This episode is about empowering you with knowledge and compassion, ensuring that when the time comes, your decisions are made with informed consent, honoring life's sacred conclusion with the grace and empathy exemplified by Jesus. Our journey doesn’t shy away from the complexities of mortality; we bring to light the sensitive nature of Do Not Resuscitate orders and the tough decisions that accompany them. With personal stories and an eye-opening discussion on the real success rates of CPR, contrasted against the often misleading portrayals in media, we illuminate the crucial factors involved in making such weighty choices.
This episode originally aired in March 2022.
This episode is about empowering you with knowledge and compassion, ensuring that when the time comes, your decisions are made with informed consent, honoring life's sacred conclusion with the grace and empathy exemplified by Jesus. Our journey doesn’t shy away from the complexities of mortality; we bring to light the sensitive nature of Do Not Resuscitate orders and the tough decisions that accompany them. With personal stories and an eye-opening discussion on the real success rates of CPR, contrasted against the often misleading portrayals in media, we illuminate the crucial factors involved in making such weighty choices.
This episode originally aired in March 2022.
And today's episode.
Bob Fleischmann:The fact that he's kneeling and praying and saying, pass this cup from me tells you that, no matter how bad that cup tastes that you're drinking out, that he's been there, he knows what you're going through. You are not alone. He knows what's happening and that's his perfection he has. He perfectly identifies with us.
Paul Snamiska:Welcome to the Life Challenges podcast from Christian Life Resources. People today face many opportunities and struggles when it comes to issues of life and death, marriage and family, health and science. We're here to bring a fresh biblical perspective to these issues and more. Join us now for Life Challenges.
Christa Potratz:Hi and welcome back. I'm Christa Potratz, and I'm here with pastors Bob Fleischmann and Jeff Samelson. Today we are going to talk about Christ's passion and what that teaches all of us about dying well, and so that is really our Lent Focus today, and there isn't one specific passage that we're going to read today about that, but we're going to just use Jesus and his dine as the model for how we can prepare for death as well. Now, I mean, we're not all going to get to prepare for death in this way. Some people are taken just relatively quick too, and but for many of us, we may get a chance to think about these things as we walk into death.
Jeff Samelson:Yeah, and that's a good point that sometimes it happens fast. Sometimes you've got plenty of time to prepare for it. But most of the people for whom death comes suddenly, they actually had time to prepare for it. They just didn't, and so it came to them as a surprise Person who steps out the door and gets hit by a falling air conditioning unit. Okay, yeah, that's sudden, but we want to be prepared for that as well.
Bob Fleischmann:And I've always felt that the cornerstone of the Christian faith is the getting to the point where death is not something that you fear. And so when you recognize that the problem with death was solved by the passion story, that is what changes everything around. It makes it a focus. And then, once you realize that death is not something you fear, then you look at life as a blessing, of which you are a steward over. You're watching for it, you're caring for it, and then your decisions reflect accordingly, like when I'm taking care of my mom and dad, who still live next door. If they were to loan me their car, I'd take care of their car. I'm a steward of their car, and when they want it back, they get it back. That's kind of how you view life. Now, as I take care of it, it doesn't mean that it's going to be mine forever. No, they want it back, and God takes life back to Himself, and so we approach it with that sense.
Christa Potratz:So when we think about Jesus then being the model for how to die, one of the maybe we'll just kind of go through some of the different things that we notice. So one is he prays a lot, and he prays a lot in life too. But there is also this beautiful scene the night before he dies with his prayer in Gethsemane, and he is praying. I mean we can probably say hardcore. And then I mean I just remember too as a kid thinking whoa an hour, and then the disciples fall asleep and he comes back and it's another hour and that just baffled me how long the prayer was. But he knew he needed that connection with God too.
Bob Fleischmann:Which is why, in that story, I most identify with the disciples waiting while someone's praying for an hour. Chances aren't real good. I'd stay awake, I would just conk out, I mean it just. And yet it tells you knowing what's coming. He basically established a priority system. My first communication is the one who is the author of life and death. I think that's the first prayer lesson we learn is he establishes the priority. Where does our conversation go first? Does our conversation go to Wikipedia or the internet, or does it go to God first? And a lot of times, working with members, a lot of times the first thing we do is we do the research on the melody, we do the research on the statistics and then we get to God. And he did it like the other way God first. It's also useful to.
