Medical Ethics Part 2

Overview

Welcoming One Another in the Hard Questions of Medical Ethics

Paul's prayer in Romans 15:5-7 frames every conversation about medical ethics: that God would give us endurance and encouragement so that together we might glorify him, welcoming one another as Christ has welcomed us. The questions surrounding the beginning and end of life are rarely simple, but they are always pastoral. They concern real people whom Christ has received.

Beginning of Life: How Many Parents Can a Child Have?

A generation ago, the answer was obvious—two. Today, between sperm and egg donation, surrogacy, mitochondrial DNA replacement, and cases like the recent Texas situation in which two women shared egg donation and gestation, a child can be biologically and legally connected to six or more "parents." Infertility affects roughly 15–20% of couples, and the array of treatments (AIH, AID, IVF, ICSI, GIFT, ZIFT, embryo donation) raises ethical questions long before we get to the harder cases.

Even a relatively "simple" technique like artificial insemination by donor raises real concerns: loss of genetic diversity, half-siblings unknowingly marrying, the impact on a child who cannot trace medical or relational origins, and the impact on donors who may father hundreds of children. Add prenatal genetic screening—where roughly 90% of children diagnosed with Down syndrome are aborted, and Iceland reports almost none born at all—and we must ask hard questions about what kind of society aggressively eliminates those it deems too costly. Eugenics is acceptable to most when applied to dairy cattle; Scripture will not let us extend that logic to image-bearers. Our weaknesses, as much as our strengths, are part of who God has made us. Pastorally, adoption remains a beautiful picture: every Christian has been adopted in Christ Ephesians 1:5.

Substituted Judgment: Who Decides When We Cannot?

Consider Marsha—a 67-year-old believer who, after a sudden respiratory crisis, never regained consciousness. Her family faced the question every family eventually faces: what now? Medical ethics typically appeals to four principles: non-maleficence (do no harm), beneficence (do good), justice (treat fairly), and autonomy (the patient decides). But autonomy is precisely where Christians must press back. Autonomy—deciding apart from God—is what Scripture calls sin. It is what Adam and Eve grasped at in the garden Genesis 3. We are not isolated decision-makers; we are bound to spouses, children, congregations, and ultimately to Christ.

When a loved one cannot speak, the question shifts from "what would they want?" (we are often wrong about even our own parents) to "what is in their best interest?"—made by someone they have entrusted with the responsibility. That is why having a designated decision-maker, who knows your faith and your wishes, matters enormously. Marsha's family knew where she stood with the Lord. The decision to remove the ventilator was not a decision to end her life—she was already dying—but to entrust her to the Father who had claimed her in baptism.

Suffering, too, has a place in the Christian life. Paul learned that strength is made perfect in weakness 2 Corinthians 12:9-10. Suffering shapes the sufferer, draws the body of Christ together in service, and sometimes calls us simply to receive rather than always to give.

End of Life: Care, Not Killing

Physician-assisted suicide, now legal in roughly a third of the United States and across Canada, is marketed as compassion and dignity. But there is no dignity in death itself; death is the enemy 1 Corinthians 15:26. Dignity belongs to life, because life belongs to the God who made us. The confessional Lutheran position—shared broadly across faithful Christian traditions—is "always to care, never to kill." We reject the framing that compassion requires us to end suffering by ending the sufferer.

This raises agonizing pastoral questions. If a church member announces an intention to use such a prescription, the pastor must speak the truth: this is sin, and God offers another way. And yet pastors are shepherds who walk with sinners, not gatekeepers who abandon them. We name sin clearly, we proclaim grace fully, and we do not leave the dying alone. Where exactly that puts a pastor in any given moment requires wisdom, prayer, and the counsel of the church—but it never permits us to bless what God has not blessed, nor to walk away from a sheep who is afraid.

A Pastoral Word

These are hard questions, and easy answers usually betray someone. What holds us steady is not our cleverness but the One who welcomed us. Plan ahead. Talk with your family. Designate someone you trust. Discuss heaven openly with those you love, long before crisis arrives. And when the moment comes—for you or for someone you love—remember that Christ has already gone ahead through death and out the other side. Our calling is to care for one another all the way to the threshold, and to commend each other into the hands of a faithful Savior.

Transcript

Oh, hi. So we're back at this again. I think I've seen you all before. 0s

Well, most of you. Tonight, oh, did you keep me? 4s

Is that right? 10s

Well, it's time right here. She gave me four copies of it. 12s

Okay. Tonight we were starting with a simple question. 18s

What does that say next? Well, I'm told to do this. 21s

That's right. I got it. 26s

There you go. 28s

Oh, there you go. 31s

Do you want that, Bruce? 35s

Can you all read it as my question? 46s

Or do I need to read it to you? 49s

So the goal is that God would give us endurance and encouragement so that we can together 56s

to get things and praise to Him. 61s

The goal is that we work on things together and that as Christ has welcomed us, 65s

we're supposed to welcome other people. 70s

Now, who do we welcome? 74s

Who are the people out there? 76s

The first question is a difficult one. 78s

It's Uzuredati. Historically, that was a very simple question. 81s

Right? Uzuredati. 87s

Now, how many parents, parents are in quotation marks here? 90s

Can a newborn infant have without adoption or divorce? 96s

We're going to get to that in a second. 105s

After a while, we're talking about substitute judgment. 107s

How do you make decisions for other people? 109s

And is that appropriate? 112s

And finally, we're going to talk about end of life. 113s

But there's the only one who I'm going to do. 117s

There it is. There's the question. 119s

Who wants to raise her hand and give me a number? 123s

So that's six you got? 127s

I grow up with a death. 131s

So this is six. 133s

That's five, six, seven, eight, nine, ten. 135s

That's three. 138s

I kid you not. 140s

That's three. 142s

So you were saying three. 144s

Who are the three be then? 146s

And a donor. 160s

A donor of what? 161s

Firm. Okay. 164s

So what he's talking about is technique called artificial insemination by donor sperm. 164s

Shortened it up AID. 171s

So that's three. 173s

Close them out there. 176s

Okay, you could have an egg donor. 179s

That's called OOSI donor. 181s

Now we're up to four. 183s

So the parents that the child is legally belongs to. 186s

And gamete cells sperm and egg from two more. 190s

That's four. 194s

A surrogate. 197s

The surrogate add anything. 199s

I mean we'd call them a parent. 203s

They're at nutrients. 207s

They're blood. 209s

It's all that kind of stuff. 210s

We're up to five. 212s

Wendell. 217s

Okay. 228s

When I started teaching this a few years ago, that was a theoretical possibility. 229s

You could take the DNA out of one egg and put it in a different egg. 234s

So this woman's donor egg, you could change the DNA. 238s

That's not a possibility. 243s

Was it possible in the past? 244s

Now it is beginning to happen. 246s

So we're now up to what was that? 249s

Six. 252s

You have another one you want to add? 255s

Well, I'm not going to get into how the young woman was born up to here. 258s

Or how does it end up in the white area? 263s

Why is that? 267s

That's not an accurate. 268s

It'll end up in the white area. 269s

I intentionally left out all that stuff. 272s

I was not getting involved in illegal, how many parents you have. 277s

It still says no divorce, no adoption. 280s

Are we up to six? 289s

Is that what we're up to? 290s

Is that it? 291s

Not yet. 296s

The loose question is can you take a sperm and take the DNA out of it and mess with that and eat? 297s

No. 302s

The sperm is too simple, guys are too simple. 304s

We just don't want anything happening to us. 306s

We're not complex enough to just deal with this at all. 308s

Women are a little more complex than we are. 312s

I went the wrong way again. 314s

So how many we have? 317s

We've got the legal parents. 319s

We've got the sperm donor and the egg donor. 320s

We've got the mitochondrial DNA replacement. 323s

That's the one we were just talking about where they take the DNA out and switch it. 325s

We've got surrogate and then we get Texas. 330s

Bevo? 336s

Oh, sorry. 340s

No, there's a case in Texas recently. 342s

Have you heard this? 344s

So two moms decided to have a kid and one mom's is the egg donor and I think it was done by even in vitro. 345s

I don't know where the sperm came from at all and then the other mom carried the kid as the surrogate. 356s

Did you hear about this one? 365s

I mean it's within the last month. 367s

So they both wanted to share and being the parent. 369s

Now how many parents did you have? 375s

I had two, right? 377s

He's going, no, that's an L. Sorry. 384s

Or that's 21. 388s

You just confuse your mom or more. 391s

That's an L or that's 21. 393s

So I only had two. 395s

He only had two because we're brothers that's the same two people. 396s

My kids have four I guess because we never got things done the right way or the usual way or stuff like that and our two children are adopted. 399s

So I now put adoption back in and they had a birth mother and a birth father and then the two of us. 408s

Okay. 417s

How complicated does this get then? 418s

Alright, so here it is. 422s

Infertility is about 15, 20% of the population, 30% of the time the challenges with the lady, 30% of the time, challenges with the guy, 30% of the time it's something in between and then there's us. 423s

They never could figure it out. 434s

We spend a lot of money. Our doctor has a really nice house. 436s

He's a really good guy. 439s

He was chairman of the congregation of the Big ELCA Church in Sioux Falls which has 5,000 members. 440s

We go in and my wife would be up in these things and she's talking and he's looking things over and we're talking church. 446s

Because you know that's what we do. 453s

He's the president of church council and I'm the pastor and my wife's like over here. 455s

Remember? 460s

Yeah. 462s

Things never change. 464s

He's a good guy though. 465s

I don't know what that would mean. 467s

How do you deal with this? 469s

Here are all the treatments. 472s

The first one is you do the reverse Roman Catholic thing. 475s

Does that make sense? 479s

Do I have to explain that at all? 480s

You look at the calendar and use a basal thermometer and you go the opposite direction as the Roman Catholics do. 483s

There are some medications. 488s

There's AIH and an artificial insemination by human, by the husband's sperm. 490s

AID. 495s

There's an ICSI, inner satire, the plasma's move. 497s

Yeah. 501s

That's where they take a sperm and they just inject it directly straight into the egg. 502s

That could be done with a husband's sperm or it could be done with a donor's sperm. 507s

You've all heard of in vitro fertilization, right? 512s

They take the sperm and the egg and mix it outside of the womb in a petri dish or somehow and they put it together. 515s

And how many embryos are in storage right now? 521s

I don't know. 527s

When does it look up for me? 528s

Thanks. 531s

But I think it's like a bunch. 532s

The technical term, a bunch, like well over millions. 535s

They're in frozen and then are in nitrogen right now. 542s

There's gamete in a philopian transfer. 546s

Oh, transger. 549s

That's not good. 550s

That should be an f in there, not a g. 552s

That's where they take the gametes and they put them in the philopian tube and hope they come together. 555s

This is that there's something wrong with the egg production or sperm or we got all kinds of endometriotus or something like that. 561s

