A Lost Goodbye


A recent Business Weekover story highlighted the mammoth cost of treating Terence Foley’s rare kidney cancer: over $600,000.[1] His widow, Amanda Bennett described the long journey from diagnosis, through experimental drugs, culminating in his final episode that ended with his death. Even though Amanda had doubts about whether to ask for cancer-fighting drugs that had a low probability of success, and the mounting costs, she ratified the choices they made. She wrote, “Would I do it all again? Absolutely. I couldn’t not do it again.”

Terence Foley and Amanda Bennett’s story makes a rich case study, because it raises so many bioethical issues. For example, we could talk the high cost of health care for rare diseases, the use of experimental drugs, and whether a patient can “demand” such drugs. Or, there are the issues about end of life decision making, advance planning, and palliative care.[2] We’ll save those for another commentary.

But, the issue I’d like to address is the contrast between Terence and Amanda’s pursuit of every possible treatment, and what actually happened at the end of his life.

We understand the desire to try anything to kill the cancer that is killing our loved one. We won’t give up we will not stand accused of “not doing enough.” But, where do we draw the line? When can we say, “enough is enough”?

Desperation to find a cure at any cost could stem from an incorrect view of the human body and our physical existence. Some believe this earthly life is all there is, therefore the end of life can be terrifying. Trapped in hopelessness, they may grasp at any treatment, whether or not it benefits their loved one. Or, Christians may ask for every possible treatment in well-meaning effort to honor the dignity of every human being. This can migrate into a dangerous vitalism. The vitalist preserves the body at all costs, no matter how horrific the remedy. That’s not what being “pro-life” means.

This anxious staving off of death may rob us of true life at the end. We would do well to learn from Christians in the Middle Ages. They prayed against a sudden death, because it deprived them of the opportunity to confess all their sins—in modern language, to enter heaven with a clean slate. They wanted reconciliation with family and friends, and an opportunity to say farewell to God’s good world. Today, hospice makes space for that truly human, dignified death.

Whether at home or in a hospice care center, dying well is a gift to the patient and his family. Amanda Bennett, in her relentless quest to save Terence’s life, lost this gift. “Looking back,” she wrote, “my memories of my zeal to treat are tinged with sadness. Since I didn’t believe my husband was going to die, I never let us have the chance to say goodbye.”

As Christians, we know that physical death is not the end of living, and that we are to live well, even—or especially—at the end.[3]

[1] The story is republished at Amanda Bennett, “End-of-Life Warning at $618,616 Makes Me Wonder Was It Worth It.” http://www.bloomberg.com/apps/news?pid=20601087&sid=avRFGNF6Qw_w.

[2] CBHD offers an Advance Directive form that gives guidance to those that will make healthcare decisions for you, should you become unable to do so. http://cbhd.org/resources/advance-directive

[3] I recommend a forthcoming book by InterVarsity Press. Rob Moll, in The Art of Dying, takes the fear out of dying, replacing it with rich models of dying well. He draws form a broad spectrum of historical, theological, bioethical, social, and practical resources. Moll shows what dying well looked like in the Christian community for centuries, and what it can look like today. 


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