LCMS Convention Workbook St. Louis, Missouri — 2026, Page 203

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THEOLOGICAL DOCUMENTS­­—COMMISSION ON THEOLOGY AND CHURCH RELATIONS

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The principles and considerations laid out in this report provide concrete guidance for faithful end-of-life decisions
amid the ambiguities of incomplete knowledge and often competing values. We all live under what Thielicke called that
“alien dignity” that forbids us to be subjected to the “dictatorial rule” of our own technical capacities. We were created by a
divine benevolence who bequeathed to us a value and dignity that remains, even this side of the fall. Whatever else we say
about the value of God’s creation of man and woman, it implies a sanctity that must not be trampled under or made subservient to what human ingenuity and inventiveness can design by way of medical interventions and treatment protocols.
We do well to seek counsel from physicians and pastors, consider the relative merits of the options, pray to the One who is
the source and Lord of life, and exercise our duties as the designated surrogates of a dying loved one. But along the way of
the entire process, we joyfully acknowledge and believe the forgiveness of God in Christ Jesus and His Holy Spirit as our
real and present Comforter in every circumstance.

Reflecting upon Luther’s handling of Psalm 90, Pless sees it as establishing both a foundation and a framework for
pastoral care in the face of death.161 With Luther, the pastor is called to face death squarely and name it for what it is. Death,
the alien work of God’s wrath, remains the last enemy and may only be overcome by the death and resurrection of the one
“who was delivered up for our trespasses and raised for our justification” (ROM. 4:25). Secular notions of death as “natural”
seek to keep it in the biology lab and treat it as merely another part of the “circle of life,” and a rather natural one at that.
Paul, like Luther much later, had a much more realistic view of death as our true enemy. “The sting of death is sin, and the
power of sin is the law,” Paul declares in 1 Corinthians 15:56. The trio of death, sin and the law are the unholy trinity of
Luther’s exposition of Psalm 90.

B. The Reality of Death and Our Struggle with Helplessness

Christians affirm both the unnatural nature of death as the curse that fell upon a sinful human race and the hope held out
for us in the death and resurrection of Jesus Christ who came that death may die.153 Luther never flinched from dealing
with the severity of sin’s consequences. His handling of Psalm 90, for example, serves as a “corrective for therapeutic
pastoral theologies.”154 For the reformer, “The entire human race fell so far away from God and is so thoroughly blinded
by original sin that man knows neither himself nor God. Indeed, he does not even know his own sorry state, although he
feels it and languishes under it. He neither understands its origin nor does he see its final outcome.”155 In his commentary,
Luther rejects any minimizing of death as the “worst blindness” in the face of what one certainly knows and experiences to
be the opposite.156 Luther comments on Psalm 90: “First, Moses here stresses the tyranny of death and of God’s wrath, since
he shows that human nature is subject to eternal death; he does this for the purpose of terrifying hardened and unbelieving
despisers of God. Secondly, Moses prays for a remedy against despair, that men might not succumb to despair.”157
We cannot escape God’s wrath and its inevitable consequences in death by wishing them away with flowery eulogies,
which amount to little more than secular attempts at absolution by works and worthiness, or by exercising our self-determination by choosing when and how we will “die with dignity.”158 Self-determination is what got humanity into the
problem of sin in the first place! Luther thunders that it “is wicked to invent a new god and in this way to escape God’s
wrath and so to attempt to avert something which we, because of sin, have justly deserved.”159 The law focuses like a laser
on what death is and remains: our enemy. Werner Elert rightly observed that God’s call deals a “destructive blow” to any
notions of autonomous self-determination. But looked at “with the eyes of God,” all of this autonomy shrinks to the “mathematical point,” and we see that “the outer side of our life is death.”160

153
The short piece, “What About Death and Dying” by A.L. Barry in the Synod’s “What about …” series, offers a succinct statement dealing with the types of questions laypersons often ask
regarding death and dying. It can be downloaded online at The Lutheran Church—Missouri Synod’s LCMS Document Library, https://files.lcms.org/file/preview/4C9b1IpSFPRy18M2tCdDXhzJXAEw1Azd.
154
John T. Pless, “Luther’s Reading of Psalm 90: The Eschatology of Pastoral Theology,” in Take Courage: Essays in Honor of Harold Senkbeil (Irvine: New Reformation Publications, 2016), Kindle
Edition.
155

Martin Luther, Luther’s Works, Vol. 13: Selected Psalms II, ed. Jaroslav J. Pelikan, Hilton C. Oswald and Helmut T. Lehmann, vol. 13 (St. Louis: Concordia Publishing House, 1999), 76.

156

LW 13:77.

LW 13:78. The old Henry Cole translation of Luther’s devotional thoughts on the Psalms, A Manual on the Book of Psalms (London: Seeley and Burnside, 1837), offers a wonderful summary
of Luther’s view of Psalm 90. “This Psalm contains a very great and important doctrine; in which Moses teaches what is the origin and cause of that death to which the whole human race is
subject, and the reason why so horrible a punishment was inflicted on the whole race of mortals: the Psalmist saith, it was on account of sin: and the guilt and desert of sin are greater than can be
conceived by the human mind, unless God touch the heart with a knowledge of it; and yet, in this sin and guilt, and under this wrath, all the sons of Adam are born.”