You can do that with a zift. 570s

You can take the zygote and put it up there. 571s

You get them an O site donation and an embryo donation. 573s

Between an embryo and a... 579s

Yes. 584s

Between a zygote. 586s

Are there ethical issues? 591s

Let's take one that's very, you know, just kind of simple. 595s

AID. 598s

AID stands for... 599s

Artificial and Semination Donors sperm. 604s

This is exactly how every last dairy cow is in 70 years right now. 606s

Because there are no husbands and there are no bulls on dairy farms. 611s

You know that? 615s

There aren't any. 616s

They don't exist. 617s

Some where they exist but real dairy farms don't have any. 619s

They might have a bull to clean things up later and that's the way they talk. 622s

The clean things up later but there is no whole steam bowl on a dairy farm. 627s

It's all done by AI. 631s

Is there any problem with that in cows? 634s

You could have some lack of genetic and adversity but they work hard on it. 644s

Thanks for walking around. 650s

Miss Boots. 652s

These Boots are made for walking. 655s

So you could have that. 659s

They actually now have in cows and bovine they have sex selection already figured out. 662s

So you can actually pick out whether you want a male or female coming out of the steel. 667s

And they'll give you an 80-90% rate, something like that. 671s

And of course on a dairy farm they only want women. 674s

That's all they really want so they go that way. 679s

Any problem there. 682s

I mean all these techniques were developed in bovine stuff and livestock and horses equine. 683s

They do that in horses now too. 692s

Any problem? 694s

How about humans? 695s

If it's okay to do it in a cow it's okay to do it in a human right? 698s

Yeah, six fingers and six toes we got going on here. 707s

My name is Imigno Montoya you killed my father. 712s

We're fair to die. 715s

Six fingers and six toes. 718s

You could have a lack of genetic diversity. 719s

Okay. 721s

What might happen? 722s

I didn't bring the stuff in here. 724s

So Robyn and I. 728s

Siblings could marry each other. 729s

They would necessarily be siblings. 731s

They could be half siblings. 734s

Is that possible? 735s

Sure. 736s

All right so up our way I don't know about here because I don't know Texas very much at all. 737s

Up our way the nearest sperm back is in the cities in Minneapolis and St. Paul. 741s

And there was a case out of there where everybody picked the same guy. 745s

So the women get to pick whoever guy they want. 750s

And some of this is because husband sperm didn't work and it's an intact husband wife family. 752s

Some of it is because they didn't want a husband around and you know a variety of reasons. 759s

But a lot of people picked the same guy. 764s

So there was a thing in the Sioux Falls paper about number four hundred and I don't know what number it is. 766s

And everybody kind of picked him. 771s

And now there's a website because if you don't need sperm there's this wall saying we will not give you information about these people. 773s

But there's this wall. 779s

But the women all got together and we all said well we went to the same sperm bank and we all picked this number. 781s

Who else did it? 786s

And they found out there's a whole bunch of people in our part of the country that this happened. 789s

So it's possible that one half sibling could marry another half sibling and we get six fingers and six toes or whatever it may be. 794s

What other problems are there? 804s

I guess you're... 811s

I heard a voice from Canada. 815s

It was down south but it was better on the back if it was Canada. 818s

A child wanted to find their parent for genetic reasons or other reasons. 821s

Okay. Because of the neighbors. 826s

What is the impact I think you're asking on the child? 828s

In some way the child is now differently related to the mother than the father. 833s

Now will the child find out? 840s

Well they won't find out who the father was because the sperm donor is the sperm donor or father. 847s

What's the impact on the sperm donor someday? 857s

I mean he's just a college kid. 860s

He didn't pay 20 bucks to deposit something at the bank. 861s

You know he's not a big deal. 865s

You know it does this. 867s

Okay. 868s

Well someday he'd wake up and wonder how this all worked out. 869s

So there could be an impact on there. 873s

There's actually a story out of the University of Michigan where there was the go-to stud. 874s

So when in the early years when they had somebody who was needing this he would come in on many minute notice and there's like 1100 kids they figured out now are from the go-to stud. 882s

He actually was married to one of the nurses that was in the clinic and it was his job to help out. 895s

And so he was helping out people. 901s

I mean he looked at it as a kind of a kindness as a sacrifice. 903s

He did all these things and now he wonders how many are really out there. 907s

So he got what's the impact on the donor? 914s

What's the impact on the child? 918s

Would you tell the child this happened? 919s

I would think you better because then you're lying. 922s

I mean we made it very clear to our kids. 926s

We never hit it once that they were adopted. 928s

Is there any shame in adoption? 931s

In fact you're all adopted. 934s

You know that right? 935s

Ephesians says we're all adopted in tri-stuces. 936s

So that's their story. 940s

Their story doesn't begin with a hospital. 942s

It begins with a Lutheran social services where we went and picked them up. 944s

So please. 952s

Do you all hear them? 990s

So the question is he's saying that this is kind of a natural thing. 994s

I'm saying already with this one they're all kinds of issues. 999s

Before you even get to the next one. 1002s

So this one seems like a pretty simple deal. 1005s

The one you're talking about I would firmly agree is much more complex. 1008s

And now the real question is unintended consequences. 1012s

And what else will happen? 1016s

It is not allowed to happen anywhere in the world right now. 1018s

But that doesn't mean it isn't happening. 1022s

You know the UN has had says we cannot do this but some Chinese guy just did it. 1025s

What's in their case where the donor father has been ordered to pay child support? 1032s

For the... 1039s

I don't know for sure. 1040s

I think it's Washington state or something where they had... 1041s

As being a couple they had the child by AID. 1044s

They went on welfare and the court ordered him to pay child support. 1050s

You know I'm not going to get into legal questions because almost anything can happen now that way. 1054s

I'm not even going to attempt to try to deal with legal things. 1061s

But you know normally there is this wall that says if you donate we will not tell anybody who this is. 1063s

What's the other challenge with this now is I'm the child of this relationship. 1071s

My kids have a little bit of knowledge of who their birth parents... 1077s

Well my daughter knows who their birth mother is. 1083s

But her birth father she doesn't know much. 1086s

As she gets older how will she be able to ask her parents about all the questions that come with when you get to the doctors about what is your relationship with your family and how all these things happen? 1089s

Did you have heart problems? Did you have kidney trouble? Is it in your all? She doesn't know. 1101s

If it's a donor sperm and there's this absolute wall there's no way. 1106s

In my daughter's case her birth mother just diagnosed with a very aggressive form of breast cancer. 1111s

She is a... 1119s

Nicole is about I don't know 45 or something like that. 1121s

And because they know each other and their friends on Facebook and all this stuff. 1125s

Nicky Sarah's birth mother said you better go get tested right now. 1132s

And then actually they came back about a week later and said no you don't need to be tested. It's not actually a genetic thing. 1136s

But here's just even of this simple thing how do you have that kind of stuff? 1142s

Now my kids don't know but this is adoption. 1146s

Here's another level of it. 1150s

It's back to you again. Congratulations. 1152s

Oh I was just going to tell you I have a the administrative assistant who works with me is 58 and she did an ancestry.com test because she was adopted. 1154s

Long story short her adoptive parents are dead. She found her real dad. 1165s

And she's like completely obsessed with it. 1171s

It's like even her husband's mad at her because she just always wants to go see her newfound dad who's in his 70s. 1173s

And she feels like she missed a lifetime. 1181s

And that's not that. That's adoption too. But those ancestry tests can have. 1184s

Interesting. These kind of things are happening. 1190s

Alright so here's just some simple things with the simple thing. 1192s

We haven't gotten to the complex really hard ones. 1195s

We just took some ethical issues on a simple one. 1198s

Genetic diseases. 1202s

Just want to talk about what's happening today. 1204s

Cystic fibrosis. This is old facts. 1207s

But the number of people with these diseases is going way down. 1209s

Why is it going way down that last line? 1214s

How many down syndrome people will there be born in the next generation? 1219s

I think the number right now is about 90% of the people who find out they have a child who have down syndrome. 1225s

Which is not a genetic problem. It's a problem with chromosomes. 1233s

So it's in the process of the baby dividing and becoming bigger and bigger. That's where it happens. 1238s

It's not somehow it's in my genetics and my wife's genetics. It's a different kind of a thing. 1243s

They think that 90% of them are being aborted right now. 1250s

In Iceland it's very clearly haven't had one born in many years. 1254s

Because they just get rid of them. 1259s

Is the world a better place without people who have down syndrome? 1262s

Or pick your deal, right? 1267s

I had a student in class when I was teaching undergrad who came into class one day wearing a Yankee shirt. 1269s

And I almost made the Darth Vader noise. 1279s

Because this is the evil empire. 1283s

I'm making fun of him. 1287s

Why are you wearing a Yankee shirt? 1288s

Well you got to go to the Yankees game. 1291s

Because I got there because I make a wish foundation. 1293s

Now I'm feeling bad. A little bit. 1295s

Why did you get to go there and make a wish foundation? I have cystic fibrosis. 1297s

So it was a theoretical question at that point in this class. 1304s

And also I'm making a very specific question. 1307s

So I flat out ask him if they could have saved you from the cystic fibrosis would you wanted that? 1309s

His answer was, I don't know. 1316s

I've always had it. It's me. 1323s

This is who I am. 1325s

Is what the strengths that we have make who we are or is it our failings? 1327s

And the answer is sure. 1332s

Absolutely. 1336s

This guy, a Colombian in New York City. 1341s

A lemonade disease is a noble goal but also should give us pause. 1343s

If a society is so willing to screen aggressively to find these genes, 1347s

then to potentially have them work the fetuses, what does that say about the value of those lives who have these diseases? 1350s

And there's also a subtle pressure. 1362s

You know if you have a cow to a downs, it's going to cost more. 1364s

And we want to save society all this money. 1367s

So you know you really should do your part as an American. 1371s

The guy whose library is not very far from here, 1374s

he's to say, buy American, do things that way. 1376s

We know this guy. 1379s

Something about a W or something. 1381s

I don't know. 1382s

But this, what I don't know, I don't know. 1383s

But instead, what would happen if it's now you're called your patriosis and you're called into a event, 1390s

into question because you're having a child that's all going to cost us a lot of money. 1397s

You know already now, health plans are saying if you're overweight, 1406s

it's going to cost you more money and everybody else more money. 1409s

So we're going to start charging you. 1412s

Let alone the smokers and the other people in the first place. 1413s

Okay, so here are the ethical issues. 1420s

Is there a right to reproduce? 1422s

Maybe. 1425s

What's the best interest of the child? 1427s

I want to have a kid. 1430s

This is the way I want to do it. 1434s

It's going to be interesting that kid that's from two moms, 1437s

how they're going to explain that whole story someday. 1441s

You know? 1445s

Is that the best interest of the child? 1447s

I don't know. 1449s

The right to information, do you have the right to information about your genetic origins? 1451s

