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Dying as a Christian–An Interview with Christopher Bogosh

Interview by Matthew Claridge–

If you read sermon collections anytime before the 20th century,  you will find many covering the topic of “preparing for death.” Honestly, when’s the last time you heard a message on that? Martin Luther’s famous sermon on that theme made the following exhortation: “what more should God do to persuade you to accept death willingly and not to dread but to overcome it? … [God] lays your sin, your death, and your hell on his dearest Son, vanquishes them, and renders them harmless for you.”  Luther’s phrase “accept death willingly” might seem innocent at first until it’s set against modern marvels to extend and preserve life for much longer than ever was possible before. What does it mean to “accept death willingly” today? Christopher Bogosh, a registered nurse at Community Hospice of Northeast Florida and a regular teacher at New Hope Baptist church, address this question head-on. Far from being simply a personal preference, Mr. Bogosh explains in his new book, Compassionate Jesus: Rethinking the Christian’s Approach to Modern Medicine, that there are two different worldviews vying over what it means to die. Lacking our fore-bearers reflection on these matters, its possible we have bought into a perspective on death that’s alien to our Christian testimony.

You speak of there being two distinct worldviews vying over the nature and procedure of medicine. The one you call the “modern medicine” worldview and the other the “compassionate health care” worldview. What are the differences between these two?

 Modern medicine has chosen to root its science in philosophical naturalism, humanism, agnosticism, and evolutionary theory. These assumptions are not scientific and they contradict a biblical approach to medical science that affirms supernaturalism, theism, absolutism, and redemption.

 While Holy Scripture asserts the existence of matter it insists on real entities that are supernatural (e.g., angels and souls). After Jesus died, the Bible says he gave up his spirit (i.e., soul or life force) and his body lay without life for three days (John 19:30). Modern medicine has adopted brain-death criteria, which essentially says if there is no detectable activity in the brain then death has occurred. This view of death challenges the very heart of Christianity, namely, the death of Christ, his three-day burial without life, and his bodily resurrection (after his soul returned to his body to reanimate his life). If one assumes the validity of brain-death criteria, then he or she has to adopt a form of monism (or is an inconsistent dualist) and Jesus did not die, he just swooned for three days.

 Holy Scripture also presents a worldview that is theistic in orientation not humanistic. Holy Scripture directs human affairs, morals, and ethics. Humanism places humans at the center and God and his revelation on the periphery, that is, if it acknowledges God and the Bible at all.

 The Bible is not agnostic about the existence of one true God, judgment, heaven, and hell, whereas, modern medicine uses agnosticism as a way to accommodate private beliefs, so that people may be better able to cope in the midst of a medical crisis while they receive real help from medical science.

 While Christians affirm microevolution, that is, one species evolving or mutating within a species group (e.g., a bacteria becoming resistant to an antibiotic), we reject macroevolution one species changing into another species (e.g., a monkey becoming a human). Modern medicine affirms the latter and its effect on modern medical science is extremely pervasive. Evolutionary theory is not simply the a priori position for biology, however, it is also at the root of psychology, sociology, and various schools of theology—it is the metanarrative for modern medicine. In an evolutionary context, humans evolved from biochemical substance and life is lived between the points of viability and non-viability, as determined by utilitarian ethics, with no ultimate purpose but survival. On the contrary, the Bible’s metanarrative is redemption set in the context of creation, fall, salvation, and restoration (Eph. 1:3-14). God creates human beings in his image to redeem some in Christ and to reprobate others so that he will glorify himself in mercy and judgment. The problem with the world is sin (not disease and death), the entity from which humans need redemption to find everlasting healing. Jesus took the punishment we deserve for our sins in order to redeem us, and he will return one day to restore the world and complete redemption. Redemption stands in stark contrast to evolutionary theory.

 These are two radically different starting points for the application of medical science. The goal of modern medicine is to eradicate disease, stop aging, and seek to prolong life at all costs. Although these goals seem admirable, they are not biblical. Rather, these ends are rooted in the evolutionary drive for survival and they totally ignore the real problem at the bottom of all disease, aging, and life—sin and the curse. The goal of a biblical approach to medical science is compassion, not cure, and spiritual restoration, looking forward in hope to physical healing at the second coming of Christ. The Bible sees the goals of modern medicine as hopelessly misguided, idealistic, and arrogant. At the same time, the Bible calls Christian medical professionals to exercise dominion over the creation by seeking ways to treat disease, not to find cures (Jesus will bring the cure at his second coming), to manage symptoms in order to show compassion and encourage spiritual restoration.             

Frankly, I think many Christians will be disturbed by your idea that we are not obligated to extend life for as long as possible. To do anything less, they might think, moves us in the direction of assisted suicide. Your response?

 Jesus willingly died around thirty-three. He did not seek to prolong his life as long as possible. Stephen could have avoided death by keeping his mouth shut about Jesus. James, the Lord’s brother, Peter, and Paul, according to tradition, were willingly martyred. Many throughout the centuries of the church received death at a young age because they refused to deny Christ. They could have extended their lives but they choose death rather than idolatry. I use the example of martyrs and our Lord because they loved God and his will more than their own lives, and this is the crux of the whole matter. If one seeks to “extend life as long as possible,” he or she may actually idolize his or her life, exercise self-love, and ultimately not follow God’s will (cf. 2 Chron. 16:12).

