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If The Doctor Asks You… (via Kathryn Butler at Desiring God)

Last Saturday night I participated in a phone conversation that dealt with directions about various medical treatment choices that may or may not be needed for someone who is not capable of making those choices themselves.
I found this article by Kathryn Butler at Desiring God covered a lot of the considerations that were being put before us, and approaches how those options can be thought of from a biblical perspective.
It is more positive to have given some thought to this beforehand, and to have even discussed them with those for whom you may end up making choices (or who may be making them on your behalf).
Butler is/was a trauma and critical care surgeon, her reflections do not come from a place of pure theory.
Well worth a read:

Making life-or-death decisions for loved ones cripples many with feelings of guilt and doubt that persist for years, and which can progress to depression, complicated grief, chronic anxiety, and even post-traumatic stress disorder.
So how do we make compassionate, Christ-honoring decisions about our loved ones’ care when the unthinkable happens? How do we discern the right path when time to reflect is nonexistent, and when the mind balks at the ramifications of our choices?

Read the whole post at Desiring God.


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Therapeutic Lying (via Larissa MacFarquhar at The New Yorker)

An in-depth article in The New Yorker dealing with dementia care and the way its practictioners struggle with the lying and untruths that are part of the life of carers and patients.
Over the decades and even within among practitioners differing points of view and practices have been dominant and then given way to others.
Consider what it is to work day by day in a world where truth is often judged as being what the patient needs to hear.

In dementia care, everybody lies. Although some nursing homes have strict rules about being truthful, a recent survey found that close to a hundred per cent of care staff admitted to lying to patients, as did seventy per cent of doctors. In most places, as in Chagrin Valley, there is no firm policy one way or another, but the rule of thumb among the staff is that compassionate deception is often the wisest course. “I believe that deep down, they know that it is better to lie,” Barry B. Zeltzer, an elder-care administrator, wrote in the American Journal of Alzheimer’s Disease & Other Dementias. “Once the caregiver masters the art of being a good liar and understands that the act of being dishonest is an ethical way of being, he or she can control the patient’s behaviors in a way that promotes security and peace of mind.” Family members and care staff lie all the time, and can’t imagine getting through the day without doing so, but, at the same time, lying makes many of them uncomfortable. To ease this “deception guilt,” lying in dementia care has been given euphemistic names, such as “therapeutic fibbing,” or “brief reassurances,” or “stepping into their reality.”

Read The Comforting Fictions Of Dementia Care at The New Yorker.


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Heidelberg Catechism – Lord’s Day 42

Heidelberg Catechism – Lord’s Day 42

110.
Q. What does God forbid in the eighth commandment?
A. He forbids not only the theft and robbery which civil authorities punish, but God also labels as theft all wicked tricks and schemes by which we seek to get for ourselves our neighbor’s goods, whether by force or under the pretext of right, such as false weights and measures, deceptive advertising or merchandising, counterfeit money, exorbitant interest, or any other means forbidden by God. He also forbids all greed and misuse and waste of his gifts.

111.
Q. But what does God require of you in this commandment?
A. That I work for the good of my neighbor wherever I can and may, deal with him as I would have others deal with me, and do my work well so that I may be able to help the poor in their need.


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Heidelberg Catechism – Lord’s Day 41

Heidelberg Catechism – Lord’s Day 41

108.
Q. What does the seventh commandment teach us?
A. That all unchastity is condemned by God, and that we should therefore detest it from the heart, and live chaste and disciplined lives, whether in holy wedlock or in single life.

109.
Q. Does God forbid nothing more than adultery and such gross sins in this commandment?
A. Since both our body and soul are a temple of the Holy Spirit, it is his will that we keep both pure and holy. Therefore he forbids all unchaste actions, gestures, words, thoughts, desires and whatever may excite another person to them.


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Heidelberg Catechism – Lord’s Day 40

Heidelberg Catechism – Lord’s Day 40

105.
Q. What does God require in the sixth commandment?
A. That I am not to abuse, hate, injure, or kill my neighbor, either with thought, or by word or gesture, much less by deed, whether by myself or through another, but to lay aside all desire for revenge; and that I do not harm myself or willfully expose myself to danger. This is why the authorities are armed with the means to prevent murder.

