2-21-2016 Bioethics Part 45

The transcript contains a discussion about the virtues of contentment and courage in relation to dying well. Contentment is defined as finding peace in every circumstance and is seen as important in preparing for death. It is noted that contentment can be hard to find and maintain, but it is a virtue that Jesus commands and is based on the knowledge of who God is. The pursuit of contentment now is emphasized to avoid regret later in life. Courage is defined as acknowledging and overcoming fear while proceeding forward wisely. It is not seen as being unafraid, but rather knowing the dangers and taking appropriate action. The courage to face medical procedures is given as an example. The transcript also discusses how courage is grounded in love, faith, and hope, and how it can be applied to the issue of death. The Apostle Paul's example of courage in the face of death is referenced, highlighting his confidence in deliverance whether he lives or dies. Overall, the virtues of contentment a Alright, well, let's pray and we'll get started. We thank you for today and we pray that as we come together as your people, that you would open our eyes and our hearts and our minds to your truth once again. In Jesus' name, Amen. We are looking at the virtues and how they are particularly relevant and apply to the case of dying well, which as we have seen, and if we have not seen, we are at least begunning to come into the knowledge of the reality that dying well is hard. So, how do we do it? Well, one of the ways is we focus on cultivating the virtues that will be necessary in death before we are dying. We've looked at faith, hope, love, and last week we looked at the virtue of contentment. That's right. So, when we use the word contentment, what do we mean by the word contentment? Finding peace in every circumstance. Finding peace in every circumstance. Okay. I'll take that. It's something. What are some things that are true about contentment? For us, particularly like thinking of Americans. Hard to find and rather elusive. Hard to find and rather elusive. That's right. So, even once we think we have found it, we have a hard time keeping it. It's easy to be content for a time and then lose contentment very quickly. That's right. Why ought we to be content? Jesus tells us to. Good. So, there's the imperative. What we ought to do. Anything else? The object of our faith. Okay. So, that would be the imperative. Right. So, there's indicatives and imperatives. That would be the indicative. So, the imperative, what we ought to do. Jesus does command us to be content. Right. To rest. To believe. To have faith. And then the indicative or what is defined as true of us is, this is who our God is. And if these things are true of this God, then I can be content because he is my God. What or how does contentment play into the issue of dying well? More at peace with leaving this life. Okay. Good. I like the way you put that. We should be more at peace with leaving this life. Right. Is leaving this life going to be difficult regardless of how much contentment you have? Yes. However, by believing who God is and cultivating that knowledge, then we can better find contentment and die better and seek to die well. Anything else? Why should we focus on contentment now instead of like when we're old? Because now, okay, our object of our faith, but then what that means for us when God is done, what's true of us now, we can be content now in our faith because of what's true of us now. Because of what's true of us now. Alright. So, but why, that's true, that's what we can do, but why should we do that now instead of later? Yeah. Yeah, so it'll make it easier to make it, to pursue contentment. And we might even go further than that and say that it might be possible, or it might be impossible. When your life is falling apart, it's the wrong time to get comfortable with the fact that you didn't get to do everything you thought you wanted to do in life. That's why, another reason why contentment is so important is because there's a limited number of options in this life. You're not going to be able to do everything you want to do, and you will be less important than you think you were going to be when you were, you know, seven. You're probably not going to be as important as you would like to be in this life, no matter what level of life you attain. And so, at the end of your life, there's a very big possibility of a large amount of regret at what you either did or weren't able to do. And this pursuing of contentment is one of the things that helps us today, something that helps us to have at least a better chance of being content in the end. It's also just the right way to be. This is the thing, it's not just helpful, it's also correct, because if this is who your God is, going back to this thing, then contentment is something that we ought to be pursuing. So, not only is contentment a virtue that is helpful, but also courage. Courage. What do I not mean by courage? Unafraid, that's right. That is the kind of... Sometimes when we think about courage, that's the way we like to talk about it, not being afraid of anything. Why is that not courage? What's that actually defined as? Huh? Foolishness, that's right. Why is it foolish