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Thursday, June 11, 2020

Was it Suicide?


I have seen a couple of social media posts where some have questioned whether or not Steve’s death was a form of suicide.  After all, the announcement we made included the fact: “He had cancer and heart disease. Both conditions were initially treatable, but he declined treatment.”  So that brings up the moral question: If you decline treatment for something, is that the same thing as committing suicide?

Before answering this broadly, we can first look at the specifics as it relates to Steve Hays.  If you read his memoir, A Backward Providence, you will see that when Steve was in his thirties, he was diagnosed with Fibromyalgia (p. 65).  At the bottom of that same page, he notes: “…I was thirty-five, which is a very different time of life. I had far more to live for. I underwent the full course of treatment.”

So Steve had already gone through the treatment he subsequently refused back when, as he pointed out, he had far more to live for.  There are a couple of ways you could parse that phrase, but included in it would definitely be the fact that at thirty-five you are much closer to your prime than when you are sixty years old.  You have more strength and vigor.  You don’t have as many aches and pains.  In addition, Steve was 35 years old in 1994. He still had both parents at that time (his father passed away in 1999, and Steve became the caretaker for his mother until she passed away in 2013).  When he was diagnosed with the recurrence, he had none of that remaining: no youthful strength, no family to take care of, and the long pain of Fibromyalgia, in addition to other health issues.

Knowing this will address a couple of other things raised by other individuals.  Since Steve was a Calvinist, some have questioned whether he had decided to “accept his fate.”  But Calvinism is not fatalism, so that’s already framing the issue incorrectly.  Steve clearly held to the belief that predestination included the means, not just the end, and “means” included the ability to use doctors for treatment of normal diseases.  So it was not due to a belief that God had predestined him to die that he refused treatment, for he would have held that God had predestined him to use doctors to fight against his disease had he wanted to fight the disease.

Somewhat ironically, another person speculated that perhaps Steve was trying to get God to heal him miraculously.  This is due to the fact that Steve was not a full cessationist and had argued against some cessationists in the past.  However, when you read A Backward Providence, it is very clear that Steve was ready to die.  He didn’t want God to heal him, although if God had done so Steve would have accepted it as God’s desire.  But as mentioned above, he had less to live for as he aged.  So, he prepared himself for his death, and he was ready to meet his Savior.

To add a bit of my own speculation (since Steve and I never talked about this point directly), I also think that since Steve went through the full treatment already, he knew what kind of toll it would have on his body.  And he also knew that “treatment” wasn’t the same thing as “cure” and there’s a good chance he would not have wanted to add another couple of years to his life just to have to go through the same painful treatment again and again until it finally killed him.  Add on the reality that treatment can be expensive, so those painfully extended years might have come at the cost of Steve being forced to live on the streets, unable to blog or to do anything he considered useful.

So those are some specifics in dealing with Steve’s death itself.  But while that may perhaps give us understanding for why Steve chose not to get treatment, it does not yet answer the question of whether it was morally licit for Steve to decline treatment.  So let us examine the moral question.

First is the question: what is suicide?  At a simple level, suicide is deliberately taking an action, the result of which will knowingly cause the end of one’s life.  But even this simple definition needs to be examined.  I can immediately think of a counter: if a soldier sees an enemy about to shoot his friend, and he leaps in front of the bullet and subsequently dies, he has deliberately taken an action that ended his own life.  Yet hardly anyone would view such a death to be suicide.  It was instead noble.  Indeed, Jesus Himself would declare such an action to be that of which there is no greater love (John 15:13).

There is also the fact that refusing to do something is not the same thing as deliberately taking an action.  That is, it was not Steve taking an action that resulted in his disease not being treated—it was the absence of an action that resulted in the disease not being treated.  So defining suicide as "deliberately taking an action that will end one's life" clearly would not apply.

So let us amend it slightly.  "Suicide is deliberately taking an action, or refusing to take an action, the result of which will knowingly end one's life." And that brings us to the crux.  If refusing to take an action to save one’s life results in one’s death, is that suicide or not? 

It's perhaps beneficial to look at the conundrum slightly differently.  When Terri Schiavo was being kept alive with a feeding tube, pro-life activists argued that removing the feeding tube would be murder.  Under the same logic, if one chose to remove one’s own feeding tube, would that be suicide?

The Terri Schiavo case helps us examine this philosophically.  Why was it that removing a feeding tube was considered tantamount to murder by the pro-life side?  After all, the opposition to the pro-life crowd pointed out:  “We’re not killing her.  We are just removing the feeding tube and letting nature take its course.”

But of course, if you keep anyone from food, then “nature’s course” is death.

