of venerable grandparents helps children maintain hope. It is for this reason they should be kept from the last experiences of the grandparents’ struggle and the wasting of their bodies. Adults, on the other hand, have an important role in caring for the diseased and distressed because in doing so they become increasingly repulsed. The repulsion helps separate them and begins the mourning process. For children, they should see their parents propped up in bed, or made up in the coffin.

Spirit Keeps Growing        Even when the body becomes deformed and the mind is deteriorating, the person’s spirit can keep growing. Thus the palliative care should increasingly emphasize the need to nurture, encourage and embolden the person’s spirit with scripture and hymns and stories of brave endings.

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#6. ABSOLUTELY UNIQUE

Everyone is Their Own Norm     Although it is the custom in medicine to compare everybody’s biochemical, physical and mental parameters to the mean or average, there is no such thing for the individual. The blueprint of everyone is their own unique standard and norm.  The blueprint describes who they should be. Their present state indicates how far they are removed from that person, and to that degree they are diseased or deranged. This means that physicians need to keep a record of a person’s biochemical parameters beginning from their healthiest stage of life and use that as an indication of how much a person has declined and how much treatment they need to regain that healthy status. The physician’s intention is to return the person to the closest approximation that is possible in this life of the person they were designed to become. Any definitions of health that is different from this will only tend to confuse the individual who wonders why their physician is so concerned about their low blood pressure, according to the average, when they have had that all their lives.

Knowledge of Blueprint     Beginning at early ages, children should be encouraged to: discover, unabashedly declare what is their blueprint and without shame or hesitation request the nutrients and experiences they need to become the Person God Intends Me To Be, [PGIMTB]. (19) [Deeply Damaged] This should not be too hard for parents. A child who is constantly making a wide variety of sounds by hitting or plucking various objects is indicating his/her design to become a musician.   A child who is persistently making towers from blocks is likely showing an interest in civil engineering. Parents must stand back and watch children at work and play, eating, etc. to discern who their child is really designed to become. Over a period of time, their blueprint becomes increasingly clear.  As it unfolds, the knowledge of a child’s blueprint is a primary source to guide parents in knowing how that child should be nurtured and guided. A major aspect task in dying is for the individual to recognize he / she will never become the beautiful, dignified, serene, joyful person God designed them to be. Thus they must mourn the loss of the person they should have become. When that is accomplished, they will more readily see and accept themselves as they are.  They then can accept others as they are, so they are no longer disappointed in themselves and in others.  In doing this, they are much better prepared for their own death.

#7 CREATED TO BE FRIENDS

Mature Friends       God created humans to become His friends (20) Abraham] but He wants them to be mature friends.  Much as He loves children, He does not want to spend eternity with people who should have grown up. Much like us only more so, He wants to spend eternity talking with interesting people who have:  had a wide variety of experiences, learned as much as they could, traveled widely, have many scars in their fight with the evil one and have many God given accolades in their efforts to love others.  He wants as his friends, people who are keen to discover and quick to express their thanks and praise.  Christians need to be reminded that they won’t want to be like those in a recent survey of 70 year olds, the majority of whom stated, if they were given an opportunity to live their lives again, would take more risks.  It isn’t hard to imagine the regret of dying Christians, who are now much more aware of heaven and wish they had not been so selfish and self protective.

Hard Choices          When humans chose not to spend quiet days walking and talking with God in beautiful gardens, God provided the alternative route to life and maturity. It required humans to be reborn then to grow in wisdom and knowledge painfully. It seems that only in crises do people mature. God allows crises to occur in people’s lives.  And He insists on hard and difficult choices. Even when humans desperately plead to be shown the way, God stands back and allows them to agonize through all the alternatives.  Since God keeps hoping people will keep maturing, even when they are dying, the choices are just as hard.  The choices of when and how to die are probably even harder than the ones they encountered when they were young and healthy. God does not often provide easily discernable open and closed doors. After all you stopped opening and closing doors for your children when they were three. God does not want you to stay 3 year olds, so He insists that you open and close your own doors.  When given choices about do they want to die at home or in some church run facility, about how much medication to ease their pain but possibly dull their wits, about when to dismiss their spirit, about who to ask to be with them as they pass thru, they should be encouraged to continue that hard maturing process and not too easily have some surrogate make their decisions or give someone the power of attorney.

Ambivalence about Life         Since God created choices so that he would have friends by their choice, the inevitable outcome for most people was vacillating in their decision between the alternatives. Thus nearly everyone is ambivalent about everything almost all the time.  People are ambivalent about life and death; living and dying. To ask people whether they want to live or die creates a false dichotomy.  Any assessment that asks, “Do you want to be alive or commit suicide with a doctors help?” distorts the reality of the ambivalence of the suffering dying patient.  Part of them is battling to stay alive and another part would like to be totally relieved of suffering.  It is all too easy to tilt the balance of their ambivalence toward death, if death can be made to look easy and friendly, ie. euthanasia. 

Having assessed thousands of patients I have found very few who haven’t felt that life wasn’t worth living at some point and had thoughts of suicide.  What I find far more serious is when I get positive responses to these inquiries:  I would like to know if you feel or have felt, you don’t deserve to be alive, Tell me if and when you feel guilty about being alive.  Please tell me about any feeling you have of impending doom, something out of nowhere killing you.  I now make these inquiries routinely.  The positive responses are almost pathoneumonic? of the Post Abortion Survivors Syndrome.  It almost invariably means the patient has aborted siblings.  When these people are decompensating in a depression, there needs to be urgent treatment.

Foolishly, rating scales or clinical questions seldom represent the continuum of the spectrum about wishing to die or live.  It is much easier and more reliable to represent  these alternatives from extremes of “never” or “always”, on a visual analogue scale.  To force choices between unreal dichotomies leaves a clinician caring for dying patients with distorted information.

Negotiate Improvement Needed              In my practice of over 4 decades [thank you Jesus] I have found that although many thousands of people have expressed a desire to die or even kill themselves because they feel entrapped, angry, hopeless, no one really wants to be dead.  I have interviewed thousands of suicidal patients but I cannot remember one patient who wanted to be dead if there was any chance of sufficient improvement.  The clinician needs to determine just how much less pain, discomfort and confusion would be required before the patient would feel life was worth living again.  With those who express a desire to be euthanised, a clinician will usually find they can negotiate with them how much improvement, with the time and resources available, would enough to make them appreciate life again. What percentage of less pain or depression would they require to make them feel hopeful and want to continue their life. The patient might say, 100 %.  The doctor would respond with,  “I’m sorry that isn’t possible but how about 50%” The patient might counter with, “Actually doc, 25% reduction would do”.

Capacity to Know God         God clearly wants people to know Him. (21) This implies that in spite of the fact that knowing God means knowing everything, people have the capacity to know him and the inherent desire to do so. This is an awesome feature of humans. Practically it could only be possible with eternity. In the meantime, every person should be encouraged to discover. Much can be discovered using the scientific method, but other things can be discovered through intuition and emotional perceptions.  Since there is only one truth, the pursuit of truth will eventually lead the seeker to the source of truth, who is God.  Dying patients should be reminded they can and should keep seeking.  It is not wrong to keep asking, “why?”  “Why do I have to die now, just before my first grandchild is to be born?”  “God, why didn’t you give me a chance to finish the work You gave me to do?” etc.

Meaningless Suffering      Although life may become extremely painful and burdensome, the most awful torment is meaningless suffering.  Dr. Poltawlska,(21)used as a human guinea pig in the terrible so-called medical experiments of Ravensbruck, had to believe that some day, somebody would benefit from what the experimenters were doing to her mind and body.  Old people likewise would like to think that both themselves and someone else could learn from their painful experience.  Family and physicians can encourage dying people to describe precisely what they are feeling and how they do or do not benefit from some procedure. This is possible, as you help people describe precisely what they are feeling and how they interpret it.

Vicarious Suffering               The dying person’s caregivers, to a greater or lesser degree depending on the sensitivity of each person, will experience considerable suffering from empathizing, vicariously. That is what most frequently repels people from getting close to the dying. That is what stops them from looking in the eyes of those who are intensely ill at ease. This is what impels the doctors to be “objective”.  All too easily physicians are able to carefully examine, review the results of tests then prescribe medicines which they hope will work while they play golf, rather than spend time sitting beside their patient which is what many generations of doctors did because there was little else they could do.   Because of vicarious suffering and turmoil, those who are giving care need opportunity to speak with each other, cry on each other’s shoulders and let themselves express that pain.

