April 2015 Issue Index: End-of-Life Ethics

Approaching End-of-Life: Past & Present    

   by Roger Willer, Guest Editor
What does it mean to die well in this culture?  While far too many people never have the opportunity to face that question because their lives are snuffed out, it is being asked with greater urgency and frequency as contemporary societies become more scientifically and medically sophisticated. Last January that question brought together nearly 50 Lutheran ethicists, pastors, chaplains, hospital and hospice care-givers at the annual Lutheran Ethicists' Gathering for a rich and wide-ranging discussion that taught us much and reminded us all again of two things:  1) The sources of that question and the answers are becoming increasingly complex today, while they matter as much as ever to human lives teetering on the boundary of life and death;  2) The church as a source of both pastoral care and moral vision has untapped resources to share.  Read more.​

Articles

End-of-Life Ethics: An Ecological Approach by Kenneth J. Doka

Over time, we have moved from a model where doctors have the final say in end-of-life care to patients having ultimate decision-making power. Though both of these have benefits, neither inherently consider the family members involved, or the ways in which hopice and palliative care have developed in recent decades. Doka argues for an ecological approach to end-of-life care in which each of these dimensions is taken into consideration to ensure that the ecosystem of a person's life--including the grief process of their family--is taken into consideration when preparing for a patient's passing.

Luther, Linck, and Later Lutherans on Pastoral Care to the Sick and Dying​ by Austra Reinis

 In the Christian tradition, pastoral care to the dying has a long history. ​​Reinis particularly explores ​​the medieval literary genre of self-help books known as the ars moriendi, or “art of dying.”  Martin Luther contributed to this genre with his Sermon on Preparing to Die (1519); dozens of Lutheran pastors, among them Wenzeslaus Linck in Nuremberg and Martin Moller in G​​örlitz, followed in his footsteps.  All of them offered spiritual comfort to the dying in ways that addressed contemporary concerns.  The recently-published The Divine Art of Dying (2014) by Karen Speerstra and Herbert A​nderson heralds a long-overdue renaissance of this genre. Reinis considers how ​the practices of the past can inform our actions today in our increasingly secularized society.

Book Reviews

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Is God Still at the Bedside? The Medical, Ethical, and Pastoral Issues of Death and Dying​ by Abigail Rian Evans

    Review by Alyson Isaksson Capp 
In Is God Still at the Bedside? Abigail Rian Evans presents a comprehensive survey of how Americans view the roles of medicine and religion given contemporary understandings of the meaning of life and death. Particular attention is paid to ethical issues that can arise when different values are held in tension, as well as how clergy and other spiritual support providers are an underutilized resource for healing. Her central question asks whether a modern focus on freedom of choice in pursuing or foregoing medical technology has usurped the role of God’s presence at the bedside, therefore squelching the need for spiritual care. 

Hippocratic, Religious and Secular Medical Ethics: Points of Conflict​ by Robert Veatch​

    Review by Aaron Klink  

Robert Veatch, is professor ​of medical ethics at Georgetown and author of numerous books on bioethics  including his classic Transplantation Ethics.  This book is a revision of his Gifford Lectures at the University of Aberdeen.  The book combines historical, philosophical, and theological analysis to make a strong argument for why the ethical codes propagated by  professional societies such as the American Medical Association, cannot serve as morally neutral or universally acceptable  codes of ethics.  These codes​ cannot serve as neutral guidelines for professional practice since some medical practitioners adhere to faith traditions that have their own teachings on how adherents should value, evaluate, and interact with human life.