I discussed VSED in a previous blog post here.

Here is the link to the podcast on Jill’s website.

Here is the link to Apple Podcasts

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Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving People and Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

The post New Podcast with Hank — “Seeing Death Clearly” on nutrition and hydration first appeared on Hank Dunn.

I had a great conversation with Hospice Nurse Penny and Halley Hospice Social Worker  on their great podcast “Death Happens.” You can find it wherever you get your podcasts.

Here is the link to the podcast  on YouTube:

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Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving People and Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

The post Hank on “Death Happens” podcast first appeared on Hank Dunn.

Hand feeding on the memory care unit

It was lunchtime on the memory care unit of the nursing home where I was chaplain. I was always looking for ways to minister to these poor souls who were losing their minds. What might work for more oriented patients, like a Bible study, was no good here.

Over my years there, I learned to feed the dementia residents who couldn’t or wouldn’t feed themselves. After all, Jesus did say, “I was hungry, and you gave me food; I was thirsty, and you gave me something to drink.” Although I did prefer patients who were not prone to choke or spit their food at me.

Voluntarily Stopping Eating and Drinking

The beginning of Hank’s “Dementia” addendum to his Advance Directive.

I previously wrote about hastening death by voluntarily stopping eating and drinking (VSED), titled She Fasted to Hasten Death. It was the story of a patient with decisional capacity who chose to end her life sooner rather than live with what she felt were too great of burdens.

But what of advanced dementia patients, who all need help with feeding and can no longer “choose” to hasten their death? I wrote another blog, VSED by Advance Directive — an Alternative to Prolonged Dying, about how to write an advanced directive (AD) indicating to your caregivers to stop hand feeding when you get to the last stages of the disease. I personally have such an advance directive.

Problems with VSED by Advance Directive

It sounds so simple: I want a peaceful death not dragged out over multiple years. So, I wrote instructions to stop hand feeding if I decline to the last stages of dementia. But there could be problems following my instructions:

1. State regulations require addressing weight loss. If I am in a facility and am losing weight because hand feeding has been stopped, the administration might worry state regulators would not look too kindly at that.
2. Caregivers might refuse to carry out my wishes. My family or professional caregivers might feel uneasy withholding feeding when I still open my mouth to eat and drink.
3. Honoring wishes. I wrote the advance directive when I was healthy and of sound mind. I know when I get to end-stage dementia, I will not remember my desire to hasten my death. So, demented Hank is still willing to eat and drink. Who do you honor? Competent previous Hank or demented current Hank?

Minimal Comfort Feeding

Screenshot

A recent article in the Journal of Pain and Symptom Management reports on “minimal comfort feeding” as an alternative to VSED by AD. Titled “‘Mr. Smith Has No Mealtimes’: Minimal Comfort Feeding for Patients with Advanced Dementia,” The article is available for free.

The authors identified three possible approaches to advanced dementia regarding feeding:

1. Comfort Feeding Only. Attempt to feed the patient on a regular basis but give no more food and liquid than is comfortable. Advanced dementia patients can live for years with this approach.
2. Minimal Comfort Feeding (MCF). Provide the patient only as much food and liquid as necessary to avoid discomfort. With this approach a patient might live just weeks to a few months.
3. Stopping Eating and Drinking by Advance Directive. No food or liquid at all. The patient will live just days.

The second option would be especially appropriate for the “patient with advanced dementia who previously expressed a wish to avoid living with advanced dementia.” MCF also addresses the problems with VSED by AD I listed above. The case study patient in the journal article did not put his expressed desire to avoid prolonged hand feeding in an advanced dementia condition in an advance directive.

Withholding ALL food and fluid does have uncomfortable symptoms like a sense of thirst and hunger. MCF addresses these symptoms by only giving enough food and fluid to avoid discomfort but not so much to sustain life for what could be years with comfort feeding.

There are morally acceptable ways to avoid prolonged dying, perhaps for years, by pursuing “voluntarily stopping eating and drinking by advance directive” or by “minimal comfort feeding.”

I feel good about the prospects for my last days should it come by dementia.

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Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving People and Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

The post Do we honor Competent Hank or Demented Hank? first appeared on Hank Dunn.

Source: National Inst. of Health

“Dialysis May Prolong Life for Older Patients. But Not by Much,” by Paula Span unpacks the results of a recent medical research study published in the Annals of Internal Medicine. The researchers compared the length of life and quality of life of two groups of elderly patients with advanced kidney disease. One group started dialysis to manage their disease, and another group declined dialysis.