Demands of the Dying Teach Their Family to Love        The expressed and the silent demanding of dying people teach others to reach beyond their present capacity to meet the needs that they never thought they could. In this way, dependency of the elders is a gift to those who wish to become more loving and mature.  Instead of fearing they will become dependent, elders should acknowledge to themselves and others that they are performing a vital role.  In this respect, government and professional care interposed between the dying and their family prevents the family from gaining and maturing.

#8. TRUTH, BEAUTIFUL AND TERRIFYING

Near Death Experience        Having listened to my patients describe their near death experience, it became increasingly clear that when a person dies they don’t become unconscious; they wake up to a reality they have never known before. They don’t go to sleep or oblivion, they become part of a much wider world. This wake-up to previously never contemplated reality makes an indelible impact on their lives from that point onwards. It governs much of what they think and do.  Dying people need to be reminded that they are about to wake up to a reality that could be glorious or despairing depending on whether or not they have made peace with their Maker.

Dread or Glad          In the process of dying, people may have one or more near death experiences [NDEs].  They should be encouraged to talk about these in detail.  If those were bad experiences, they will anticipate death with great dread that will encourage them to request sedating doses of medication for their pain. They hopefully think it will make them so stupefied that they will pass into unconsciousness and not experience life after death. On the other hand, many who anticipate a glad rather than a rude awakening, should be encouraged to talk about their hoped for awakening and happy reunion with family who have “passed on before”  Those at the bedside of a dying person should say,  “Now what do you see? Please tell me what it’s like.”

Attraction or Repulsion         Depending on one’s core values, a person is either attracted or repelled by truth and by those who speak the truth. As people age, they generally become better able to discern falseness and distinguish pride from truth in solicitous speakers. This is why the elderly are also generally more eager to listen to the truth about God. That truth of course, needs to be spoken well before they become deranged or unconscious.  It needs to be spoken in love and with urgency but without coecion.

Danger of Consensus        Although many government and medical programs now tout and boast ‘consensus’, (  ),consensus is a pathetic substitute for truth. Truth more frequently is discovered by mavericks who are courageous enough not to be molded by the mindset of most of their friends and colleagues. Too much consensus is forced agreement.  Too often, the group of experts are pushed into agreeing because of time constraints, fatigue, the urgency of coming up with a document and government agendas or simply because no one can think of a better solution. Too often the words ‘a consensus document’ cloak the real agenda, which is hidden in the small print. (23)[ney analysis.  The truth is seldom recognized when it is first brought to light.  The truth is usually discomforting.  And though the truth can make any man or woman free, too often, too many cannot bear the painful pursuit of truth or the even more difficult implications of truth for their lives.

I encountered this as an NGO at the UN meeting in Beijing on women.  At the end of a long auditorium, the chair person, whose English I could only partly understand, made a pronouncement something like this.  “I believe we have now had sufficient time to discuss this, does anyone wish to add something”.  Her poor English was being translated into the 5 official languages for the delegates, many of whom could not understand any of those languages even if the translations were good, which by reason of the poor English was doubtful.   I sat near some ladies from one of the African countries who, either could not comprehend what it was all about, didn’t care or were so fed up with the constant manipulation of a few countries to whom it really did matter or possibly other reasons, chatted about shopping.  The chairperson continued, “Are we agreed”.  I count 5.  No vote.  No record of those who disagreed or abstained.  “We have consensus” and down came the gavel.  With some variations, that is how over 300 resolutions were adopted and then conveyed to member nations where most of them were put into law without further debate or vote by that country’s representatives.

Another brazen example of manipulation and pseudo agreement is the recently promulgated “Clinical Practice Guidelines for Quality Palliative Care.”  “These guidelines were developed through consensus of care organizations…funded by The National Consensus Project For Quality Palliative Care.” [For comment, see appendix A]

Post-Mortem Catecholamines        Even the best of palliative care with appropriate medication, etc. doesn’t seem to work in the final stages of death.  It appears that when analyzed immediately after death, cadavers have high levels of catecholamines regardless of the amount and quality of medication. This would normally mean some terrifying or exhilarating experience occurs at the point of death that is so powerful, medication has no appreciable effect. Anticipating this, doctors may want to employ even higher levels of medication.  That certainly would not be in the interest of humans who must make choices even at the moment they are crossing over to the other side.

Christian physicians must be very careful not to deprive a dying person of their last chance to come to know the Lord, by stupefying their minds with high doses of narcotic.

Junk Science                 Much measurement on the experience of dying people is done with 3, or 5 and occasionally 7 point rating scales.  These look and sound scientific until you realized that they artificially dichotomize reality, which is universally spread on a continuum. What they should use are analogue scales that are more accurate and easier to fill in although they are slightly more difficult for analyzing the data. (23) ney Attempts to use rating scales to determine how people are dealing with their spiritual struggle is quite meaningless and probably should be avoided.

The Enslaved Mind                Jesus’ encounter with a man who had a hundred or more demons, clearly illustrates that every man, even the most deranged, still has the capacity to recognize Christ and the ability to move mind or body in His direction. No criminal is so perverted, no demagogue or dictator so dehumanized, no mentally ill person so confused that they cannot recognize the truth of Christ’s simple gospel.  They will always have some capacity to choose, although after a life of pride disregarding truth it has become increasing difficult to go any other than their own way.  Those who minister to the spiritual needs of dying people must remind themselves that this “reprobate” with a long history of taking advantage of others, may still hear and respond to the quiet voice of Jesus.  They will need to first address that person’s need to be forgiven by all those they have hurt and to forgive, preferably through Letters of Reconciliation, those who hurt them.

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#9. DEHUMANIZATION

To Recruit and Enslave Rather than Kill             Regardless of how one considers the force opposite to good, it appears that force is less bent on destroying humanity than it is determined to recruit and enslave humans. The purpose for that is not entirely clear, but logically it would seem to gain some greater power in the battle with God’s force for the good of humankind.  The evil one’s first ploy is to confuse people by distorting truth then to dehumanize them.  Once people are less than they were designed to become they are far more easily influenced, recruited and enslaved.  Too often those who are aged and dying, rather than grieve the loss of the Person I Should Have Become will become cynical and despairing.  They think, “So it never happened, so what’s the use of anything.  I’ll just give up.”  If and when they grieve the loss of all they should have and could have been, they can see the inherent dignity of their authentic but warped, wounded, weary person they are.

Species Specific Instinctual Restraint to Aggression (SSIRA)            It appears that all higher order animals have an instinctual restraint that keeps them from destroying and possibly eating their own.  Obviously this is a necessary instinct otherwise the species would destroy itself.  The wolf, denned up in the later stages of her pregnancy, becomes extremely hungry. When her pups are born, she has a strong desire to eat these warm, succulent, tender morsels.  However the wolf’s species specific instinctual restraint to aggression stops her.  If on any occasion she would destroy her young, it’s not hard to imagine the whole pack avoiding her and she would not be bred. In humans, it means that any time they overcome that restraining instinct to destroy a fellow human, the instinct is damaged, lessened or nullified. Since the instinct is most strongly expressed in preventing humans from destroying their own young, this means that should they kill a child the instinct is most definitely damaged.

Worldwide, there are approximately 100 – 150 million abortions per annum. Approximately 50% of all women have had an abortion by the age of 45. This means that 50% of all men have contributed either actively or passively to the death of their own young. In such a large percentage of the population, in such a profound way the instinct that stops them from hurting their young is weakened or nullified. For that reason, it is not surprising that infanticide increases as the rates of abortion do.

Once the instinctual restraint to aggression has been damaged, it appears very hard to repair. In spite of the fact that parents try so hard not to hurt their young, they cannot count on an instinct to quell their anger; they must consciously stop themselves.  Sadly, too often they think, “I better get a hold of myself before I hurt someone,” too late.  In many cases, they may be able to restrain their physical aggression, but hurt their young by verbally abusing them.  Recognizing they might hurt their young, and how that would interfere with a good outcome from their parenting, adults who have had abortions are more inclined to put their children in daycare. And the more the research done the more day cares are found to damage children. [Ney, findings on day care for a Royal Commission] A recent study found that day care of small children leaves them more aggressive and less obedient. [   ]Marie]  In this way the government may inadvertently or consciously encourage abortion because it means more small children and infants come under their direct influence and control. Thus the government thru government approved day cares and staff, becomes more the giving parent.  Then governments can exert mass control with increasingly less effort as people become progressively more dependent upon them.