Jeff Samelson:We know that he prayed long term there in Gethsemane, and what the Gospels tell us is just a snippet or summary of what he was saying, but even from that we can learn something, in that he's praying Father, if it be your will, take this cup from me. If we know death is approaching, it is perfectly legitimate for us to follow that and say I don't want to do this. I've got things to do, I've got people I still want to talk to or spend time with or whatever, but if it is your will, then prepare me for it. And God answered that prayer. He was strengthened there as a result of that, and that's again a model for us as well, an example that we can pray God, please take this from me if it is your will, but at the same time, in faith, we prepare to receive it. If it is his will that we die or that it comes soon, and then we simply ask for his strength and comfort and everything that we need to bear what is coming.
Christa Potratz:I remember my grandma. She wanted to die. She wanted to go peacefully in her sleep and not have it be a big thing. But so I said, oh, grammy, have you prayed to God about that? And she said, oh no, I don't want to ask him that. She didn't want to be demanding of God as to how she was going to go. And I said, well, you know, I was like you probably can pray that prayer, but if you don't want to, I'll pray that for you. And so that was. Then my prayer was that she would have this peace and this quiet death that I knew she wanted, but she didn't feel like she could ask God for that.
Jeff Samelson:And we should also back up a little bit from Gethsemane to consider most of John. Chapter 17 is what's called Christ's high priestly prayer. The same night, just a few hours earlier, his disciples are there and awake with him while he's praying this prayer, but his prayer is all about the church. He is interceding for the people of this world that he's leaving behind, taking this to his father in prayer, and that's again part of an example for us, too, is that when we are praying preparing for death, that we do not want to be just focused on our own situation, but that we be praying for those who are going to be left behind, that we pray for the mission of the church, which is God's mission he has given to us, that we consider all of those things as well, and that'll be part of our prayer life.
Christa Potratz:Another thing that Jesus seems to take care about, before he's dying as well, is to look out for others being left behind, and we've recently done an episode on that, but maybe is there just something important that we can mention about the emphasis that Jesus puts on that.
Jeff Samelson:One thing I would point to, a specific point, is obviously we are not Christ, so we cannot do all the things he did. But following his example, in terms of the priorities, what was one of the very last things he did for his disciples and therefore for the entire church before he was betrayed and taken away? He gave the Lord supper. That's a huge deal Looking out for the needs of God's people, for forgiveness, for life, for salvation, for that assurance that their sins are taken away. This tangible way of receiving that, because of course he would not tangibly be present with us anymore this was a priority for him. He didn't do it three months early and said I better take care of this while I'm thinking about it. And the same way, then we learned from that to place a priority on the spiritual health of those we are leaving behind. What kind of gift can we give them? Our loved ones or maybe even just strangers that we meet? What can we do for them with what we leave behind?
Christa Potratz:And I think, too, with Paul's talk too, when he was able to come and talk on our podcast. The thing that I remember him saying was this idea of a legacy what is our legacy and how that is with Jesus. The Lord's Supper was a huge part of that legacy, and so just in terms of our life too, what we can leave behind for those that we care about. Another point is also just this reliance on God. Can you expand a little bit on that?
Bob Fleischmann:Well, there's the. Though I walk through the valley of the shadow of death, I shall fear no evil, for I'll use King James version for the art with me. But the shadow of death actually in the Hebrew says the darkest shadow, and it was always kind of a phrase that was used to describe death. The point is is that your family can be at your side during dying, but you still will feel alone. I remember I was visiting with one fellow on his deathbed and he said, even though the family's here, we were talking privately. He says I feel alone. And I said that's a mistake. I said because you're not, and I'm not talking about me and I'm not talking about the wife, I'm not talking about the kids, I'm talking about God, because God is with you. It's his rod, his staff that protects you. And this kind of fits in with a kind of a broader discussion on dying well, which is we like to talk about? Dying with dignity, dying with the kind of dignity that is God pleasing, which is always a focused heavenward. It's kind of the Job thing of. And again, I'm going to use the King James translation because I love it, because it's so graphic. I know that my Redeemer lives. The worms may destroy this body, yet in my flesh I will see God. I mean, when you have somebody who's dying with that kind of conviction coming from their lips, it's amazing, I mean it's, and it's comforting because they and a lot of times I'll tell people that when people will tell me, you know, I don't need to go to church to be a Christian, I still believe Part of the great comfort that they leave for others is the high priority that you place on the things of God and they don't see that high priority. They hear you say the words but they don't see the actions. You may say, well, I believe in God, but I can go fishing on Sunday morning. You are absolutely right, you can. But sometimes, when you're thinking more of others than you are of yourself, the priority you show for the things of God is that legacy that you do leave for others, that they see, that they watch, that they imitate that in time. And I think that that's part of dying.