Well now we can get on the internet and we can send in the stuff that we spit a little bit 1455s

and we take care of it. 1458s

And we can find out that we are mostly Western European. 1460s

My brother did this. 1466s

I have no desire to know these things. 1467s

I think our genetics are similar. 1469s

So we're most Western European. 1471s

Our family first came over and... 1474s

Well, yes, something like that. 1479s

1658. 1480s

We were here before a lot of people. 1481s

But I already knew my genetic origin. 1483s

I was born in this country. 1485s

That makes me native. 1486s

The right to know about genetic origins. 1490s

So not only the information about it, but the truth about it. 1493s

What's the effect on people? 1498s

And this last one, you know the word eugenics? 1500s

We are all in favor of eugenics when it comes to bovine with cows. 1505s

Right? 1509s

We want to make cows better. 1510s

And the way we know they make them better is they give more milk. 1512s

And they have high butter fat. 1517s

Do you know this stuff? 1518s

Is this sound familiar at all? 1521s

Yeah, I mean some people have been around farms. 1524s

So we know what that exactly means. 1527s

Can we make better people? 1528s

Should we only let certain people reproduce with each other? 1532s

What does this sound like? 1537s

Market Sanger. 1545s

Yes, it sounds like Americans in the 20s and 30s 1546s

let alone Germans at the same time period. 1549s

Right? 1552s

And there was this experiment going on in some far off country 1556s

called Minnesota. 1559s

You may have heard of it. 1560s

But they were trying to get rid of those who weren't as good as the others. 1561s

The students today looked at a case in 1972 or 1973. 1567s

This is still going on in a far off place called Alabama. 1572s

You may have heard of this. 1576s

We were forcibly sterilizing women 1578s

who they didn't think should be able to reproduce anymore. 1581s

And doing it in a way they had no idea it was going on. 1587s

It was a real problem with informed consent. 1589s

Now I don't know about you, but I remember the 70s. 1593s

Some of you remember the something you don't, I get it. 1597s

But... 1600s

Oh, thank you. 1603s

What happened now? 1606s

What did you do? 1608s

Well, there's one who wasn't even born. 1609s

Caleb, what century were you born in? 1612s

Well, the 80s. 1616s

You know, I remember the 70s, right at the bell bottoms, the plaid pants, 1619s

the platform shoes, the lack of... 1623s

Okay, so that's that work. 1631s

Let's do some of those. 1632s

So what are the challenges with these treatments? 1634s

Oh, yeah, please. 1637s

We've talked a lot about impact on the children. 1639s

The question I have is what about the impact on the rest of the members of that family? 1643s

Sure. 1649s

Yeah, no, it's going to be a challenge, right? 1651s

Now, sometimes the rest of the people in that family have the same thing. 1654s

You know? 1659s

But how is that all going to work? 1662s

You notice I didn't answer the question, right? 1668s

I just raised the question. 1670s

Cool. 1676s

Cool. 1677s

Okay. Let's move on. 1677s

We'll move on to something to do with judgment. 1679s

In front of you, I didn't change the name on here, but I changed it in the other place. 1681s

This lady's name actually is Marsha. 1684s

That's her real name. 1686s

I put Susan on there to begin with. 1688s

So Marsha is a 67-year-old married woman with two sons and four grandchildren. 1691s

She has been sick for many years. 1697s

She's been on disability for a decade. 1700s

She struggles with dizziness, lightheadedness, and weight. 1702s

This is a real human being. 1705s

She was a member of our congregation, and I asked on Sunday her husband, Roger, if I could bring this story. 1707s

And he said, sure. 1713s

This happened last summer. 1715s

She goes to the pulmonologist because of difficulty in breathing. 1717s

She's been having difficulty in breathing for a long time. 1720s

But she is cognizant. 1723s

She is aware. 1724s

She's everything. 1725s

She just goes to the pulmonologist. 1726s

He runs some tests and sends her home. 1728s

That would do. 1731s

Doctors do. 1732s

Run some tests and send her home. 1733s

Says, I'm not sure what to do. 1735s

When she gets home, she complains she can't breathe. 1737s

So what does her husband do? 1739s

He calls the ambulance. 1741s

We have ambulances and stuff to go to just a case you're wondering. 1743s

It's not dog sledding. 1746s

It's like the Canadians in the room. 1747s

And she's transferred to the big hospital. 1749s

Oh, no. 1751s

At the hospital, CPR is needed. 1751s

She codes. 1753s

And they put her on a ventilator. 1754s

A little tiny hospital has four beds. 1757s

Something like that. 1760s

It's just really a first-day station moving you on to the big hospital. 1762s

Big hospital is a level three, at that right, level three, drama unit. 1765s

Yeah, it's huge in Sioux Falls. 1770s

She never regains consciousness. 1772s

After a couple of days of test, the intensivist wants to know what to do. 1775s

You want an intensivist? 1779s

You don't know that? 1782s

So there's a hospitalist. 1783s

They work in hospitals. 1785s

An intensivist works in intensive care units. 1786s

So that's, he's an internal med doc normally who is specialized in this kind of medicine. 1791s

Marsha's, we're gonna leave, has been an active member of the church all over adult life. 1801s

Her family has come together. 1805s

Some of them live, one son lives in the cities. 1806s

One son lives in Des Moines. 1809s

They're all there. 1811s

Okay. 1812s

So you're a member of the family unit. 1813s

You're an aunt and a cousin. 1815s

What would you ask? 1817s

Or what would you say? 1819s

Yeah, Steve. 1823s

Did she have a living will? 1825s

Did she have a living will? 1826s

Or a DNA. 1828s

Or a GNR. 1829s

Or a DNR, excuse me. 1830s

Yeah, she made choices around that. 1832s

I would ask that. 1834s

No. 1836s

Has it ever been discussed? 1840s

I don't know. 1843s

Have we ever discussed heaven? 1845s

She and I discussed in her husband had discussed heaven a numerous occasions. 1846s

Because, you know, her house wasn't all great. 1850s

But she literally is basically pretty fine. 1852s

You know, she's had trouble, but she's never had anything life-threatening trouble. 1855s

What is her family unit? 1861s

What is her doctor think or the chances of coming off the ventilator? 1864s

She is breathing a little bit on her own, but it's mostly the ventilator. 1867s

Is she brain-gued? 1872s

Is there any brain activity? 1874s

Well, they, of course, did not run an EEG. 1878s

If that's what you're asking, they don't normally do that. 1881s

They would do the tests with, you know, you do the little hammer thing, 1885s

and the best with your bottom of your foot. 1889s

It doesn't seem to matter how much going on. 1892s

You can't squeeze when you ask her. 1894s

There are no signs that there's anything going on there. 1897s

She's laboring, breathing, even with a ventilator. 1902s

She's certainly not comfortable. 1906s

Not any of that. 1909s

How does she feel? 1912s

Yeah. 1914s

We have no idea. 1914s

She's not conscious at this point. 1916s

The doctor has run a couple of days of tests, and they've tried a bunch of things to see what they could do, 1926s

and he's basically saying there's really nothing more we can do. 1932s

What we probably need to do now is take her off the ventilator and transfer her to someplace else, 1937s

because the ICU unit is not really for people who are just here. 1943s

We probably need her to move her somewhere else. 1948s

You have a little time to think about it, but that's, you know, perhaps what we're going to do. 1950s

Are you just playing with your hands to the other side? 1960s

Okay. 1961s

You're the family. 1965s

How do you feel? 1966s

This is a tough situation. 1969s

It's a tough situation. 1971s

Yeah. No, they're crying. 1972s

So the two sons are, the husband is about five years older, and she is 72 now. 1975s

And the two sons are late 30s, close to 40. 1983s

They both have wives that are there and the grandchildren are nearby too. 1991s

What do they say? 1998s

What do they say? 1999s

What should we do with mom? 2000s

That's what they're asking. 2002s

And now you're part of that family. 2004s

I'm making it your decision. 2006s

And what would you say at this moment? 2008s

And what are the doctors telling the family? 2011s

Doctors telling the family, not getting any better. 2013s

What does the ethics group say in the house? 2018s

We haven't gone to them. 2020s

We don't need to get to them unless there's a problem. 2022s

At this point, I'd say it's between her and God. 2025s

At this point, you would say it's between her and God. 2030s

I'd take her off the ventilator and see what happens. 2032s

Enough is enough. 2035s

Let's keep her comfortable. 2037s

Let's move her into a situation where she's okay. 2038s

Anybody else got an opinion on that? 2043s

I can't. 2044s

You could ask what she would have wanted. 2052s

You could ask what she would have wanted. 2055s

Now, she doesn't have the legal documents. 2057s

You asked about earlier. 2059s

But you could ask what she would want. 2061s

You could ask that. 2062s

And the answer would be. 2065s

If she could speak what might she say in this situation? 2079s

She knew clearly that Jesus died for her sins 2083s

and that she's going to heaven someday. 2085s

Now, did she want to go to heaven that day? 2088s

No, she wanted a breathe. 2091s

It was very clear. 2093s

I'm in panic. 2094s

I want a breathe. 2095s

So, I'm in panic. 2096s

So, it's not that day she wanted to go to heaven. 2096s

Now, would she want to go to heaven at this point? 2099s

What's the challenge with asking that question? 2105s

I couldn't hear it. 2113s

You have to make a lie that her... 2115s

I put the position in my conversation or someone that can't make a decision. 2117s

So, you're putting that position and you don't know what they want. 2121s

And because you've made that decision, 2126s

then you may have the regret if you find out later that maybe something else could have been done. 2130s

So, you may have to deal with regrets and all kinds of stuff yourself or you're making a decision. 2136s

But what's wrong with the question of saying what would she want in this point? 2141s

Thank you. 2151s

So, you don't know what you want in that point until you're in that point. 2152s

All kinds of people say, I would never want whatever it is. 2156s

But then they end up in that situation because of a stroke or, you know, like, 2161s

is it your dad had a stroke, right? 2165s

Or, you know, whatever it may be, they might want not say that. 2167s

But then they end up in that position and go, well, I guess that's not all that bad. 2171s

It's not as bad as I thought. 2174s

I am the best. Yeah, I'm her pastor. 2179s

You've had discussions with the woman and her husband before. 2183s

Absolutely. 2187s

But we had no idea this was coming. 2188s

Exactly. 2192s

I mean, she seemed to be, you know, she wasn't healthy, but on the other hand, 2193s

she wasn't dying anytime soon and all of a sudden this happens. 2197s

Could have been a car ride or something. 2202s

Could have been anything, right? 2204s

Could have come to Texas to many people down here. 2206s

Got plowed down by something or whatever. 2210s

Are you freezing death up there? 2212s

Are you freezing death up there? 2214s

You know, I don't know if anybody has frozen death in South Dakota in a long time. 2216s

Now, there have been people that have fallen into the water because they've been out there ice fishing 2222s

and the ice isn't all that thick right now. 2225s

And they've died, but maybe the problem was they were ice fishing in the first place. 2227s

I don't know if they were drinking beer. 2235s

I'm not sure about that. 2237s

This is back to working. 2238s

Okay. 2240s

Why are we here? 2242s

Oh, I don't know. 2243s

I put it back where we were. 2244s

Okay. 2246s

How do we make this decision? 2247s

The way ethics tends to work is they think in these terms. 2249s

So they think of non-molevelants, which are the huge word, 2253s

does simply means do no harm. 2256s

What would harm be in this case? 2258s

Let's not do that. 2260s

And the family is pretty clear. 2262s

They didn't want to do anything that would cause her more trouble. 2264s

And they were pretty clear about how can we make it so that she's okay. 2269s

Actually, when they take the ventilator off, she had this, I don't know what the thing is, 2273s

but something about back in here, and her breathing got to be really hard, 2276s

and it was just really hard to be in the room. 2281s

She was gasping for air, seemed like. 2284s

And you know, that's both of them. 2286s

But something had something to do with the back of her. 2289s

Tongue back in here was causing this to close off. 2292s

So they ended up turning at the morphine a little more to calm her down. 2295s

Yes, they gave her morphine. 2301s

I mean, she was already attached to the gave her that. 2303s

There was some other thing that they put in there to kind of open it up 2306s

and see if they could do it in after about an hour or two of just really bad. 2309s

