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Aging, Death, and the Quest for Immortality is a timely volume by physicians, health-care professionals, pastors, and ethicists who explore the experiences, dilemmas, and possibilities associated with aging. The book opens by offering three distinct perspectives on aging; this section includes practical suggestions for dealing with retirement, disability, healing, and death. Several contributors then analyze controversial ethical issues raised by aging and health care, including medical decision-making, the moral standing of patients with dementia, health-care rationing, and assisted suicide. A third group of essays applies a theology of care to ministry to and through older adults, the counseling of seniors, and the application of palliative care. The book closes by discussing some of the emerging technologies and interest groups aimed at achieving immortality, also asking, appropriately, what insights the Christian faith brings to the discussion.
Reflecting much wisdom and sensitivity, this book will give welcome help to care providers and to those who are themselves in the later stages of life.
A Personal Perspective
VERNON GROUNDS, PH.D.
A creative friend of ours made a plaque which hangs in our kitchen. It is the picture of an aged couple, husband and wife, sitting side by side on an old-fashioned swing. Underneath the picture are those familiar lines from Robert Browning:
Grow old along with me The best is yet to be.
Was Browning overly optimistic? All of us are aging, of course, second by second, whether we are forty or seventy or eighty. Wherever we find ourselves on the timeline of life, we must acknowledge that we are growing older.
We all need to be reminded that aging is an inevitable process. We cannot stop the tide from sweeping in. We cannot stop the sun from setting. We cannot keep flowers from fading. Neither can we arrest the passage of time which second by second is making all of us older. An inevitable process, aging is also an irreversible process. We may entreat with Henry Wadsworth Longfellow,
Backward, turn backward, oh time in thy flight, Make me a boy again, just for tonight.
But that entreaty will never be granted. As Aldous Huxley put it, "There are no back moves on the chess board of life."
In addition to being inevitable and irreversible, the aging process is individualistic. No two humans have precisely the same reaction to the ticking away of the hours. Just as no two snowflakes are identical, no two aspen leaves are identical, and no two fingerprints are identical - so no two human beings are identical. We differ radically in temperaments, endowments, and experiences. We are each of us unique, and our responses to the changes and challenges of life are distinctive and different.
Yet, by and large, as we move through time we discover that growing old is a constrictive process, a process that confronts us with a common problem, one set forth suggestively by Robert Frost in his poem "The Oven Bird." That feathery creature is perched on a stone wall in New England; summer is past and autumn rapidly moving into winter. Before long, freezing weather will set in and the world will be blanketed with snow. Yet the oven bird is singing gallantly, Frost writes, "as if to make the most of a diminished thing." That's the problem we confront as we age; how can we make the most of a diminished thing?
Think with me, then, about the ways that life is diminishing. For one thing, it is diminishing temporally. We have less and less time in this world. With David, Israel's poet-king, we exclaim, "Teach us to number our days aright, that we may gain a heart of wisdom" (Ps. 90:12).
Life is also diminishing physically. Exercise and diet as we may, our energy is less and less, and our strength is gradually ebbing away. We cannot walk as fast and far as we did earlier on. The tasks that we once performed with the greatest of ease may now be laborious struggles.
Moreover, for many of us, life is diminishing spatially. We have sold the sizeable houses in which we formerly lived and moved into an apartment or a retirement community. We may be consigned to a room in the home of our children. Once we may have traveled widely, but now perhaps we are confined to a wheelchair or a bed. We cannot walk or drive or move about as we so freely did in years gone by.
Add to all of this shrinking process the sad truth that life is diminishing vocationally. In our society we reach a certain year in our journey, usually sixty-five or seventy, when we are expected to give up our professions and jobs. Even simple tasks may be relinquished. I think of my mother-in-law who lived with us for a quarter of a century following the death of her husband. She had enjoyed being a homemaker and insisted on keeping busy when she moved in with our family. At that time, we had no dishwasher, so one of her self-assigned tasks was to do the dishes. Yet as she was increasingly unable to see clearly and to grasp things firmly, she was even relieved of that assignment, much to her distress.
Again, for many of us, there is a diminishing financially. We may not have as much money as we once earned or controlled. Indeed, we may be eking out our existence on slight pensions, or meager Social Security, or all-too-uncertain investments.