Bob Fleischmann:Well, is that when we recognize that all of us, from the moment we're born, are already dealing with a defined timeline. Just the fact that we don't know what it is is beside the point. We're dealing with a defined timeline. You should always, all of your actions, all of your words should be already preparing your people, your family, for what's going on. Tim Keller always makes a big deal about you know, sometimes the other God that we establish in life might be our spouse or our children and so forth. He says you got to realize when you have death in the world and this is important for him to say because he's dealing with pancreatic cancer now but he goes when you're dealing with death in the world. He said one of you will always disappoint the other. There will always be one who didn't last Go first. And he said you point your attention heavenward, and there's where your hope is, there's where your trust is.
Christa Potratz:Another thing that we really learn from Jesus and death is this being very firm on the faith, both for himself, but then also for other people too. Where do we kind of see that?
Jeff Samelson:Yeah, that's important for us to remember that, though Jesus was the Son of God, he was still also fully human. He was a man and, as such, faith was something that had to be expressed, had to be exercised. He had to take hold of what he knew of God, the truths of God's plan for him and everything, just as much as anybody else. And he stood firm with all that. Despite all the things that he was going through, the same temptations that Satan had thrown at him in the wilderness at the beginning of his ministry were still there, just as in the wilderness. You're hungry? Well, make these stones into bread and you can have something to eat.
Jeff Samelson:He could have used his divine power at any moment to say enough of this, I don't want these people bothering me anymore, I don't want to hurt anymore, I just want to rest. But he didn't, because he knew what was ahead. He held on in faith to what lay ahead, and then that's again the model for us to follow as well. We hold on to what we know is true God's love for us, god's plan, the fact that heaven is the other side of death for us, that our sins truly are washed away entirely in Jesus' blood, and that we don't have to worry about those things coming back and biting us after we die. We hold on to those firmly and we don't let the temptation to say you know what, I'm just going to give up on this. It's too much trouble or anything to distract us or steal away our confidence.
Bob Fleischmann:But you know, apart from the church and scripture, nothing in this world is going to teach you to think that way.
Bob Fleischmann:Everything about this world is teaching you to prosper, to succeed, to accomplish, to the one with the most toys wins that kind of mentality, and the world very much focuses on that.
Bob Fleischmann:And another reason why you stay engaged with the church is to stay engaged with God's word, because sometimes you just got to get slapped around the ears on occasion to be reminded that there's more to life than life, that we have a different kind of life that goes on forever, and that's what guides our decision making when we start approaching, you know the failing years when life begins to start ebbing away Because you recognize you're not clean, to something that you're going to lose anyways, but yet you care for it.
Bob Fleischmann:That's where that passage out of Philippians I desire to depart and be with Christ, which is better by far, but it's more necessary for you that I remain. And so the idea is as long as I'm here, I am working for you, I'm going to do things for you, I'm going to care for you, I'm going to love you, I'm going to share with you everything that God wants me to share with you. But I recognize that there's still something better coming, and it's not going to be that kind of confidence by which I approach life and by which I approach death.
Christa Potratz:With Jesus. There is this idea in a way like, oh, yeah, he makes it look easy, but to know that it really was very hard. And I'm reminded to have a friend who is going through cancer right now and she just, oh, she just I feel like she just handles it like a rock star. I mean she just is amazing and everything, and I don't think I'd be that strong at all, but just seeing her do it, and then she had posted something on Facebook, one of these inspirational quote things, and it said, just because she carries it well doesn't mean it's not heavy, and that I just thought, wow, yeah, I mean, you know, I feel like, oh, she makes this look so easy, but it's got to be really hard for her. And so when I think of Jesus too, I am just reminded of that, being a lifelong Christian too, sometimes, all right, yeah, you know, we got lent, this is what happens, and he dies, but to just really remember how that had to be on the human Jesus.
Bob Fleischmann:I always say, sometimes going to Lent is a little bit like watching the movie Titanic. You know that the ship is going to sink in the end. You know what's going to happen in the end. Well, and we ascribe things to the perfection of Jesus, which I don't think are correct. You know, we learn in Hebrews, you know that he was tempted like we are, and we're told in one of the epistles that he suffered for you, leaving you an example. He suffered and normally, if you're consistent, you're thinking none of those things are consistent with perfection. You would think that he wouldn't experience those things, but in fact he did. The fact that he's kneeling and praying and saying, pass this cup from me tells you that, no matter how bad that cup tastes that you're drinking, now that he's been there, he knows what you're going through. You are not alone. He knows what's happening and that's his perfection. He perfectly identifies with us and I think that that's the key point that keep in mind, and that is that you're not in some isolated cocoon.