And I calm down. 2314s

But it was really bad there for a little bit. 2316s

Beneficence means to do good. 2319s

What's the best thing we can do for her? 2321s

Justice is, let's treat her fairly. 2324s

The question it was asked was, if this was your mother, what would you do to the doctor? 2327s

The doctor is not meant in before. 2335s

He was an excellent guy and says, number one, just because I would do this with my mother 2337s

doesn't mean that you do this with your mother. 2342s

We are not the same. 2344s

We have different sets of values and all kinds of things. 2346s

I don't really know you. 2348s

You don't really know me. 2349s

So while it's an interesting question, it is really answerable. 2351s

But that's justice. 2357s

That's what we do the same for everybody. 2358s

And the last one is autonomy. 2361s

And in medical ethics these days, autonomy is the question, who gets to make the decision? 2362s

Mark, did you have something you want to say in it? 2369s

I was thinking back on the first term and non-manableness. 2371s

You started off saying that the doctor would move her out of ICU. 2377s

But at that point, I would have said, is that going to be harmful to her? 2385s

She cannot stay in ICU because they are not doing any for her anymore. 2390s

There are protocols, there are ways of doing things that says, if you need this, you are here, if you don't need this, you are not here anymore. 2395s

He wasn't moving her out with the next five minutes. 2402s

No, I just got to say. 2405s

I was actually came and talked to them. 2406s

Oh, it was about noon on a Friday and said this kind of thing is happening. 2410s

I was actually doing a funeral, well almost 200 miles from there at that point. 2418s

So I got in my car and I went immediately down there. 2422s

They didn't want to be any decisions till I showed up. 2424s

And so that takes about, well, South Dakota is like Texas. 2427s

You know the speed limits are kind of if you get in the way. 2431s

So 200 miles is, you know, what is that? 2433s

Two hours. 2435s

Actually, it's about three hours to do that. 2439s

Do you want the speed limit isn't South Dakota for the doctor? 2442s

80. 2445s

So it might be safe and crude. 2446s

Yeah, but we have no cars and no people said it really matter. 2448s

I think he has a point though, because it becomes a question. 2451s

I mean, obviously she wasn't expecting this. 2457s

But like as soon as you get the medical professionals involved and they do all that stuff, 2460s

then everything you stop doing, you feel like you're maybe doing harm. 2465s

Sure. 2469s

You know, so you're not necessarily like what if we just never called the ambulance in the first place and been like, 2470s

oh, looks like you're going to die because you can't breathe. 2475s

But that's what you do sometimes with people on like hospice. 2477s

It's like, please don't call the ambulance because all we're going to do is come here and intubate you 2480s

and you're going to die in the hospital rather than at home, which is, you know, 2484s

from your medisthenic cancer. 2488s

So it's kind of harder than you think. 2489s

It seems simple. 2491s

So legally, there's no difference between not having something and taking it away later. 2492s

But it feels different. 2498s

It feels different taking it away because somehow we're actively doing something. 2500s

But bottom line here, she's dying no matter what. 2505s

And we're not really making decisions about that. 2507s

She's dying. 2512s

There's nothing that anybody can do at this point about that. 2513s

The only real questions are, and he's not blunt, but he's trying to be kind and all that kind of stuff. 2517s

And when I show up, I tend to be a little blunter. 2524s

Because I got something on my side that the doctor doesn't have, right? 2528s

I mean, finally, she's going to have it here pretty quick. 2531s

And some of you don't need me at the end of the week. 2541s

Pretty straightforward. 2543s

Okay. 2546s

So this is the problem is, if you can't make the decision for yourself, 2547s

it's called substitute judgment. 2551s

Someone has to make it for you. 2552s

If you're going to make a decision for yourself, you have to be able to understand what's all that's happening. 2558s

That's called informed consent. 2564s

Do you all understand what informed consent? 2566s

Congratulations. 2570s

I don't really. 2571s

You know, if a doctor comes in and says, this is what we're going to do, 2573s

I don't really understand fully what he's talking about or what she's talking about. 2576s

Because I don't have the background they have. 2580s

Right? 2583s

We're going to work on your help. 2584s

I told you my wrist story. 2585s

We're going to put my wrist back together again the second time. 2587s

I asked the doctor, should we do this? 2591s

He says, yes, I love a challenge. 2592s

I'm like, okay. 2595s

I really want to be a jigsaw puzzle for the doctor. 2598s

This is my goal in life. 2602s

I want to grow up. 2604s

I want it to be something that the doctor could experiment on. 2605s

Should I do it or shouldn't I? 2609s

So there's knowledge base. 2612s

There's changing circumstance. 2614s

You know, at this point, maybe it's a good idea, but at this point, maybe it isn't a good idea. 2617s

And within her case, 12 hours, things change dramatically. 2621s

She was at the pulmonologist, the doctor who deals with breathing, 2625s

and within a few hours, she can't breathe. 2629s

I'm not blaming the doctor. 2634s

That's how it goes. 2636s

All right. 2638s

Here's the question. 2639s

If we're supposed to be autonomous beings, how does that fit in with who we are as Christians? 2640s

What do we tend to call autonomy in the church? 2645s

So the students are in the room or already heard this, and I call it sin. 2655s

Right? 2664s

Autonomy, me making decisions on my own is called sin. 2664s

When people started making decisions on their own, they decided to eat some fruit, 2668s

and the fruit got them into trouble. 2672s

And what was that fruit? 2674s

I know, kung-kwa is what I think, because they taste terrible. 2678s

But I don't know. 2681s

It's some sort of fruit of the tree of knowledge, you're good at view. 2682s

They ate it, and apples are good for it. 2685s

It can't be an apple. 2687s

So they ate this fruit in the ground, so it's in real trouble. 2688s

Correct? 2691s

If I make decisions on my own, I'm also just flat out stupid, because I am, right? 2693s

And any time I make decisions on my own, as a married man, I get myself in real trouble, 2702s

including deciding what I'm going to wear today. 2709s

You're not really going to wear this, are you? 2711s

No, I think I am. 2713s

No, no, you're not really going to wear this. 2714s

Okay, yes. 2717s

I think you know better than I do about what I should wear, for what I should do, right? 2718s

And besides that, I'm not an autonomous being, not even Ruth and I, because I have kids. 2724s

And what my do has an impact on them. 2729s

And more importantly, I have grandkids. 2731s

Right? 2736s

And it's even butter. 2740s

And I got these two people who call me pop all the time. 2742s

And you know, whatever they say, I'm doing, because that's what I'm going to do, whatever they want to do. 2746s

And they're like, well, pop it, it's here, we're just going to have a blast, we're having fun. 2750s

Because there are no rules. 2754s

There are very few rules when I had kids, but they're even less now. 2758s

The problem with this is substitute of judgment is, how do you make a decision for somebody else when they might change their mind regularly? 2762s

My wife's never changed her mind, of course. 2772s

But how somebody else might have changed her mind once in a while. 2774s

And how do you make a decision that's accurate? 2778s

And once went to a lecture, led by an ethicist out of the big hospital system in Milwaukee. 2781s

And he did a little experiment. 2788s

He took a document about what could happen and what would you do, some circumstances to two people. 2790s

And he said, why don't you fill it out on behalf of the other and you fill it out on behalf of the other. 2796s

They were right about 50% of the time. 2800s

He'd filled out the same forms because there were his parents. 2804s

And he wasn't right 50% of the time. 2809s

So here's just this little family of people that are heavily involved. 2811s

I mean, I think he said his father was a doctor, in fact, that they couldn't guess what each other wanted. 2815s

And then you put in family. 2825s

And this family, perfect. 2827s

Don't ask him. Don't even ask him. 2832s

Well, that was you. 2836s

I keep saying family, everybody should have one. 2838s

You know, because there are a few challenges along the way. 2840s

And I have never found a family that got better the day pressure was put on them. 2845s

It just doesn't seem to work that way. 2851s

So how do you make decisions? 2853s

Autonomy is the first step. 2855s

Substitute of judgment is the second step. 2860s

I would like to argue now for something else. 2863s

And it's the last step up there. 2869s

What does that mean? 2871s

Or at least to the patient. 2879s

So when my children were young, I did not ask them. 2881s

My daughter was two and she had pneumonia. 2885s

We did not ask her if she wanted to go to the hospital. 2887s

Ruth and I made a decision. 2891s

I had a funeral to do that day, so it was really hectic and really tough. 2893s

But we still made a decision. 2896s

Doc said she needs to go to the hospital. 2898s

We took her to the hospital. 2900s

Took her to the hospital and these days they weren't too smart. 2901s

So they had a crib in the room and they put the IV in the crib into her. 2904s

She was in the hospital for a week. 2909s

She never went back in the crib again. 2911s

Because that's where you get pain. 2913s

They've learned since then to do this down the hall someplace. 2916s

And anybody ever came in that room wearing white, she would scream to high heaven. 2919s

So we had to pay the respiratory therapist a bunch of money so that I could stay in there 2924s

and hold this in front of her mouth. 2928s

Because that person's not getting nearer. 2930s

She was very clear. 2931s

But we did it because it's in her best interest. 2934s

She did not like it at all. 2936s

Someday, my daughter is going to have to do things in my best interest. 2939s

Correct? 2944s

She's going to need to take into account everything that's happening at that moment 2946s

and say, this is what we need to do with that. 2950s

I've told her you've got to take the keys at some point. 2954s

Because that's in my best interest if you take the keys. 2957s

I probably never will give them willingly. 2960s

Ah, if she gives me keys, I always give them my pockets. 2962s

I have to have that. 2965s

I've told her clearly, never give me a nursing home near a golf course. 2966s

Because I will be out of that building so fast and wandering around you can't believe. 2970s

So she has to make these decisions, right? 2975s

Can she ask me what I think? 2978s

Sure, but it's finally her decision. 2980s

I don't want her to have any guilt or at least guilt is possible. 2982s

Just do whatever in my best interest with one caveat. 2987s

I'm going to heaven. 2992s

Jesus said it's clear. 2994s

Just make sure that you know that's okay yet. 2998s

Don't delay that if you don't have to. 3003s

Does that make sense? 3006s

We get all wrapped up in these DNRs and all this stuff and we'll talk more about it on Thursday. 3008s

But finally comes down to you. 3014s

Do you trust your daughter or your son or whoever's going to make this decision? 3015s

And yeah, they do stupid things my kids do. 3020s

But they learned it from me. 3023s

So it's okay. We're in this together. 3024s

So I just trust that my daughter will do this. 3028s

Now my son, I hope he never has to do this because that's a older problem. 3030s

But my daughter and she already knows this. 3035s

But at some day she's going to have to make decisions about her parents. 3037s

Just like some day our brother, not the two of us, but our brother, 3042s

is going to have to make decisions about my dad, our dad, and his wife. 3045s

The other brother is doing this because he lives 70 miles from them. 3052s

And Steve lives in Waco and I live in South Dakota and they live in Michigan. 3056s