Wantedness Determines Who Lives and Who Dies “The first right of every child is to be wanted.” So penned Margaret Sanger, the birth parent of the International Planned Parenthood Federation, [IPPF].   She turned out to be an eugenicist, who admired Hitler and wanted to exterminate the black people in the United States. She was also a witch. However, the phrase sounds so pleasant to the ear, very few people question what it really means. It means that unless you are wanted, you have no right to be. For that reason, wantedness has becomes the principal criteria by which people live or die. The wanted are chosen to live, the unwanted are chosen to die. So it was in Auschwitz.  So now it is almost universally true around the world. It is a most pernicious philosophy.

It is the determinant of death for: preborn children, handicapped people, people of the wrong sex, size or intelligence. It increasingly determines who lives and dies among the elderly. There is plenty of evidence that where euthanasia has been approved, there are many who die at the hands of physicians who are not given a choice, but were chosen to die by the physician or members of the family who wanted them sent lovingly on their way.  Why? Because they had “poor quality of life”, were costing the family too much in care, or time, or effort, or whose bed the care facility needs for some other urgent dying person. The trend of the family or ethics committee or government agent who impute into the wasting form of someone’s father or mother, a desire to die, is sheer arrogance. They cannot assess whether or not that muted person truly wants to be dead.  And since they: 1) are sure to be ambivalent 2) have not been given the option of negotiating the “Required Amount of Improvement” 3) probably have not had a chance to reconcile with their Maker or their family, 4) have a basic biological desire is to live, it would be far wiser to err on the side of life.  Even if the agent or surrogate could assess that choice, they could hardly know that it sits on a knife edge and can be easily swayed one way or another, by forces and factors which they cannot perceive.

Post Abortion Survivors Lives Hang in a Sensitive Balance           Much scientific data and thousands of patients have shown me that abortion survivors, having been wanted and chosen to live while their siblings were cruelly terminated through abortion, have deeply conflicted sufferings.  They suffer acutely with survivor symptoms of: existential guilt, distrust of parents and caregivers, a sense of impending doom, thought and language suppression because of pseudo-secrets, difficulty bonding to partners and children, a fear of conceiving and giving birth, ontological guilt, dancing with danger and flirting with death, fascination for the power of the occult, and a callous disregard for the essential value of themselves and of other people, particularly those who appear less wanted. This now affects 40 - 50% of people born in North America, up to 90% of people born in the Ukraine, and almost 100% of those born in China. It is becoming increasingly rare that a child is unconditionally welcomed into their family.  Regardless of who they are, when they arrive, and what is material substance, they should become an essential member of a family that never even considered an abortion.  It is now a rare blessing even in Christian families but it should be a given.

These abortion survivors are increasingly the older middle-aged, who are faced with decisions regarding in which place and for how long their elderly infirm parents should be cared. They remember how these their elders considered them with callous regard and chose who should live and who should die.  They are regarding their parents with the same dehumanized callousness. They become less interested in caring for them, particularly at home and more inclined to unhesitatingly decide whether their care should be terminated or not.  Meanwhile, the elders fear their family and dread the decision that may end their lives when they are struggling to hang on to whatever life and dignity they have.

Choice to Die      Modern humans believe that self-determination is of great value. When they approach dying, that socially approved consideration is added to the fear that at some point their family, without consulting them, might decide that their treatment should stop and strongly imply or suggest that it is time to choose to end their own life.  So they choose: Physician Assisted Death [PAD] or Doctor Assisted Suicide  [DAS] or Physician Assisted Suicide [PAS] or Doctor Administered Euthanasia [PAE] or Physician Eased Euthanasia [PEE].  At least then they know when it will happen, and by what method.  People hate to wait, especially on death row.  Most prefer to “get it over with”.  Therefore there is an increasing desire for someone to push them over the edge rather than dangle until someone in the family cuts the rope. Older people would rather decide their fate rather than have it decided for them especially those who have difficulty trusting their family.

Mindless Sex Results in Serial Polygamy       The Creator gave the greatest human experience of both pleasure and joy to accompany heterosexual intercourse, because he was determine the species should survive. That drive to procreate supersedes every other human drive or desire, even when humans are really struggling to just make it.  Before the introduction of contraceptives, humans had children whether they wanted them or not and learned to welcome whoever came whenever they arrived.  And the species thrived.  With the introduction of contraceptives, it became possible to have the pleasure of sex without the responsibility but still God’s laws of Pair Bonding held. Although sex became increasingly meaningless and intimacy illusionary, whoever they had sex with became a mate, made so by God who will not set aside his laws because they are inconvenient.  Sadly the more pair bonds there are, the more superficial is each one.  Yet people on reflection can sense that bond.  When they die, they know each bond will be undone and that each bonded partner will suffer a complicated grief.  Those dying feel guilty from being one of many partners and yet because they are bonded they will grieve.  They should say a good goodbye to all their partners but that act will probably uncover some secrets which they have not been able to share for many years.  More and more, humans were having oral and anal sex which depersonalized the object of their affection and dehumanized themselves.   So people who are dying, especially those dying of AIDS have a double difficulty.  They must say good bye to the many they are bonded to but bonded in a very unusual way.

Anal Sex Is Unhealthy        For many years before it was made public, researchers and clinicians knew that the spread of AIDS had little to do with homosexuality per se but was the result of anal sex. Because there is an increasing percentage of the “heterosexual” population that engage in anal sex, heterosexual AIDS is also rapidly increasing. Humans alone among all God’s creatures have face-to-face sex. This was to ensure the main component of sexual intercourse was interpersonal intercourse.  During and after anal intercourse, the immuno-suppressing factors found in semen neutralize the local immune response in the anus so that infections of all types are more likely.  The fragile single cell columnar epithelium is easily ruptured.  The bleeding that results is precisely the right environment for the HIV-AIDS virus carried in the semen. It was thought and is still taught that people could engage in oral and anal intercourse with impunity. This is certainly not the case.  The best protection from a good condom properly used is 87%. [    ]  That is now known as “safer sex”.  Not long ago it was promoted as “safe sex”.  Yet ask yourself, if you had a free ticket to a most wonderful resort, would you fly there if you knew the plane was going to crash and burn 13% of the time.  In practice condoms are about a 70% barrier to HIV.  Now all those who are painfully dying of AIDS are furious at being so badly misled, but they know it was their mistake.  What will they do with all that anger and who will help them through the years of difficult dying?  Certainly the usual euphemisms do not help.  The truth will set free all those who are courageous enough to face it and deal with all the implications.

Pair Bonding                 Humans designed to be monogamous bond with everyone with whom they have sex. The 8 factors that determine the bonding occur willy-nilly, whether on soft pillowed beds or on rough park benches, with or without consent. Most humans are pair bonded to between 2 and 52 other people. Intimacy is greatly damaged, and the marriage that God intended is nullified.  The clear evidence is that the more the premarital partners, the more the extramarital affairs. The bond to a mate, partner, spouse, wife, husband is greatly diluted, therefore there is less concern and care expressed by that partner as one of them ages and dies.  As they lived, so they will die, wondering if their partner will remain faithful to the end or even now is planning with whom to spend the inheritance.   Rather than live to witness the spouse wandering away, many would sooner find a handy, not too expensive, specialist in euthanasia.

Neglect Is Worse Than Abuse    The impact of neglect on a child is far more damaging than that of abuse. [   ]  When a child is neglected they are not given the building blocks to become the person God designed them to be.  Because time and development are only unidirectional, what they miss is gone from their earthly life, and there is no way to recapture it and no way to heal the damage to self esteem, expectations, hope and resilience.  Children who are neglected struggle to extract or scrounge from their world, what little they can in their effort to become the Person They Should Be. Their determination to build themselves means that they cannot be stopped from eating garbage from the street, literally or figuratively. They are not able to protect themselves. They are the least able to protest their dehumanization. They become subservient and have difficulty making decisions. These neglected people, as the elderly and dying, too readily agree to the government and medical authorities that determine their care. They are too frightened to protest, lest the very little they are given be withdrawn. They don’t have anybody who will protest on their behalf, when it is decided their time is up. Because abortion means so many more of these people are PASS, more and more daycares are needed where they are neglected at earlier and earlier ages.  Because the children are cared for by government approved people, they must believe their caretakers can be trusted.  The government can easily take advantage of this vulnerability and persuade them it is too everyone’s advantage for them to not use up medical resources when dying but quietly accept euthanasia which the generous Dept. of Health offers them at cut rates.

