Death, Dying, and Grief
Introduction Death and dying are a bitter part of the reality of life, in general, and a particularly common experience for those called to health care. The nature and meaning of death is not simply biological or scientific, but rather involves deep philosophical and religious questions. Once again, medical technology has changed the scope, quality, and experience of death (or at least the dying process). It has even prompted a changing of the very definition of death. Death in the 21st Century One of the incredible benefits of modern science and its application in medical technology has been the ability to extend physiological life. In the 1960s, the development of CPR, ventilators, and the like allowed never-before-seen intervention in the process of dying, such that a "millennia-old general understanding of what it meant to be dead" was transformed (Veatch, Haddad, & English, 2010, pp. 390-391). In the field of biomedical ethics, the very definition of what it means to be dead is a controversial topic. In continuing with a fundamental theme running throughout this course, it should be noted that while the pathophysiological and scientifically detectable signs of death are crucial in this debate, they should not be taken to be determinative or comprehensive. This debate still crucially depends on the philosophical background of one's anthropology (i.e., view of personhood) and in the resulting interpretation of these scientific and physiological signs. The medical definition of death is not a purely or irreducibly scientific question. Worldview and the Meaning of Death Two of the more controversial issues in bioethics are euthanasia and physician- assisted suicide. As you read and research the ethics surrounding these issues, consider how the Christian worldview would analyze the ethics of such actions. On a worldview level, the question of the medical definition of death is just the tip of the iceberg in terms of the broader significance and ultimate meaning of death. Whether or not there is any meaning to death and what it might be is a question of one's worldview. Questions regarding whether or not there will be ultimate moral accountability for the way one lived life and whether there is an afterlife are key questions in this regard. The very phenomenon of the loss of (at the very least) physiological and perhaps conscious integrity and activity is a fact of life that calls for explanation. Once again, an accurate understanding of religion and worldview is required. Furthermore, the distinctions among each religion must be appreciated and not collapsed into one another. The way in which both technology and religious background color the experience and meaning of death (both in dying and grieving) must also be
appreciated. Whatever rituals or practices a religious or cultural group engages in are informed by a view regarding the nature and meaning of death that fits within an overarching worldview narrative. Death in the Christian Worldview Death takes on a particular meaning when seen within the Christian narrative. It is, in fact, not the greatest evil that could befall a human being and is furthermore transformed in the light of the resurrection of Jesus Christ. The Christian teaching that "God died" essentially transforms the way in which death is seen and experienced (Sanders, 2007, pp. 6-8). Death is certainly a tragedy and an evil, but it is now a conquered enemy. It is a conquered enemy because in the Christian biblical narrative, death is a perversion of God's original design plan. And yet, the Christian God constantly redeems that which is broken. Loss and Grief Death is a particularly traumatic and difficult experience for both family and caregivers. Understanding the process and stages of grieving is immensely beneficial for caregivers to assess the well-being of patients and families. There are numerous resources that can be of tremendous benefit for both caregivers and family. One of the most influential is the work of American psychiatrist Elizabeth Kubler-Ross. Perhaps the most influential insight of her work was to notice certain patterns or stages in the human experience of grief, especially after the loss of a loved one in death. She called these the five stages of grief. Briefly, they include the following: (a) denial, (b) anger, (c) bargaining, (d) depression, and (e) acceptance (as cited in HealGrief, 2016). Expectations regarding an afterlife will in large part determine the manner in which patients and families welcome or spurn the prospect of death. Furthermore, the way in which a person experiences the stages of grief will be in the context of his or her worldview. Christian theologian Nicholas Wolterstorff's (1987) memoir, Lament for a Son, is a personal reflection of his own personal grief after losing his 25-year-old son in a mountain climbing accident. As he engages with his own grief and experience, it becomes clear that everything is ultimately seen in the light of God's loving control and the ultimate hope found in the life, death, and resurrection of Jesus Christ. Why Did God Become Man? Incarnation, Atonement, and Resurrection Jesus was the Son of God before he was born into our world. The event of God taking on flesh and dwelling among us—the incarnation—is amazing and is celebrated all over the world at Christmas. The incarnation is proclaimed clearly throughout the New Testament (Luke 1:35; John 1:14; Phil. 2:5-7). So why did God become man? The most famous verse in the Bible clearly tells us, "For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life" (John 3:16 NIV). And Jesus knew what this would