And Peter should make these decisions because he's closest. 3063s

Even though I spend all the time thinking about it and he's a CPA and he should take care of the money. 3065s

But that's a different issue. 3069s

But he's there taking care of them on a regular basis. 3070s

So the real question is, and if I was this Thursday, 3072s

do you have somebody that you've already appointed and have the agreed to it? 3077s

Because as we talked about, it could happen to any of us on any day. 3083s

I'm not going to ask you to arrange my own case on the daughter or whoever's going to arrange your best. 3088s

So if I, whoever this is, I need to make sure that they know they're going to make the decisions. 3098s

So my daughter knows that fully. 3106s

We actually did the legal document too that says her. 3108s

And in South Dakota, I don't know what the rules are in Texas. 3111s

In South Dakota, she would have been the one chosen anyway according to the law. 3114s

Okay. 3125s

The challenge is what is the role of suffering in the life of a Christian? 3128s

Often people say, I don't want this to happen to me. 3133s

Right? I never want this to happen. 3141s

Do you get these choices? 3145s

Why were you born in, I don't know where you're born. 3148s

But why were you born in this country as opposed to Rwanda? 3151s

Ethiopia. Canada. 3159s

You know, it's picked some far off place. 3160s

I don't care where it is. 3162s

Why were you born here? 3164s

Why were you at this place in this time? 3165s

Why were you able to walk here and be here? 3169s

Is that you're doing? 3173s

Of course not. 3176s

If suffering comes, actually, when suffering comes, is that your choice? 3179s

Does God want you to suffer? 3185s

No. 3187s

But suffering is a part of this world. 3189s

It comes because of sin. 3191s

Maybe it's something that's specific since. 3193s

Maybe because of just general that's sin in the world. 3195s

Why do I have asthma? 3198s

Did I do something wrong? 3200s

No. 3202s

I got it from my dad and my mom. 3203s

He didn't get that one. 3206s

He didn't get that one, did he? 3207s

No. He got other things. 3208s

I got that one. 3209s

Okay. 3211s

Why did I get it and he didn't? 3211s

I don't know. 3215s

But I'm in church, right? 3217s

What is the rule of suffering in the life of Christian? 3223s

When you suffer, is that bad? 3226s

Of course it's bad pastor. 3230s

It's suffering. 3232s

We're not into this kind of stuff. 3233s

We're not the type to go knocking on doors just to have people 3236s

be mad at us and we can suffer. 3239s

That's not us. 3241s

Those people come from other places in the world. 3244s

That's not us, right? 3246s

We just like to be good kind of people. 3247s

Just leave us alone and we won't suffer. 3249s

But of course it's why I am weak that I am strong, Paul. 3253s

Secondly, so it has a benefit for the sufferer. 3260s

Does it have a benefit for the family and friends of the person? 3263s

I broke my wrist. 3267s

I couldn't drive. 3268s

Actually I couldn't drive because I was on some really good medication. 3269s

They actually let me preach on some really good medication one Sunday. 3274s

I didn't get addicted to this really good medication but you all know what it is, right? 3281s

It's this oxy-something or rather. 3285s

And I just decided I better not drive. 3287s

I didn't stay on it very long. 3291s

Even after I got off of it, I better not drive. 3292s

I have this broken wrist. 3294s

I'm going to work in my arms right now. 3296s

So what happened? 3297s

A whole bunch of church people got the hall of the pastor on. 3299s

No, actually it was a good thing, right? 3304s

And so instead of me going to see a shut-it, now we have two people going to see a shut-it. 3306s

Maybe we should have been doing this in the first place. 3310s

And they got the pleasure of, all right, I need to go see somebody in Sioux Falls. 3314s

It's a hundred miles brown trip. 3317s

Who can take me? 3319s

Hands go up. 3321s

We're going, right? 3322s

Got to spend the day together in the car. 3323s

And I'm fine. 3326s

Right? 3328s

And they're fine. 3328s

And the people are fine. 3329s

And we're good. 3330s

Does my suffering, my pain, have an impact on others? 3332s

In this case, it was very positive. 3335s

It also helped me see how silly sometimes the whole systems are. 3337s

Because I told the students, I got the second time I did surgery, the problem was, 3342s

this was a Makita in here, and they only had duels. 3345s

The screw bit was different. 3350s

They had to take it out and put a different one in. 3352s

And then they had to go through all the process of sterilizing it. 3354s

And I'm sitting on a journey while this is all happening. 3357s

I just, it was cracking me up big time. 3361s

And I don't remember whether the yellow was the right one, and green was the wrong one. 3362s

But I had, first surgery done in one hospital, and the second surgery done in a different hospital. 3365s

And I got 13 screws in my wrist on the way down. 3369s

Do you have anything in your body? 3373s

Yes, I have something right here. 3374s

So I told them once. 3376s

But, you know, it's a whole thing, right? 3377s

Suffering allows us to help others, even though we don't like it. 3382s

Do you know the name Henry Nallen? 3387s

Henry Nallen is a Roman Catholic priest. 3390s

I don't think he's alive anymore. 3392s

But he wrote about for about four or five years he worked in a place with people who couldn't talk or move or hardly anything. 3394s

It's severely disabled. 3401s

And he gave them bars, and he took care of them, and he did everything. 3405s

And he learned more from them than he learned from anybody else throughout his life, about Jesus and his love. 3409s

The amazing thing is we all want to give, right? 3418s

We want to give. 3420s

It's better to give them receipt. Where is that written? 3421s

It's a hallmark card. 3428s

Where you go. 3430s

What's so many of the ego to? 3433s

It's actually in the book of Acts, right? 3436s

You know this? 3438s

If you said, better give them receipt. 3439s

But if I'm giving all the time, who's receiving? 3441s

And sometimes maybe I'm called to be the recipient, and just to stop for a minute and let other people help me. 3445s

Although nobody likes to do that, but maybe it's important for me to do. 3456s

Okay. 3464s

Last topic. 3468s

So we talked about some ethical issues at the beginning of life, and there are many challenges there. 3469s

There are all kinds of ethical issues when we get to substitute a judgment. 3475s

The one I talked about tonight is a fairly easy case, right? 3478s

I mean, this isn't very hard. 3481s

She's dying. There's nothing much more we can do. 3483s

They waited until I showed up because they wanted me in the room before the immediate decision. 3485s

And I'm like, okay, what are we waiting about? 3489s

And the doctor said, yeah, you can stay here another night, and then tomorrow we're going to move them to another facility. 3493s

And the great thing was I was starting on my way down Saturday morning to go see her, and I get the phone call and said, guess what pastor she went to heaven? 3500s

So I didn't have to drive all this. She'd fall, so she didn't get moved to another facility out of the room. 3508s

And I just met the family back in the town where they're from and a little later in the day. 3514s

And we got to celebrate God's grace. 3519s

Now, her husband is 71. He's been a widower now since last summer. 3522s

And when I asked him the question, you could tell it it was still hurting. 3526s

So there's still pain. There's still trouble. 3531s

And it's a challenge, but we all know what Marsha believed and where Marsha is on God's promise. 3533s

Some of these are very hard questions when it comes to substitute judgment. 3540s

Actually, most of them are pretty easy. 3545s

Because by the time you get to these questions, it's pretty straightforward. 3549s

Now, I mean, take my word for it, but often there are a lot of things to get to that point. 3554s

But when it comes to the end, it actually gets fairly. 3560s

So we talked about those. Here's a whole different issue. 3569s

And one third of the population in the United States, all of Canada, has the right now to go to a physician and ask for some medication and end their own life. 3573s

I was asked by a pastor who was part of the group called the Canadian Association of Lutheran Churches, Calc, 3586s

which I think Mark, you're a part of that group, right? And Teresa, you're not. 3592s

I know one of those. Mark, part of this group. He and I were at the same meeting together. 3597s

A pastor asked me on the guy from America. I went up to Canada and I ought to give a presentation. 3600s

This happened. I don't know what to do. 3606s

Pastor says, I got a member of my church who is going to his doctor to get this stuff. 3609s

And he wants me there when he takes it and ends his life. What should I do? 3615s

And all of us people go, right? What are the issues here? 3628s

So why am I happy to see that answer when we don't? Because clearly that priest wouldn't be there. 3639s

I don't know whether clearly the priest wouldn't be there. I don't know that for sure. 3648s

I don't know. The doctor doesn't agree with the assisted suicide. 3652s

Yeah, but all kinds of things happen on a local parish level that is not in agreement with what they're doing. 3660s

You know that, right? 3666s

I know that the issue is they have an answer. The answer is you don't do it. 3667s

Right. Isn't that our answer? 3672s

Surely that's good with us. 3674s

Yeah. Now, do we want to be involved in sin? 3676s

So, one of my members calls me up and says, Pastor, I'm going to sin today. 3680s

Would you please come over and be with me while I'm doing it? 3683s

Right? I mean, it's a ridiculous question. 3687s

In fact, they don't want Pastor doing it being there when they happen, because it'll stop them from doing it. 3691s

So, in some ways, it's a very simple question. 3698s

You don't go where sin is happening and be there. 3701s

On the other hand, this guy is going to heaven, or not. 3705s

And shouldn't you be there to visit with him? 3712s

Shouldn't you have visited with him before? 3717s

Well, sure. 3720s

And my thought is, who's going to... 3721s

Who's going to talk to my behalf to God because I helped this person? 3728s

Well, okay. 3736s

I mean, that's between him and God. 3737s

But if he wants me there... 3739s

So, if this is a sin that you're there, could you be forgiven in the sin? 3742s

Sure. 3747s

But do we go into things saying, I'm going to sin now, please, Lord, forgive me later. 3748s

That's somehow making a mockery of the whole situation, right? 3753s

Now, we do it all the time. 3756s

We just never say it that way. 3757s

Now, we go to communion and we say, Lord, please be with me. 3760s

Forgive me. 3763s

Give me the strength to leave this place and not sin. 3764s

How far do you make it back before you sin? 3767s

Oh, you make it all the way back and then you... 3772s

Oh, standing up on here. 3774s

Okay. 3777s

Right? 3779s

Because you get on the way back, you see somebody go, oh, really? 3780s

Or do you think about, I don't know, whatever it is, football. 3784s

This part of the country, they think about the saints. 3788s

Is that right? 3790s

Is that correct? 3791s

I think I knew that, yes. 3793s

And, you know, what are they going to do today and all that kind of stuff? 3797s

Or do they think about, you know, what one of the lunches? 3800s

That was pretty good, but what one of the... 3802s

And you get all kinds of things. 3804s

Luther once said this guy had said he never sinned. 3806s

So, Luther said to him, let's try this. 3809s

Let's pray the Lord's prayer together and you think about God perfectly. 3811s

How far do they get? 3815s

Not far. 3818s

Let's just go that way, not far. 3819s

So, we're sinning all the times. 3821s

I think that's the telly. 3824s

I think that pastor has a publication to tell him to tell him who it is. 3826s

Okay. 3832s

So, Robin? 3833s

Sir, I'll say it again. 3834s

I think the pastor has an obligation to tell him that what he's doing is wrong. 3835s