Finally, (and I apologize for this dismal recital), life is diminishing relationally. Neighbors, friends, colleagues, and family members are far removed or have preceded us in death. One by one our human ties are being cut. The circle of known and loved people is constricting.
What I have been saying about life as a diminishing process may strike you as being excessively melancholy, and I must emphasize that the specific kinds of constriction do not apply to everyone. Bear in mind that, as I have pointed out, we are all different and thus our experiences will be different as we age. Nevertheless, we have, I must repeat, a common problem. How can we best handle this constrictive process? What will enable us to make the most of our diminishing days? I suggest that we can determine, with God's help, how the autumn and winter years of our lives are going to be spent. We can simply refuse to let circumstances control our attitude. After all, attitude in the whole sweep of our experience, and especially in older age, is the crucial factor. Victor Frankl, the well-known Austrian psychiatrist, was sent to a concentration camp when the Nazis took over his homeland. The situation in which he there found himself was worse than deplorable. It was purgatorial. Many of Frankl's fellow prisoners succumbed to despair and so to death. But Frankl observed that, if anyone had a hope for the future, a reason to struggle on, he was likely to survive. Thus in the book he composed while a prisoner, Man's Search for Meaning, he argues that there are varieties of values, and that a person can resolutely decide to hold fast to self-chosen values. There are, he says, experiential values. We can experience activities and things that give us pleasure, whether food and drink, married love, a beautiful sunset, magnificent music, any and all of the enriching joys of life. But what if we are in a situation where we have no opportunity to relish a delicious dinner or feel delightful sensations? What if, in short, we are robbed of all opportunities for experiential values?
In the same way, what if there is no opportunity to produce any creative values? And these are not simply the higher reaches of culture like art and literature. Creativity can be exercised in the making of an apple pie, the carving of a piece of wood, the furnishing of a home, and the upbringing of a family. But suppose creative values are impossible? What then?
Frankl argues that there is always the possibility of achieving attitudinal values. We can, as was done by some of his fellow inmates in the concentration camp, decide whether we will succumb to despair, give up any hope for the future, degenerate into mere zombies, or, instead, will to be brave, cheerful, helpful, prayerful, and patient.
Frankl reached that conclusion as the fruit of his almost intolerable imprisonment. The well-known American preacher, Chuck Swindoll, has reached the same conclusion from his study and observation:
The longer I live, the more I realize the impact of attitude on life. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think or say or do. It is more important than appearance, giftedness or skill. It will make or break a company ... a church ... a home. The remarkable thing is we have a choice every day regarding the attitude we will embrace for that day. We cannot change our past.... We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude. ... I am convinced that life is 10% what happens to me and 90% how I react to it. And so it is with you ... we are in charge of our Attitudes.
That may sound like baptized stoicism, but it can be viewed, rather, as the appropriation of divine grace by the Holy Spirit's enablement.
The Benefits of Vital Faith
To face the inevitable process of aging with courage, confidence, and even cheerfulness we need a vital faith, yes, a vital faith; not some religion which, as philosopher William James put it, is merely a dull habit. No, we need a vital faith that provides sustaining resources, and I speak now as an octogenarian who is convinced that the gospel of Jesus Christ is precisely such a faith.
The Comfort of an Abiding Presence
A vital faith in Jesus Christ provides, first of all, the comfort of an abiding Presence. We may lose family members and friends, we may be living alone. Human companionship may be limited. Yet the gospel assures us we are not alone. We are not abandoned and forsaken. In God we have that friend who sticks closer than a brother. At this stage of life some of the great biblical texts can become even more meaningful to us. One is Deuteronomy 31:6-8: "Be strong and courageous. Do not be afraid or terrified ... for the Lord your God goes with you; he will never leave you nor forsake you.... Do not be afraid; do not be discouraged." Another such text is Matthew 28:20, "And surely I am with you always, to the very end of the age." Hebrews 13:5 is a third antidote to depressive loneliness: "God has said, 'Never will I leave you; never will I forsake you.'" Indeed, the aging process can be the translation of these texts from mere verbiage to a sustaining experience. The diminishing of flesh-and-blood relationships can stimulate the development of a deepening friendship with that invisible companion whose name is Immanuel, "God with us."