require of him. He stated in Matthew 20:28, "The Son of Man came not to be served but to serve, and to give his life as a ransom for many." God is both holy and just, so although he created humanity to be immortal, he could not accept them into his holy kingdom in their sinful state. So from the beginning God enacted and unfolded his plan for humanity, to redeem a people for himself (Titus 2:11- 14), requiring that justice be upheld and sin punished. Therefore, a sacrificial lamb was needed—one that could atone for the sins of the world. Only the perfect and sinless Lamb of God would be sufficient. Yes, God himself would have to be the sacrifice somehow. So the incarnation led inexorably to the cross, the torturous experience that had been prophesied nearly a thousand years earlier by David in Psalm 22. All four Gospels give vivid accounts of the crucifixion of Jesus, the most unjust execution ever to be carried out, as testified by the centurion there who said, "Certainly this man was innocent!" (Luke 23:47). But as unjust as the crucifixion was, Jesus willingly accepted it, for as the Son of God he could easily have been rescued (Matt. 26:53). Instead, Jesus bore the sins of the world on the cross. This is called the atonement—the reconciliation of humanity with God through the sufferings and sacrificial death of Christ. It is interesting that the clearest account of the atonement is found in the prophecy of Isaiah 53: 5-12 (NKJV) where the atonement is specifically stated seven times: He was wounded for our transgressions; he was crushed for our iniquities…and the Lord has laid on him the iniquity of us all…stricken for the transgression of my people…when his soul makes an offering for sin…and he shall bear their iniquities…yet he bore the sin of many. God went out of his way to make the extent he would go to bring about reconciliation clear. The resurrection of Jesus Christ is by far the climax of his life. .All four Gospels provide vivid accounts of this amazing miracle that conquered death. There have been many who looked at the history of the times, read the many accounts of what happened both in the Bible and in other sources, and came to the inevitable conclusion that there is no other explanation for what happened except that Jesus surely rose from the dead. After the crucifixion, the disciples gave up and went back to fishing—the 3 years of exhilarating ministry were over. But then the resurrection changed everything. It was not long before the disciples were accused of turning "the world upside down" (Acts 17:6). This world-changing event was not just a historical miracle, it was a sign of the promise that God gave to those who put their faith in him. Death is a conquered enemy because Jesus's resurrection from the dead made a way of salvation, and also was a sign of the future that God has for those that have died "in Christ." The phrase "in Christ" is very common in the New Testament and crucial to understanding the gospel. To be "in Christ" means to place your "hope in Christ" (Eph. 1:12), or in other words, making Christ the object of your faith. Paul expresses the gospel message most succinctly in Galatians 2:16 where he says, "a person is not
justified by works of the law, but through faith in Jesus Christ." Conclusion Christianity is unlike virtually every other religion in the world. Other religions show you what they believe is a way to God by living in a certain manner, praying certain prayers, and many other religious customs. Christianity teaches that people are not capable of being good enough, which is precisely why God sent Jesus to be the Savior of the world. Other religions offer good advice, whereas Christ offers good news, the gospel—which is that by trusting in what he has already done for you, you are restored. Other religions offer possible salvation (eternal life in heaven) through trusting in one's own good works, while Christianity offers certain salvation through trusting in Christ's good works. Paul makes this clear in Ephesians 2:8-9, "For by grace you have been saved through faith. And this is not your own doing; it is the gift of God, not a result of works, so that no one may boast" (ESV). The final chapter in the biblical narrative will involve a restoration of all creation, and those that died in Christ will be resurrected and receive imperishable bodies.
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