But the group that declined dialysis didn’t just DO NOTHING. Here’s how the NY Times article put it:

“The alternative to dialysis goes by various names — medical management, conservative kidney management, supportive kidney care. In this scenario, nephrologists monitor their patients’ health, educating them about behavioral approaches, prescribing anti-nausea drugs like Zofran and diuretics like Lasix to reduce fluid retention, and adjusting their doses as needed.”

I contacted my nephrologist friend, Dr. Alvin Moss, at the West Virginia University School of Medicine. He has long been an advocate for treating kidney failure in elderly patients without resorting to dialysis. He said his patients like to call this approach, “active medical care without dialysis!”

I wrote about this topic in a blog post three years ago. Also, if you want to watch a humorous spin on the very serious subject of the for-profit dialysis business go to Dialysis: Last Week Tonight with John Oliver.

Longer life with worse quality of life

It is true that those on dialysis lived longer, on average, about 25 months, where the group receiving active medical care without dialysis lived about 23 months. But the quality of life for the dialysis patients was worse.

The dialysis group spent about two weeks less at home (in a hospital or nursing home) than those getting supportive care. Almost all the dialysis patients had to travel to a center three times a week to be hooked up to a machine for several hours each visit. Yes, they lived 2 months longer, but with greater burdens.

Photo by Harry cao on Unsplash

Here is one patient’s approach to the dialysis decision from the NY Times article:

“Even before Georgia Outlaw met her new nephrologist, she had made her decision: Although her kidneys were failing, she didn’t want to begin dialysis.

“Ms. Outlaw, 77, a retired social worker and pastor in Williamston, N.C., knew many relatives and friends with advanced kidney disease. She watched them travel to dialysis centers three times a week, month after month, to spend hours having waste and excess fluids flushed from their blood.

“‘They’d come home weak and tired and go to bed,’ she said. ‘It’s a day until they feel back to normal, and then it’s time to go back to dialysis again. I didn’t want that regimen.’

“She told her doctors, ‘I’m not going to spend my days bound to some procedure that’s not going to extend my life or help me in any way.’”

Nursing home patient stopped dialysis

 What happened to the patient worried about suicide?

That patient who asked me about suicide? You guessed it. He was on dialysis and had had enough. He wanted to stop the treatment and die peacefully in the nursing home. He was also a very devout Catholic and wanted assurance that stopping dialysis was not suicide.

“Of course not,” I told him. “You will be dying from kidney failure. It will be a very natural death.” He got that peaceful death he wanted.

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Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving People and Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

The post Is This Suicide? first appeared on Hank Dunn.

I recently posted a video of me eating a tomato sandwich, just bread, mayonnaise, and thick, juicy, farm-fresh tomatoes. I closed the reel commenting that there is no free will in whether we like tomatoes, “Perhaps there are more things we think we are making choices about, but we really aren’t.”

NOT ONE of the many comments on the post picked up on the lack of free will. Everyone wanted to talk about their love of tomatoes and all the different ways to eat them. Our love (or dislike) of tomatoes is an easy example of how we lack free will.

A lot goes into acquiring a taste for a food: where you grew up, what your family ate in your childhood, textures you like or dislike, or how a particular food settles in your stomach. You don’t “choose” to like a tomato, you either do or don’t based on many factors outside of your control.

Judgement or pride have no place when you accept that there is no free will in a liking for tomatoes. There is no judgement by us tomato lovers toward those who dislike them. Heck, more are available for me if a certain portion of the population dislikes them. Conversely, there is no sense of pride or achievement by those of us who have attained such a refined palate to appreciate a fine tomato. We are just the lucky ones.

Free will and “choice” in end-of-life decisions

I have made a career of helping patients and families with end-of-life decisions as a healthcare chaplain and author of Hard Choices for Loving People, which has sold over 4 million copies. The first chapter on CPR discusses the “choice” a caregiver may need to make to put a frail or elderly patient through a resuscitation attempt.

I remember the scores of patients and families I helped make end-of-life decisions as a nursing home chaplain. Most often, once I explained that only about 1% of nursing home patients survive the event that led to CPR and survivors are in much worse shape than before, the families would say, “No CPR. Let her go in peace.”

But occasionally, they would say, “Life is precious no matter how poor, and a 1% chance IS a chance. We love grandma and don’t want her to die,” and then the patient remained a full code.