This brought up the key distinction in the ethical debate.  Terri Schiavo was not on a ventilator or heart bypass machine.  She could breathe on her own, and her heart beat on its own.  What kept her from dying was the nutrition her feeding tube gave her.  Nutrition—the same thing that keeps all of us from dying.  The pro-life argument had been that there was no medical issue with refusing extra-ordinary treatment, but ordinary care that everyone needs for basic survivability could not be turned off without resulting in murder.  In other words, turning off a heart bypass machine resulting in the death of the patient would not constitute murder because hearts beat on their own naturally, but because everyone needs food to survive then depriving her of food was tantamount to murder because everyone needs food to survive.

This moral argument clearly made sense to a lot of pro-life adherents, myself included, and so using that same principal we can ask: is chemotherapy ordinary or extra-ordinary treatment?  Chemotherapy is poisonous.  The hope is that the cancer cells die before all the healthy cells die.  Given that, if you are healthy and you take chemotherapy, only bad things could possibly happen to you.  Clearly chemotherapy is not ordinary care, like food and water are.  This means that under the same principal that it is moral to turn off a heart bypass machine because of it being extra-ordinary care, so too one can refuse chemotherapy without it constituting suicide.

Of course one could still object that this is just a philosophy argument, not Biblical.  The Bible may still forbid one to refrain from doing anything possible to stay alive.  To that, I would respond: “Do you think that I cannot appeal to my Father, and he will at once send me more than twelve legions of angels?”  These words from Jesus recorded in Matthew 26:53 show that Jesus could have done much to keep Himself from the crucifixion.  Does the fact that He did not act to save Himself, knowing full well that He would die if He did not act, mean that He committed suicide?  Clearly not!

So there is at least one example where not choosing to save one’s own life does not constitute suicide.  Indeed, I would suspect that no one could come up with an example where someone does nothing at all to save their life—while also not doing anything active to endanger it—where that would be classified as a suicide.  Regardless, the onus is on the person who says that refusing treatment for a disease is equivalent to suicide to prove that it is.

At the end of the day, I think it’s clear both from philosophy and theology that there is no rational basis to claim that there is a moral imperative to prolong one’s life using extra-ordinary means.  There’s no admonition against it either.  So when faced with two options, neither of which is sinful, then whichever option is chosen is, by definition, not sinful to take.

47 comments:

  1. For what it is worth my intuition agrees with your final paragraph. This is probably a pretty sticky question in the abstract: how much is one obligated to preserve one's life? I can think of so many examples going in all sorts of directions. (And, this isn't a place to debate/discuss out of respect for the dead.)

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    1. Hello Eric,
      I disagree on one point. I believe this IS a place to debate and discuss it. Steve certainly wouldn't have shied away from discussing it. :-)

      And yes, it can be quite tricky to determine what obligation there is to preserve one's life. For example, if I eat veggies for dinner, that's going to be healthier than eating hamburgers. Am I suicidal if I go to McDonald's?

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    2. No, you're not suicidal if you go to McD's in a controlled manner.

      You may be suicidal if you eat there constantly and out of control, knowing the health risks.

      There's a happy meal, I mean medium there.

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    3. There is a difference between causing death but not wanting to die and causing death wanting to die.

      By declining the treatment of a deadly disease I cause my death but if I don't want to die I don't commit suicide. I just don't want the treatment.

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    4. Hello Conhecereis a Verdade,
      I agree 100% with what you said, although I'm not sure it applies to Steve's case because I think there was a sense in which Steve was ready to depart this mortal coil (i.e., in that sense, he wanted to die). It also brings up more questions to consider:

      Is there no difference between causing something and, through inaction when you could have acted, "causing" something? Or is there a relevant difference that makes it so one thing is a cause and the other isn't really a cause?

      If you have a disease, the disease is technically what will actually cause your death. While taking treatment may help (and I should note there's no guarantee it will) cause your cure, not taking treatment will not cause anything at all--the disease itself will just progress, and it's the disease that is strictly speaking "causative."

      If causality is parsed out that finely, then one could argue that one does not cause one's death by declining treatment, but instead that one simply does not cause one's recovery.

      And of course bear in mind the other factors. 1) It's not cheap treatment and, to be honest, I would be astonished if Steve could have even afforded it (but I wasn't privy to his accounting books either), so this might all be a moot point anyway; and 2) Steve had had previous treatment and chemo can be very painful. I have read articles where people have said they prefer the pain of cancer to the pain of the treatment. So what if it was actually so painful that it was impossible to choose treatment? Consider the story behind 127 Hours. If you are pinned by the arm and your only option is to cut your arm off or die of exposure, and you are unable to cut your arm off, does that mean you have chosen suicide?