Mutual Distrust Between Sexes    The courts have decided men have no rights in determining whether or not their preborn child should experience a premature and painful death by abortion in his/her mother’s womb.  Although no court has stated women have a right to abortion, in practice the medical profession will provide abortion based not on what is good for her but because she, for the most superficial reasons, chooses this child must die.  Men abdicate or coerce their partners into having an abortion because there is no way in which he will allow himself to bond to the preborn child, knowing she will or possibly will abort the child without his awareness or consent. Women are pressured into having an abortion when threatened with abandonment by their spouses. The women that are most susceptible are those who were neglected as children, and could not face another abandonment, particularly if they were abandoned by their fathers. Thus there is growing distrust, one sex of the other, often resulting in bashing the opposite sex. When people approach death, they are often alienated from family and spouse. In their loneliness, they wish to sink into oblivion and hope death will erase all their bad memories. Yet there is an intuitive awareness that death is not the end of them, and that they may have to face a rude awakening.

Fear of Death and Dying  The evil one has always used fear to coerce people into serving him. The fear of death is one of his best weapons to recruit and enslave humans. Suddenly he reinforces that fear in documentaries on the big screen of what can happen in some homes for the aged.  As in the extermination camps, when the inmates felt so powerless, they identified with the aggressor.  The result is that some incarcerated individuals became aggressive to their fellows and appeared to agree with the terror.  In homes for the aged, staff often know little about how to handle obstreperous old people and so persistently request the attending physician to provide more medication.  Older people with failing faculties, have enough difficulty thinking clearly without having their minds clouded with chemicals.  Far too many are robbed of the opportunity of completing all their pre-death tasks.

Respect for the Body        In very nearly all cultures there has always been a determination to bury the body if the dead, respectfully. This taboo against leaving a human body to rot above ground has prevented cannibalism and necrophilia. The human body is now desecrated in more scientific ways.  It is cannibalized for replacement organs, experiments and student dissection.  The bodies of the preborn are harvested for stem cells, the benefit to anyone is unsupported by objective evidence.  But still legislators believe they can benefit at the expense of the most helpless.  They will learn soon enough, that no one can take advantage of the weak and poor without feeling the ire of their Protector.  Because the selfishness is so rampant and almost everyone has the thought, I too could gain from this someday, the hitherto solid taboo regarding the body is vanishing and the body itself is losing respect. The fear of polluting the ground is aiding the emphasis on incineration thereby polluting the air with smoke and dust. In any case, the aged fear what will happen to their body and though reassured that their wishes will be respected, they understandably distrust those into whose care they are involuntarily being thrust.  The socially motivated appear to desire to donate their body to science or for body parts, but they also fear, Will they wait until I am really dead or turn off the machines, so they can have a fresh organ of mine. Little do they realize that in agreeing to donating, they encourage people to shut off the machines as soon as possible.  It used to be there must be clear indications of brain death, now it is heart cessation. That may occur before they have any desire to die. Those dying need to be assured by some one they can trust that their body will be buried and their wishes of where acknowledged and acted upon. Much clinical evidence shows for the benefit of those who are grieving it is good to have a grave and a marker where they can return whenever necessary to commune with God, to weep and to mourn.

Talking to the Spirits of the Dead                      Communicating in any way with the spirits of the dead is expressly forbidden in scripture.  It is so for our protection.  Evil spirits are adept at mimicking dead relatives and friends. King Saul thought he was contacting his old and revered friend Samuel but it was the medium who saw an old man coming out of the ground.  I cannot imagine a witch with power enough to command the appearance of one of God’s most wonderfully used ministers.  Besides, when Samuel died he didn’t stay old and he most certainly not was in the ground.[  ]  Many people have been led astray.  They think they are contacting grandma when it is a spirit imitating her with whom they are having an intimate conversation.

#10. DANGERS IN A WHITE COAT

Ancient Ethics        There have been well established ethics for caregivers for many centuries, beginning with the Greeks. Hippocrates and his colleagues, 300 years before Christ, recognized the difficulty in gaining patient confidence for themselves and their profession, if the patient was not absolutely sure of the physician’s intention. With this in mind, they swore by Zeus and the whole pantheon never to poison or hasten death, never to cause an abortion, never to have sex with their patients and always to honour their mentors. Over many centuries, the ethic was gradually accepted and gained trust for physicians. The medical profession is now rapidly undermining that confidence by doing precisely all those things that were once forbidden: aborting women, aiding death, having sex with patients and not honoring their mentors, particularly the wise individuals who went against the common view of ethics and consensus. As the confidence in the medical profession was eroded, so the ethics became more complicated, and in turn the confidence declined. At one time, patients could count on the fact that their doctor had sworn the Hippocratic Oath.  Every medical school I know no longer requires the graduating class to swear by that oath.  Now there are very complicated statements of ethics, the fine print of which allow many variations in practice.  Now in order to gain the patient’s cooperation for an examination or procedure, the doctor relies more upon popularity than upon credibility. To be popular, he has to agree with popular opinion. In this respect, doctors are prone to adopt what they believe is public feeling toward abortion and to agree with it.

Pseudo-science Replaces Ethics                      Physicians have become increasingly arrogant, asserting their dependence upon science when it is truly pseudo-science. Because there is only one truth, good ethics and science should agree and they do if it is good science.  If not, and many physicians suspect the science they rely on isn’t that good, physicians will become part of the charade orchestrated by the multi-billion dollar pharmaceutical industries.  There is a tacit agreement that if the physician accepts the lovely free lunches provided by the drug company, he will not enquire too closely about the studies that underlie the claims for a drug’s efficacy. 

A primary example of this is reliance upon the double-blind studies to demonstrate the benefit of some new medication. In fact, double blindedness is difficult if not impossible to achieve. [   Ney]  Those people who are subjects in the drug trial, having been ethically informed they are part of the drug study and could be on active medication or placebo begin trying to guess which it is for them.  They have lots of clues, namely the effects and the side effects of a powerful chemical on their physiology and so they guess.  It isn’t that hard to believe they are taking some active ingredient when their vision becomes blurred and their mouth dry.  Yet many people cannot accept the fact a doctor would put them on a sugar pill when they are so sick so they go on believing they are being treated when in fact they are being duped with a inert substance or glucose.  This belief they are receiving good medicine based on trust of the medical profession, can give them significant improvement in their symptoms.  We found that depending on the medication, the accuracy of subjects guessing varies from 60% to 91%. When they are convinced that they are on the active medication, there is a placebo effect on top of whatever benefit the drug may have. What is truly amazing is how well a placebo works.  In a recent presentation of the benefit of inhalers for COPD, the placebo was more effective than some very expensive drugs.

It is claimed that by immunizing people for Human Papiloma Virus, [HPV], the incidence of cervical cancer is reduced by 70%.  But injections of water as a placebo in the treatment trial, is not far behind. How could a placebo possibly immunize a person against a virus?  Does faith in the medical profession have such a profound effect?  If so maybe faith in God would be even better.  Science has yet to determine this and seems to have little interest in doing so.  This is a great shame because placebo in so many studies is almost as good as the drug being studied, without short or long term side effects and much less expensive. 

It has been shown that drug studies sponsored by drug companies, on average  show 78% effectiveness, the same drug study by an independent researcher show an average of 50% effectiveness.  When that same drug is studied by a competing firm, it is only 23% effective [   ]. The growing influence of pharmaceutical companies has a great impact on physicians who are sometimes more likely to choose the best advertised rather than the most effective medications for dying patients.  In addition, patients, trying to be cooperative lest their physician abandon them, too readily consent to being a subject in experiments when they are not aware of all the implications and don’t have staff or family to explain.

Medical Sophistry    Doctors have been persuaded by their colleagues, medical associations and colleges that statements of ethics should permit wide variations in procedures. These statements use sophistry, pretending there is an essential difference between passive and active euthanasia. That distinction is not recognized in law. The person who rolls a boulder down on a passing person to crush them to death is no different from the person who knowingly stops holding the boulder back as the person passes and thus allows them to be crushed. They are both murder. Excessive pain medication, stopping treatment and withholding the basic ingredients of life, food, water and air are no different than lethal injections.  They are all deliberate acts of killing.  They all infringe on a person’s Species Specific Instinctual Restraint Against Aggression and will result in guilt. The persons who are providing passive euthanasia are subjecting their patients to death by starvation or dehydration, will probably feel more guilt because this infringes on a deeply imbedded more about this kind of killing.  Family members who agree or assist will feel greater guilt and have a more persistent Guilt Complicated Grief [GCG]. 