106.
Q. But does this commandment speak only of killing?
A. In forbidding murder God means to teach us that he abhors the root of murder, which is envy, hatred, anger, and desire for revenge, and that he regards all these as hidden murder.

107.
Q. Is it enough, then, if we do not kill our neighbor in any of these ways?
A. No; for when God condemns envy, hatred, and anger, he requires us to love our neighbor as ourselves, to show patience, peace, gentleness, mercy, and friendliness toward him, to prevent injury to him as much as we can, also to do good to our enemies.


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Westminster Confession Of Faith – Lord’s Day 38

Westminster Confession Of Faith – Lord’s Day 38

Chapter 22 – Of Lawful Oaths and Vows (Cont.) (Paragraphs 4-7)
IV. An oath is to be taken in the plain and common sense of the words, without equivocation or mental reservation. It can not oblige to sin; but in any thing not sinful, being taken, it binds to performance, although to a man’s own hurt: nor is it to be violated, although made to heretics or infidels.
V. A vow is of the like nature with a promissory oath, and ought to be made with the like religious care, and to be performed with the like faithfulness.
VI. It is not to be made to any creature, but to God alone: and that it maybe accepted, it is to be made voluntarily, out of faith and conscience of duty, in way of thankfulness for mercy received, or for obtaining of what we want; whereby we more strictly bind ourselves to necessary duties, or to other things, so far and so long as they may fitly conduce thereunto.
VII. No man may vow to do any thing forbidden in the Word of God, or what would hinder any duty therein commanded, or which is not in his own power, and for the performance of which he hath no promise or ability from God. In which respects, monastical vows of perpetual single life, professed poverty, and regular obedience, are so far from being degrees of higher perfection, that they are superstitious and sinful snares, in which no Christian may entangle himself.


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Westminster Larger Catechism – Lord’s Day 37

Westminster Larger Catechism – Lord’s Day 37

Q & A 149
Q Is any man able perfectly to keep the commandments of God?
A No man is able, either of himself, or by any grace received in this life, perfectly to keep the commandments of God; but does daily break them in thought, word, and deed.

Q & A 150
Q Are all transgressions of the law of God equally heinous in themselves, and in the sight of God?
A All transgressions of the law of God are not equally heinous; but some sins in themselves, and by reason of several aggravations, are more heinous in the sight of God than others.

Q & A 151
Q What are those aggravations that make some sins more heinous than others?
A Sins receive their aggravations,
1. From the persons offending: if they be of riper age, greater experience or grace, eminent for profession, gifts, place, office, guide to others, and whose example is likely to be followed by others.
2. From the parties offended: if immediately against God, his attributes, and worship; against Christ, and his grace; the Holy Spirit, his witness, and workings; against superiors, men of eminency, and such as we stand especially related and engaged unto; against any of the saints, particularly weak brethren, the souls of them, or any other, and the common good of all or many.
3. From the nature and quality of the offense: if it be against the express letter of the law, break many commandments, contain in it many sins: if not only conceived in the heart, but breaks forth in words and actions, scandalize others, and admit of no reparation: if against means, mercies, judgments, light of nature, conviction of conscience, public or private admonition, censures of the church, civil punishments; and our prayers, purposes, promises, vows, covenants, and engagements to God or men: if done deliberately, willfully, presumptuously, impudently, boastingly, maliciously, frequently, obstinately, with delight, continuance, or relapsing after repentance.
4. From circumstances of timed and place: if on the Lord’s Day, or other times of divine worship; or immediately before or after these, or other helps to prevent or remedy such miscarriages: if in public, or in the presence of others, who are thereby likely to be provoked or defiled.

Q & A 152
Q What does every sin deserve at the hands of God?
A Every sin, even the least, being against the sovereignty, goodness, and holiness of God, and against his righteous law, deserves his wrath and curse, both in this life, and that which is to come; and cannot be expiated but by the blood of Christ.