      I hope everyone realizes that I'm bringing up these questions not to hassle or annoy, but because the topic is genuinely one that is fraught with difficulties and there aren't always clear-cut paths we should go. In my opinion, we should hash out the moral grounds to our own satisfaction BEFORE we ever need to, so that if we ever are forced to confront the same decisions we'll already know the pros and cons and what we've decided.

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    5. Peter--

      (I wrote this response earlier in the day, so many of my points have been covered. But I believe the last two paragraphs have not been touched on. Normally, respect for the dead might well dictate against this topic. But I'm assuming Steve would have welcomed it.)

      Peter--

      I think your argumentation is sound...as far as it goes. I just think there are further criteria to explore.

      It's difficult to decide when serious treatment goes over the line into "extraordinary" efforts. We're wimps in this day and age. Go back to a Civil War battlefield surgical tent, and you're likely to see someone get a limb amputated without anesthetic (other than a swig of whisky) and then cauterized with a hot iron!

      My father died of small-cell lung cancer about three months after being diagnosed. As a result of deciding to fight it, his last few months were sheer agony. An oncologist at the hospital where he died said that if he himself ever developed small-cell carcinoma, he would just go home to die. The treatment wasn't worth it.

      Does the treatment offer a significant lengthening of life? What are the chances that it will succeed? What level of suffering will one need to endure? All these questions have different answers depending on the type of cancer, the stage of cancer, the age and health of the patient, the treatment option chosen and so forth.

      Lymphoma responds to treatment only slightly worse the second time around. Radiation and/or chemotherapy may not be as excruciating as it was 25 years ago. Medical knowledge and practice progresses. Steve got 25 extra years out of the last round of treatment. Should he have fought harder? Don't know. Way too many variables are missing for any of us to pass judgment.

      Every single one of us is passively suicidal in one sense or another. We don't do everything we could do to squeeze every last possible day out of life. We like ice cream a little too much. We enjoy sitting back in an easy chair far more than jogging and sweating.

      I don't know what kind of a biblical case can be built, but I believe it is somewhat sinful not to (at least try to) make the most of our days both quantitatively and qualitatively. I believe we are to fight (against the dying of the light). We will have plenty of days in heaven.

      My question about Steve is not whether letting go was suicide, but whether letting go was the right thing to do. What if he could have had another 20 years of productive ministry?

      If I die, my small kids will suffer. Steve's death leaves thousands without a clear head to lead them back to sanity. Sure, God will fill the gap. But Steve's death affects a heck of a lot more people than mine would.

      Maybe treatment wouldn't have lengthened his life much at all. Maybe it would have merely heightened his suffering. If so, all well and good to let go.

      But Steve SOUNDED depressed. Speaking of this blog as a duty he performed sounds like anhedonia. Does anyone know for sure that this was not a factor? Suicidal people are sometimes hospitalized with a treatable illness and then, wishing to die, refuse treatment. Depressed people can do similar things...just with less conscious intention.

      Depression is not ignoble, and, if true, it would do no honor to Steve's memory to sweep it under the rug. (There is, after all, some correlation between high intellect and psych difficulties.)

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    6. Thanks Eric, I do appreciate your response, and the concerns you raise are definitely worth examining. I think you can tell I've been raising far more questions than just providing answers, because I think the topic is important enough to think on, and it's too easy to provide some kind of "pat" answer--especially a pat *Christian* answer that says the "right things" as dictated by Pastor Bob despite the fact that the Bible is silent on certain aspects of the issue. So I'm thankful you took the time to flesh out your concerns as well.

      I agree it can be quite difficult to tell the line between ordinary and extra-ordinary effort, between morally obligated choices and choices that are left up to us, etc.

      Since, as you mentioned, much of what you wrote was from before the points got addressed throughout the day, I'll focus on your last two paragraphs as you indicated. I think it's possible for a reasonable person from a certain mindset to conclude that Steve was depressed and that drove his decision; I also think it's possible for a reasonable person from a different mindset to conclude that Steve had thought it through objectively and it wasn't any sort of depression driving him.

      I can't go into too much detail (because it involves other people than just myself and Steve) but there was a group of us who were essentially the Psalm 88 Club. Each of us in that "club" were there because we were dealing with trauma by supporting each other. I can tell you by far that Steve did the vast majority of the supporting.

      Steve does touch on some of his own pain in his memoir, including the portions surrounding what he said about writing from a sense of duty, but I don't want to publicize anything beyond that as it wouldn't be fair. Nor can I talk too much about my own side of that because of other people who don't need to be dragged into this. But what I will say is that while I can understand given the vagueness with which I've had to state that, that someone may easily conclude there must have been depression at the root of his decision, I do not believe it was. Especially given that people who struggle with depression will have good days in the midst of the bad days, and Steve was consistent with his decision not to have treatment for a year before passing away.

