Accepting the Diagnosis of Death

The goal of hospice is a peaceful death.

A peaceful death is achieved medically by providing comfort care measures that bring contentment and an absence of pain. Socially, a peaceful death is achieved by growing closer to our family and friends by expressions of love and forgiveness. This includes reaching out to those we’ve hurt or who have hurt us and making things right. Spiritually, a peaceful death comes through peace with God through the redeeming work of Jesus Christ and placing our lives in God’s hands.

Within these three variables of a peaceful death, there are multiple levels of activity. All three levels can only be reached fully when the terminally ill and their families accept the diagnosis of death.

Frankie Melton

Humanity clings to the human body as if the body is the center of the universe or the essence of eternity. As believers, our first inclination is always to pray for healing for those who are sick. As a pastor and hospice chaplain, I want to give hope to those who are terminally ill. The question is, is praying for continued life on earth the only avenue of hope?

Praying for physical healing is right and biblical. James 5:14 states, “Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord.”

However, pastors and other believers must be cautious not to give false hope of physical healing to patients and families. Every terminally ill person I have ever visited wanted to live. Yet, I have never known a patient who did not die — eventually. I say eventually because some patients outlive their medical life expectancy. When that happens, it is always a reminder that life and death are in the hands of Christ. He said in Revelation 1:18, “I have the keys of Death and Hades.” 

One of the most difficult aspects of a terminal illness is accepting the diagnosis that the sickness will end in death. People of faith are conditioned to pray for healing. Many feel they will live, somehow defying the medical community’s diagnosis of terminal illness.

One man I visited stated bluntly, “I feel fine. I’m gonna beat this. I plan to see my grandchildren graduate high school, but thank you for coming. I need all the prayer I can get.” The general message was, “I don’t need anyone to help me prepare for the end, but you’re free to pray for me. God is going to heal me.” The desire to live is noble and very human.

When ministers, friends and family members pray for the healing of a terminally ill person, it can have devastating results. Of course, to caution someone against praying for healing brings a certain level of dissonance to the ears. Suggesting we not pray for healing seems to be the last thing a pastor should be saying. After all, can’t God do anything? Isn’t God so powerful that He can even raise the dead, as He did in the case of Lazarus in John 11?

Of course, it is true that God can do anything, but the fact that God can do anything doesn’t mean He will. Pastors and chaplains do a great disservice to the terminally ill by praying for their healing. George Whitefield said, “Sudden death is sudden glory.” We could add to that: “The anticipation of death is the anticipation of glory.” As a hospice chaplain, the goal is to get the patient to a point where they stop seeking medical treatment and accept that death is approaching. When patients and families cling to the hope of physical healing, it prevents them from preparing for the end of life. If a pastor, chaplain or fellow believer feels impressed to pray for a patient’s healing, he should do so privately, not in the hearing of the patient.

When I first became a hospice chaplain, I was confronted with a dilemma that I had not faced as a pastor. I had always prayed for the sick to experience healing. Except in cases where the person was very near death, I always prayed a prayer that sought continued life in this world. I wanted to give hope of continued life for all. I now realize that hope is not chained to continuing life in the body. As one of my favorite hymns declares, “Life shall not end the strain.” Hope, joy and praise all continue after death. An acceptance of death is not antithetical to hope. God’s Word provides tremendous hope to God’s people even when death is imminent. I realized that if I prayed for their physical healing and continued life, I was actually hurting them. I was giving them false hope and preventing them from preparing for the end. When a patient does not accept his or her diagnosis of terminal illness, they are not inclined to address some very important end-of-life issues.

Those who minister to and pray with the terminally ill walk a tightrope between offering hope to the dying and at the same time helping them come to a point of acceptance of the end of life. Some may recoil at the thought of not praying for healing or dashing the patient’s hope of living. Acceptance of death may feel like a defeat or lack of faith to many. People like to describe those who are sick as being “a fighter” or “never giving up.” A patient who accepts the outcome of death is not giving up; rather, they are choosing to die with dignity.

When the terminally ill come to a point of acceptance, it enables them to avoid excruciating disappointment and severe pain, and it allows them to prepare on multiple levels for death. When the terminally ill are unaccepting of the news that they cannot be cured and that death is imminent, they continue to hold out false hope of physical healing. When that false hope reveals itself to be false, the patient can sometimes lose faith altogether, feeling that God let them down. Death is not a defeat for believers; it is simply the completion of one phase of existence.

Preparation for death includes finding peace with God, peace with others, and peace with self. Peace with God means coming to a point of confidence that Christ is Savior and Lord and having the peace-knowledge that Christ has saved me. Peace with God through Christ is the first priority.

The second priority is peace with others. We all have relationships in need of repair or, at the very least, in need of nurturing. The terminally ill have relationships that need attention. The terminally ill have words that need to be spoken, and families of the terminally ill have words that need to be heard. Some patients have broken relationships with family members as a result of disagreements that may be decades old. God’s gift to the terminally ill is allowing them time to be reconciled with their loved ones and friends.

A widow whose husband had died sat across the table from me, weeping. She said, “I didn’t say the things I should have said, because I didn’t believe he was going to die. I wish I could go back and say those things.” She described how her husband tried to have end-of-life conversations with her and she avoided them. On one occasion he blurted out, “I’m dying!” She dismissed it, saying, “Oh, honey, we’re all dying.” Neither the wife nor the husband was able to say what needed to be said before death.

I stood by the bedside of a lady whose body had been racked by cancer. She was already in a non-responsive state. Her sister stood beside me, the only family member present. The sister described how the woman had argued with her daughter a year before and how the two had not spoken since. The daughter had been informed of her mother’s sickness but had not come to see her. As I read Scripture and prayed, the door of the house swung open suddenly, and the daughter sprinted across the living room and fell across her mother’s bed, crying, “Momma! Momma!” Unfortunately, the daughter had waited one day too late to ever hear her mother’s voice again.

When families and patients accept the diagnosis of death, they are more likely to seek reconciliation, offer forgiveness, say “I love you and I’m proud of you,” and confront their spiritual condition before God.

God’s timing is perfect. We can be assured that an acceptance of death does not hasten death by one day, or one minute. God is in full control. Though acceptance does not quicken death’s pace, it does cultivate a peaceful end-of-life experience.  

— Frankie J. Melton Jr., who served for more than six years as a hospice chaplain, is pastor of Heath Springs Baptist Church and assistant professor of Christian studies at North Greenville University.