to live that way? Yeah, exactly. Because you're going to die if you're not... A lack of fear, a right fear, means that you're an idiot because there are things to be fearful of. If you walk up to a snake and go, this snake ain't going to do nothing to me, that snake is going to bite you. Your belief that the snake is not going to do anything is not going to change the opinion of the snake. The snake doesn't respect you, the snake doesn't respect your opinion or how you feel about the snake. The snake just wants to bite you. The snake is going to bite you. You should have proper fear of the snake. So, think of the snake analogy. What would courage be in the face of the snake? It's not going, this snake can't touch me. What is it? Courage is, in illustration form, to take a shovel. Yes. And with distance, cut his head off. Right, okay. That would be one option, right? Knowing what about the snake. That he will bite. That's right. That he will hurt you. He'll mess you up. That's right. This snake is going to mess me up. Yeah, preach. This snake is going to do damage. However, I need to take care of the snake. Now, this is not a statement about the murder of snakes. You might love snakes, and I'm not saying all snakes should die. However, if the snake is coming after your child or something, you're like, I've got to put this snake down. You better believe that that snake can hurt you just as much as it can hurt the one that it's coming after. So, courage is not going, this snake ain't nothing. Or else you wouldn't have to do anything. You'd just look at the snake and rebuke it in the name of Jesus or something weird like that. If it's dangerous, though, it's dangerous. You're proceeding knowing that it's dangerous. Courage overcomes fear. Acknowledging the danger that is in the world and proceeding forward wisely. Getting the shovel. So, as we saw when we originally looked at this virtue, we're not talking about stoic detachment. Stoic detachment is that nothing really matters. That's why I can proceed. I can seek to kill the snake because my life does not matter. I am just here. That would be kind of stoic detachment. But we saw for Christians, that can't possibly be true. Why? The idea that nothing matters cannot be true for Christians. There's like 45 answers to this question. Things matter to God? Great. Yes, that's a good one. And you matter, right? All kinds of things matter. It's wrong to say things don't matter. Nobody actually lives as if things don't matter. Everybody lives as if something matters. You and I ought to allow God's word to shape how things are to matter to us, as well as providing to us a basis for courage. So, for example, go to Philippians chapter 1. Philippians 1, chapter 1, verse 18b. This is a terrible numbering. Yes, and I will rejoice. For I know that through your prayers and help of the Spirit of Jesus Christ, this will turn out for my deliverance. As in my eager expectation and hope that I will not be at all ashamed, but with full courage, now as always, Christ will be honored in my body, whether by life or by death, for to me to live is Christ and to die is gain. If I am to live in the flesh, that means fruitful labor for me, yet which I shall choose I cannot tell. I am hard pressed between the two. My desire is to depart and be with Christ, for that is far better. But to remain in the flesh is far more necessary on your account. Courage here, for Paul, is grounded in what? Huh? Love of others? Absolutely. What else? Yeah, that Christ would be highly honored in him. So, we also say it's in love, it's in faith, and it's in hope. It's all of these things. Because he knows he's going to be delivered. He knows he's going to be delivered. He knows he's going to be delivered. He knows he's going to be delivered. He knows he's going to be delivered. He knows he's going to be delivered. He knows he's going to be delivered. Because he knows he's going to be delivered. You go back and you say, this will work for my deliverance, whether I live or whether I die. Please explain to me how the heck that could possibly be true. Let's take off the living thing, we understand that. He'll be delivered because he gets to go free. What about the dying part? How could he be delivered if he's going to die? Exactly. He wins. The Romans kill him, he wins. He gets freed, he wins. So the courage is in seeing that, well, this is who God is. This is who I am. I'm going to exhibit this kind of courage, expressing love towards God, in worship and towards others, in seeking for their good. This is the kind of life that I'm going to live, knowing that whether or not this thing turns out well for me in this life, I win. This is the epitome of Christian courage. So, how does courage work itself out as we think about death? There's a lot of answers to this. But what can you kind of think of? One thing. That was good. Please slowly. Raise your hands. Talk in turn. Okay, that's right. I'll give you one. The courage to go through with a medical procedure. I'm just giving you the answer now. I need you to explain what that looks like. Why would you need courage? Okay, there's some things you don't know. Right. Right. Even if the doctor tells you what is going to happen, that is only an approximation of what is going