It seems tried and true ethics are discarded for the convenience of allowing greater latitude for euthanasia and eugenics. These ethics have in common the royal law of love, eloquently stated by Jesus Christ. “Do good to your neighbours as you would have them do to you.” That law insists that needs are met regardless of how you feel about the other person. It has nothing to do with affection. It has to do with a careful scientific determination of what is needed and then extending oneself to meet those needs.

The Universal Ethic of Mutual Benefit (UEMB) states you cannot benefit at the expense of your neighbour, no matter how small, defenceless, aged, scarred or debilitated they may be. If it is not good for your neighbour, it cannot good for you. If it is not good for a black person, it cannot be good for a white person. If it is not good for a man, it cannot be good for a woman. If it is not good for a preborn baby, it will not be beneficial for his/her mother or father. If whatever a physician plans to do is not therapeutic in the long run for any patient, regardless of any ethic he adheres to, it will not be good for him or her.  Once the physician is perverted by transgressing the UEMB and thereby damages their SSIRA, they should not be trusted.  The more frequently a physician kills, the easier, it is.  And yet isn’t it amazing that because of the wondrous legacy of the Hippocratic Oath, some women will trust an Obstetrician who kills helpless babies by abortion, to deliver their babies.  Similarly, some elders will put their care in the hands of a physician who has just administered “euthanasia” to the patient in the bed beside them.  But this hold-over effect will not last indefinitely.  Even now those physicians are building a reputation and image that makes patients avoid them or demand more tests and second opinions.

The application in medicine of the basic principles of “love your neighbor as yourself”, insists that before any investigation, evaluation or treatment every physician must be sure there is:

1)     Recommendation.  With informed consent, the patient is carefully, empathetically evaluated, then told precisely what are the doctor’s intentions, stated in an understandable recommendation for further investigation or treatment.

2)     Necessity: There must be good reason to perform any medical procedure that has been determined by long term scientific studies. It must be shown as necessary for that group of patients in which is this particular patient and after examination, is necessary for this patient.  Sadly, most drug studies are no longer than a few years. With rare exceptions, the effects on people over a lifetime are not measured. Yet more frequently, drugs are prescribed for the rest of a person’s life such as blood lipid or blood pressure lowering drugs which ostensibly prolong an effective, alert life. Before an abortion is performed, there must be very good reason to show that abortion is necessary. Now there are virtually no medical, surgical, psychiatric or social indications for abortion.  With the availability of effective treatment for eclampsia, there are virtually no medical indications for abortion. Every psychiatric illness is a contraindication because they are worsened by abortion. There are no well established social indications although it was once contended that abortion should be available to prevent the occurrence of unwanted and therefore abused children. If there is no clear indication of a group of patients with a particular condition or for the individual they are considering, the ancient ethic “Primum non nocere” (First do no harm), must apply.

3)     Benefit. Unless there is proven, substantial long term benefit, the application of any invasive procedure is considered as assault, and would be punished accordingly. It is not good enough justification to only relieve pain or anxiety. Whatever procedure is used must be able to demonstrate the person is alive, alert and healthier for a longer period of time then they would be with no treatment.  The burden of proof is upon those who recommend or perform the treatment to show beyond reasonable doubt to show that what they offer is beneficial.

4)     Alternatives. The patient must be offered simpler, non-invasive alternatives to the recommended treatment. These have to be clearly enunciated and tried for a sufficient period of time to determine whether they will work.

5)     Informed consent. Every patient must be made aware of the benefits, the adverse effects, the outcomes and the alternatives in clear, understandable language. They must be given an opportunity to discuss these as fully as they need to and then be given an opportunity to think about them. With respect to abortion, this must include seeing the ultrasound of their preborn baby. For the aged, this must mean a true friend or family member sits discusses with them the recommendations and all the ramifications of the proposed treatment.

6)     Cost. The patient must be made aware of the cost, not only money but personal costs of time and convenience, etc. If they choose a treatment they cannot afford, the family and some church, social or government agency should be provide the funding.

7)      Wait and See.  Whenever there is uncertainty or ambiguity, the family and physician should wait and see what happens next before acting.  During this time their church, neighbours, friends and family should pray intently.

Always Treat                       A physician’s only intent must always be to treat to the limit of his/her ability and resources. If their ability is insufficient, he should seek more training.  If her resources are limited, she should determinedly seek more tools and medical supplies on behalf of her patients.  Physicians must never contribute to the dying or death of any patient. According to the Law of Reciprocal Effect, what they have done to their patient has been done to them.  They will have lessened or broken their species-specific instinctual restraint to aggression (SSIRA). They then will fear themselves, and others will fear them because they are more likely to kill again.  The helplessness of their patient will more probably evoke aggression rather than self-sacrificing nurture. Whenever a physician attempts to gain benefit at the expense of another person, they lose their ability to empathize. As such, they become less accurate observers and poorer diagnosticians. The Christian physician who lives and works by the Law of Love and the Universal Ethic of Mutual Benefit, will always and only treat and will always fight against the hospital administrators’ decision to turn off of the patient’s life support.  That same Christian physician, because he believes that every person is equal and must have equal access to medical treatment and having ensured that hospital will use the resources made available by stopping treatment of his patient, to more needy patients in developing countries, will not fight the hospital administrator too ferociously. The physician who always and only treats will be much better trusted by patients and thus his patients will be more cooperative to investigation and post operative exercise, etc.  Thus the physician who practices with Christian ethics soon becomes the one who is not only practicing better medicine but also saving patients and the government money.  

Display Ethics         Most patients can no longer assume their physician adheres to the Hippocratic Code. Therefore it is necessary for every physician to display in the waiting room of their office or clinic, a clear statement of their ethics. [ Ney] These should cover all the major issues; abortion, homosexuality, the UEMB, eugenics, euthanasia, poverty, etc.  Appendix A & B. The physicians will notice when these are clearly displayed, some patients will leave their office, and others will breath a great sigh of relief. Physicians must not be ashamed of their ethics but publicly proclaim them whenever they have the appropriate opportunity.  As they do so will accumulate patients who are more determined to become well.  They will be trusted more and therefore the placebo effect will work more effectively with their patients. Part of providing informed choice means the patient is aware of the doctor’s ethics.

Ambition Gets in the Way Physicians are altogether too human and subject to the human desire for money and power. This is expressed in terms of enlarging their practice and seeing too many patients in a day, or expanding their department with more funds for research with drug company grants etc. Palliative care has become the most widely promulgated, newly arising empire. This is built on the assumptions that there are proportionately more aged and dying who need specialized care.  It is now claimed, [   ] that these patients need the attention of a specialist. So a new specialty is born and the family doctor who knows the family of the elderly much better is eased off the scene.  And as that empire burgeons, so the responsibilities are taken away from the family. The families are too easily persuaded that they are inept and inadequate; only the specially trained professional knows what they are doing.  They purport to listen to the family but seldom have time to do so now they are asked to consult on so many patients.  While the caring family stands in the background waiting to be directed to do what they would have done quite naturally on their own. 