Did these families exercise their free will in making these choices? What if the “choice” was not consciously made by the caregiver but resulted from a series of factors and information leading up to the decision?

Determined: A Science of Life without Free Will

Last year, Robert M. Sapolsky started making the media rounds, including a New York Times interview and a guest appearance on Sam Harris’ Making Sense podcast. He has a new book, Determined: A Science of Life without Free Will. Yes, THAT free will.

Sapolsky presents a credible argument that we are not making “choices” the way we think we are, based on the science of our brains. Here’s an excerpt of his argument:

“Once you work with the notion that every aspect of behavior has deterministic, prior causes, you observe a behavior and can answer why it occurred: because of the action of neurons in this or that part of your brain in the preceding second. And in the seconds to minutes before, those neurons were activated by a thought, a memory, an emotion, or sensory stimuli.…We are nothing more or less than the cumulative biological and environmental luck, over which we had no control, that has brought us to any moment.”*(see his full 4-paragraph summary below)

What about that family who “chose” a full code for their frail, failing, nursing home patient? Maybe they watched Rescue 911 on TV, where 100% of patients getting CPR survived (see my previous blog about CPR on TV). Perhaps this previous exposure to all of the CPR successes on TV makes them say, “Yes, do everything,” without even thinking about it.

Why present a choice if there is no free will?

So why would I take the time to explain CPR and present a “choice” to use it or not, if there is no free will to make that choice? Maybe they did not know about the 1% survival rate. This new information might connect to millions of bits of data previously registered in the family’s brains, activating an assessment that Grandma would likely not survive.

I’d also have these conversations because I can’t help myself. I am compelled by forces within my brain, formed over years of experience, for which I have no control: Talking about end-of-life decisions was part of my job, family values instilled in me from my youth was to do your duty on the job, the long line of nurses in my family fostered a natural compassion for these patients and families.

I believe the scientific evidence Sapolsky presents that we have no free will is quite compelling. Most people may disagree, citing religious and spiritual arguments over whether or not we have free will.

Humor me on this one. If there is no free will, we must be less judgmental of those who “choose” a path we feel is wrong. If they’re basing that decision on information spanning generations, they couldn’t help themselves. Conversely, I can’t take credit if my actions led to more compassionate end-of-life care for a patient. I had nothing to do with all that went into their family’s “choices.”

In this brief blog, I cannot begin to cover what it took Sapolsky over 500 pages to say, but I added a larger excerpt of his book below.

Now I’ve got to go back to the farmer’s market because I am out of tomatoes. I can’t help myself.

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Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving People and Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

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*Below is the summary of the basic thesis by Robert M. Sapolsky in his book, Determined: A Science of Life without Free Will, pages 3-4

“Once you work with the notion that every aspect of behavior has deterministic, prior causes, you observe a behavior and can answer why it occurred: as just noted, because of the action of neurons in this or that part of your brain in the preceding second. And in the seconds to minutes before, those neurons were activated by a thought, a memory, an emotion, or sensory stimuli. And in the hours to days before that behavior occurred, the hormones in your circulation shaped those thoughts, memories, and emotions and altered how sensitive your brain was to particular environmental stimuli. And in the preceding months to years, experience and environment changed how those neurons function, causing some to sprout new connections and become more excitable, and causing the opposite in others.

“And from there, we hurtle back decades in identifying antecedent causes. Explaining why that behavior occurred requires recognizing how during your adolescence a key brain region was still being constructed, shaped by socialization and acculturation. Further back, there’s childhood experience shaping the construction of your brain, with the same then applying to your fetal environment. Moving further back, we have to factor in the genes you inherited and their effects on behavior.

“But we’re not done yet. That’s because everything in your childhood, starting with how you were mothered within minutes of birth, was influenced by culture, which means as well by the centuries of ecological factors that influenced what kind of culture your ancestors invented, and by the evolutionary pressures that molded the species you belong to. Why did that behavior occur? Because of biological and environmental interactions, all the way down?

“As a central point of this book, those are all variables that you had little or no control over. You cannot decide all the sensory stimuli in your environment, your hormone levels this morning, whether something traumatic happened to you in the past, the socioeconomic status of your parents, your fetal environment, your genes, whether your ancestors were farmers or herders. Let me state this most broadly, probably at this point too broadly for most readers: we are nothing more or less than the cumulative biological and environmental luck, over which we had no control, that has brought us to any moment.”