      Anyway, I will conclude by saying that if Steve sounded depressed to you, what it meant for me in the Psalm 88 club was that Steve didn't sugar-coat and pretend things were roses. And had he done that--had he NOT been in the dirt and mud with me--I would not have been able to hear his wisdom. The truthfulness of someone who doesn't concern himself with trying to pretend that his faith makes everything puppy dogs and roses, but instead can honestly say, "This is how bad things are, and yet despite all that this remains true" was the only way anyone could speak to me. None of my Christian counselors were able to do that for me, because everything they said I should try to do was predicated on a lie about how Christianity should be light and fluffy. Even if they said to do the same things, I would automatically block them out; but Steve addressed the issues matter of factly and without airs, and as a result I could *hear* his wisdom.

      So I don't take his views to be depressed, but rather true and clear. Of course, I'm well aware you may conclude by my own statements that it is because I myself am depressed. And I won't be offended if that is what you conclude.

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    7. I'd add:

      Clinically speaking, there are specific criteria to be diagnosed with major depressive disorder: changes in sleep patterns, loss of interest (anhedonia), inappropriate guilt, low energy/fatigue, poor concentration, changes in appetite, diminished psychomotor (e.g. slower thoughts, speech, movement), suicidal ideations. And there are two major types - melancholic and atypical.

      I highly doubt Steve had these. He may have had, for example, fatigue, but that wasn't due to depression, but due to other medical issues.

      At best, one might argue he had a "lesser" form of depression. Dysthymia or persistent depressive disorder. Basically chronic low grade depression. It's not as serious as MDD. However, I'm not even sure about this with regard to Steve.

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    9. Suppose Steve wanted to commit suicide. Why let cancer evolve until it is terminal and go through great suffering? There are faster and painless ways to die.
      By refusing treatment, his death was the natural and inevitable consequence of his decision and, even if he accepted that consequence with contentment, it was not the intended consequence.
      Suicide is not a natural death but a projected, intended, designed death.
      So are people being intentionally obtuse?

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    10. Excellent points, Conhecereis a Verdade. And thanks for the last question :-D

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  2. I meant to say: "Peter, for what it is worth....".

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  3. I'm sure steve would have argued the point framed around greater and lesser duties. It's not clear to me what duties steve had irl, but it's hard to imagine him not basing his decisions on his understanding of God's Word, and in obedience to it.

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    1. For what it's worth, I think you're correct, Coram Deo. If Steve's mother had still been alive and it was within his means to afford treatment, he nearly certainly would have concluded he had a duty to his mother requiring him to live as long as possible. Since he never married nor had any children, that meant there were no familial bonds that would have required his duties to maintain.

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    3. Twenty-two years later, my lymphoma returned. On the first occasion I was thirty-five, which is a very different time of life. I had far more to live for. I underwent the full course of treatment.

      This time I'm letting nature take its course. I might well be dying of cancer as I write this. People can live too long for their own good. Modern medicine extends life, but that's risky in other ways. I'm puzzled by Christians who cling to life. It's okay to let go.

      In the last few years I've had an increasing number of angina attacks - a prelude to a full-blown heart attack. So I've been close to death on many occasions.

      For Christians, a fatal disease is a gift. A friend. A doorknob out of this world into a better world. What is dreadful is not the prospect of death, but a world without a doorknob.'

      Steve Hays, A Backward Providence (65)

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  4. Hello Roger,
    You raise some good points. The point of me quoting Jesus's words was not to make Steve equal with Christ, of course, but instead to show that there clearly are some actions whereby one gives up his life and it's not suicidal. In fact, much of Jesus's teaching was to have us hold our *own* life in disdain even while we protected other's lives: "For whoever would save his life will lose it" (Matthew 16:25) and "Whoever loves his life loses it, and whoever hates his life in this world will keep it for eternal life" (John 12:25) and "If anyone comes to me and does not hate ... even his own life, he cannot be my disciple." (Luke 14:26). So while saving life is definitely an imperative, it's not the ultimate focus of Christian living to save one's own life.

    Now with those words, one could quite easily infer that even active steps that you know will put your life on the line need not be suicidal. For example, when John Allen Chau went to North Sentinel Island despite knowing the tribe there has killed every single outside who ever stepped foot on the island, he did so to share the gospel. He knew he was facing impossible odds, but did so for the gospel.