Christa Potratz:So I want to just move on a little bit to a question that we got from a podcast listener. We always love questions, so keep them coming. We do have one about the do not resuscitate order, so that really kind of fits in, I think, when we're thinking about death, and it was from somebody who was filling out their medical directive and just started thinking about do I want to be resuscitated or not if I die? And so Maybe one place to start is when is it recommended to have a do not resuscitate order? If you are in assisted living, in a nursing home, many of those places won't resuscitate you because they say that people are too frail to be doing resuscitation on somebody who's maybe 90 or something. How can we look at this?
Jeff Samelson:I'll just start first off by saying the average person doesn't need to worry about this. If you're in decent health, you don't want to put a formal DNR do not resuscitate order in place. That's going to restrict things that you might actually want done. I mean, if you're in fairly decent health and you're having an operation relatively minor operation and something goes a little wrong, it's not a huge thing, but your heart stops during the operation, it's something. I say it's a little wrong in the sense that, oh, it's going to be a pretty easy thing because you're healthy and everything like that for the doctors to zap, zap and get your heart going again.
Jeff Samelson:If you've got that DNR in place, they can't do that. You don't want to put some kind of order in place that's just going to restrict things that you may actually want done. You want a decision made based on the actual situation you're in and you don't want to put a straight jacket on the medical people who are going to be taking care of you in other situations. A DNR is most appropriate when you're in a situation where you are frail, where, if you are resuscitated, there's not going to be much life left for you after that. Anyway, if you're done with things like that, and so how would you make that decision?
Christa Potratz:like, oh, I'm done, Like I mean 80 years old. Is there an age, Is there a condition of your body? Like, oh, I've had a heart attack before or I don't know?
Bob Fleischmann:Well, there's a couple of things. First of all, let's get some of the basics down. A resuscitation means that the heart stopped, and a primary concern when the heart stops is oxygen flow to the brain, which is why CPR has begun, which is usually, you see that pressure on the chest and regular beats. They always say you learn the song Stay in Alive by the Bee Gees and that's the rate you do it at. But the goal is it moves oxygen to the brain, but that doesn't start the heart. It's going to take an electrical force to start the heart. So when we talk about do not resuscitate, we're basically saying no cardiopulmonary resuscitation, no CPR, no electrical jolt or anything like that. So what does that mean? When do I get to the point where I say I don't have it?
Bob Fleischmann:The University of Arizona has a center on aging and in their August 2019 eldercare bulletin they have this. I'm just going to read this paragraph. It's pretty fascinating. It says the success rate of CPR in movies and on television is around 67%. Patients and their families tend to be even more optimistic about the success rate, with 81% of patients over the age of thinking that they have a 50% chance of survival and 23% thinking their survival chance is 90% or more. In reality, the overall survival rate for adults following outpatient CPR is about 6%.
Jeff Samelson:Wow.
Bob Fleischmann:Yeah, for patients who undergo CPR in a hospital, the survival rate is slightly higher at about 16%. But some survivors have impaired neurological function. So a lot that goes into this that's not mentioned here. But they talk about the chance for in hospital CPR survival rate. If you're over the age of 65, it's 18%. If you're over the age of 90, it's 12%. If you're living in a skilled nursing facility, it's 11.5%. If you have any form of cancer, it's 6%. You mean. So these are startling things.
Bob Fleischmann:There's this thing called co-morbidity, and co-morbidity means what else is going on in your life? Whenever I speak on this, I always tell people that there has to be a reasonable expectation that resuscitation would work. In other words, when Jeff described you're healthy, really stopping the heart is something totally unexpected. Nobody expected it to happen. And there I think there's a reasonable expectation that I'm going to work on resuscitation, because that was not expected. When you're dealing with advanced age frailty, heart problems, kidney problems, other issues going on in your life, you're not looking at a reasonable expectation of success. Is there a definitive formula? No, there isn't.
Bob Fleischmann:I was guarding that light for a 63-year-old lady who was advanced dementia and she was very, very frail and I put a do not resuscitate order on it because there was no reasonable expectation that she would survive resuscitation. I had an 85-year-old fellow who was in who was like the picture of health. He went to the doctor regularly. They knew about his heart and everything and he went in for some surgery to clear out vessels in his legs and he had to put on whether he wanted to be resuscitated. I don't know if the family did it. I thought there was a reasonable expectation that he would survive because nobody would be expecting his heart to stop. So it's kind of this reasonable expectation. There used to be a time there was a number floating around that said that the rate of success of CPR was quite high until he hit the age 70. And then in those days and I still remember I was saying that to a Bible class group and this poor guy sitting in front of me it was his 70th birthday that day it was like I'm toast.
