Who decides when medicine prolongs dying, not living?

Doctors at Gundersen Lutheran, long a pioneer in ensuring that the care provided to patients in their final months complies … Continued

The statistics are in. The millennials are leaving the church, and nobody seems quite sure what to do about it.

I am one of them. Born in 1983, I belong to the wispy beginnings of the new generation. I turned 30 this year, and I’m raising two small boys. I hold within me both cynicism and hope. I left the church. I came back.

Here is what I can tell you about millennials: We grew up on easy answers, catchphrases and cliché, and if we’ve learned anything, it’s that things are almost always more complicated than that.

When I returned to church, it wasn’t because of great programs, alluring events or a really cool “café” set up in the foyer. I went back not because of what the church was doing, but rather in spite of it. I went back because I needed community, and because, thanks to a steady dose of medication and therapy, I was finally well enough to root through the cliché to find it.

But not all of us are there yet. For some of us, the clichés are still maddening and alienating. Recently, I asked my followers online for the five church clichés that they tend to hate the most. These were the top five responses:

“The Bible clearly says…”

We are the first generation to grow up in the age of information technology, and we have at our fingertips hundreds of commentaries, sermons, ideas, and books. We can engage with Biblical scholars on Facebook and Twitter, and it’s impossible not to see the way that their doctrines – rooted in the same Bible – differ and clash.

We’re acutely aware of the Bible’s intricacies. We know the Bible is clear about some things– but also that much is not clear. We know the words are weighted to a culture that we don’t completely understand and that the scholars will never all agree.

We want to hear our pastors approach these words with humility and reverence. Saying, “This is where study and prayer have led me, but I could be wrong,” does infinitely more to secure our trust than The Bible clearly says…

“God will never give you more than you can handle”

This paraphrased Mother Teresa quote has become so commonplace in Christian culture that I was shocked to learn that it wasn’t in the Bible.

Inherent in this phrase is the undertone that if life has become “more than you can handle,” then your faith must not be strong enough. We millennials may be a bit narcissistic, but we also know the weight of too much. We understand that we need help. Connections. Friendship. Sometimes therapy.

We know that life so often feels like entirely too much to handle. And we want to know that this is okay with you and with God.

“Love on” (e.g. “As youth group leaders, we’re just here to love on those kids.”

In addition to sounding just plain creepy, this phrase also has troubling implications. We may understand that we need help, but we certainly don’t want to be anyone’s project or ministry.

It may just be semantics, but being loved on feels very different than being simply loved. The former connotes a sudden flash of contrived kindness; the latter is simpler…but deeper. It suggests that the relationship is the point, not the act of love itself.

And really, that’s what we’re looking for: relationship –that honest back and forth of giving and receiving love.

Black and white quantifiers of faith, such as “Believer, Unbeliever, Backsliding”

Millennials are sick of rhetoric that centers around who’s in and who’s out. We know our own doubtful hearts enough to know that belief and unbelief so often coexist. Those of us who follow the Christian faith know that world around us feels truer than the invisible God who holds it together.

Terms like backsliding that try to pinpoint the success (or, more accurately, lack thereof) of our faith, frustrate us. We don’t want to hustle to prove our faith; we don’t want to pretend. We want to be accepted, not analyzed.

“God is in control . . . has a plan . . . works in mysterious ways”

Chances are we believe this is true. But it’s the last thing we want to hear when something goes horribly wrong in our life. We are drawn to the Jesus who sits down with the down-and-out woman at the well. Who touches the leper, the sick, the hurting. Who cries when Lazarus is found dead…even though he is in control and has a plan to bring Lazarus back to life.

You’ve heard us say that we like Jesus but not the church, and it’s not because we’re trying to be difficult. It’s because the Jesus we read about enters into the pain of humanity where so often the church people seem to want to float above it.

In the end, it’s not really about what churches say or don’t say. What millennials want is to be seen. Understood. Loved. It’s what everyone wants, really. And for this generation of journeyers? Choosing honesty over cliché is a really great place to start.

Check out our related article: “5 really bad reasons to leave your church.”

If you liked what Addie had to say in this piece, consider purchasing her recently released book, “When We Were on Fire: a Memoir of Consuming Faith, Tangled Love and Starting Over.”

Addie Zierman
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  • WmarkW

    Gee, Susan, couldn’t you have made your return a little less of a downer?

  • lepidopteryx

    A dear friend of mine recently passed away – we lost him to cancer. He had taken chemo years before, gone into remission, and it returned. When it did, the doctors told him that more chemo would add, at most a few months to his life, and that during those few months, he would have three to four days of feeling like hell for every day he had of feeling decent. He decided that it wasn’t a good enough trade-off, and opted for a hospice team and palliative care at home. He died in his sleep, in his own bed, with his beloved dogs beside him, about a month later.