    Of course, that itself doesn't speak to the issue of denying a treatment that may save you, for a least a little bit of time. My point is merely that the issue is not so cut and dried as people often think it is. I think you may agree with that too, given your second to last paragraph.

    In any case, I think where Steve was at fits very close to Paul's thoughts as well: "For to me to live is Christ, and to die is gain. If I am to live in the flesh, that means fruitful labor for me. Yet which I shall choose I cannot tell. I am hard pressed between the two. My desire is to depart and be with Christ, for that is far better. But to remain in the flesh is more necessary on your account" (Philippians 1:21-24).

    Steve didn't go out of his way to get cancer or heart disease. Having received those diseases non-volitionally, was he under a moral obligation to fight them? Or could he make the other decision that Paul said he was torn between? Paul only chose to prefer living longer for the sake of the Philippians, not because he deemed that it would be immoral to chose death to be with Christ.

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  5. So it follows that I do not have to be forced to breathe by pressure tube in my older years. That measure is not suicide. And the person objecting to other details can find peace for their own life.

    Rob.

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  6. Thanks, Peter!

    And Steve discussed issues like these somewhat often. Here's an archive of our posts with the suicide label, including one written by Steve as recently as last November.

    Because issues like these are often difficult to sort through, the extent to which we have reason to trust the individual making the decision is important. He may know about various factors he isn't discussing with other people or at least certain other people. Given what we know of Steve, including the intellectual capacities he had until as close to the time of his death as we can trace these things, there's a lot of reason to trust his judgment. I'm not saying that's the only factor we should take into account. But it's one of the factors we should consider.

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  7. Lymphoid neoplasms can range a wide spectrum, and while indolent ones can have good prognosis, many do not (say, 1-3 years with treatment, which, as noted above, do not come with its costs). Given Steve's demographics and prior history of lymphoid neoplasm, I can only speculate. Lymphoid neoplasms at his demographics tend not to be kind. Moreover, lymphoid neoplasms that arise secondary to prior treatment can be particularly nasty.

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    1. We have specifics beyond "lymphoma", but I don't know that we should say so in public.

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  8. I forgot to mention: chemotherapy, which is first line therapy for lymphoid neoplasms, has non-trivial risk for cardiotoxicity, which further complicates morbidity given Steve's history of cardiovascular disease.

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  9. Hi Hawk,

    Thanks for the reply. Just to be clear, I wasn't angling for more information (I suspect you weren't implying this of me, but just to be explicit). I was just trying to weigh in on the fact that it is apropos to think of the disease process and morbidity/mortality given the medical history/context. It is arguably controversial even amongst physicians when it comes to treatment for hematologic malignancies, especially in the setting of late age and possible recurrence.

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    1. Cool, thanks, Andrew. Oh yeah, I understand. Sorry, I didn't mean to imply otherwise. And I'm certainly no oncologist, but of course we had to learn about all this in med school (among other things). I do agree with much of what you say.

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  10. This discussion brought to mind another post of Steve’s on cancer:

    http://triablogue.blogspot.com/2011/01/saying-good-bye.html?m=1

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  11. From not going through chemo, again, at 60 to fatalism to a jab at Calvinism? Are people being...intentionally obtuse?

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    1. This was my thought too. This is exactly the sorts of arguments that Steve would have dismantled with extreme prejudice. I'm not gonna lie, it's going to take a while to get used to him not being here to do it for himself.

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    2. I even thought I saw Phil Johnson(after saying something nice) go on and make an unnecessary jab at Hays' continuationist views.

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    3. That sounds like a very Phil Johnson thing to do.

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    4. Sad, but then again the MacArthurites are a hive mind. Essentially the Borg. Non-assimilation cannot be tolerated.

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    5. I see what you did there, TheFlyingCouch.

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  12. Thanks for this Peter. I just have a couple of thoughts.

    he had less to live for as he aged

    Steve not only expressed this to me recently, but it is the period of life between the ages of, say, 60 and whenever, that concerned him. As you mentioned, he was the primary care-giver for his mother for many years, and he personally had a chance to watch the ravages of age on her -- both physically and mentally. That was not an appealing path for him.

    Chemotherapy is poisonous.

    When my wife was recovering from leukemia, we had a chance to see the former Steeler running back Merrill Hoge at a "cancer survivor" event. Hoge had had lymphoma, and he talked about his course of chemotherapy. He was in the chair, and someone had put the needle in his arm, and the woman who was to administer came out in a full hazmat suit. He said, "what's the suit for?"

    She said, "if I spill this on myself, it could give me third degree burns".

    "And you're going to inject that into my veins?"

    Hoge, too, was young at that point. But that can't have been an appealing thought at any age.