The post Tomatoes, No Free Will, and End-of-Life Decisions first appeared on Hank Dunn.

So, is the takeaway to never do chemo? Absolutely NOT.

Photo by Hiroshi Tsubono on Unsplash

Country singer Toby Keith was diagnosed with stomach cancer in 2021. About six months later, he announced to his fans on social media that he was receiving chemotherapy, radiation, and surgery.

“So far, so good,” Mr. Keith wrote in a June 2022 statement on multiple social media platforms. “I need time to breathe, recover, and relax. I am looking forward to spending this time with my family. But I will see the fans sooner than later. I can’t wait.”

Keith’s last concert in Las Vegas, (TobyKeith.com)

Indeed, he got back out there and played a series of shows in Las Vegas less than two months prior to his death a few weeks ago. In an interview right before he died, he said, “Cancer is a roller coaster. You just sit here and wait on it to go away — it may not ever go away.”

“[Keith] handled it with grace and faith and family and stood up to the cancer as good as you can,” said the former Green Bay Packers quarterback. “[But] I think in the end he was just tired,” Favre added.

We can hardly base treatment decisions on one man’s experience. Mr. Keith, diagnosed at age 60, made his decision based on the type of cancer he had and his own unique goals of care at that stage in the disease.

I am guessing if, during that last phone call, Favre asked, “Do you regret getting the chemo?” Keith might have responded, “Not at all.” Perhaps it bought him some time. Maybe, earlier in the treatment, he did not think it was causing “more damage… than the cancer.”

In my years as a hospice chaplain, I got to see patients after they had stopped treatments that were meant to cure the disease. Heck, you can’t get into hospice unless you stop curative treatments. Many expressed similar sentiments as Toby Keith. In medical-speak, “the burdens outweighed the benefits.” There, perhaps, was a time when the benefits were greater, but no more.

Or, to paraphrase Ecclesiastes in the Hebrew Bible, “There is a time for chemo and a time for no chemo.”

Let go and let be.

_____________________

Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving Peopleand Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

The post Toby Keith Quit Chemo first appeared on Hank Dunn.

I am the guest this week on “The Clarity Podcast” with Aaron Santmyire. Aaron is a missionary in Africa and started the podcast to help other missionaries with issues related to their work overseas. We talk about the unique difficulties of long-distance caregiving for family members with a serious and terminal illness. We cover the end-of-life decisions I have written about in my book, “Hard Choices for Loving People.”

Here is the link to the podcast:

https://player.captivate.fm/episode/386e2924-4d3a-4759-af07-97c58ebb7461

_____________________

Author Chaplain Hank Dunn, MDiv, has sold over 4 million copies of his books Hard Choices for Loving Peopleand Light in the Shadows (also available on Amazon).

Follow Hank: LinkedIn | Instagram | Facebook | YouTube

The post Long-distance Caregiving is Difficult: Listen to Podcast first appeared on Hank Dunn.

Hank’s extended family of origin, 1960. All but one of the adults in this photo died with dementia

One photo says it all. 1960. I am twelve. My mother’s family of origin gathered with our various aunts, uncles, and cousins surrounding my grandmother. Seven adults and seven children. Six of the seven adults died with dementia. Aunt Martha was the only one spared, and she was not a blood relative of mine.

My mother, who probably had Alzheimer’s, died at age 92. Dad got a double-whammy of Parkinson’s and multi-infarct dementia (a series of small strokes). He was 85 at death. Both spent their final years in a nursing home or a memory care unit.

What I can control

Hank with his mother at her memory care unit.

There are no cures for the various forms of dementia that could befall me. Yet, there are actions I can take to reduce the risk or delay the onset of cognitive impairment.

I have written before about reducing the risk of dementia and how my hearing loss is a risk factor that could lead to cognitive decline.

Recently, I read an article in JAMA titled “Lifestyle Enrichment in Later Life and Its Association With Dementia Risk.” Here is part of the summary of the research:

“[M]ore frequent engagement in adult literacy activities (e.g., writing letters or journaling, using a computer, and taking education classes) and in active mental activities (e.g., playing games, cards, or chess and doing crosswords or puzzles) was associated with an 11.0%… and a 9.0%… lower risk of dementia, respectively.”

Author event with Ann Patchett at Square Books, Oxford, Miss.

Keeping my mind active

I read articles like this recent one and wonder, “Am I reducing my risk?” I like to say, “Yes, I am.”

