Today down the street at a hospice or in your neighborhood hospital, one of many thousands of Americans is in a coma, or is "brain dead," or in a "persistent vegetative state," or any of a score of variations on the above. Unless the person is your patient, your relative, your friend, or your fellow congregant who is regularly being prayed for, you've never heard of this person, and never will.
In the language of the Christian majority, however, "his name is written in the book of life," so no one needs to absolutize or idolize utterly reduced "lives." More than half of them are under the care of priests, ministers, rabbis, chaplains, trained and certified deacons, and lay care-givers -- all of them pastors.
Who is a pastor, what does he or she do, and what does it mean to be under pastoral care? The pastor is trained in medical ethics, consults experts, and has thought through the theological implications of what is going on, since such circumstances are constants in the pastoral world. The pastor really, really cares about life, each life under pastoral care, valuing the life to come and the life that is. The pastor no doubt knew the "brain-dead" patient when he was hearty. She knows the one who is now in a "persistent vegetative state" back in good days and bad. Dealing with persons in comas is part of the regular rounds for pastors.
Though not a parish pastor since 1963, I still get to do pastoral acts, thanks to such conveniences as autos and jets, plus snail-mail, e-mail, and telephones that make possible "virtual pastoral calls." Even at the margins, I will get calls that say: "Marty, your friend XX is slipping away. You agreed to phone a final prayer. We are going to let her sleep tomorrow." That is not "physician-assisted suicide." It is natural and godly. Or: "XX can't hear you anymore; she's really gone, except for the tubes. You and she agreed you'd talk to the family as we look ahead."
Oh, yes, the family. Pastoral care regards the patient in context, and knows that the family will outlive the dying member. Over a period of time a pastor, a chaplaincy-circuit, a congregation will study the issues and make personal decisions with which families have to live. The pastor will do all he or she can to help a family find courage to make the right decision, the freedom from guilt that goes with any choices -- all of them always bad -- and then to help them look ahead to the life that is really life. The family can blend back into society and know that they also will be cared for spiritually in tough times.
It's too bad that because good pastoral activity is personal and private, most citizens do not know about it, or for good enough reasons of their own do not avail themselves of it. Really too bad is when, whatever wonderful pastoral care may go on behind the curtains, the patient becomes a "case," an "object," a "thing" to be fought over, exposed to public view, used for a variety of political and religious and other causes. Really, really too bad is when the family and their supporters are tempted and expected to spend their subsequent years in frustration and fury, wreaking vengeance (on whom?), nursing resentment, seeking more power, dividing and distracting the citizenry.
With sympathy for her family, both sides of it, most of us will turn when the time comes and say: Terri Schiavo, rest in peace and let the people say, Amen.