Because if the pastor won't tell him that, then who else is going to tell him that? 3839s

And then worst case scenario, he goes and dies alone and feels alone. 3844s

But gosh, do you really want to make him not feel alone? 3852s

And that? 3855s

I mean, not that you want to make him feel alone. 3856s

I don't mean that. 3858s

But you have to not condone it. 3858s

You have to be the one to stand up and say, no, he might be just waiting for somebody to say, 3860s

you don't want to do this. 3864s

Yeah, exactly. 3869s

And here we go. 3871s

Oh, you keep running. 3872s

Those boots are made from running. 3874s

It's asking for justification for his decision. 3876s

An endorsement for saying, 3881s

or what else could it be? 3883s

He's scared. 3887s

And do people who are scared do things that they shouldn't do? 3889s

Theresa. 3897s

Couldn't you as a pastor tell him what he's doing is wrong and still be there for him? 3898s

Okay, you could be there for him, but are you in the room? 3906s

I mean, what people do things that are wrong, I go to them and say, 3910s

you know what you do is wrong. 3915s

It's called sin and grace. 3916s

The fancy turn of the law in gospel. 3917s

And say, you know, that was wrong. 3919s

We talk about forgiveness and then we give forgiveness, right? 3922s

God is with you. 3927s

He cares for you, who loves you. 3928s

It's my job to be with people, not to be outside of people. 3930s

I'm the shepherd, right? 3936s

The pastor, that's what a pastor means. 3937s

Pastor is supposed to hang out with a flock. 3939s

I just give you a little way of thinking about this. 3943s

I mean, how many couples getting married are already living together? 3946s

You haven't been here very long. 3954s

No, I haven't. 3956s

And I am not squealing on anyone right now. 3958s

Squealing. 3962s

No, I don't know. 3963s

I think, you know, I think if you were to ask, most of them are living together. 3966s

Is that a sin of a willful disobedience to God? 3971s

Maybe. 3976s

Is it a sin of my parents got divorced and never worked for them? 3976s

And I'm not sure how this is going to work. 3981s

And I just had one recently where the mother of the guy is not paying for the apartment for the two of them. 3983s

They can move in together, because it would be cheaper. 3994s

I have an easier time dealing with people who are sort of outside of the church or on the edge of the church on issues like this. 3998s

And bringing them in because they're weak and they need help. 4005s

Then I do if it was somebody in my confirmation class that I haven't teaching and knowing for the last 22 years or all of their life, 4008s

and then they're going to go off and do this. 4015s

In some ways, this one is easier because I don't know them, and I'm helping them who are weak. 4018s

This is a guy or a girl that I've known all their life. 4023s

I know their parents, I know their grandparents, and you are willfully disobeying God. 4026s

Now I don't know that that makes any sense, but that's where I'm at with that one. 4031s

Steve, bail me out. 4036s

I have a question. 4038s

And yeah, I'm not a fairer, new believer. 4042s

There it goes. 4049s

I just love how they're just all of a sudden loud. 4051s

All right, so, 4053s

it's assumed for a minute that the pastor in this situation obviously is saved. 4058s

Let's assume the guy is going to do himself in. He's saved too. 4062s

If, again, I'm a neophyte, I'm no pastor, but I'm learning a lot. 4068s

So if that's the case, and they both make the conscious decision to go ahead, 4074s

okay, I'll be here with you, but it's wrong. 4079s

It's sin. 4083s

And maybe by me being here, I'm willfully sinning, and the guy is doing himself in his willfully sinning. 4085s

But they pray about that, and they know that it's, I mean, if that not covered by grace is my question. 4092s

I think that's a great question. 4099s

Are we at all? 4102s

For that back then, and believe me, I've got a past, and it was hard to let go of, 4104s

but I've given myself enough grace to let go of that. 4109s

It's a miracle. 4112s

In Jesus Christ spoke to me on Thanksgiving weekend of 2017. 4113s

And you say to most people in the street, you look at you, you've got three heads, but I know he did. 4120s

Sure. 4125s

And that made the biggest difference. 4125s

And I've learned an awful lot about grace since then. 4126s

Still have a lot to learn about that, and a lot of other things. 4129s

But the biggest gift that I got beyond the salvation was somebody told me, 4134s

don't leave grace on the table. 4139s

What about that, Steve? 4142s

And that made sense to me, and I worked through that, and stuck with that for a long time, 4143s

and it finally became clear to me, and I like Stephen Bradley a whole lot better now. 4149s

And I know where I'm going when I'm gone. 4155s

So I'm totally, I'm all in on grace. 4158s

If that's the deal, then my future is assured. 4162s

Now that does, obviously, isn't going to give me license to go run wild. 4166s

You know, that's cheap, cheap grace. 4170s

That's a whole other discussion. 4172s

But for this particular situation, it just comes to mind that if that's the case, 4173s

and I really care and love this person from my heart, 4180s

and maybe somebody really knows, and the guy doesn't want to be alone, 4184s

personally, I would sit there with him and go for the ride and be there and comfort him as he leaves. 4189s

Because what could happen? 4196s

You might change his mind. 4201s

Sure. 4203s

Or at least he's sorry about it. 4204s

Or if he's not saved, he might get saved. 4206s

Well, my impression is this is a member of the church, no grace, all of a sudden. 4209s

Not an outsider, he's an insider. 4214s

I don't know where he's at with Jesus. 4217s

I don't know if any of those questions. 4218s

But my impression is that this is somebody who should know better. 4219s

The guy that's contemplating suicide. 4225s

Exactly. 4228s

He knows better. 4229s

You should know better. 4230s

I mean, this is how tough this gets, right? 4231s

You know what I didn't give an answer one way or the other. 4235s

I mean, we don't want to propose sin. 4239s

On the other hand, we want to help sinners. 4243s

I told you about this living together thing, because that's just easier on me. 4246s

Right? 4252s

And in some ways, I end up being the dad of the confirmation class. 4253s

These are my kids in some sense. 4256s

I care about them deeply. 4258s

I don't want this to happen to them. 4259s

But on the other hand, when my kid did something wrong, I'm still there for them. 4262s

Because you know the old saying, the first kid could come at any time. 4268s

The second kid takes nine months. 4273s

You know the saying? 4277s

You never heard the saying before? 4282s

No, that's very, very important. 4284s

Completely inappropriate. 4286s

So my daughter comes to us and says, guess what? 4290s

The first kid's going to come at any time. 4293s

In fact, we maybe need to move away today, though. 4296s

And what did I do? 4301s

I cried with her, and I said, I love her. 4305s

And pro-life Lutherans say, okay, we're in for this ride as you put it. 4309s

I don't agree what they did. 4316s

I wasn't promoting it, but okay, we're here. 4318s

And we had a wedding, and it was a totally sober wedding. 4322s

My daughter said, if I can't drink, nobody else can drink. 4325s

Okay, it makes sense. 4327s

And now I have Oliver, my grandson. 4330s

Who, you know, can't do no wrong. 4334s

Oh wait, he can't do no wrong. 4337s

He's done no wrong. 4340s

Let's just be clear about this. 4341s

Oliver and I, we're just peas in the pod. 4343s

We just go out and do our thing. 4346s

And he found my nerf gun in my office. 4348s

And I'll have to teach him how to use the nerf gun. 4351s

Well, I have an assistant pastor, and if he ever gets out of line at the shoot-in. 4354s

So we have all kinds of crazy things happening, but he's found it. 4357s

So now I have to teach my grandson how to run a nerf gun. 4360s

His mother and his grandmother are not sure that this is a good idea. 4362s

But someday I'm going to actually introduce him to the three stooges, too. 4366s

I mean, that's just kind of thing it is. 4369s

So should I be there? 4374s

Is the pastor's question. 4376s

And at that meeting, I did not try to answer, and I tried to raise questions. 4379s

I just tried to say, okay, we're not condoning sin. 4384s

We don't want to promote sin. 4388s

This is wrong. 4390s

This is totally. 4390s

How do you get that across the guy? 4391s

And on the second side, how do you get it across the guy? 4394s

We're still here with him. 4396s

Even when you do stupid. 4398s

You know what I mean? 4401s

I just think it's amazing how complicated life has gotten. 4404s

Because when I went to the seminary, I'm sure they never talked about this. 4408s

But that's a long time ago. 4413s

There's the act. 4421s

Now the other side of this is, what should we do? 4423s

It's not here in Texas, right? 4426s

So in 1994, they put together this thing called the Death with Dignity Act. 4431s

Is there any dignity in death? 4435s

No, it's the opposite of dignity. 4438s

Dignity is life. 4439s

And we were created to live. 4441s

Now, are some deaths better from our point of view than others? 4443s

We're sure. 4446s

But death is a horrible thing. 4447s

It's not anything that God wants at all. 4450s

It's in fact created by mankind who decided they knew better than what God had said. 4452s

So we put their field, they put it together. 4459s

This comes straight off their website. 4462s

I didn't change this at all. 4464s

Over the 18 years since it took effect really in 1998, 4467s

1500 terminally pale ill patients have received prescriptions and a thousand have died. 4471s

Why is there a difference between those two numbers? 4479s

What? 4484s

Five of them changed. 4484s

Four died. 4486s

The death. 4487s

For the most part, the people who, 4489s

one, they just felt comfortable having it and they never used it. 4493s

They made me one side of it. 4496s

The second side of it is, many of them died or they're underlying problems in the first place before it happened. 4497s

In 2006, the Supreme Court ruled that organ physicians can provide. 4508s

You have to have two dogs and all kinds of things. 4512s

You can't really read the green, yeah. 4515s

So this is their point of view. 4519s

Death with dignity laws. 4521s

Also known as physician assisted dying or aid in dying or in Canada. 4524s

Medically assisted medical assistance in dying. 4528s

It's called there. 4530s

Stem with the basic idea is, 4532s

internally ill people not the government and its interference, politicians and their ideology, 4534s

or religious leaders and their dogma, 4539s

who would and that sound nasty all those phrases right there, 4541s

should make their life an end of life decisions and determine how much pain and suffering they should endure. 4545s

It's about autonomy. 4551s

Right? 4556s

I get to decide how much pain I want to endure. 4557s

Nobody else can do that. 4559s

Not politicians and their stuff and their not even religious leaders and those people. 4561s

How can you trust any of them? 4567s

I went the wrong way again. 4573s

So this is the group I belong to. 4576s

I don't have, I said that yet so far. 4579s

So the summary I hope with is not necessarily 4583s

any particular Lutheran nomination. 4587s

There are two faculty members who belong to this group. 4589s

Have you heard of this group? 4592s

They're really annoying at times. 4594s

They're just amazing. 4596s

They're all related to each other. 4598s

And that is all kinds of problems. 4600s

Yeah. 4604s

It's pillbillies, they're out of misery. 4607s

It's kind of interesting. 4609s

The difference between LCMS and other church bodies though, 4610s

is we've been around a long time and we have a lot of documents and a lot of things. 4613s