 Consider Thomas (a fictional character), a loving Christian husband and father of four diagnosed with Stage 4 cancer. He decides not to have treatment to avoid the miserable side effects and to spend quality time with his family to prepare them for his death. This does not sound like someone seeking assisted suicide but wise planning, selfless living, trust in God’s sovereign care for his family, and a bold assurance of being with Christ in heaven after he dies.

 “For none of us lives to himself, and no one dies to himself. For if we live, we live to the Lord; and if we die, we die to the Lord. Therefore, whether we live or die, we are the Lord’s” (Rom. 14:7-8, NKJV).

 In your view, what are some of the consequences to a Christian’s testimony when he or she adopts a “prolong life at all costs” mindset?

 I believe there are three major consequences. First, the Christian may not be a good steward of his or her body. Aggressive treatment to prolong life at all costs may address the disease but it may also destroy the body and create other problems. Second, the Christian may cause those close to him or her to suffer physically, emotionally, spiritually, socially, and financially. The Family Caregiver Alliance recently reported that caregivers have a 63 percent higher mortality rate than non-caregivers, they neglect themselves, and they have a higher rate of depression. Third, the professing Christian may be self-deceived, thinking he or she is a Christian when the reality is the person is not. Although death may be fearful, the Christian should desire to be free from sin and misery, the world, Satan, and want to enter into the visible presence of Jesus—death accomplishes these things for the Christian.

 Destroying the body to eradicate a disease, loving one’s self before others, and not desiring to go to Jesus in heaven are a poor testimony to the saving power of Christ. Rather, the Christian should be a good steward of his or her body (which may mean receiving treatment to manage symptoms with the result of prolonging life), love one’s neighbor before one’s self, possess the hope of being free from sin and misery, and long to be with Jesus in heaven—this is the testimony Christians need to have.         

Being an “organ donor” seems like such a compassionate and reasonable thing to do in light of the many people out there in need of transplants. What could possibly be wrong with it?

 The problem is not with donating or transplanting organs. It is with today’s definition of death. In 1981, Congress created the Uniform Definition of Death Act to address advances with life-support techniques. This Act defines death in two ways: brain death and cardiopulmonary death. Brain death is a legal definition of death, thus, doctors may pronounce people dead without allowing cardiopulmonary death to occur. Most transplanted organs today are from “brain-dead” victims. These depersonalized humans, now renamed “cadavers” in the medical literature, have their organs cut out, flown via Life Flight to eager recipients around the nation, and donor family members receive succor with the promise of saving the life of others.

 Here is a recent article that speaks volumes about this unethical practice. On July 9, 2013, ABC News reported on an organ donor, Colleen Burns, who woke up on the operating table just prior to having her organs cut out! The title of the article says it all, “Patient Wakes Up as Doctors Get Ready to Remove Organs.”

 It’s very common for medical needs to dominate prayer requests in churches. What is your advice for how Christians should approach both the prevalence of these requests and the desire for them to be met?

 I think it is important to place these prayer requests into the context of God’s sovereign care and providence. These afflictions are not random and God is still in control. I believe a better way to pray is to ask the Holy Spirit to draw sick Christians near Jesus through the means of grace, and to ask for wisdom and guidance concerning the will of God. I have found during our prayer time as I frame requests and pray in this manner people have become more thoughtful in their praying. For example, most of them have stopped telling God to heal Aunt Betsy (a fictional character) from her dementia, but, rather: “Father be pleased to draw Aunt Betsy near Jesus in her confused state, and grant her family wisdom and guidance as they care for her. Amen.”

 In what ways do you think a Reformed theological perspective informs our approach to medical ethics and end-life-issues?

 First, the Reformed view of Scripture summarized in the Latin phrase sola Scriptura (i.e., Scripture alone). While broad evangelicalism affirms Scripture as the Word of God, how this comes across in interpretation and practice is wanting. There is an attempt in Reformed camps to carefully interpret Scripture with Scripture and apply these findings to a comprehensive biblical worldview to inform every aspect of life, which includes medical ethics and end-of-life issues.

 Second, the Reformed faith takes seriously God’s preordained purposes before time began. Ephesians 1:3-14 (et. al.) clearly teaches that God planned to redeem specific people in Jesus Christ before the beginning of time. This has significant implications on the way we understand why God created all things, ordained the fall and his purposes for sin and misery, established salvation in Jesus Christ, and how he will bring all things to completion in Christ at the end of time. The Reformed understanding of the first and second Adams and the unfolding progressive covenants centered on the Immanuel principle (contra dispensationalist thought) is hugely significant as well. History is truly HIS-story beginning before time began, and, therefore, our medical ethics and how we view end-of-life matters needs to fit within this redemptive context.

 Third, closely aligned with God’s redemptive program is the Reformed concept of “already, not yet.” Christ has already completed everything during his incarnation but he has yet to finish it. This concept is extremely important because it helps us apply medical ethics and address end-life-issues in the context of redemptive history and God’s providence in the midst of our present circumstances. Our focus at present is on spiritual restoration looking forward in hope to physical healing at the second coming of Christ. Christian medical ethics must be in line with Scripture and the goals of sanctification; and how we view end-of-life issues must take into account Christ’s second coming, the bodily resurrection, restoration of the creation, and the future state of glorification.

Matthew Claridge is married to Cassandra and has three children, Alec , Nora, and Grace. He is an editor for Credo Magazine and is Senior Pastor of Mt. Idaho Baptist Church in Grangeville, ID. He has earned degrees from Trinity Evangelical Divinity School and the Southern Baptist Theological Seminary.

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