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  13. Mr.Pike do you think that the distinction between letting one die and killing one could be employed, or do you think it is too vague a distinction to be helpful?

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    1. Hello TheSire,
      I think it definitely could be employed, but the real issues such a distinction is probing would be 1) Does one "cause" something that would happen anyway simply because one does not try to stop it? 2) Is one *obligated* to stop something when one is able to do so?

      There could be other issues raised by it as well, of course.

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  14. 1. On the one hand, if Steve had lived longer, then perhaps he could have done more to benefit others.

    On the other hand, given Steve's circumstances in life, should Steve have done more to benefit others? Did Steve have a prior or acquired duty to live longer for the benefit of others?

    2. Moreover, where does one draw the line in asking Steve to sacrifice his (physical, mental, emotional, spiritual) health for the sake of others?

    3. There may have been diminishing returns over time, and Steve may have believed he had reached such a point.

    4. Length of life doesn't necessarily imply fruitfulness in life. In fact, it may mean quite the opposite. Consider the example of King Hezekiah.

    5. Many people desperately cling to life, even if they have no duty to cling to this life, even if they are already dying. I've seen people willing to spend tens of thousands of dollars to extend their lives by mere weeks or months at most. That's an extreme, but it seems to me to be an increasingly common extreme in our secular society.

    By contrast, for the Christian, death itself is a witness to life. Eternal life: "though he die, yet shall he live". Doubtless Steve wished for his death to be his final witness to the risen Jesus. Indeed, the fact that he declined treatment when he could have received it perplexed his physicians. Steve was able to offer a Christian witness to them as a result. And that may have ramifications for how Steve's physicians practice medicine, which in turn may have ramifications for countless patients under their care.

    (This isn't to suggest I'm using the example to argue for what Steve did. Rather I simply use it as a contrast to the secular outlook on life and death. In other words, I'm not suggesting Steve was right or wrong to do what he did, per se, but whether it was right or wrong it contrasts starkly with the secular perspective. And that, in and of itself, is something worth considering, I think.)

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  15. Peter--

    One last quibble. I do believe that in Philippians 1, Paul is indeed mandating that we fight for life. It is "necessary" that he remain.

    It's not an unqualified mandate, however. We do not fight as one who has no hope. We should always keep the resurrection right before our eyes. As a result, we have no need to fight against all odds...or as a meaningless "show of bravery." Our lives are hid with Christ, and he is in control. We don't need a showy death. A good and faithful one will do just fine.

    On the other hand, we shouldn't be laying down our weapons and letting go prematurely. It is one thing to count our lives forfeit. It is quite another to throw them away.

    My own takeaway from the deaths of John Allen Chau and Jim Elliot, Nate Saint, et al. is that they were more foolish than noble. We are not supposed to run toward martyrdom as some of the early churchmen did. Origen's mother had to hide his clothes to keep him from joining the throngs.

    Admittedly, it can be a fine line. Early missionaries to West Africa brought their own coffins with them, realizing that the tropical diseases would almost certainly get them within a few months or years. But they came with the reasonable expectation of significant time spent in viable ministry. Chau knew that without a spectacular miracle he was toast...immediately if not sooner.

    I love the story of the conversion of the Aucas, but with 20/20 hindsight, it's clear the missionaries should have proceeded more cautiously.

    Yes, we long to be with the Lord, but in most circumstances it is "necessary" that we remain here. We are not to devalue our lives in the here and now by glorifying the letting go.

    Steve was right to lecture us on the folly of tenaciously hanging on. We get too enamored of this life. We're certainly afraid of dying in ways we don't need to be.

    But the pendulum can swing too far in the other direction. Steve's musings could help convince someone who WAS clinically depressed that giving up is inherently a noble thing. The way Steve's obituary was worded--both conditions were initially treatable--makes it SOUND like he could easily have fought, but decided to throw in the towel instead. (This is why the lack of detail can actually be somewhat dangerous. What WAS his initial prognosis? Were the conditions merely "technically" treatable? Was he likely going to die soon no matter what his response? Or were the conditions eminently treatable...and he stood a good chance of recovery if he acted quickly? I hear you saying that it was basically the former. But the obit says no such thing.)

    Depression has been my lifelong companion. A blessing in some ways. It can make you more introspective, more sensitive, more creative.

    But it can also paralyze you and leave you with a life that feels like a failure. It can make you way too isolated and idealistic. And it doesn't need to be clinically diagnosable to effect you to the core of your being.

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  16. Thanks, Eric. Some of this will come down to differences of opinion (e.g., whether Chau, Elliot, and Saint were noble or foolish, etc.). I think in those instances, you have to go with your conscience, even if others disagree. I don't think there's a "right" or "wrong" answer as to how you come down on that, because God doesn't always give us clear guidance for every single situation we will face on Earth.

