By Marie Bowen, Presbyterians Pro-Life.
The Advisory Committee on Social Witness Policy brings a resolution (Item 11-14) for commissioner approval to the Presbyterian Church (USA) 222nd General Assembly meeting in Portland, Oregon June 18-25, 2016. The resolution includes a pastoral guidebook, a statement of affirmation, and recommendations for conversation and advocacy. It’s long—49 pages—but the subject is critically important for human lives and so it what the church says about life at its end matters, just as what the church says about life in the womb is of critical importance. So, I am taking a literal and figurative big breath and plunging into a blog series to analyze this piece of business coming to the PCUSA with both potential and pitfall.
Here is my working outline for a seven-part series I am calling “End of Life pastoral guidebook holds potential and pitfall.” Part one begins below the outline.
- Overview of the Recommendations and the Affirmation
- Guidebook intro and contextual settings of the conversation
- Pastoral Support and the clash of cultures
- Hospice, palliative care, and advance directives
- Special concerns: Those with disabilities, the terminally ill, pregnant women
- The appendices
- PPL’s analysis and concerns
Part I: Recommendations and Affirmation Statement
In the Presbyterian Church (USA), a 1.6 million member (2014) denomination with an aging demographic, there is a growing need for pastoral care at the end of life. In a culture where the number of states that have legalized physician assisted suicide (PAS) is growing, it is appropriate that to produce a “pastoral and educational booklet” giving guidance for decision-making at the end of life in response to a 2014 General Assembly action. Specifying a team of 7-8 made up of “ethicists and physicians,” the original proposal from Synod of the Covenant was amended, adding theologians and pastors to the writing group, and approved. A broad range of topics to be addressed was included: physician-assisted suicide (PAS); palliative and terminal sedation; the role of medical professionals and pastoral support; the special circumstances of dying children and the dying pregnant woman, the chronically ill and severely disabled persons; organ donation; faithful conversation about end-of-life planning and advance directives; and support for the faithful exercise of Christian conscience on these matters.
The resolution presented for approval to the 222nd GA in Portland, Oregon in June contains the requested pastoral guidebook as its rationale. Four recommendations accompany the resource. Together they comprise a very comprehensive approach to encouraging conversation, education, and advocacy focused on individual development of advance directives for end of life treatment and care. If implemented in a biblically faithful context there is great potential for this resource to be a helpful to individuals making decisions at the end of life for themselves and loved ones and also to those engaged in pastoral care. There are some pitfalls—I’ll get to those as this blog series progresses.
Recommendation 1 is a standard call to “approve the pastoral guidebook titled, “Abiding Presence: Living Faithfully in End-of-Life Decisions,” as a “theologically and ethically grounded resource for pastoral care.” It specifies that the resource be made available through both electronic and print means. The guidebook (scroll to rationale) and its appendices are 45 pages long and will be considered by the GA Committee on Social Justice Issues as item 11-14. I’ll focus on the guidebook in Parts 2-6 of this series.
The second recommendation asks the Assembly to “approve the affirmation and recommendations following for Christian public witness in support of the advance care planning, healthcare access, and respect for personal conscience described in the guidebook.” Take notice of the broad reach of that recommendation! At first reading, one might think it only asks for confirmation of the statement: “Affirmation: Faithful Living at the End-of-Life” (which actually resides in recommendation 3). Commissioners approving recommendation two will also have affirmed advocacy of advance care planning, healthcare access, and respect for personal conscience. Those who have followed the advocacy of the PCUSA for very long understand that such a broad statement could take us to supporting things which do not hold with our convictions that every life is valuable from fertilization and for every day that God gives life until natural death.