Distrust of Physicians          In ancient Greece, the physicians had a dual responsibility; to treat as best they could.  When they failed, they would acknowledged that the patient was being justly punished by the gods and therefore their duty was to send the person as painlessly as possible on their way across the River Styx. Only since Hippocrates and his colleagues put a stop to this dual intent, [  ] has the public developed a modicum of confidence in the medical profession. In the Soviet Union, the medical ethic was to both treat and preserve the individual and treat and preserve the state. This meant it was honorable to get rid of the dissidents who were deemed to be pathogens that should be isolated if not exterminated for the health of the state. These outspoken people often ended up in mental hospitals. Because of this practice and the rampant abortions, physicians in the Federation, do not hold the lofty esteem they have earned in Canada.  Yet even in this much blessed country of ours the current distrust of the medical profession is rapidly growing. It has risen because:

a)     Doctors losing their SSIRA because they performed or recommended abortion in healthy patients, euthanised the elderly and facilitated the death of the severely handicapped newborn;

b)     Patients are not clear about the doctors’ ethics and the doctors are not trying hard to make their positions well known. Upon graduation, they do not swear to a particular ethic, but adhere to the one that is most recently advocated by their medical colleagues.

c)      Doctors are becoming increasingly interested in having a good lifestyle, enjoying themselves with money and power. They are less likely to spend time at the bedside of a patient and more interested in prescribing from a distance.

d)      The colleges of physicians have become more interested in attempting to shore up public trust in the profession by savagely punishing erring physicians. The public sees the way the physicians are treated by their colleagues and conclude the profession must really be in dire straits.

e)      Physicians have become more dependent upon being popular with their patients to gain their cooperation because confidence in them is waning. Since popularity is dependent upon agreeing with current morality, doctors must appear to approve of radical feminists demands and “rights”.  Yet the public soon realizes that doctors cannot be trusted to see the way through whatever is the current morality to something more enduring.

f)       Doctors are too often involved in organ piracy, advocating for life sustaining machines to be turned off so that other patients more powerful or wealthy can benefit from the fresh organ.  Yet almost every physician knows of a patient who was comatose for 6 months or more and suddenly, spontaneously became conscious and cogent.

g)     Patients fear the doctors’ complicity with the medical administrators who demand that costs be cut. Instead of fighting the administration for more resources, the doctors too readily agree that beds and treatment resources must curtailed in the interests of economy or other more persuasive departments.

In these ways the doctors are undermining the confidence and credibility of their profession while blaming it on the lack of money, interference by other medical professionals and too few doctors.  They seem to forget that whenever they point a finger at others there were 3 pointing back at them.  The articles I have written criticizing my colleagues have never been published after repeated tries.  How I wish there were others who saw the rapid collapse of a once noble profession and were courageous enough to speak up.  We are witnessing what is so predictable. What you do to others is being done to you.  As doctors dehumanize their most vulnerable patients, the preborn, handicapped and elderly so they are dehumanized. Physicians were once so respected they were excused if they made a small mistake. They are now being taken to court for larger and larger sums for the most trivial error.  More frequently news reporters are taking pot shots at them and more often they are the butt of cynical jokes.  There is increasing tension between specialists and family physicians, more fawning for the largess of pharmaceutical firms and more working to rule by doctors who instead of seeing their career as a demanding public trust, see it as the best route to an expensive golf or yacht club.  

Ethics Committees      The ethics committee can ostensibly be more objective better informed and more experience in making life and death decisions are intruding in family matters while repeatedly saying they put the family’s preferences first.  In reality because they are more removed and have less empathy for the patient and family, their decisions are more likely to be callous.  These somber faced or cynically joking group think they are so smart there could be no one who would make as good a judgement call with such smooth wording.  And most often they have long meetings at public expense.  If these Christian ethical principles were followed, I believe there would be little need for ethics committees.

End Of Life Medication      Too frequently, physicians feel they are being ethical and empathetic by prescribing pain and anxiety killers as their patients struggle with some of life’s most important issues.  They seem not to care that these drugs cloud the mind and greatly interfere with the individual’s ability to make clear choices. Lacking the clear thinking necessary for the important tasks prior to death, among many other works, patients are robbed of an opportunity to reconcile with their Maker, neighbours and friends. Too frequently, grief interfering antidepressants are prescribed for the relatives. Too often the elderly are prescribed antihypertensives, which can depress them and slow the resolution of important issues that once cleared would enable the patient to relax.  Too often they are prescribed REM suppressing hypnotics which result in break through nightmares whose terror the elderly wish to avoid with even more medication rather than help to understand the meaning of the dream, the interpretation of which can greatly aid in the dying patients understanding of themselves and their deeper dilemmas.  People with Guilt Complicated Grief are more likely to become depressed because they cannot grieve because of medication. Thus prescribing the antidepressant provides a justification for continuing its prescription.

Kept Alive for What Purpose?     Many people advocate a person should have a dignified, painless death because there is no point to their increasing suffering.  Yet a person’s spirit can always keep growing as long as their spirit within their body.  As a person dies, they can gradually separate from their body and live more in their mind and spirit. When that separation is almost complete, it is so much easier to dismiss their spirit and commit themselves into the mighty hand of God.  So many have written how in times of suffering, their mind and spirit matured.  If dying is a difficult process, it must be something the Lord of mercy thinks is very important.  Woe betide the physician or family who truncate a process, the maker of everyone has ordained.

This book proposes that death occurs when the spirit leaves the body. Up until that point there is a purpose to continue living, both in enhancing the life of the spirit and in struggling with the difficult tasks involved in parting from loved ones.

Inadvertently Reinforcing Maladaptive Behaviour        The medical profession must attend to expressions of pain, anxiety and depression. However in doing so, they are providing attention at the time people are most complaining. Thus they inadvertently reinforce dependent, complaining and sick behaviour. The medical profession is caught on the horns of a difficult dilemma.  They must respond to pathetic complaint because most of it is legitimate and points to real illness.  However before they can decide the moaning is for attention, they must carefully listen and thereby increase the frequency and the loudness of the complaint. Eventually, the patient becomes so dependent and vociferously objecting to discomfort that often the doctor cannot ameliorate because the patient has something incurable, the doctor prescribes just to stop the noise or to give the staff a break.  Doctors tend to avoid these patients whose persistent distress they have accidentally created.  The staff must deal with Mrs. Jones who is agitated and screaming and so accost the physician with, “we must do something she is upsetting the whole ward.”  So the doctor prescribes more stupefying drugs or avoids going to that facility as long as he can.  In both instances he feels bad.  If the family questions him about “Why does gramma look so doped when we always knew her as bright and perky”, he comes up with some medical rationalization which convinces no one, least of all himself. 

Note:

The physician imputes quality of life depending on how they view life. When their hopes and dreams are frustrated, then they become depressed. In dealing with older people, they impute low quality of life and are more likely to recommend euthanasia.

#9 RE-ENACTING TRAGEDY

Perpetrator, Victim and Observer          There may be exceptions to the rule, however in my experience and from data I have collected, [   ] it appears every tragedy is comprised of a perpetrator, victim and observer, [PVO]. These individuals or groups all contribute to personal or international tragedy. The most important contribution is probably that of the observer. The observers are relatively uninvolved and therefore can more objectively view the tragedy occurring.  Sadly, if accosted and asked why they did not use their objectivity or influence to stop the tragedy, the observer will say, “We didn’t see, we didn’t hear, and there is nothing we could have done about it.” Whether the tragedies are individual, family, national or international, these three groups play out a predictable tragic end. With time, these 3 positions of the triangle will rotate. Victims too often become the perpetrators, observers become victims or perpetrators depending upon the time and circumstances. There are no innocent bystanders. Those who will most likely disclaim any participation are probably the more important observers in matters of life and death. All people are contributing toward the enhancement of life or the progression toward death.  This is particularly true for the tragedies of abortion and euthanasia.

Transgenerational Transmission of Tragedy      Certain tragedies are more likely to be transmitted from one generation to the next than others, especially those whose tragic impact is not so observable.  We have found that verbal abuse is more likely than physical or sexual abuse to be transmitted from one generation to the next. It appears that even when people tell themselves they will not do to their children as was done to them, they cannot stop themselves from saying, “Stupid”, etc. when they become annoyed at their children. Neglect is the most likely aspect of childhood mistreatment to be transmitted from one generation to the next.  It seems it is very hard to be a better parent, than one’s parents.  Those who are must make a conscious effort and deprive themselves, or so it seems of fun or promotion.  They deserve a medal or plague on their tombstone.  Our evidence show that abortions also run in the family.  It is possible that surviving children have abortions partly because they fear children and partly because they repeat their parents tragedy in an effort to understand what really happened.  It is possible suicides run in families for the same reason.  If that is true, there would be a significant correlation of Doctor Assisted Suicide between generations.