to happen. This is probably going to produce this. This is probably going to feel like this. You'll probably have these side effects. It'll probably take this long to get better. You have this much chance of surviving. Whatever. That's not a, this is what's going to happen to you, this is how long it's going to take, and you're definitely going to live, or you're definitely going to die. They don't know that. And so the courage is not, what if we lived in this kind of detachment? No fear at all. Why would that be foolish? You make bad choices. That's right. You might make the right choice. Right. But the choice would always be foolish, whether or not it was right. Because you're not making it for the right kinds of reasons. You're like, I don't care. I mean, yeah, let's do that. And if the goal, if the right thing to do would be to live on, and you lived on, that'd be fine, but you actually become the wrong kind of person because you don't live mindful of the kind of person you ought to be. That's why these virtues are so important. Not because they make you make the right kinds, or make you make the right decisions, but because it shapes you into being the right kind of person. You might go, there's no distinction there. There's all the distinction in the world there, because our goal isn't just to make good decisions in life. What is the goal of the Christian life? That's right. Yeah. Yeah. Our goal in the Christian life is to be conformed to the image of Jesus Christ. That does not mean you make the right decision every day. It means you become the right kind of person. Now, that will inevitably lead to more better decisions being made. But if you and I live as if nothing matters, we're becoming the wrong kinds of people, even if we make the right kinds of decisions once in a while. Courage is necessary when pursuing medical treatment, because you don't know what ultimately will happen to you all the time. And few of us in here, I'm guessing, have had to make life-deciding decisions about whether or not to pursue a treatment or not. Some of us are like quality of life decisions, but very few of us have said, Very few of us have said, Oh no, okay, I need to do this or I'm going to die. Or not. Maybe you have. I'm saying the vast majority of us have not had to experience that yet. But the longer that we live, and the better able we are to keep people alive, which is a double-edged sword, the more opportunities you are going to have, and the more opportunities will be foisted upon you, whether you like it or not, to have to make decisions about, Should I do this thing or not? Let me give you a good example. I'm not a doctor, but, you know, so take that into consideration. There is a way to, somebody goes into a stroke because they have a blood clot in their brain, there is a way to remove that blood clot by sending up something to remove the blood clot that goes in through a vein that is actually in your inner thigh, and they run it all the way up and go into your brain, hook onto that sucker and pull it out. It's amazing. You can save people's lives in this way if you do it quick enough. It's the craziest thing in the world, right? I'm right, nurses, right? That's the thing? Okay, great. Alright, passed. So, here's the thing. You go, that is amazing and that is great. Everybody should do that. Here's the problem. People who are in a stroke state are very often losing stuff every single second, every single minute. Time is critical when it comes to a stroke. And nobody knows exactly what the person is going to be like when they come out on the other side. And oftentimes people are different on the other side than when they were before they got the thing and the stroke has affected, rarely positively, the person in their brain, often negatively. So, here's the question. Is that technology a good one or not? You go, of course. I mean, people can survive. It is a blessing on the one hand, but also, before that technology existed, when you got a stroke, you know what happened to you? You died. That's right. You're dead. Dying isn't inherently a good thing, but the necessity of having to make that decision, not you as the patient, but you as the one who has durable power of attorney or something, you're going to have to make the decision for somebody else do they go up and remove that thing or not. Or do they let them go? Because if they don't do it, they're probably going to die. But if we do do it, we don't know how they're going to turn out on the other side. Oh, and by the way, every second that goes by is a greater effect of the thing that's currently happening. What do we do? You go, what do I need to think about courage for, pursue courage for? It's for moments like that. You go, I don't know that's going to happen to me. You're right. You don't know that's going to happen to you. But the longer we live, the better opportunity and chance there is that something like that is going to happen to you or somebody you know. And the time to cultivate courage is not before or not in the moment. It's before that moment leading up to that moment. So when that moment comes, you will be better prepared to know what to do. Because here's the thing. Is it the right decision to remove the blood clot? Yes or no? That's