Bishop's Pastoral Letter on "End of Life Decisions"


[1] Christ has risen!  He is risen, indeed!

[2] On Easter morning Jesus provided the ultimate answer to matters related to the end of life.  We proclaim it in the words of the hymn:  "Thine is the glory, Risen, conqu'ring Son; Endless is the victory, Thou o'er death hast won!"   For the believer, the last word is "Victory!"  Christ has conquered both sin and death, and promises New Life!

[3] I have been watching and reading along with all of America, the painful and sad story of Terri Schiavo.  We have witnessed all too first-hand the struggles of a family and community bitterly divided over her end of life decisions.  Even as I write, it appears that death is ever more imminent as the courts have upheld the belief that her wish was not to be kept alive under such circumstances.  There are many, including her parents, who feel otherwise.  This is a time for prayers not only for Terri Schiavo and her family but also the many families who are dealing with painful decisions about life and death.

[4] I am writing not to engage in conversation directly related to this particular situation, but to share some perspective of the Evangelical Lutheran Church in America on end of life decisions.  In 1992 the ELCA Church Council approved a message on End of Life Decisions prepared by the Division for Church in Society.  This message provides timely guidance for the people of our churches at this time.  It will help inform my comments to you in this pastoral letter.

[5] It needs to be recognized that decisions like the ones that the relatives of Terri Schiavo are facing are addressed nearly daily in hospitals, nursing homes and hospice care situations around the world.  I expect many within our congregations are facing, or have faced, such difficult decisions as they care for loved-ones facing death.  My dad, sisters, and I were faced with such a decision at the deathbed of my mother. 

[6] The matter of withholding or withdrawing artificially administered nutrition and hydration is perhaps the most difficult of all such decisions.  Most living wills now address this matter with a very specific question seeking the individual's wishes.  While food and water are part of our basic needs, artificially administering hydration and nutrition is considered a medical treatment.   Artificially administering water and nutrition can serve as very critical temporary measure for sustaining life in a process towards recovering health.  However, a decision to withdraw such treatment should never be equated with starvation.   When it is believed such treatment will not lead to improved health, and is preventing natural death from occurring, a decision to withdraw such treatment may be the morally responsible thing to do.  We would continue to surround the dying loved-one with the assurance of God's love and do what is possible to relieve any suffering.

[7] Competent patients are always the prime decision-makers and may refuse any treatment whether recommended or not by medical professionals.  When the decision has not been made in advance, it falls usually to their family or to persons who are their legal spokespersons.  Often family, friends, pastors and health professionals will consult together and prayerfully determine the course of action that they feel their dying loved-one would desire, whether that had been spoken of specifically or simply determined by a life shared with the now dying loved-one.  Sometimes a family is deeply divided on such decisions, as in the Schiavo case, and the courts must make rulings based upon testimony of all concerned.

[8] Our church has traditionally been very sensitive and pro-active in matters of death and dying.  We believe in holistic ministries which help to prepare people for end of life decisions.  Our Easter faith helps us deal with our fears and our hopes.  We rejoice, as our end-of-life statement declares, "in the faithful and compassionate congregations, pastors, health care professionals, and church institutions that minister with persons who are dying and their family and friends."  Within our own Florida-Bahamas Synod, several pastors serve as full-time hospice chaplains while others, both lay and clergy, offer support to the hospice program.

[9] This is an opportune time for clergy, congregation councils, parish nurses and other church leaders to encourage members and friends of our congregations to provide for advance written directives which make known a person's desires regarding medical treatment related to life sustaining measures.  Attorneys and medical professionals can provide information about the different kinds of directives that are available.  This would also be a good time to encourage the preparation of wills.

[10] I am aware that I have just touched upon the very complex matter of decisions faced by those facing end-of-life decisions.  Yet I felt it very important that the views portrayed by some in recent television or newspaper interviews do not necessarily reflect the beliefs and practice of our church.  If you desire to read more about our church's message, you may access the full report at

[11] We rejoice again that our Easter faith assures us that the death of the body is not the end of life!

[12] Christ has risen!  He is risen, indeed!




© April 2005
Journal of Lutheran Ethics
Volume 5, Issue 4