So that's why I use them. 4619s

I don't think LCMC has spoken on this issue yet for any LC. 4620s

And what ELCA would have said would not have been good. 4625s

But advocates of euthanasia as well as assisted suicide, 4629s

and I sought to justify the taking of human life on moral grounds by describing 4632s

as a truly compassionate act aimed at relieving human suffering. 4636s

It's a lot people like to talk about it in terms of you take your dog to the vet. 4641s

Like you take my dog to the vet, like you take my spouse to get this done 4647s

so we shouldn't have to suffer anymore. 4652s

And why do what the scriptures say about the kind of care God wills 4654s

that we provide to those who suffer in our facing death? 4657s

We reject such claims as neither compassionate nor caring. 4660s

This is on the website of the death of dignity folks. 4666s

So they have religious points of view there and this is where we're at. 4670s

And it's very clear and they mess it up and they just put it right on there, 4675s

which I thought was kind of amazing. 4678s

Going that direction. 4686s

We don't tend to be public like that, is that what you're saying? 4687s

Or not. 4690s

Are you asking if this, you go ahead. 4691s

Ask what you want. 4694s

The question I have, I thought Missouri Synod was supposed to be a stricter of the 4696s

losing conventions. 4705s

And why are they taking? 4708s

No, we're on there because they're quoting us. 4711s

This is where we believe. 4712s

And in the end of it says we think it's totally wrong, 4714s

physicians assisted death. 4716s

We're totally opposed to it. 4718s

Our motto is always the care never to kill. 4720s

What's interesting is they quoted us directly and correctly, 4724s

which is amazing. 4730s

Normally you get stuff and they talk about the church and they get it all wrong. 4732s

But this time they got it right. 4735s

My apologies, I misunderstood the direction. 4737s

Yeah, okay. 4740s

You're forgiven. 4741s

Right? 4745s

So they got it right. 4746s

And this is on the Oregon Deaths with the Indianity website. 4747s

And it clearly says we're at it. 4750s

I think LCMC would agree. 4751s

And NALC and whatever alpha but soup we got going today. 4754s

Right? 4760s

This is where we're at. 4761s

So as you said clearly, I'm not disagreeing with you in any sense. 4762s

This is wrong. 4765s

We have a constitution that this is a thing formed under God. 4772s

I know it was put in late and I think Eisenhower or somewhere in that region. 4778s

But how can the states then reconcile the fact that God was mentioned in there? 4786s

Okay, so what? 4792s

And they went on their own way. 4792s

What Oregon did to begin with in other states of follow suit, 4795s

Washington where he lives, other places, Canada where these people are from. 4798s

What they've said is now they leave God out of the question in the first place. 4802s

But even if they were going to talk about God, they also quote other religious people on that website 4806s

who would say God doesn't want people to suffer. 4811s

And because God doesn't want people to suffer and he's given us wisdom and he's given his medication, 4816s

we don't have to suffer needlessly. 4821s

And so we can in our own wisdom and our own decisions make a decision about one to end life. 4824s

And they would even go so far as to say that we talked about this lady in the ventilator. 4833s

Can we take the ventilator off? 4837s

Well, it's an artificial thing. 4840s

Sure. 4841s

But why if you can do that? 4842s

Why can't you just give something else to help this? 4843s

And this will help the suffering. 4847s

And you notice what I don't agree with that at all. 4851s

I mean, it may clear here I'm not agreeing with that, but that's the argument. 4853s

When we're taking a ventilator off we're saying this is pointless. 4858s

We're not getting anywhere. 4861s

There's nothing else that can be do here. 4862s

This is an active step to do something. 4864s

Because we want to stop suffering. 4873s

And that's the good thing normally. 4875s

What if this is right here enough to stop suffering and stop suffering? 4881s

Can you decide to stop eating? 4893s

And not me. 4896s

I'm not doing this. 4897s

Yeah, absolutely. 4906s

Okay, so let's just talk about it. 4912s

Do you have to have food always? 4915s

Yes. 4917s

At what point does food not be important to you? 4919s

When you're dying. 4927s

In fact, they used to talk about you always had to give people food and water hydration 4929s

because if you take the hydration away from any of us we'll die. 4933s

How long can you go without food and water? 4937s

I know somebody who went over 30 days. 4945s

Without anything. 4950s

She's lying in a bed. 4951s

She's basically in a coma and she doesn't need any calories. 4952s

She doesn't need any. 4958s

And actually if we pushed water into her, what would happen? 4959s

She would drown. 4963s

Yeah. 4964s

Because her kidneys aren't working at this point anymore. 4964s

Her bladder is not working. 4966s

They aren't able to take the water off of her anymore and just put more water into her 4967s

is not the answer. 4971s

So at some point in life you don't need this. 4973s

Way at the end. 4976s

This lady, particularly I had a stroke, all kinds of things happen. 4979s

But she's literally laid in the bed. 4985s

And every day her family was there and every day I come here. 4986s

She's about 40 miles away and driving and I kept saying, 4989s

Lord, anytime now, it would be great. 4992s

But it can go well. 4995s

It can be. 5000s

It might be in certain, right? 5002s

Yeah, it could be some of the natural process of dying in certain people who are terminally ill 5004s

and that it's really real distressful to family members. 5008s

But they're truly not thirsty or hungry. 5014s

You know, so it makes sense that we always say we want them to eat. 5017s

But maybe they're at the end of life issues or at that stage where their bodies are shutting down. 5020s

They don't need it. 5026s

The behavior that they're talking about is normal. 5027s

They're not okay. 5030s

He doesn't taste good anymore. 5031s

Predictive cancer patients and so on. 5032s

And eventually the body just doesn't eat anymore. 5034s

How many calories do you and I, because we're of the same size? 5038s

How many calories a day do we need to have? 5043s

Well, I think I need a bunch. 5046s

But we can go a while, the two of us. 5050s

I have some reserves built up here. 5054s

You skinny people are going to be in trouble or there's a drought coming. 5057s

But I am not, because we can go a while without this. 5059s

So back to what Wendy was saying, that could be the end of life happening. 5063s

Here's a real life situation. 5074s

Her name is Thelma. 5077s

If you'd like to include her family and your prayers, that's perfectly fine. 5079s

She had a very aggressive cancer, breast cancer about five years ago. 5084s

That got sorted out. 5089s

In the summer of last year, a new cancer researched itself. 5091s

She had some treatments. 5097s

She felt at that point that she made a decision that that was not the way she wanted to go. 5100s

She didn't want to suffer through all the treatments again. 5105s

She is a devout Christian believes that she wants, she's going to be with the Lord when she leaves. 5109s

Her children feel the same way. 5114s

The doctors said she wouldn't live past Christmas. 5118s

So she was admitted into the hospice about a week. 5122s

No, but two weeks before Christmas, believing that she wasn't going to go much longer. 5126s

She's had her ups and downs. 5134s

She's had days where she takes in water, takes in food. 5136s

She's had days where she just goes and nothing at all. 5139s

All she's on is pain relieving medication. 5143s

And basically we're all just waiting now for her to go and meet with the Lord. 5149s

And this is where she is and where her family is right now. 5155s

The interesting thing that I heard just recently is that the doctors are saying that all her internal organs are functioning really well. 5161s

But they think now that the cancer is progressing to the brain. 5173s

So now the question is, is how much longer is she going to keep going? 5176s

And this is just where she is. 5180s

She's just being comforted and we're just waiting for her to be with the Lord. 5183s

What we're talking about now is the goal of care. 5189s

At some point the goal of care is to heal. 5192s

At some point the goal of care is just to take care of people. 5195s

Because there's nothing more, there's no healing coming to this thing. 5201s

Okay. So do we get this? 5206s

I don't want to get us too far of healed, which we've had trouble all day with. 5209s

And it's mostly been my fault. I'm not blaming anybody. 5213s

Adam? 5217s

This is going to remain on the same subject to my neighbor across the street Yvonne, 5218s

who's also a church member over the course of this last summer, developed a schizoaffective anxiety disorder. 5222s

And just became completely unable to take care of herself or do anything. 5232s

And she quit eating and drinking. 5241s

And it went long enough that they forced an invention on her. 5246s

Because she's not physically sick. 5252s

So in her best interest, you know, even though she wanted to die because of what was going on in her head. 5256s

Are there other reasons why people can do this? 5265s

Yeah, absolutely. 5267s

I'm trying hard to, at this point, okay? 5271s

Because I agreed to eight o'clock. 5277s

You've got to get the red. 5287s

No, no, I'm trying to be. 5288s

You know, if I go over on Sunday morning, I better have a good reason for it. 5290s

Right? My people are not going to walk out, but I probably should have a good reason for it. 5295s

We can continue this conversation quietly as well, I'm trying to say. 5301s

Because that's the last slide, I think. 5305s

Oh, no, there's one more. 5310s

I think there's two challenges here with this particular issue. 5313s

How do we speak up as citizens of the country and say this is not a good idea? 5316s

And two, how do we help people in their life? 5320s

And this is going to become more and more of an issue. 5324s

Adam's comment is, I think that's what's really scary about the whole taking a medication to kill yourself. 5332s

It's when it crosses over from somebody who has a real terminal illness and somebody who's just depressed or just kind of wants to. 5338s

That's what's really scares me about that process. 5347s

Okay, so the problem is, how many people who are elderly are depressed? 5351s

Good number, because they can't do what they once did. 5357s

And so the Oregon law requires two physicians to talk to these people separately and to do a screening for depression. 5361s

But can you get through that anyway and then get the medication? 5371s

Yeah, so yeah, that's the scary part about it. 5374s

Yeah, please. 5379s

The scary thing all about is when it becomes a good thing to do. 5380s

Oh, sure, absolutely. You know, you're correct. 5384s

So there's a doctor in California in LA, because all the fruits and nuts are out there, of course. 5387s

And he puts up this big sign and says, come to me, I'll give you the pills. 5392s

See, he's running a death clinic. 5396s

We all knew it was going to happen, right? 5401s

The next thing is going to happen, they're going to start advertising on TV. 5404s

Probably, I don't know. 5407s

Get your pills here. 5409s

I didn't see somewhere in our readings that where hospice becomes more prevalent, even in places where physician assisted death is ill, 5411s

that the rates of physician assisted death goes down as hospice care becomes more prevalent and goes up. 5422s

I think that is the goal of the hospice people, but I don't think it's happening. 5430s

Is that it is somewhere in Mark? 5440s

In one of our readings, I can't remember. 5444s

Oh, it's said it's happening somewhere, perhaps. 5446s

But I mean, just think about it, the more available it becomes, the more it happens. 5449s

And it looks like more states are looking into it. 5453s

Thankfully, in my state, I've told it, they wanted to put it on a ballot initiative and it didn't know anymore. 5458s

They didn't get enough signatures. 5465s

We have an interesting state. 5467s

There are six Democrats in the state. 5469s

We all know who they are. 5472s

You know, our state is like 80% Republican. 5476s

They've never elected someone to Washington DC as a president who was not a Republican. 5480s

There was even this guy with name George McGovern, who was from South Dakota, who was not voted in by the South Dakota people. 5487s

So our state is different than other places, but even in a very conservative place like I'm from, it's being talked about. 5493s