right. There is no right answer to that question. And that's not because I'm a moral relativist and I don't believe in truth. It's because there is no black and white answer to that question. You cannot cite a verse and show that to me. Shockingly, the Apostle Paul never talked about blood clots in the brain. So, we need to pursue courage to know if we need to pursue treatment to make better decisions. What else? Pursuing courage in the face of death. Or just different kinds of what does courage look like? Why do we need courage in death? We know that we need that in order to pursue treatment. What else? Okay. Why? Okay. Yeah. So, what would a lack of courage look like in that instance? Okay. Yeah. Good. So, courage when it comes to being with other people. It's very easy to not care for somebody if you are not around them. Right? We all know this. And the easiest way to pursue that is to just not see them ever and to pretend that they don't actually exist and that what they are going through isn't actually something that they are actually going through. This is why it's easy to judge people you don't know. Right? Because you don't actually know them. You don't actually know the situation. We all have trouble doing it. Some of us struggle with this more than other people. But it is the reason why you will get defensive about situations or people that you know of and you're very connected to that event. But the same exact thing that's happening to somebody else, you almost immediately go, well, of course, they're this way. You find yourself doing that. That's what we do as humans. When it comes to death, you go, the death is not nearly as painful if it's over there. Right? And in our culture, it's almost always over there. Death is very rarely in our society the way it's set up close to home. Although, thankfully, that's becoming more of a reality. But you need courage in order to say, okay, I do not want, I don't like, I mean, raise your hand if you love being around dead people and dying people. Right? Very few people do. You have to thank God for hospice nurses and doctors. So it's going to take, for everyone in here who is not like inherently joyful about being around dying people, it's going to take courage to say, okay, I should do this. For the very same reasons that Paul is seeking courage. Because I desire to both glorify God and love human beings. That's why. Not because this doesn't matter, I just need to get over it. No, what's happening here is terrible, and it's difficult, and it's hard to deal with. But this person matters. This situation matters. We're going to need courage. Anything else? What's the flip side of pursuing treatment? Right. Do not pursue treatment. We're going to talk about this later. But why would you need courage to not pursue treatment? For the same reasons you need courage to pursue treatment. Because if you're not going to pursue treatment, it's going to mean that certain things are going to transpire. Just like if you were to pursue treatment, certain things are going to happen. And some people will take it and go, I don't want to deal with it, which is not good courage. But then others could go, I don't want to do this. Whatever the reasons are, what they thought through, this is probably the best thing to do. Yeah. Apathy is not a virtue. I just don't want to deal with this, I'm just going to go ahead and die. That is not virtuous. That's called lazy. And in foregoing treatment, like Tim said, it's the flip side where we equally don't know what's going to happen to us, except for we know we're probably going to die faster than we otherwise would. Here's a question. Does the decision to either pursue treatment or forego treatment, is that a one-time decision? No. That's right. The day that you decide to stop pursuing chemotherapy, that next day you're waking up facing death in a whole new way. It is always a reality. But in this case, it's coming down the pike and there's no stopping it, it's going to happen. And it's going to happen almost inevitably faster than it otherwise would. Because if you did the chemotherapy, it might be a worse quality of life, and so we're going to talk about these things at the end, these determinative things, how do we work through this. But you know you're going to die faster. Because the doctor goes, you pursue this treatment, you get four months. You don't pursue this treatment, you got four weeks. The question is, what do you want the end of your life to be like? And more and more of you will face that decision in the future than you will today, because people are continuing to live longer and longer, and medical procedures are continuing to get quote-unquote better and better. So, we're not asking about the question of how to pursue those things, but when you receive that notification, and you say initially, you have courage, and you go, you know what? My time has come. I'm determined, not autonomously, just within myself, but this is a sober determination that I've made prayerfully. You say, I'm done. I'm forgoing treatment. Then the next day, you have to make that same decision. Because I guarantee you that there will be something flirting in the back of your head saying, you just made the dumbest decision of your life. You just