    It wouldn't surprise me if that's part of why Steve crafted his obituary the way he did (as mentioned in the original post, that entire first paragraph is essentially what Steve wanted to have said). The fact that he didn't even NEED to mention that both his heart condition and his cancer were "initially treatable" and yet he chose to say that indicates to me that he wanted people to ask questions about it. Clearly, he could have just asked us to say, "Steve died after a lengthy battle with cancer" and it would have been true, but no one would have even questioned whether or not it would be "suicide" to turn down treatment because no one would have known he did that. Given the options of how he could have written his obituary, it's clear to me that he DID want that aspect to be known.

    It's partly because of the fact that Steve so clearly intended his obituary to be part of his final message that has made it difficult for us, or at least me, in terms of what we say here. Some of us have more information as to what the precise initial prognosis was, as well as other health issues he was facing, but he didn't even share all that information equally among the various people who write for Triablogue. Maybe at some point in the future it will become more relevant and necessary for us to explain more fully what each of us knows, but for now I believe honoring his wishes as to how his death was to be announced is the right thing to do, and the questions that he knew would be raised and talked about are worth raising and talking about.

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  17. There is a difference between accepting death and aiming at death and refusing life-prolonging treatment does not necessarily mean that one is aiming at death. I wish Christians would understand this. Perhaps Steve felt he could no longer do more in the body than away from it. It was his decision and no one really knows from his point of view how the burdens of treatment stacked up against the benefits other than he thought that the burdens outweighed the benefits. Let him rest in peace.

    I say this as someone who often disagreed with him and took his licks from him on this blog. I am sad to hear of his passing and the questioning of his character in this matter.

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    1. Good points! I want to add Steve didn't need to meet a higher bar (as critics seem to be assuming) than simply having a reasonable or justifiable position for letting cancer take its natural course in his case. So even if one doesn't necessarily agree with what Steve did, as long as Steve had a reasonable or justifiable position, then that should be respected.

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  18. This thread is so long that I can't quite lock on to the context from which "Coram Deo" wrote about us "macArthurites" being assimilated. Was that meant in jest or should I get upset? Thanks in advance for any explanation.

    I'd hate to think that my 40 years under JMacs teaching is viewed as my being a mindless borg. I didnt know I was mindless. Shows you how mindless I am!

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    1. Hi Coreysan,

      Of course, I'm sure Coram Deo can speak for himself.

      However, as I see it, I think the context in this particular case is what Phil Johnson tweeted here and here about Steve's death. Not to mention others like Fred Butler. Of course, John MacArthur, Phil Johnson, and other Grace leaders famously subscribe to cessationism.

      Steve wrote his own obituary before he passed way (i.e. most of the first paragraph) which included the following: "He had cancer and heart disease. Both conditions were initially treatable, but he declined treatment. He was content to let go and die a natural death. What he lived by, he died by."

      Phil Johnson initially wondered if Steve didn't seek treatment because "he was holding out for a miraculous healing" which Phil Johnson seemed to believe was related to the fact that Steve "doggedly defended continuationism". However, those of who knew Steve knew he certainly wasn't "holding out for a miraculous healing". In fact, he didn't expect any healing whatsoever. He expected the cancer to take its natural course. He expected it would kill him. He expected to die. (Whether that was morally licit or illicit is the very subject of this post by Peter.)

      For the record, Steve wasn't a continuationist if that's what Phil Johnson was attempting to imply. Nor did Steve "doggedly" defend continuationism in general. He criticized both continuationism and cessationism. Steve took a mediating position, though cessationists like Phil Johnson seemed to have equated a mediating position with continuationism. Perhaps their idea is, roughly speaking, if you're not a cessationist, then you're a continuationist.

      Hope that makes sense? Thanks.

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    2. Coreysan,

      A lot could be said, frankly, and although my comment was somewhat tongue-in-cheek it was also meant as a semi-serious critique.

      Let me explain. I've followed and benefitted from J-Mac's ministry for many years. Much less than your 40, but for probably 14 years I've listened to countless hours of his sermons, read his books, and studied GTY materials including several Grace Life Pulpit series by Phil (and Don Green). For many years I also sat under the teaching of a pastor who is a Master's doctoral grad in expository preaching and who served on staff at GCC for many years. I've studied nouthetic counseling under another Master's grad who is broadly published and who was an elder at my church at the time. John actually preached the installation service for our pastor.

      So I don't speak as an "outside critic", but as someone who views himself as loving and appreciating J-Mac and Phil from the "inside".