Before I proceed any further let me pause to insert an explanatory comment. A vital Christian faith can greatly enrich the experience of older people. Many, if not most, of those we endeavor to help are believers in the gospel, once active in church affairs, knowledgeable about biblical doctrine, some even theologically educated. But whether strongly religious or only rather superficially God-oriented, they need to have doctrine become emotionally meaningful. My wife and I conduct a late Sunday afternoon service at the assisted living center where we live. Those attending are by and large educated, many of them ex-professionals. Yet when we started this ministry more than a decade ago, I, a seminary professor, quickly realized that central concepts must be so interpreted as to be personally meaningful. Truth must be communicated with graspable simplicity and illuminating vividness.
Consider, then, the point I have been making. Christian faith provides a sense of divine presence. Actually, therefore, I am referring to the doctrine of divine omnipresence as taught, for example, in Psalm 139. But how do I make the reality of God's pervasive presence personally meaningful? Here is a story of graspable simplicity.
A bed-ridden man was alone in his room at the nursing home except for the necessary visits of his caretakers and a weekly visit by his daughter. When he complained to her of loneliness, she reminded him that as a Christian he believed Jesus has promised to be with those who trust him always and everywhere. Yes, he did believe that, yet it was hard to feel any comforting presence. So his daughter suggested that they put a chair alongside his bed, and he could imagine Jesus sitting there, and talk with Jesus day or night. He could even put his hand on the chair as if he were touching Jesus. That simple technique proved a significant help in making the truth of divine omnipresence meaningful to him. In fact, when the nurse entered his room after he had quietly died, his outstretched hand was resting on that chair.
Our problem, then, in ministering to people in general - but especially, I have found, in ministering to older people - is discovering how can the truth be concretized. And how is this to be done? Not by the use of theological jargon, I can assure you, but (keeping in mind, of course, the individual's background) by expressing truth with graspable simplicity and illuminating vividness.
The Awareness of an Unchanging Self-Worth
For another thing, a vital Christian faith provides the awareness of an unchanging self-worth. From a purely human perspective the diminishing process may reduce us to unproductive drones no longer contributing anything to the general welfare. We may become shriveled organisms who have lost their charm and vitality. We may be costly burdens to our families and society. Yet from a faith perspective our self-worth is as high as ever, for what is it that gives us value, an even inestimable value? It is the basic biblical affirmation that we bear the image of God whether vibrantly young or helplessly old.
In the Gospel according to Matthew, for example, we learn from Jesus Christ that, as God's image-bearers, we possess a self-worth age cannot diminish. What does our Savior teach us in chapter 6, verses 28-30? "And why do you worry about clothes? See how the lilies of the field grow. They do not labor or spin. Yet I tell you that not even Solomon in all his splendor was dressed like one of these. If that is how God clothes the grass of the field, which is here today and tomorrow is thrown into the fire, will he not much more clothe you, O you of little faith?" What is Jesus saying? We have a value that exceeds the value of flowers, and that value never diminishes. Chemically we may be worth at best only a few dollars. By contrast there are beautiful orchids that command a price higher than our market value. Yet our worth exceeds that of the most rare and exquisite of flowers because we are made in the image of God.
In that same sixth chapter of Matthew, Jesus urges us to consider another aspect of nature: "Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they?" (v. 26). Again in chapter 10, Jesus emphasizes our value compared to that of the birds: "Are not two sparrows sold for a penny? Yet not one of them will fall to the ground apart from the will of your Father. And even the very hairs of your head are all numbered. So don't be afraid; you are worth more than many sparrows" (vv. 29-31). Sparrows may be next to worthless, but there are gorgeous birds in our pet stores which command a fabulous price. Yet Jesus insists that we are measurelessly more valuable than the most exotic feathered creature because we are God's image-bearers, and they are merely his creatures.
Excerpted from Aging, Death, and the Quest for Immortality Copyright © 2004 by The Editors and Contributors and The Center for Bioethics and Human Dignity. Excerpted by permission.
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|A personal perspective||3|
|A theologian's perspective||17|
|A geriatrician's perspective||33|
|Does gray hair cause gray answers : ethical issues in an aging population||45|
|Age-based rationing of life-sustaining health care||58|
|Neuropsychological aspects of aging and their implications for decision-making among the elderly||75|
|Dementia : inclusive moral standing||87|
|Local church ministry to and through older adults||107|
|The virtues of talk therapy||121|
|Palliative care : suffering and healing at the end of life||134|
|The quest for immortality||153|
|Reflections on disability, life, and God||163|
|In search of the philosopher's clone : immortality through replication||175|