Paul Snamiska:Nothing's going to happen to me.
Bob Fleischmann:But it doesn't work that way. It has to do with reasonable expectation. And when you look at the other factors that are going on in your life, that's that's how you make the judgment, and it's not as startling as you think it is, because you work this way all the time. I mean when you drive. When you drive, you're looking at the speed limit. It's a little snowy out, so you make little adjustments because you can't reasonably expect that when the roads are icy you're still going to be able to drive 70 miles an hour. You know you make adjustments like that and what it is for a Christian? It's a stewardship decision. God has given me these blessings. I'm maintaining these blessings, so I'm going to ride or drive that way.
Bob Fleischmann:Well, the same thing too when it comes to your life, when you you're not afraid to die because you have nothing to be afraid of. Jesus did it all, but you're a steward. So you get to a point where you say I don't think reasonably I can expect to survive. You know, I'm in my 80s, I'm in my 90s, I've had some trouble breathing or I've had kidney issues and so forth. And a lot of times people will say how do we know when we're dying, and I always say it's a little bit like a domino thing kind of One thing begins to start getting weak and another thing gets weak. The person who's in good health, those are the people you resuscitate.
Christa Potratz:I think that's an interesting point too about the TV and movie perception, because I think too, even so, in movies and television, when they are resuscitated, they just go right back to their normal state too, whereas, like you mentioned, sometimes there is cognitive damage or other things as well.
Jeff Samelson:I mean you're Crushed ribs.
Christa Potratz:Right, exactly. And so to think then, okay, if I'm going to be resuscitated, am I just going to go back to being normal?
Bob Fleischmann:Well, and one of the things they show you In normal, in quotes you know On television. They almost never show you getting electrically zapped. It's usually me pumping on your chest and then all of a sudden you come back. First they listen. There's no heartbeat. We pump on their chest and then we wake up. It doesn't work that way. No one resuscitates that way. If you don't have a heartbeat, you're going to be pumping on the chest till cows come home and you won't be brought back to life. It requires a jolt But-.
Christa Potratz:But yeah, I mean, I just think the movie and television has clouded us from the actual effects.
Bob Fleischmann:Yep, very much, very much so.
Christa Potratz:Just as a general rule of thumb, then we can say if you're healthy, kind of regardless of age, then the recommendation would be to not have a do not resuscitate to order.
Bob Fleischmann:Well, and part of it too is just to remember that in Christian bioethics, motivation's the first determinant of what's right or wrong. So why are you saying don't resuscitate me? Are you saying just because I'm sick of this world and I want to get out and this might be my way out? Well, that's not the right motivation. But when you are accepting the fact that I'm observing these domino effect things going on in my life I've got age working against me, I've got organ failures working against me I just can't reasonably expect that I'm going to survive a resuscitation. So I would say DNR, do not resuscitate.
Jeff Samelson:Yeah, and it's helpful, I think, to remember if you're filling out that kind of form or something like that, it's not like, okay, either I fill out a DNR and absolutely nothing is done, or I don't fill out a DNR and that means that the doctors have to do everything, everything. There comes a point where the doctors will say, well, yeah, that's not doing anything and they'll stop, or if you have a power of attorney for medical care given to a loved one or whatever, then they'll be able to make the decision Okay, this is something that is futile and so we're not going to do this anymore. It's not quite the stark extreme either, or that some people might be thinking.
Bob Fleischmann:And it changes. You make a decision now and it'll change five years from now. The other thing I should to fog over this a little bit, is that you need to remember too that there have been studies that suggest that the level of care given to somebody who has a DNR order is less than the level of care of somebody who does not have a DNR order, and I don't know how you can fight that all the time, but there are studies. That is kind of a hot issue that comes out in this topic is because grandpa has a DNR order on him, all of a sudden, people are not taking care of him as well. That would be wrong. They deserve the same care of everybody else, but somebody might bring that up and, yeah, some studies suggest it. That's where you got to know where, if you're talking about assisted living or something like that, you got to know the place.
Christa Potratz:Right. Well, I want to thank our listener who sent in the question for us. I'd like to encourage anybody else too. If you ever have any questions, please let us know. We are always eager to answer them, and so we just want to thank everybody for listening today and we will see you back next time.
Paul Snamiska:Thanks a lot, bye future episodes at lifechallengesus or email us at podcast at christianliferesourcescom. In addition to the podcasts, we include other valuable information at lifechallengesus, so be sure to check it out For more about our parent organization. Please visit christianlife resourcescom. May God give you wisdom, love, strength and peace in Christ for every life challenge.