Living wills

[Robert Rager]

What is the Orthodox position on Living Wills/Advance Directives? In the last few months, this has been a "more than academic" question for me, & I keep forgetting to ask my priest, when he visits. Does the Orthodox Church have a position on restricting just how far one wants healthcare providers to go to save/prolong your life in the case of a medical emergency?

[Paul Cowan]

I don't know if this will help...It is NOT intended to sound cold.

My mother in law died 4 times and was revived each time only to die again, later, after much more torment in her body. Was her husband keeping her alive out of obligation, selfishness, per her wishes, other reasons? I doubt we will ever know.

I have asked my wife to only resisitate (sp) me once. After that, it is God's will that I leave. Many if not all monks I have read about refuse all treatment relying on the will of God to either take them or leave them for a while longer. I don't want to live as a vegetable. I refuse the idea of suicide.

In the end, we all die. How long we postpone it seems a personal choice unless God Himself pulls the plug. Personally, I rather go to meet him sooner than later, provided He will have me.

I too am facing this same question concerning my wife. What will I do when the time comes? God's will be done.

Paul

[John Charmley]

Dear Robert,

Good question,

Dear Paul,

Excellent and thought-provoking answer, which poses some important questions.

It depends, perhaps, upon what is in the living will. Our Faith teaches the sanctity of human life; we are made in His image, and we aspire, with His help, to be remade in that image during the course of this earthly life to prepare us for what comes next.

Too often, modern medical science tends to treat the dying as though they are objects of experimentation; can we keep her alive if we do x or y, sort of thing. That can, sometimes, lead to us forgetting the reality of the dying person, who should be treated with love, compassion and care.

Twenty years ago, when my beloved mother had a stroke at a ridiculously early age, I, as the eldest surviving child was asked to make the decision about whether she should remain on a life support machine. We had never discussed such a thing - she was only in her late fifties and none of us had imagined that this would happen, her mother had lived to her late eighties, and her oldest sister is still with us in her eighties now. It would have been some comfort to me if I had known what she wanted - but I could only talk with my brothers and sisters and try to divine what she would have wanted.

I remember sitting with her through a long, long night, praying silently for guidance as the nurses bustled to and fro, and as the dawn broke and the hospital sprang to life, still being none the wiser. It came to me that I needed a break - I had been by her side for three days by this time. The doctors assured me that there was 'no danger' - which I remember thinking was an odd thing to say.

I went back to my mother's house, showered, had a quick breakfast with my brother, and within the hour we were all back at the hospital. As we approached her room there were nurses running; as we arrived they said 'she has just slipped away'. So she had, sparing us the pain of seeing her depart, and me the agonising decision. All I could do was to thank God for His great mercy to us.

So, a living will? Yes, on balance I think so; I know how much easier it would have been had I had an idea of what my dear mother would have wanted done; but she was always so full of life that the question never arose between us - until she could no longer tell me. Peace be upon her precious soul.


In Christ,

John

[Fr Raphael Vereshack]

I might have posted this before, I can't remember. But it's important enough to repeat.

When making a will it is very important to specify that one wants a church funeral, burial, meal afterwards, etc.

A number of our older people not knowing better did not specify this. And as their children or whoever the executor of the will was were not believers, the results were grievous.

In two examples in our small parish upon the parents' repose the children announced they didn't want a church funeral or any service at all. In one tragic case (granted the poor fellow rarely got to church so we didn't know he had died) the children had their father cremated & buried. We only discovered this when we went out to the cemetary in the spring to do Panichidas for Radonitsa.

In Christ- Fr Raphael

[Father David Moser]

What is the Orthodox position on Living Wills/Advance Directives? In the last few months, this has been a "more than academic" question for me, & I keep forgetting to ask my priest, when he visits. Does the Orthodox Church have a position on restricting just how far one wants healthcare providers to go to save/prolong your life in the case of a medical emergency?

It is certainly permissible to have a living will and certainly adviseable to provide some kind of advance directives. My wife and I have mutual "Power of Atty for Healthcare" set up between us. This means that should one of us fall ill or be in an accident and there is a question of life-prolonging treatment, that the POA has the authority and responsibility to make that call. Having done that, we have talked about what our own wishes are so that at the time of crisis the proper arrangements can be made.

As far as restrictions on live saving/prolonging care goes: The only restriction is that one cannot actively take the life of ones self or another (so no euthansia). It is permissible to refuse medical care and put yourself in the hands of God alone. It is permissible to accept care and/or medications for a period of time and then refuse it. This applies even to food and drink which are "artificially" administered (feeding tube, IV's). One cannot withhold nourishment, and so food and drink should always be offered, but it is not necessary to force the food and drink via tubes and needles. The whole thing here is that by setting aside medical care, one is putting oneself firmly in the hands of God and so the ill person and those who are supporting him have an obligation at this time to pray with increased fervor for the forgivenss of sin and for a peaceful, God pleasing death. Certainly the sacrament of Holy Unction should be administered (if it has not been given already) and all things set in order so as to "complete the remaining time of our life in peace and repentance" and to have a "Christian ending to our life, painless, blameless, peaceful, and a good defense before the dread judgement seat of Christ"

One of the former members of this community - Hieromonk Averky - did exactly that. For many years he suffered from kidney failure and was on home dialysis. He would have to "flush" his system up to 4 times a day. He mananged with this treatment quite well and was active for a number of years but finally, his condition worsened to the point where, with the blessing of the abbot of his monastery and his ruling hierarch, he simply stopped the treatments. Over the next 2 weeks he slowly slipped away finally reposing in his sleep. During that time he made numerous phone calls and had numerous visitors and with each person he could recall, he asked forgiveness and resolved any conflicts and hard feelings that might have arisen (as we were close friends for many years, he and I spoke twice, at length during this time). It was a blessed opportunity for him to prepare for his own death of which he made good use. May his memory be eternal.

Fr David Moser

[Anthony]

I would be grateful for any more advice on what should go into the will of an Orthodox Christian (as I am for what has already been given on this thread). Currently I have no will, no Orthodox relatives, and probably actually no documentation that I am Orthodox (having mislaid my certificate of chrismation).

[Father David Moser]

As for "evidence" of being Orthodox - the parish where you were baptized (or however you were received) will have a permanent record of your reception in the parish record book. You can contact the current rector there and ask for a new or copy certificate.

In your will, as Fr Raphael mentioned, you should specify that you are to be buried according to the tradition of the Orthodox Church. You can specify your own home parish as the Church in which you wish the funeral to be done. You should also specify in your will that you are to be buried - not cremated so that there is no confusion. In your will, you should make a bequest of a certain amount of money for the purpose of a memorial meal and another bequest to your parish (and if you wish to a monastery) with the request that you be commemorated at each liturgy and in any general pannykhidas (memorial services) that might occur.

That should cover any eventualities. Other things, like the "advance directives" and living wills should not be part of your will itself, but rather provisions/documents that are entrusted to someone who is empowered to and will see that your wishes are fulfilled. I am the "power of atty" not only for my wife but for various parishioners who have made those same arrangements. I also have been entrusted as the executor of certain wills in my parish left by those who have no family nearby or who are Orthodox. Ask your priest if he will fulfill that role for you as well.

Fr David Moser

[Anthony]

Thank you, Father; this is very helpful.