  • amelia45

    Good for you and thank you, Ms. Jacoby.My father died at home, electing to have no further chemo or radiation when cancer returned; treatment promised a few months of misery. We had Hospice help – a wonderful organization who brought help and peace to my father’s leaving and our staying. My mother told my sister and I how far she wanted “extending life” care to go. Being Catholic, she wanted cured what could be cured, or even tried. But, she did not want feeding tubes or oxygen masks when that was what was required to live on and on and on, with no real cure for whatever her final disease was. She had alzheimer’s disease and knew it, but hoped her heart would give out first. It didn’t – she lived to her early 90’s. If you live in Georgia, you can get information about planning for end-of-life care and designating an agent for health care by going to http://www.critical-conditions.org. This organization has a booklet available in lots of places across Georgia. It is free to Georgians but costs $15 for non-state residents.

  • Linda813

    My dad died two days ago of pulmonary fibrosis. That means that there is scar tissue in the lungs and there is no cure or hope for imporvement. After a bout with pneumonia a few weeks ago he decided that he did not want to fight for every breath anymore. He refused all meds and treatments at the hospital and ended up in a nursing home. He then refused all food and water. He wanted so much to be “put down” and have his suffering ended. He said that he would have never let any of his pets suffer the way that he was suffering. It was a long, slow, painful death for him. I wish, too, that the family did not have to watch all this suffering. Other that starving one’s self to death, I wish there could be a more humane, comfortable, and acceptable way to come to the end of one’s life.

  • PSolus

    Susan,”Who decides when medicine prolongs dying, not living?”Ideally, the person who is dying, with the aid of whoever that person seeks for assistance.Also, ideally, the person who is dying has the right to decide to hasten his/her death, with the aid of whoever that person seeks for assistance, and to implement whatever is necessary to humanely hasten his/her death.

  • WmarkW

    I know this isn’t the point of the article, but I come from a family of good genes, and never had to watch a non-smoking relative die without dignity or before 83.The President really had to delete the consultation provision to keep that distraction out of debate. There are too many serious issues about constitutionality and severability, wildly differing budget projections, and concerns whether promises about recission and illegals getting benefits will come true, that end-of-counseling needs to be detail issue set aside for later.That said, the cost of dying is a very important part of the budgetary discussion along with the moral issues.

  • acebojangles

    This death panel business illustrates an unfortunate truth:For politicians in general and conservatives in particular, controlling the terms of a debate (often to generate and capitalize on fear) is more important than being reasonable or correct. Why win a debate when you can scare people by suggesting that the government is going to kill them to save money?

  • Nosmanic

    Thank You Sasan for taking an issue straight on. For all Christians out there read the bible… literally and while your at it the constitution I’ll know if you did because if you don’t… You’ll argue with me.

  • justsit

    Several posters have mentioned the wonderful end of life care given by hospice, and, indeed, it is extraordinary. One problem that arises frequently, though, is the physician’s reluctance to make a referral until the very last minute. Hospice is most effective when given sufficient time to get to know the patient and loved ones and to make seamless care arrangements. When the physician waits until the patient is actively dying, all hospice can do then is provide pain medicine. It is often up to the individual or family to suggest hospice, as the physician is heavily invested in ongoing treatment. As a former hospice nurse, I can attest to the fact that many doctors are indeed not only very uncomfortable with death and dying issues, they are frequently unfamiliar with the signs of impending death, and overestimate the patient’s life expectancy, sometimes by many months or even years. In hospice, the focus shifts from hope for a cure to hope for comfort, a distinct shift from the medical model, and often unknown territory for MD’s. Then, too, there are sometimes blatant control issues.

  • mrbradwii

    Hmmm, an enumeration of provisions that can be spoken about in a consultation. How much more government can you ask for?Sounds like bureaucracy meets special interests in an effort to find a way to charge different rates for different “services”.Obama was right to remove it in order to remove government interference with doctor and patient discourse.Old people go to doctors a lot. Yearly at least and more when something happens. At each of these events, consultation happens, prognoses are prognosticated and questions asked. To force doctors to account for the free speech that they engage in with their patience and stuff it into government-approved categories for state-approved compensation is ridiculous.Thank you president Obama. One minor win for the future.Speaking of WTF:From my experience with dying family, pneumonia is the killer that upsets all end of life plans. In a nursing home, they’re ill-prepared to handle the curse of pneumonia and make the patient comfortable. Next step is the hospital.Cancer, piece of cake, home hospice situation. Administer meds, say goodbye and wait. 1-2-3.Pneumonia, you need antibiotic drips, fever reducers, and isolation to prevent spreading. i.e. more skilled care and resources. This kind of care needs to be available outside the hospital. And simply must accessible in nursing homes. I also suspect that part of the reason residents are shipped to hospitals is the “score” of how many die at the home.There is going to be a burgeoning market for medical services and the service industry is hamstrung or paralyzed by the current and coming healthcare “systems”. It can’t be this hard to figure out. Lack of competition, price-gouging, incompetence aren’t addressed by any proposal out there.Obama is right, it’s time for all sides to pony up ideas that open up the bottleneck we’ve imposed upon ourselves.

