The Advance Directive as a Vehicle for Christian Stewardship

This guest post is by Emma Plotnik, Regent Law 3L and current Wills, Trusts & Estates student who is completing her 3L year from California where she is clerking for the law firm of Mokri, Vanis, & Jones, LLP:

In the area of estate planning, an advance health care directive is beneficial to a person in indicating to family members, caretakers, attorneys, and physicians his or her wishes for medical care. According to a HealthStyles Survey taken of 7,946 respondents in 2014, only 26.3 percent claimed to have an advance directive. The most commonly cited reason for this statistic was lack of awareness, according to Jaya K. Rao, MD, Lynda A. Anderson, PhD, Feng-Chang Lin, PhD, & Jeffrey P. Laux, PhD, Completion of Advance Directives Among U.S. Consumers, Am. J. Prev Med., Jan. 2014, at 65-70. An advance directive becomes applicable when a person is diagnosed with a terminal condition or is in a permanent vegetative state and is incapable of making health care decisions independently. It may be included as part of a comprehensive estate plan, including a will or a will substitute (such as a trust) and a power-of-attorney to transfer decision-making authority to one’s family members and to account for their prosperity.

The living will is a particularly important provision of the advance directive, typically containing an individual’s decisions regarding medication, pain relief, and artificial nutrition, hydration, and respiration. Many jurisdictions allow for the modification of statutory forms in the preparation of an advance directive. In other words, a person may elect to write in his or her own health care instructions, rather than simply checking a box for “prolonging life” or “hastening death.” Thus, it is advisable for Christians to make this election and to include a statement of faith and health care provisions designed to prolong their time on earth with their families, while acknowledging that a terminal condition may require withdrawal of treatment when God calls them home. Ecclesiastes 3:1-2. “Christian Life Resources” supplies some helpful language in drafting these provisions by jurisdiction.

It is imperative to differentiate between a terminal condition and a permanent vegetative state in drafting one’s living will. A terminal condition, such as Stage IV cancer may encourage the removal of artificial nutrition, hydration, and respiration, as foods and fluids may either bear no effect on imminent death or contribute to greater pain if the body cannot digest these substances. In the circumstance of a permanent vegetative state, however, it is recommended that Christians continue receiving life-sustaining treatments. The unfortunate advent of physician assisted suicide sparked by decisions, such as Schindler v. Schiavo and by right-to-die statutes adopted in a minority of states has caused several misdiagnoses. There is a misconception that people cannot wake up from comas and should therefore withdraw support to minimize the financial and emotional burden to their families imposed by continuous treatments. Yet, stories, such as that of Martin Pistorius offer hope. After a twelve-year coma, Mr. Pistorius was restored to full consciousness. It was during Mr. Pistorius’ return to consciousness that he was first acquainted with God’s presence. He now serves as a web designer, author, and speaker who shares his story via international platforms to fulfill the Great Commission. See the full article by Martin Pistorius entitled “Trapped Inside My Own Body For 12 Years,” in Christianity Today (July 20, 2015).

As Christians, we have the blessed assurance of eternal life when we accept Jesus Christ into our hearts as our Lord and Savior. While we must be eternally minded, rather than clouded by temporary worldly mindsets and possessions, we are commanded to steward our gifts lent to us by God during the time that we are here on earth. 1 Peter 4:10. One such gift is that of bodily health and preservation. Indeed, Paul challenges his listeners to consider this truth in 1 Corinthians 3:16-17 when he queries, “Do you not know that you are the temple of God and that the Spirit of God dwells in you? . . . For the temple of God is holy, which temple you are.” We can steward this holy gift by making health care decisions in our advance directives that redeem the time we have on earth to minister to our loved ones and acknowledge our appointed time as we press forward in the hope of Heaven through Christ. Philippians 3:14.