Looking back at my previous blogs about reducing the risk of memory loss, I can check several boxes. I work at vigorous physical activity and try to get enough sleep. Several times a week, I journal and often am on my computer (maybe too often?). Almost weekly, I attend an author event at Square Books or a lecture at the university’s Overby Center for Southern Journalism and Politics or at the Center for the Study of Southern Culture.

All the advice includes staying engaged socially to keep the mind active. Besides church activities, I attend two weekly men’s groups. One is here in Oxford, where we sit around and mostly talk about politics. The other is on Zoom with the group I have been in since 1992.

I like to think I would be doing all this active-mind stuff even if there were no evidence of health benefits. I just enjoy all the activities I mentioned above.

Even my father’s active mind suffered cognitive decline

Hank with his nursing home resident father

All the advice is about REDUCING the risk of dementia, not PREVENTING it. A good case in point is my father. He was a lifelong reader and writer. He authored almost a score of books. Even while in the nursing home, he tried to write a weekly column for publication.

Mom told me that as it became more difficult for Dad to compose a few paragraphs, she suggested they stop making the effort. Dad responded like a typical child of the Depression, “We need the money.” They didn’t need the money, and he eventually gave up on writing.

Even though Dad kept an active mind, he did not “check all the boxes.” He never participated in vigorous physical activity and was a heavy smoker for probably thirty years.

There are enough examples of public figures who ended their days with cognitive impairment, like Ronald Reagan and Pat Summitt. The mental exertion necessary to be President for eight years or to win eight national basketball championships did not prevent memory loss in the end.

My preparing for the worst

Knowing that memory loss could likely be in my future, I have made a few preparations. Like my parents, I have purchased long-term care insurance. They both used every bit of the four years of benefit that paid for their institutional care.

I also recently added an addendum to my living will, instructing my family to withhold hand-feeding if I reach stage 6 or 7 on the Functional Assessment Staging Tool. I have used the addendum put out by End of Life Choices, New York, which is in line with my right to refuse medical treatment. I discussed this Voluntary Stopping Eating and Drinking (VSED) in a previous blog.

Whew! That’s a lot. I think I’ll take a nap — also one of the boxes to check.

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together, they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

The post Dementia? I’d Rather Not first appeared on Hank Dunn.

Four decades later, I am still learning our words matter.

“Need” implies you have no choice

I read a recent JAMA Online article titled “Reconsidering the Language of Serious Illness,” which illustrates that when healthcare professionals use the word “need,” aggressive treatment is often the result. Example statements from the article:

• “If her breathing gets any worse, she will need to be intubated.”
• “He needs a central line, a special IV catheter in his neck, so we can give him blood pressure medicines.”
• “If she doesn’t make any urine soon, she will need dialysis.”
• “If she can’t be extubated soon, she will need a trach.”

The article’s authors argue that once you say the word “need,” it implies that the family has no choice but to proceed with the treatment. Who would deny their mother what she NEEDS?

“To need is to lack something essential”

From the article: “To need is to lack something essential. As clinicians, we regularly use the word need to think about and describe the condition of patients with acute serious illness. These patients lack something essential for survival, and clinicians have the technologies and therapies to sustain their lives. So need rolls off our tongues as a shorthand to convey our clinical assessments of patients with acute life-threatening illness.”

Their suggestion for changing the language: “When a patient is facing a life-threatening illness, instead of saying she ‘needs to be intubated,’ we suggest that clinicians say, ‘Her illness is getting worse. I would like to talk with you about what this means and what to do next.’”

This language change opens the conversation up to more options than just “the need to be intubated.” What does the patient think about their current situation? What are her preferences about being kept alive on a machine? What are her chances that she will ever get off the vent? Intubation is one possible choice, but others are equally possible, including shifting the focus from cure to comfort.

Changing “What does the patient WANT?” to “What does the patient THINK…”

Six years ago, I made a significant change in the language in one sentence in my Hard Choices for Loving People book. Once again, a medical journal article convinced me to change a question I had used for almost three decades. I wrote about this in a previous blog, “You Can’t Get What You Want.”

Since the first edition of Hard Choices in 1990, I have included “What does the patient want?” as one of five questions to ask as an aid to making end-of-life decisions. In 2017, I changed it to: “What does the patient think about their current and probable future condition?”

A career using language to help with end-of-life decisions

Soon after I became a part-time nursing home chaplain in 1983, our administration formed an ethics committee. Virginia had just passed a “Natural Death Act,” which gave patients a right in the code to refuse treatment and provided a form (e.g., “living will”) to express their treatment preferences.

