One of the tenants of the Biblical Christian faith is that God is in control, that nothing happens by chance, that God has our days numbered. God is in control of the day of our death. What effect does this way of thinking have on the approach to palliative care? What effect should it have?
Palliative care refers to the approach to a person who needs care and it is believed that they are approaching the end of their life on this earth. A Palliative care approach is considered appropriate when there is nothing further that can be reasonably done to encourage healing and to halt the dying process, like when a person has a cancer that is rapidly progressing in spite of anti cancer treatments. A palliative approach may also be used in the advanced years of life when a person’s health is rapidly failing and one does not see the sense in seeking out more tests and treatments.
In Palliative care, it is common to talk of not prolonging life. Examples of things that could be considered to prolong life would be continuing intravenous fluid hydration or starting nutrition by tube feeding. As euthanasia gains acceptance there will also be talk to speeding up dying.
If indeed God is in control and has our days numbers, even to know of the day of our death, is it proper to think in terms of prolonging life or even of hastening death? If we can willfully do things that prolong, or for that matter shorten, a life, how can we say that God is in control of the timing? What would this say about murder? Can we really willfully kill another person?
The biblical position is that God has our days are numbered. We are not in control of the day of death. This has implications in the approach to palliative care. God’s instruction to each of us is to love God and to love our neighbour. Rather than thinking in terms of prolonging and shortening life, one can think in terms of doing what can be done to help the dying person to be in the best position to interact with God and those around them until the day God has for the end of their life. Adequate pain control may go a long way in allowing a person to think through their situation. This can also be true for many medications that help settle agitation, delirium and confusion. On the other hand, too much medication, especially those that cause sedation, may interfere with interactions a person needs to have.
Accepting God’s control of the timing of death can also be a comfort to care givers and to families. Sometimes, even when one tries to care for people in a way that does not intentionally kill them, events can happen that leave a care giver wondering if what they did brought about the death of another person. Although we should likely not take this kind of contemplation lightly, we can take comfort in knowing that the life of the person we were helping to care for is in the hand of the Lord. The Lord is the one who has determined the length of days of the person. If the intent of our heart (our inner being) is to care well, to promote life, and not to kill, then we can rest in this and our conscience does not need to be burdened with whether we killed another person.
On the other hand, if the intent of someone’s inner being (or their heart) was to shorten the life of another then, even though God is in control of life and death, they have this death on their conscience and, before the Lord, they bear responsibility for taking part in the killing of another person.
The Bible says, man looks at the outward appearance but God looks at the heart (or the inner thoughts and intents). It also says that a tree is known by its fruit. One can be known to a killer when he/she intend to involve themselves in killing. The Lord knows our hearts (our inner thoughts). Let us strive to guard the thoughts and intents of our hearts and care for people near the end of their life in a way that show that we love life and desire to honour God by not killing our neighbour.
 There are numerous passages in the Bible that support the fact that the day and timing of the end of our life on earth is in the hand of the Lord. David, in Psalm 31, after describing how his enemies purpose to take away his life, says, “But I trusted in you Lord. You are my God. My times are in thy hand. Deliver me from the hand of mine enemies…” (Psalm 31:13-15) Job, as recorded in Job 14:1-6, when speaking ot the fleeting days of man, says, ” Seeing his days are determined, the number of his months are with thee, You [Lord] have appointed his bounds that he cannot pass.” Jesus, when speaking to His disciples, tells them, “fear not them which kill the body, but are not able to kill the soul: but rather fear him which is able to destroy both soul and body in hell. Are not two sparrows sold for a farthing? and one of them shall not fall on the ground without your Father. ” Jesus goes on to point out how much more important people are than sparrow. Implied is that likewise you will not be kill or will not die without it being God’s will. (Matthew 10:28-32)