Does choosing life (Deut. 30:19) mean extreme curative care—whatever it takes, fighting to the last breath—to extend our life? Sometimes, yes. We each have heroes or heroines who have endured much to recover and be there for their families and fulfill the purposes God has given them. We honor their choice of life, their fighting spirit and determination to live for others.

However, we can also be choosing life when we accept that our days are numbered, receive palliative care as did my mother, so we might say our good-byes and treasure our last days. There is a time to die (Ecclesiastes 3:2) Solomon tells us. Much can be accomplished at the end of life—affirmation and blessings given, forgiveness asked or granted, testimonies shared, and hope passed on. Exploring your beliefs and how they apply to the end of your life requires some contemplation, prayer, and Bible study. How much better to ponder these challenging questions and ethical issues before you face them.

MEDICAL EMERGENCIES: If your heart or breathing stops, do you wish to be resuscitated? If you are young and healthy, this is assumed. Both ambulance and hospital emergency personnel are required by law to provide cardiopulmonary resuscitation (CPR) unless they receive a separate directive that states otherwise. DNRs or DO NOT RESUSCITATE ORDERS  are intended for people whose poor health gives them little chance of benefitting from CPR. This is a voluntary choice, of course. If you have an advanced illness or have become frail, do you want to have CPR? If you do not want to be resuscitated, fill out a POLST form (Physician Orders for Life-Sustaining Treatment) with your doctor, nurse practitioner, or physician’s assistant and have him/her sign it. In addition, post a copy of this form on your refrigerator. These directives instruct ambulance personnel NOT to attempt CPR if your heart or breathing should stop.

THE PLACE OF CARE: Would you prefer to die in a hospital or at home? It is the mission of Hospice to enable people to  die naturally and comfortably in their homes. “Home” can sometimes be a skilled nursing facility or assisted living if your people are able to render assistance beyond what paid staff is able to provide. Hospice is paid for by Medicare and provides medical equipment such as hospital beds, instruction for caregivers as well as weekly nurse visits, and supervised pain medication. See the Heritage of Hope Health Video or our website resource page for more information on Hospice. Be aware that choosing curative care disqualifies you from Hospice as long as that choice is in effect, and choosing to be an Organ Donor would require that you die in a hospital.

THE LEVEL OF CARE: Curative Care includes both Normal care and Intensive Care. At what point do you wish to decline the more extreme, heroic measures of intensive care and just receive “normal care?” Limited Additional Interventions would include antibiotics, IV fluids and basic medical treatment. While choosing Limited Additional Interventions disqualifies you from Hospice, it generally avoids the intensive care unit. If you opt for Intensive Care, then you must also specifically consider intubation, advanced airway interventions, and mechanical ventilation or life support. At what point would you prefer Palliative care? Palliative care means Comfort Measures Only. Hospice care is an example, although some, like my mother, receive Comfort Measures Only in a hospital setting. You are choosing to allow a natural death, but your comfort will be maximized through symptom management.

Please discuss all of these options with your Medical Rep. We cannot anticipate the difficult circumstances in which they may be required to make hard decisions. You could however, discuss possible scenarios and what factors in those scenarios (probable or possible recovery?) would influence your preferences.

To everything there is a season, a time for every purpose under heaven: A time to be born, and a time to die; Ecclesiastes 3: 1-2A

Therefore choose life, that both you and your descendants may live. Deuteronomy 30:19B

Precious in the sight of the Lord is the death of His saints. Psalm 116:15