And the real question is, how different is this than what happens on a daily basis in Texas and in South Dakota? 5501s

Where nurses and doctors are giving morphine to people, and they have to find the right level where they're caring, but not actually. 5508s

And if you talk to nurses, they often wonder, or doctors, have I gone too far? 5517s

And this becomes the real issue. 5524s

And now we're dealing with their own feelings of inaccuracy and have I done something wrong? 5527s

I'm not going to say that I'm too much of a country for treatment. 5537s

Yes. 5549s

And to this, I think about that little boy and about the parents and about their right not being given to them to take that child to a new place. 5552s

And with medicine and politics and things that are going on within our country right now, and the call for socialized medicine, then I also think that a lot of choices are going to be taken away from us and other things may be forced on us sometime. 5563s

And that's a concern too. 5587s

Absolutely. There's no doubt. 5589s

So that particular case, they're in England, and the English Medical Service, which is a socialized medicine, the doctors are paid by the government in the whole bit, just said that this is not going to do any good. 5592s

Okay, that's one thing. 5605s

Then they went to court and said to the judge, they can't come from here because it's not going to do any good. 5607s

And there were hospitals on the east coast that said, come here and we'll take care of you. 5613s

So you got all this stuff going on. 5617s

And what happened? They got out, they came to this country and they're doing it good. 5620s

Not really. 5625s

So these are the very difficult questions we're going to have to deal with. 5627s

And for the record, where did the American insurance system start? 5632s

You know that? It started here in Dallas because during World War II, they could not increase wages for the teachers union. 5639s

So in order to give them benefits, they gave them health insurance. 5648s

Right here. And there was a group that did this. They're called Blue Cross, Blue Shield. 5653s

I mean, that's what they're called today. But that's where it started. 5658s

And how are we going to someday figure out how to work this all out? 5661s

And who knows? We have no idea what we're doing to our grandchildren and the national debt. 5666s

That's one issue. But the insurance side of it is just as scary. 5672s

But of course, I'm but a stranger here, having as my own. 5678s

Jesus loves me. This I know. For the Bible told me so. 5684s

So I'm not really scared of any of it. This God is with me. 5687s

And it got us for us. You know the next line? 5693s

Who can be against us, right? 5698s

But yes, it's going to, it's not going to get easier. 5702s

It's going to get more difficult. That's why I believe churches need to be talking about it. 5706s

And Christians need to be thinking about it. 5710s

And we need to be talking about how do we help our parents if we're my age or if we're going to be a child. 5712s

We're the other age that what they're going to do. 5717s

But I mean, literally I could go home today and I home to a hotel today and between here and there be wiped out. 5719s

So it isn't just about those who are over a certain age need to talk about it, all of us. 5727s

And Thursday night, we're going to talk about it. 5736s

There's a place up in Wisconsin. If you're here to the state, Wisconsin called the cross. 5739s

We're 96% 98% of the people have already filled out advanced planning. 5744s

The hospital there is called Lutheran Hospital, Gunnersome Lutheran Hospital. 5749s

And they have a whole different way of doing things. 5755s

And it seems to work so much better. 5758s

Because you don't end up with care you don't want. 5760s

And you end up with better care because they have now focused on what is really important. 5763s

We were talking his moms having some tests today. 5768s

Are these tests really important or not? 5771s

His mom fell and now they're running some CT scans and some MRIs and some all kinds of things. 5773s

At some point those tests aren't necessary. 5782s

And we're spending money we shouldn't. 5785s

At some point they are necessary and that's the real challenge. 5789s

Because I'm not opposed to medical tests. 5796s

I knew you would. 5799s

I knew you would. 5801s

Comment about that. 5802s

It was like a treatment I had. 5803s

Because I always felt like well, I feel like it was a treatment so it was a good treatment. 5806s

And then at one point I realized like, if you're doing test or treatments that aren't helpful. 5811s

And because the doctor is recommending it, you should do this. 5820s

Or the doctors make you money off of it or the hospital or whatever. 5823s

Then you really are doing harm if you just drained grandma's life savings. 5827s

And there's nothing. 5833s

So it's harder than it seems. 5833s

Because you could always, I would think you just err on the side of like just spend all the money whatever. 5836s

Just do the tests. 5840s

Just let the insurance pay for it. 5842s

Just get everything for everybody that we can. 5844s

But you do harm if you spend waste, you know, just inappropriately. 5846s

And then you see these graphs. 5853s

And it's really hard of like how much we spend at the end of life in our country compared to other countries. 5855s

And so you think like, well, I don't want the socialized medicine telling me that I don't get to have the treatment I want. 5861s

That's the first thing I think when I see that. 5869s

But then again, if you just got by some whatever charlatans or maybe super well intentioned doctors that just got you to spend a whole bunch of money on a treatment that it could be. 5871s

And you've extended your life. 5882s

Who knows how much a week. 5883s

A couple hours. 5886s

And you spent $300,000 on that or reverse mortgage at your home. 5886s

So what is the figure you've heard? 5891s

I've heard almost up to 50% of all health care is in the last three months of life. 5893s

Yeah, yeah, yeah. 5897s

Yeah, okay, there's the 80-20 rule. 5902s

But another way of putting it is that all of the health care money that we're spending in this country goes to people half of it goes to people in the last three months. 5907s

I mean, that's a figure that's out there. 5918s

I don't know if that's actually a crew or this is urban legend, but I mean, that's what I've heard. 5920s

Number, but it's it's something like that. 5924s

Yeah. 5926s

Okay. 5930s

Anything else? 5931s

So just so we get it, Thursday night we're going to do a totally different idea. 5932s

We're going to do how do you talk about these things with your family? 5937s

It's much more of a practical, this is important we've now done. 5941s

How do we do this? 5946s

And so we're not, I believe that this is not a job of the physicians and the nurses to do. 5949s

I mean, they could do it if they want, but it's a job for people to do. 5954s

There's regular ordinary folks to talk it through. 5957s

Yeah. 5960s

Yeah. 5961s

I think that's a good idea. 5962s

I think that's a good idea. 5968s

So, the evidence is there are about these other things that they have to do. 5974s

So, the other thing is that they have a very old, which is popular. 5982s

So, it's 96% of that. 5984s

That's more than that. 5988s

People think that they don't have a certain life experience that you have now. 5990s

And I think that you have a certain cost structure. 5995s

So, you can get it. 6000s

You can get the other problem that you have with that kind of experience. 6001s

But remember, it's a fact that what happened is, with the medical awareness that we came to come out of the analysis process. 6005s

We now have people living in that, and far more than normal. 6012s

So, there's a mechanism that has to be factored in the medical unit. 6017s

But it's not a burden to be able to look at the disease in the lower the top and then it's not a disease. 6022s

But the real out of the disease is that we have so much better experience than we did with the disease. 6030s

But we have a very serious problem. 6037s

And it's not a good thing to do. 6042s

I just don't know if there's any problems out there. 6047s

So, here, you hear so much of what we were doing. 6051s

Is it possible to master the statistics? 6055s

So, my favorite statistic, what percentage of marriages end in divorce? 6063s

What are you here? 6072s

Half, right? 6077s

Totally bogus. 6079s

There's nothing to do with reality whatsoever. 6080s

But that's the statistic that's out there. 6083s

The statistic comes from this, and these are just generalized numbers. 6085s

There are 100,000 marriages this year, and 50,000 divorces. 6089s

That means half of all marriages end in divorce. 6092s

I mean, it's just bogus, right? 6096s

Because where do the divorces come from? 6099s

Well, they come from the people who have been married the last 40 years. 6100s

Now, if this continues forever, then it'll happen that way. 6103s

But at this point, the probability of first marriage lasting is like 60-some percent. 6106s

Like, almost 66 percent. 6113s

The first marriage is the last until death. 6116s

So, you get these bogus statistics that are out there all the time. 6119s

Yeah. 6123s

If we want to do healthcare stuff, we could do that. 6125s

I mean, that's a whole big issue. 6127s

There are places that maybe do it better in some ways. 6132s

But there are places that don't. 6137s

So, for example, just one little thing. 6138s

How much marble is in hospitals? 6141s

And why is there marble in hospitals in the first place? 6145s

You know what I mean? 6149s

I mean, there's something simple as, why are they the fanciest buildings in town? 6150s

Do they need to be the fanciest building in town? 6155s

I mean, that's a different issue. 6159s

I mean, that might be just a small question we could ask. 6161s

Why are they the fanciest buildings around? 6164s

In France, you actually go to a pretty little small office. 6167s

You pay your bill the day you're there with a doctor. 6172s

You're reimbursed in 30 days. 6174s

I mean, there are ways of doing things that might be better or worse. 6177s

But it's just an interesting question. 6181s

Are they that way here in Texas? 6182s

You'll have marble floors as you walk in and they... 6184s

Big atriums and... 6188s

Oh, everything's a big atrium in Texas. 6194s

Mexican restaurants have big atrium. 6197s

It's just an interesting... 6202s

Why are they fancy buildings? 6203s

Okay, I think we've had enough. 6206s

We had enough for tonight. 6207s

We should close a prayer. 6209s

In our prayers, remember Adam's mom, whose name is Christine, 6210s

who had some trouble today. 6216s

We remember Dale, who works for IOT. 6219s

She is one of the staff members' wife, 6222s

who has been diagnosed with breast cancer. 6226s

Are there other things we should pray about? 6228s

Yeah, a little. 6233s

Nancy. 6236s

Nancy, your home congregation. 6238s

Expressively, some of you had that relief cheer in the front of this week. 6242s

All right, so Nancy, who might have cancer? 6245s

Christine. 6250s

And Dale. Dale is actually a woman's name, just so we got this straight. 6252s

Yeah? 6255s

Get this... 6258s

Let's get this country back in the way it should be. 6262s

Good thing we're asking God to do this. 6267s

Yeah, no, yeah, we got none of us are pulling this off. 6272s

Staves of E. Colen Cancer. 6282s

Her name is Sarah. 6284s

Sarah Christine, Nancy. 6289s

Dale. Country. 6293s

I'm going to have to get a pen if we go any further than this. 6297s

Dear Father and Heaven, we are thankful that you have given us the knowledge 6301s

of the truth, that you planted in our hearts, the good news that we are yours now and forever. 6305s

We're thankful that you've taken care of eternity through your son who died for our sins. 6311s

We're thankful that we've been joined in him in baptism and we belong to him now and forever more. 6316s

Please, Lord, be with us as we look forward to being with you. 6321s

Help us to lift up our heads and look forward to that day. 6324s

And until that day, continue to give us wisdom and knowledge as we go through life. 6328s

Help us to be a support to those who are getting closer and help those who in great need to know your love and your compassion. 6332s

Please be with Sarah who's going through cancer treatments and Nancy who might have cancer. 6340s

Be also with Christine and Dale who's now starting treatment this week. 6346s

Be with our nation. Help us to figure out how best to care for one another. 6351s

But then we might live peace, one quiet lives. 6355s

Be with each other, Lord, and we might do your will. 6358s

Help us always remember your grace and your kindness that you've forgiven us and called us to forgive others. 6360s

All this we ask, we ask in Jesus' name. Amen. 6368s

Thank you. 6412s