Fighting Entropy     Tragedy has always been seen as stupid, pointless, and without any benefit in the long run to anyone. I have proposed a different vie. The universe is fighting entropy. Humans as a microcosm must also fight the entropy that is destroying them. They must maintain homeostasis which allows for the most efficient use of the energy they consume.  This allows them to live a little longer. Interpersonal and intrapsychic conflict consumes energy uselessly. Thus, built into each human is a desire to resolve conflicts with others and more particularly to resolve the conflict that tears them apart. “Will I or won’t I, should I or should I not.” “I am angry, no I am afraid” makes the human inefficient and more likely to contract cancers and infections. Therefore the human are instinctually driven to resolve conflict. He attempts this by  constantly thinking until he drives himself mad, or constantly talking until he drives his friends crazy. But most particularly he attempts to resolve these enervating conflicts by re-enacting them. He carefully picks potential conflict partners then coaches them until there is an escalating series of encounters ending sometimes in tragedy, more often in shouts and blows. What is the point? He has once again an opportunity to observe what is happening and possibly learn from it. The re-enacting of conflict is an adaptive aspect of human experience in which he attempt to resolve the conflicts which were often forced upon him as a child. The most difficult of those conflicts is “Am I worthy to be loved, cared for, encouraged, educated?” these conflicts have become most acute now since the popular ethic, “Every child a wanted child” is making so many young people very unsure of their inherent value.

Biologically Based Guilt      To ensure the survival of our species, God designed humans to care for each other. There is a deep guilt felt whenever they trespass upon their neighbours or themselves. People feel guilty when they smoke, overeat, etc. Most feel wracked if they contribute to the death of a child, spouse or a grandparent. Whenever humans in fact or in fantasy contribute to the death of another human they feel a biologically based guilt. A man watching his wife die of cancer sees her beautiful body wasting away and her clear mind wracked with pain and confusion, at some point when he can no longer tolerate his vicarious suffering, secretly wish that she would die. When she does, he is torn by guilt, for in his fantasy he has contributed to her death. That guilt will now make his grief conflicted. Conflicted or pathological grief more likely ends in depression.

Ambivalence about Life      Since all people are ambivalent about almost everything most of the time, they consider life sometimes with hilarity and gratitude, sometimes with dread and despair, most often with some mixture of both. When it appears their suffering cannot end, their hopes are dashed, their anger insurmountable, their friends and their hopes all gone, they may consider killing themselves. Some do it suddenly and violently. Some do it in an attempt to show how angry they are, hoping those that remain behind will suffer guilt for the remainder of their lives. Some do it slowly, painfully, through alcohol, drug abuse, overeating, smoking, etc.  Some do it quietly and others violently.  They all leave friends and family, burdened with guilt or angry with shame.

As people age, their shaky ambivalence towards life increases as they realize their powers to control their ways is fleeing from them. It is all too easy to tilt that ambivalence steeply in the direction of desiring death, by suggestion, by guilt, by coercion. “My dear beloved parent, my wife and I have hardly enough, and we know that you cannot take your wealth with you. Is it not time for you to leave us and leave your wealth to those who could really appreciate better comfort?”

Reciprocal Effect      Its not difficult to understand that what you do to others will be done to you. It is apparent even to children that as you cannot break the law of gravity, you cannot undermine truth or circumvent the universal law of mutual benefit. What you do to others is being done to you at that same very moment. Most with a tender conscience will realized that when you dehumanize others through childhood mistreatment, abortion, insult, etc., that thing is happening to you. It may not be readily apparent. It may be delayed, but what you have done to others will in full measure come down on your own head. Thus as people begin more rapidly dying, they become fearful lest all the harm they have done to others will be reaped in long suffering before they descend into the grave.

The Need to Forgive and Be Forgiven As people age, painful memories come crowding in. These are memories of pain that they received, pain that they have put upon others and pain they have seen others they endure.  How should they get rid of these horrible memories that give them nightmares, or that make them demand more medication for sleep so their nightmares are repressed? After practicing psychotherapy with thousands of patients, I have concluded that only way to get rid of all those awful memories, is to forgive.

The whole painful process of reconciliation has to be engaged in by the people who created the difficulty: the perpetrators, victims and observers. It has to be done directly, not in one’s head. There is no forgiving in your heart. The scriptures make it clear you must forgive from your heart.  Until you do forgive you cannot be forgiven. Why? Because the very act for which you must forgive others is something you have contributed to.

REM Sleep     I have found the worst experience of prisoners is that now they are incarcerated, they cannot engage in those activities that distracted them from their painful thoughts. As they sleep in their cells, often for longer hours than they have known for years; morbid, terrifying, enticing but seldom gratifying thoughts and dreams crowd into their minds. So often I was asked as a consulting physician at the young offenders centre, to provide night time medication, not because the young person wasn’t sleeping, but because they could not avoid the terror of their dreams.

The scripture makes it clear that if somebody offends you, [   ]  they are to be confronted and rebuked.  If they confess, they are to be forgiven. No matter how many times the hurt occurs and the apology is given, they must be forgiven. The process is difficult; it must include every hurt for which there should be acknowledgement and a sincere apology for their contribution and a promise not to repeat the mistreatment.  There must be a record of each of the damages arising from the hurt, and for each damage, meaningful compensation. This is best accomplished by carefully written Letters Of Reconciliation. [LOR].  This pattern comes from the word of God, which is beyond a doubt primarily regarding God’s attempts to reconcile man to himself. For old people, the reconciliation process is most difficult, but most urgently necessary. They will need help of many kinds.

#12 URGENT BUSINESS

Time Collapses     With increasing age, the subjective appreciation of time changes. In youth, time crawls, in manhood, it marches, in age, it races rapidly to an inevitable conclusion. The business associated with dying is increasingly urgent. Because dying people are often handicapped in vision, hearing and writing, they need help. They must write to all those whom they have encountered in their lives, alerting them to the fact that they are dying, and inviting them to both reconcile and say goodbye.

Good Goodbyes     Too often humans have experienced many bad goodbyes that leave them with the feeling they should have said something or should get together again.  A good goodbye is comprised of:

1)     It is mutual; not one party saying ‘goodbye’ and the other ‘Please don’t leave me.’

2)     There are no unresolved issues that will affect the people when they are apart.

3)     They leave having blessed each other, possibly giving a little gift to symbolize that blessing.

Stopping Treatment       Neither the person themselves, nor their family, nor their physician should decide on the cessation of curative methods. That decision can only be made for economic reasons and only because the medical resources must be spread evenly among all people.  Even when the hospital administrator insists that active treatment cease, the family, the doctor, the friends and neighbours must resist. For only when they have done their very best to ensure that treatment will continue, that life will go on, can they have a grief that is untroubled by guilt.

If all people are essentially equal, then all medical resources must be equally shared. When a family demands or pays more for their loved one than any other needing person in their awareness, they will also feel the guilt of selfishness. If they insist that what would have been spent by the government on the terminal care of their mother or father be spent on some young person dying of malnutrition or malaria, then they can comfortably say goodbye to that parent and allow the disease or degenerative process take its course, all the while making sure the dying person has the opportunity to complete the Ten Ultimate Tasks.  The person who is dying can also love by sharing both the resources that would have been used on them on those requiring acute treatment.  Their family can, without shame or quilt, encourage them to reach out, if in no other way than a squeeze of the hand and a wan smile for those who come to see them off.

Clarity of Mind         To accomplish the highly important tasks associated with dying, every person needs as much clarity of mind as possible.  Medical attempts to dull every pain or promote sleep, usually also dull the person’s wit and wisdom.  Certain levels of pain: enhance awareness, keep the person alert, urge them to hurry up, makes them aware of the task that must be accomplished and helps them separate away from their body so they concentrate more on mental and spiritual realities.  What is the optimum can only be gauged by the patient in a negotiation with their attending physician along with family members who have witness their suffering before

Ten Urgent Tasks (TUT) 

1) Optimum pain control vs. Necessary Awareness.  The dying person, knowing what still needs to be done according to this or a similar list, must now negotiate the degree of improvement which will give them the prospect of a somewhat better day tomorrow without limiting their cognitive capacity.  This will give them hope and determination to get on with these tasks.  The negotiation itself will stimulate their thinking and show that they can still do it.

2) Reconciliation with God.  Everyone must reconcile with God from whom they have been alienated by their inadequacies, selfishness and rebellion.  It isn’t good enough to think, “I don’t know Who nor how.” God says we all without excuse. [Rom 1].  Throughout everyone’s life there have been indicators about which way they should turn. The magnificence of the universe enhanced by modern science, has made it very clear there was a Creator who they must know more about. [Ps 19]  God has always encouraged the smallest movement in His direction.  Had they put aside their fears and persisted, they would have come to know the Almighty as their God and Father through the redemptive sacrifice and advocacy of Messiah Jesus, God’s chosen one. It doesn’t take much time or long sermons, because surely by now the individual is ready to have their lifelong spiritual promptings explained.  Even those who are arrogantly stubborn to their end may respond to love and logic.