      Hawk already did a nice job of highlighting some issues, but my "hive mind" and "borg" allusions were made in regard to other areas of the GCC/Master's network which consists of, among other things, a rigid, sometimes sectarian, and undeniable cult of personality surrounding J-Mac and some in his inner circle.

      There are several issues I have in mind:

      i.) Theor zealous commitment to cessationism which in its more militant forms frankly has more parallels to atheism than to Christianity. I personally think this stems from J-Mac's personal war he's waged throughout the years with the "Strange Fire" crowd. John has rightly marshalled many excellent resources against the worst excesses of the Charismatic movement (and the health/wealth/prosperity false gospel), but in his zeal for the truth and for discernment he has, I believe, led his congregation and related ministries (Master's, GTY, et al) so far in the opposite direction that many legitimate and Biblical forms of supernatural experience are treated with thinly veiled contempt, if not outright condemned. For example J-Mac's teaching and his commentary (which I own) on 1 Cor. is fraught with strained exegesis - and I would argue eisegesis - in many areas related to the cessation of the gifts of the Spirit.

      ii.) The sectarian nature of J-Mac's, Phil's (and broadly GCC's, Master's, and GTY's) views on pre-trib premillinarian rapturism. This hardly requires explanation. For J-Mac to have infamously told a Shepherd's Conference gathering they essentially weren't Calvinists if they didn't subscribe to his eschatology - a shocking and baseless claim - is bad enough, but worse still pastors in his inner circle such as Steve Lawson have gone so far as to require as an article of faith for church membership adherence to pre-trib, premillenial rapturism. In this J-Mac has indisputably personally done much to divide the Body of Christ.

      iii.) Last but not least J-Mac, Phil, Fred Butler, and others hailing from the GCC/Master's/GTY camp are relentless in brooking no dissent. Everyone knows the unspoken rules about which lines to toe and the consequences for not doing so. Hence my "hive mind" and "borg" analogy.

      If you've been around GCC 40 years I assume you must be aware of and recognize these things.

      In closing I think J-Mac is a wonderful gift to the church, and when he's good he's *very good*. But as is often the case with strong, bold, visionary leaders when he's bad...well you know the rest.

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  19. Gentlemen, thank you for responding in a very courteous and honest manner. I do appreciate that. Hopefully I can encourage you in just one respect:
    having been at GCC for 40 years, and I might add, having worked at Grace To You for 17, Im painfully aware of the in-house rabble-rousing with Fred and Phil, et. al. Its somewhat unfortunate because they are the only ones who speak up while most others don't. It makes us pew sitters look like cult members in areas of serious disagreement.

    But we are a thinking people. We are capable of attending "Strange Fire" and asking ourselves where we agree or dissent.

    All Im saying is that I don't mind the disagreements at all. I would just as soon you and Phil and Fred continue to hash out the truth.

    All I object to is the tendency to equate disagreement with a hive mentality. I understand it: I think that way about most members of Joel Osteens church!

    But I have great confidence in our congregation and they are great thinkers. Not at all robots in a hive mentality. These people know how to reason through the issues even if imperfectly.

    So I hope there's a way to discuss and confront without using incendiary words that are categorically false. That's all.

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    1. Thanks, Coreysan. Much appreciated. I've also been to Grace before, I have friends and acquaintances who used to attend, who went to school there, etc. I think many at Grace are wonderful Christians (including yourself!). This is why I focused my comments on the leadership and the more prominent public voices.

      That said, I would likely agree with John MacArthur and Phil Johnson regarding most their theological beliefs excepting, of course, their cessationism. All said, I'm thankful for their ministry.

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    2. I'm just seeing this today, but I'll note from my perspective that I'm friends with Phil Johnson on Facebook (which means that in real life we probably wouldn't recognize each other if we were standing side-by-side, but that's how it goes!) and have engaged with him on a handful of topics over the course of a decade. I have no major criticisms of him, have benefited from a lot of what he's written, and basically shrug off the portions I disagree with him on.

      I haven't had a chance to interact any with J-Mac though. Nor do I anticipate that happening. I think it would be enjoyable, but can't imagine it would be the best use of either his time or mine :-D

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  20. Hawk - thank you dear brother. Through triablogue I came to know John Bugay, and love him dearly. I hope I can get to know many more of you with equal affection in Christ.

    With all the drama this year I am desperate to know the love and peace of Christ, especially through the brotherhood. I didn't really realize how my sense of security was intertwined with American politics until this year, so I'm eager to work through that with your help.

    Im happy we had this opportunity to communicate a little.

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    1. Thanks, Coreysan! If you ever wish, please feel free to email us at triabloggers@gmail.com.

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