signed your own death warrant. No, it's because you're human. Yeah. Exactly. Yes. Yep. And the younger you are, the richer you are, the whiter you are, the more suburban you are, the harder you're going to have to argue for your decision to not pursue medical treatment because you have more possibility of doing so. So it's like, why would you not take every opportunity afforded to you? You're so selfish. You just want to die as if living longer was inherently unselfish. Probably, they're the ones who are selfish. They want you to hang out. Hang out a little bit longer. It doesn't matter how you hold the horn on your body as they're watching you. Yeah. Right. They'll say, if they find you at home, they can see your face, hear your decrepit voice, whatever the case may be, that you're going out. Yeah. There's a lot of reasons that people just want other people to continue to live. Right? What are those reasons? People just don't like facing death. People just don't like facing death. Period. It's not even you dying necessarily. It's just like, if I got to be around somebody who's dying, I'm going to have to think about my own death. I won't think about my own death. Please keep living. Then I won't have to think about this anymore. Even if you're suffering, I will no longer be thinking, you're going to die soon. I'm thinking, this treatment might work. I don't have to care about you as much anymore because you're not actually leaving. We talked about this at the very beginning of this section. We talked about the people who just rage against death to no end and then death comes as a surprise because they're like, wait, no, no, no, we always expected you to live forever, which is the most insane of all possible situations. Mm-hmm. Yeah. Right. Yeah, right. Yeah, I mean, this happens often where people who have decided to forego treatment or who are even like considering different treatments, their friends will all of a sudden become medical experts. They will get online and find this kind of like guy in Australia who has found this bush from the, you know, aboriginal past that does this thing and, you know, this is going to work. Or there's this thing, there's a very pressing ethical weirdness that's happening right now where people are talking about the amount of time it takes for drugs to come online in the market because currently they have to go through a lot of testing that's very expensive and so the question is, should we speed that up because people are, quote-unquote, dying before these drugs become available and people are like, this drug is going to work and if we could just get this thing passed, then my son wouldn't die or my mom wouldn't die. We've got to get this thing passed, which, you know, a lot of times these drugs turn out to be not nearly the wonder drugs that they are promised to be. We have to understand the intentionality of these people is they want to just, they don't want to see their loved ones die. There's positive and negative reasons for that. But if we are not people of courage, then it's going to be hard to maintain in the face of skeptics and to maintain in the face of our own doubt our decisions to forego treatment. Again, how do you determine whether you should forego treatment, pursue treatment? We'll talk about that. Any other ways that courage is key? What about when we're talking about helping other people make decisions? Why is it important for you to have courage when you are helping somebody else? If you have that thing, they don't, that's how you can help them. Even by experience or whatever, if you have that courage, you can actually help them make decisions. Yes, inform them in any given reason not to not fear but to think better in that situation. Yes? What if you lack courage when you're dealing with somebody else who's in a tough situation? Why? Right. Yeah. So much... Yeah. Yeah. You will... We've all had times in our lives when we've made decisions based on fear and fear alone. Right? Those usually do not go very well for us. And when you're helping somebody else and you're fearful and they're fearful, it's just going to snowball effect. You know, you hear people about being like, oh, you're my rock or whatever. That can be said in incredibly cheesy ways. There's a sense in which that kind of idea is true where it's like, okay, I am unable to think well about this thing but because you are able to think well about this thing, I am better enabled to think well about this thing. So you're actually able to help the other person. Here's the last one we'll talk about. Not just pursuing treatment in the face of death as in I'm dying but also courage in the face of pursuing things that are morally nebulous that will end up in somebody's possible, at least chances of death going forward or a less beneficial life. What do I mean by that? The kind of clearest example of this is something that will be probably mainline within the next 20 years. It's already being argued about right now which is gene cell modification. We've talked about it before. So they come and they say, listen, we would never want your children to inherit this disease that you have latent within you that might come about in your children. Therefore, we would like you to do this thing to remove this