3) To Grieve the Loss of Themselves.  Surely one of the most painful losses in every person’s life and therefore the most difficult grief is for “the Person I Should Have Become” [PISHB].  The dying person needs help in recapturing as clearly as possible, an image of their Blueprint [Deeply Damaged].  Then with that in full view, they must discern and describe the discrepancy between the wonderful “castle” God designed them to be and the person they became.  The fall for all mankind was great but they will feel the fall for themselves was even greater.  They must acknowledge that despite sometimes great effort, they did not, could not and in this life will not become who God wanted them to be.  There is absolutely no point in revenge, or sour grapes and cynicism.  The only way is to grieve.  When they have accomplished that, they will be able to say good by to the PISHB and say hello to the person they are.  Yet with warts, wounds and weariness, the Person I Am [PIM] is authentic and quite likeable.   Now the dying person needs to be reminded that before the world was created, God had them in mind and therefore, their Blueprint is indestructible.  They may have missed a wonderful opportunity on earth to get a head start, but now they have all eternity to work on becoming the mature person of God.

4) Reconciliation with family, friends and enemies.  The only way to die in peace is to make sure there is no unnecessary interpersonal or intracranial turmoil.  God designed the mind to hold onto thousands of painful memories as long as there is some benefit to be gained from doing so.  Humans can learn from history, particularly their history but the most valuable lessons are to be learned from the most painful memories.  The most painful memories are the ones most deeply buried in the family archives or the recesses of the dying person’s mind.  Now they are bed ridden, those memories come flooding back in force and clarity as never before.  The only way to forgive is to forget.  God forgets when He forgives and our minds are made like His.  Because of their pride, many humans would prefer to fight to the death rather than forgive their enemies.  As they lie dying if not before, it is time to cast pride aside and reconcile with those who hurt them and those they hurt, [Ney].  It is the hardest thing they will ever do.  It was the hardest thing God ever did.  To reconcile man to Himself cost Him the life of His only Son.  It is the most difficult and most beneficial activity of any human.  Although it should have been a life long process, most people, Christians included leave this task until it is too late.  What a shame.  I recommend they follow Christ’s example of: writing a Letter of Reconciliation [appendix B] to all those they have hurt and all those who have hurt them.  As always, any one helping them with this task, will probably encounter the dying person’s most artful excuses.  Remind them that because of God’s Law of Reciprocal Effect, they will not be forgiven until they forgive.

5) Family blessings.  Before he died Jacob leaned on his staff and gave rich and peculiar blessings to his children, the colorful children of Israel.  Christians should also give a formal blessing to each of their children and grandchildren.  They will sense as they do so that God-given attribute of mind and spirit has left them and now rests in and on that child. This is a good time to outline the contents of their will.  It gives the dying person an opportunity to explain why he/she is leaving what to whom.  If that reading is done by the dying person or by his/her executor in the presence of the family, it should be audio or video recorded.  This will diminish any chance of confusion and lessen family bickering.  E.g. To my son Patrick, I leave my courage and curiosity along with…….&……& enough $ to help you use these attributes with which God so well endowed me.  They will bring joy and sorrow, for you will understand and do things for others they may not appreciate in their lifetime.

6) Final Report and Swan Song.   The dying Christian is still a soldier in God’s army.  He/she has been fighting on certain fronts and the General would like to know how it went now they are retiring from their earthly battle.  Of course God knows more precisely than any person just how well they fought but the need to report is ingrained by God.  Christians should make a final report to God, very much like Jesus reported to His Father just before He entered His final temptation and trial, [Jn. 14]  It would be such a blessing to the dying person and to some friend or family member to help compose that report.  They can help them rehearse their presentation before the Great King and the assembled host of holy angels.  Similarly every dying Christian should compose a song or ballad for God when they arrive in eternity.  After all God loves songs and was particularly pleased with His “sweet psalmist, David.

7) Good goodbyes to all.  For most people, goodbyes are both painful and regrettable.  Too often they are one sided; one person tearing away and the other hanging on.  Frequently there is unfinished business.  Though people leave in their will their possession, they forget that the most valuable blessings of God have been the qualities of their character.   Before they say a formal goodbye these 3 aspects must be dealt with.   The good goodbye should go something like this, starting with the person who is being left behind. 

“Do you have to go mum? 

“ Yes my child, I guess my time here with you is over. “                                                   “Please don’t go.”

“I’m afraid I must”

“I don’t really understand but I accept that mum”

Is there anything you need to say to me, any unfinished business?                           “No mum, we are clear’

“Goodbye Sarah.”

“Good bye my sweet mum.  I’ll see you in heaven.”

The bereft daughter or son, must resist the departure of their parent as they would when they were much younger.  In the end they must accept the inevitable and help their parent leave.

8) Is It Finished?  Upon being asked, the dying person can decide whether or not their life and life’s work is finished.  There are people who die before their time and because of that, feel a great anguish.  For them, the end is not a triumphant “It is finished” but an angry, “I wasn’t given a reasonable chance”. More probably there is a sorrowful, “I wasted my opportunities”.  What ever the response, it is important for all who are gradually dying or are about to be executed, that they are asked, “Are you finished and if not, what needs to be done, how much time do you estimate you need to finish and how can we help?” On reflection they may be able to volunteer that their hopes, projects and personal changes are as complete as life will allow.  More often there needs to be discussion with family and friends affirming just what they have done with their life and who has benefited from their living, loving and working.  Then in praise and thankfulness Christians who are dying, like Christ [  ] can shout as loudly as they as they are able, “It is finished and now I am finished with the earth”.  Like Paul it is such a triumph to assert “I have fought the good fight” [   ] and like Job “I know whom I have believed ……….[   ]  When the dying or condemned shout or croak their God honoring Last Earthly Triumph And Thanks (LETAT), it should be witnessed by as many as possible and recorded as a glorious moment in the history of humans. 

9) Permission to Let Go and Leave.  Like every family member, the dying parent feels reluctant to leave this earth because from experience they know they will be hurting those they love when they do.  Each of the family must give explicit permission for the person to let go and let God take them home.  This permission should be formal and someone should keep a record for the dying person of who has and who has yet to say good-bye and give permission to leave. “It’s okay dad.  I’ve checked and my record shows that you have reconciled with, said goodbye to and been given permission to leave by: James, Sally, etc. So rest in God’s peace and leave when you are packed up and ready.”

10) Commit My Spirit.  When all these tasks are accomplished and the end is near, the dying or about to be executed person, must dismiss their own spirit.  Jesus did it. [  ].  I believe it is the rare and unique privilege of Gods son’s and daughters.  “Into your loving hands my gracious Father, commit my spirit and I ask that you would take me home to be with You when and if You desire.”  God will honor that request when the timing is right.  I believe it will save God’s own, the final pangs and terrors experienced by most of humankind.  At or about the same time, they should be committed into the strong hands of their Maker and Keeper by their family and friends. They can all be sure that God will receive their spirit, for God welcomes all who come to Him.

Then family and friends should be able to recognize the spirit has gone by the difference in the response of the body, and the lack of life in the eyes. Then they must wait 4 hours to see if they were wrong about the spirit having left. Once they are all convinced, all life-sustaining apparatus can be turned off. Having taken the example from their master, and having committed their spirit, the person can relax in the arms of Jesus, who having died a human death knows precisely what needs to be done to help the person make the transition from life on the earth to life in heaven with a brand new body.

CONCLUSION

In importance, dying comes after conception, birth, being born again and living for God.  There are many requisites to a good death, all of which are rooted in the complexity of who is man and why is he/she created.  When these are understood, those who assist in the final stages of a person’s life, will have a much better idea of what to do.  It is such a shame so many of a Christian’s birth life and death are tied to pagan superstition and rites.  It is high time Christian carefully developed their unique ways.  I hope these will work as guidelines, and if not at least discussion points for those who wish to think more deeply on these matters.  Good reader, beware of how much you are immersed in and a product of current post Christian culture, so that you may be more objective and critical in your thinking about Palliative Care as it is now promulgated.

In all this and for a well blessed and adventurous life, I thank and praise you my loving heavenly Father and God.

 Philip Ney MD.  2/2/07

Pioneer Publishing, Victoria, BC