  • haveaheart

    “…common sense tells you that if you have a cancerous tumor in your brain and cancer in your bones at such an advanced age, it makes sense to spend your remaining time saying good-bye to the people you love instead of injecting more nausea-inducing poison into your body in an effort to live an extra week or month.”After my mother died in a wonderful hospice facility, I spent a couple of years volunteering in that facility. I saw many, many people die just as Susan describes above, with their families and friends around them. I also saw many people who had no family or friends but who were able to die as though they did because hospice care gave them love and respect in addition to painkillers and great food.One of the most moving things I experienced while working there was the amazement on the faces of visitors who would look around the beautiful facility and say, “Wow, I’d love to be able to afford this when my time comes…,” at which point I’d explain that everyone was welcome because Medicare would pay for those who couldn’t afford the cost.Quite simply, it is phenomenally cheaper to maintain a dying patient comfortably in a hospice facility than it is to keep the same patient in a hospital bed. This is fiscal sanity that the tea baggers should understand.Furthermore, for all their raving about a “nanny-state” making all the big decisions for citizens, they can’t fathom a scenario in which we let people decide for themselves how much or how little treatment they want or how they want to die.That hospice and palliative care options exist for people but aren’t routinely discussed by their doctors is criminal. The medical profession doesn’t like to acknowledge “failure,” and for many oncologists, pulmonologists, cardiologists, etc., death constitutes failure of treatment. This kind of absurdity then contributes to the reluctance of patients and their families to try and discuss palliative care as a viable option.Americans — the dying and their caregivers alike — are hungry for information about death: what to expect, how to manage pain, what to talk about with the dying person (or, if you’re the dying person, how to talk about death with your loved ones). Yet the religious right slaps down those medical professionals who would relieve the sick and dying of their anxiety simply by talking with them.Everyone dies. Most people are not lucky enough to have death come quickly or while they’re asleep. So dying is a critically important discussion that everyone needs to have with their physicians and potential caregivers.Yet, by minimizing the options, the tea baggers are guaranteeing that terminally ill patients will be able to continue suffering right up until the last treatment has failed. After all, it’s their right as Americans to live their lives to the last drop. They’re entitled to those last weeks or months of agony and misery, and, by God, the Tea Party will make sure they get what they are owed.

  • Farnaz2Mansouri2

    Susan,Thank Non, you’ve returned. The bottom line is how to get these God-forsaken religionists out of Congress, the Court, the presidency.Couldn’t they go to my country, Iran? Or, perhaps, Saudi Arabia, whose Constitutions (such as they are) synchronize with their agendas?The Constitution is supposed to protect me from Christians dominating my reproductive choices and death, is it not?Can one get them out of one’s bedroom and bar them from one’s hospice?

  • Counterww

    Susan uses this as an excuse, as a radical atheist, to attempt to demonize those that believe in God and somehow we are responsible for suffering of those that are coming to end of life decisions.The issue is not the belief in God and how it relates to those decisions, it is educating people on what THEY want when the end of life occurs in numbing pain where there is little to no hope in beating the disease that has taken over, or that your body is just too old, or the mind is demented etc etc. I have experienced this with a loved one , the mother of my wife. All I can say is that it comes down to making these decisions you have to plan them before you become incapacitated as the laws, hospitals, and institutions just don’t always follow through even when your intent in a written document is plain .I am disappointed in Susan’s politicizing this and attempting to blame the religious right. Being a believer I can tell you she is mistaken and obviously does not get out to talk to believers about this topic.

  • Farnaz1Mansouri1

    Hi Counterww,I don’t quite understand why you’re upset with Susan on this. What she says is true. I recall the controversy quite well. What exactly are you taking issue with?Frankly, I’d like to see a column on the barbaric conditions operating in some hospitals, but I suppose that has nothing to do with religion. ?

  • slowe111

    Thank you Susan for bringing this topic into discussion. I wonder how much of our shared national medical expenses are used to keep un-recoverable patients barely alive for a few weeks or months or even days at HUGE expense that we ALL pay for via insurance pools or Medicare? Follow the money. Is there an incentive for hsopitals, doctors, pharmaceuticals etc. to keep these patients alive as revenue streams? Whare are the economics of this issue? Are dying patients being “used” to balanace the books?

  • YEAL9

    Bottom line: Morphine solves most of the issues.

  • onofrio

    Will it solve you, Yeal, in your ledger domain? Or ab-solve?