Good God or Cosmic Sadist?

Continuing with some observations from C.S. Lewis’ A Grief Observed (see it here in Goodreads). Click here to read the first part.

Oftentimes when someone is facing the uncertain future at life’s end, thoughts of eternity arise. This is especially true if the person is suffering from a debilitating disease or cancer. Thoughts begin to wander and people start to wonder what kind of God would allow this kind of suffering. Wouldn’t it be better to just help this person die through physician-assisted suicide or maybe even euthanize this person if he cannot do it himself?

Lewis wrote this while mourning his wife’s death from cancer (42ff):

But oh God, tenderly, tenderly. Already, month by month and week by week you broke her body on the wheel whilst she still wore it. Is it not yet enough?

The terrible thing is that a perfectly good God is in this matter hardly less formidable than a Cosmic Sadist. The more we believe that God hurts only to heal, the less we can believe that there is any use in begging for tenderness. A cruel man might be bribed–might grow tired of his vile sport–might have a temporary fit of mercy, as alcoholics have fits of sobriety. But suppose that what you are up against is a surgeon whose intentions are wholly good. The kinder and more conscientious he is, the more inexorably he will go on cutting. If he yielded to your entreaties, if he stopped before the operation was complete, all the pain up to that point would have been useless. But is it credible that such extremities of torture should be necessary for us? Well, take your choice. The tortures occur. If they are unnecessary, then there is no God or a bad one. If there is a good God, then these tortures are necessary. For no even moderately good Being could possibly inflict or permit them if they weren’t.

Many persons, including Christians, wonder how can a good God allow one of His own to suffer so much; many persons, including Christians, determine that God is nothing more than, in Lewis’ words, a Cosmic Sadist; and many persons, including Christians, conclude that if this is who God is, then they don’t want anything to do with God. They judge God harshly through the enormity of their pain or grief, missing what Lewis comes to understand, that there is something to our benefit in that same pain or grief or suffering; a suffering that although may bring tears to God’s eyes, He allows, because “every branch that bears fruit He prunes, that it may bear more fruit” (John 15:2b NKJV).

Click here to read my concluding thoughts on from this book.

Be Ever Vigilant

In 2009’s various versions of the health care reform bill, one section that received much attention was the section that called for annual “end-of-life planning” sessions for everyone who was covered by government-approved health insurance (that would have been you and me). I’ve written about it previously here, you can read about it in Health Plans Forced to Provide Assisted Suicide Counseling.

The final version of the bill that was ultimately passed and signed into law did not include separate sections detailing these mandatory annual planning sessions. Instead, the planning sessions were folded surreptitiously into sections that altered Medicare. On January 1, the new regulation, which allows Medicare to pay for end-of-life planning went into effect. Here is an excerpt from a New York Times article:

When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.

The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.

Do you see the two-step process that was used to circumvent the public’s distaste for this kind of “counseling”? First, the health care legislation allowed for “coverage of yearly physical examinations.” That’s well and good and people on Medicare should have that kind of coverage. But the second step is what is disturbing: an administration official decided, contrary to what the people wanted, that counseling on end-of-life decisions should be part of wellness visits, and included it in the regulations that govern Medicare.

I am a proponent of discussions regarding care in end-of-life situations–that’s not the concern here. The problem  is who is giving this counseling and what resources are used. One example of a government resource would be the Department of Veteran’s Affairs document, “Your Life, Your Choices.” I’ve written previously about the problems with this document in The VA’s “Your Life, Your Choices” Document.

After the news of the new regulation was released, and pro-life bloggers and commentators started pointing this out, the Obama administration had a sudden reversal regarding this regulation and deleted it from the Medicare regulation; from a New York Time article:

The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday. …

While administration officials cited procedural reasons for changing the rule, it was clear that political concerns were also a factor. The renewed debate over advance care planning threatened to become a distraction to administration officials who were gearing up to defend the health law against attack by the new Republican majority in the House. …

Although the health care bill signed into law in March did not mention end-of-life planning, the topic was included in a huge Medicare regulation setting payment rates for thousands of physician services. The final regulation was published in the Federal Register in late November. The proposed rule, published for public comment in July, did not include advance care planning.

An administration official, authorized by the White House to explain the mix-up, said Tuesday, “We realize that this should have been included in the proposed rule, so more people could have commented on it specifically.”

“We will amend the regulation to take out voluntary advance care planning,” the official said. “This should not affect beneficiaries’ ability to have these voluntary conversations with their doctors.”

Did the Obama administration get caught with its hand in the cookie jar? The section in the 2009 health care reform bill that mentioned these mandatory visits were removed and provisions which would open the way for it were quietly hidden  in other sections. Then the proposed rule published for public comment last July did not include this regulation, once again hiding it from view. Is this the kind of “transparent government” that then-candidate Obama promised voters in 2008?

Folks, this is just one more reminder that those who are defending the sanctity of human life need to be ever vigilant. Those who want to devalue human life are constantly probing for weaknesses in our defense and will do anything to further advance their agenda where the sanctity of human life takes a back-seat to political expediency.

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The VA’s “Your Life, Your Choices” Document

In all the hullabaloo regarding H.R. 3200 over the summer, one document that was regarded as an example of how the government would treat end-of-life decisions was the Veterans Affairs’ document Your Life, Your Choices: Planning for Future Medical Decisions.

I had previously written on the LCMS World Relief and Human Care website that this document uses derogatory terms such as “vegetable” when describing a patient. Another problem that I saw was that the document asks the patient to evaluate his life based on what he can or cannot do rather than the inherent value of human life as bestowed upon him by our Creator and through the sacrifice of our Savior, Jesus Christ.

In H.R. 3200, the advance care planning consultations were mandatory. Enough people made their voices heard and in the current bill in front of the House of Representatives, H.R. 3962, this section has been made voluntary and optional.

But the concerns still remain and the VA’s document is still a good example of what a government document on advance directives and end-of-life decisions would look like. The VA has removed the document from their website and you can no longer obtain it on-line from them. But you can still download it from my blog by clicking here.