disease from you and all future generations. We talked about it. Well, I won't get all into it. That's morally wrong for a number of reasons because you're not changing a person, you're changing humanity because you're changing every single being that comes not only from you but from them all the way down the line and you will have to say, no, we're not going to do that. It's very possible that it becomes child abuse. This is the argument right now that you are abusing your child by not doing that thing in the same way that if you could make your children smarter, you'd be abusing your children by not making them smarter if you had that option. And there's current talk about how the countries who have disability should be able to find people who don't pursue that option and possibly even incarcerate them because you would be a burden on society. This isn't George Orwell's 1984. This is not a brave new world. This is the world that you will live in soon. If it's not that thing, it'll be things like it. It will take courage to not pursue every treatment for somebody else knowing that it might lead to a lesser life. It gets back to the very thing at the beginning. We are not going to live forever and we are all not going to live the most ideal life humanly possible. If we don't accept that fact in the beginning and face that with courage, then you will always be frustrated with the life that you live and the life that others live around you because they will be less than ideal. If your assumption is life should be ideal, you are going to be frustrated. It can't be anything but because it will never be as good as you would like it to be. So, in closing, we ought to pursue courage. Same way that Paul did. Not just seeking to not be fearful, seeking to see fear for what it is, or the situations, and then beating back fear with the reality of the God that we worship. Knowing that this will not just be for the glory of God and the good of ourselves, but also for the good of our neighbors. Christianity is losing influence in the culture at a decent rate today. In our culture. And that's fine. I don't really care. But, wouldn't it be great if people hated Christians but loved the way that they lived? They said, I can't stand the God you worship. I think it's morally reprehensible that you think you're the only ones that are right. However, you sure die well. Where does this courage come from? Because we're all incredibly terrified to die, and you people seem to be doing alright. Wouldn't it be great if we were imprisoned? I'm not saying this is going to happen, but this would be pretty cool. If we were all imprisoned for our beliefs and the ways that we decided to live our lives, and you were getting interviewed by CNN going, why is it that you are willing to face life imprisonment for living in this particular way? And you were to say, oh, it's because of the God I worship. That doesn't make any sense to us. We think you're idiots. And you go, well, we'll see. And go out with a bang. To be fined, to be ridiculed, to be whatever, yet to live with courage in the midst of it and say, well, if this God exists, and if this is the God we worship, then so be it. To live in a society and to be effective witnesses to the gospel does not look like something that we used to have in the past. It means being faithful in the present, whatever that looks like. Thankfully for us, we live in a society that lacks courage, especially when it comes to the issue of dying. So, that leads to a less ideal society, but it also leads to a society where Christianity becomes rather persuasive, because we ought to be the kinds of people who have courage, not only have courage for ourselves, but for others, so that maybe we end up dying and people around us say, what is this God you worship, because I'm terrified to die and you all don't seem nearly as terrified as I do. How can my death, same as Paul, right? How can my death, a good death, a death full of courage, benefit the world? Here's one way. How can it benefit the church? Well, because in death, you even proclaim the gospel louder than you might have ever done so in life. By pursuing the right kinds of things and living this life in a way that magnifies God and upholds the faith, that because of what He has done, we have all the courage in the world. Let's pray. God, we thank you for the fact of who you are. We thank you for the sure hope that we have in you. For the faith and confidence that we have as a result of the work of Jesus Christ and we pray that we would be people of great courage. People who know why it is that we ought to do the things that we do. People that are able to not only make the right kinds of decisions but help others. People who desire to proclaim the gospel with our mouths and then live in light of that very gospel that we preach. For we know that it is rather hypocritical to preach a gospel of an all-powerful Savior who has secured for us the greatest of all possible futures and then lives scared. We pray that as we constantly live towards death that we would even today pursue a life of courage so that when the time comes for us or for those that we know and love that we would be able to act with great courage for others' good and your glory. In Jesus' name, Amen.