The committee included the director of nursing, the medical director, a lawyer, an administrator, and me. In response to the new law, our plan was to inform all patients and their families about advance directives and the option of a “No CPR” order. But who would deliver the information?

The committee turned to me, “Chaplain Dunn, we will have you talk to all the patients and families about ‘No CPR’ orders and advance directives.” I had no healthcare experience and had yet to take basic chaplain training. So, I learned how to talk to patients and families…by talking to patients and families

Over the next year, we went from less than 10% of our patients having an advance directive and/or “No CPR” order to over 80%. And I learned the importance of using my words to help the process along.

We published the first edition of Hard Choices for Loving People seven years later.

[Cover Photo by Kampus Production via Pexels]

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

The post Words Matter: “Want” and “Need” first appeared on Hank Dunn.

His last days were filled with great suffering, played out publicly on social media and in the national news from March until his death on May 19^th. Here are the descriptions of the patient’s condition in the last weeks of life:

• April 26th, GoFundMe post: “He has now lost 80 pounds and subsequently continues to struggle with extreme weakness.… He’s on strong IV antibiotics three times a day.… He has intermittently also suffered [from] kidney issues and [has] been on dialysis. In addition to this, he is having heart and lung concerns, sores from being in bed for 4 months and depression.”
• April 30th, Facebook post: “He was admitted to the hospital tonight with acute kidney failure and dehydration.”
• May 9th, Facebook post: “He will be having emergency surgery tomorrow. Still in ICU fighting the infection and organ failure.”

Later, his wife refused to withdraw life support, claiming on Facebook, “He’s a fighter, and his will is strong even if his body isn’t. God is our hope.”

What does God want in a VERY serious illness?

Can we know what God wants? I was drawn to this story reading the pleas for people of faith to pray for a miracle when one could read between the lines and understand that this man was dying.

Let me be clear: If I were the chaplain in this story, I would approach this patient and his family compassionately and without judgment. As their chaplain, my role would be to meet this family where they are, not where I want them to be.

But I was not their chaplain and now have the luxury of pondering this situation from afar after it ended.

Is God ONLY for saving a life?

I find many things curious about the language and theology expressed publicly.

• Let’s start with an earlier GoFundMe post from March: “He coded, but God decided that it was not his time to go and brought him back to us.” Evidently, the patient’s heart failed, yet he continued to live after the intervention of CPR.

The family saw this as a sign of God’s intervention. The skeptic might say, “God did not decide the patient should not die during that code. Human intervention went against what seemed to be God’s plan.”

Who am I to say God did or did not intervene? I stopped speaking for God years ago.

I believe it is a slippery slope to claim that God is saving the life of someone in multiple system failure when the death expectancy rate for all of us is 100%.

Perhaps “God called him home?” Acceptance or crisis of faith?

There is another way people of faith might approach such circumstances. Other families I have ministered to chose to forgo heroic medical interventions. When the patient died, they said, “God called them home.”

I am guessing that this patient’s wife probably accepted “God’s timing” when her husband finally died. I hope that is true. People who feel God is in control of everything can often shift to acceptance when death eventually occurs.

But for some who expect a miracle, death can cause a crisis of faith. I wrote about this in a previous blog, “God has a lot of explaining to do.”

What is keeping this patient alive? The machines or God?

• May 7th, Update! “The doctors are continuing to try and prepare me for the worst. And I continue to explain to them that [we] are people of faith and that our God has the final say. I am not in denial about what’s happening to him or blind to what the medical reports say…. I just know that the God I serve is greater than any infection and more powerful than any organ failure.”

There would have been a time long ago when death was not optional. Antibiotics and other medical interventions can now cure many who would have died in another time and place.

These same modern medical treatments can also prolong the dying process, sometimes at the cost of great pain and suffering for the patient.

Other hopes besides “not dying”

I try to help families see that there are other outcomes to hope for other than “not dying.” Having a peaceful death, being pain-free, or spending quality time with family. This is what I did with the man who told me, “God has told me my wife is not going to die.”

I don’t know how the end came for this man. I only saw the announcement of his death and an obituary in the New York Times, after which the Facebook and GoFundMe pages went silent.

Hopefully, all involved, living and dead, are now at peace.

[Cover photo by Richard Catabay on Unsplash]

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Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

The post “He coded, but God brought him back to us!” first appeared on Hank Dunn.