157

But just as Easter follows Good Friday, the resurrection comes after the cross. The same Christ who gave His life as
a propitiatory sacrifice for our sins guarantees us a final victory. Our words to the dying and their grieving families does
not end with a grave or with the months of wrenching grieving that may follow. We offer the promise and hope of God in
Christ. Pless states it well:
The one who died in our place gives us his indestructible life. The end of life’s story is not the obituary; the final
destination is not the cemetery. The end of the story is Christ Jesus crucified and risen from the dead. The end of
the story is your resurrection. In light of this truth, we are set free to face the questions of mercy and care at life’s
end with the full confidence that the Lord who gives us life and who will one day recall this life to himself always
has more to give. We will neither take our own lives or those of others, nor will we hold on to them selfishly
when the Lord, who has already called us from death to life in Holy Baptism, calls us to die for that final time.162
Pastoral preparation for the various stages of life should involve at the very least an orientation to the joys and rewards
of each season of life, including the final one, despite the discomfort with helplessness and loss of control as we await union
with Christ in glory. Meilaender offers insight into the wisdom of aging and the notion of a complete life: “No longer imagining, if he ever did, that he goes to meet God on his own terms, it is the old person’s ‘special opportunity’ to discover that
the initiative always lies with God — and in this discovery to be an example for all who are younger.”163
Thoughtful Christian leaders may consider the complexity of the issues that surround end-of-life care and despair of
having a sure word from the Lord. Richard C. Eyer helpfully cuts through the clutter and affirms three key ideas: 1) The
problem comes because we are afraid of being helpless and without control over our lives in a time of great ethical and relational crisis; 2) “It is only when we find ourselves helpless due to suffering and do NOT take matters into our own hands
that we come to see God at work in our lives redeeming and remaking us through ‘death and resurrection’ of the spiritual
self ”; and 3) Part of the obedience of faith means that we use our sense of helplessness and inadequacy to learn to submit to
God and trust Him despite the specific conditions and circumstances.164 We may take each of these points in order.
1. Fear of Helplessness and Lack of Control
We fear helplessness and seek to project our own self-determination into the future’s uncertainties. God, the Creator, makes
us His creatures. Creaturely existence must, by definition, be receptive and dependent. Finding ourselves afraid of dying,
unable to control the outcome of the medical care we receive, can never be a comfortable place to be. But it is precisely in
extreme situations like these that we become the instruments of God for our family and caregivers. And in their care, they
become God’s instruments to us. We cannot forget that Jesus selected a helpless child to be emblematic of those who enter

Pless, “Luther’s Reading of Psalm 90,” Kindle Edition.

161

159

LW 13:96

Pless, “Luther’s Reading of Psalm 90,” Kindle Edition.

162

160

Werner Elert, The Structure of Lutheranism, electronic ed. (St. Louis: Concordia Publishing House, 2000), 26.

Pless, “Luther’s Reading of Psalm 90,” Kindle Edition.

163

Gilbert Meilaender, Should We Live Forever? The Ethical Ambiguities of Aging (Grand Rapids: Eerdmans, 2013), Kindle Edition, location 1543.

164

Richard C. Eyer, “A Christian Guide to End-of-Life Decisions” (Nevada, Iowa: Lutherans for Life), n.d.

158

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into His kingdom (MATT. 18:3). We revel in the grace of infant Baptism partly because it reminds us that God gives His gift of
faith precisely when we are unable to obtain it on our own. The Baptism of an infant reminds us that God rewards only the
helpless with heaven; those seeking to control the outcomes of life spend eternity separated from Him.
2. Facing Helplessness Due to Suffering
St. Paul reminds us that God specializes in manifesting Himself at exactly the point of our deepest need and showing
Himself sufficient for our every need. Romans 5:6 declares that “while we were still weak, at the right time Christ died for
the ungodly.” Luther similarly observes that “through persecution the Gospel and God’s Word only advance and become
stronger, and faith increases. This contradicts the way things work with worldly possessions, which decrease in misfortune
and adversity and increase in prosperity and peace. Christ’s kingdom increases in affliction and decreases in peace and
luxury, as St. Paul says, ‘My power is made stronger in weakness,’ etc. (2 COR. 12[:9]).”165
Our sinful nature ever seeks to become a theologian of glory rather than a theologian of the cross. Luther’s words in
his Heidelberg Disputation (1518) show our problem in stark relief when he writes, “This is clear: The person who does not
know Christ does not know God hidden in suffering. Therefore, this person prefers works to suffering, glory to the cross,
strength to weakness, wisdom to folly, and, in general, good to evil … However, God can be found only in suffering and the
cross, as has already been said.”166
3. Facing Helplessness as a School for Learning to Trust God
Part of the often painful pedagogy of discipleship involves learning to submit to God in the muddle of our helplessness
and feelings of futility. This is not the same as the famous “stiff upper lip,” nor is it a compliance through clenched teeth as
would be unbefitting the Christian, “but a childlike, willing, glorious submission to God; even as the Christian in his entire
life submits to God’s ways and permits God to guide him.”167 We follow the Christ who is truly God but also truly one of
us. His entire life was a life of faith, but His approach to His own end-of-life experience informs our understanding. In the
Garden of Gethsemane, facing imminent death, He submitted to God’s will and committed His life into the hands of the
Father (LUKE 22:42; LUKE 23:46; CF. 1 PETER 4:19).168 Now He intercedes for us in heaven and invites us to approach the “throne of
grace, that we may receive mercy and find grace to help in time of need” (HEB. 4:14–16). Of all the discipleship challenges we
face, none is more existentially pressing than our own death or that of a loved one.

C. Christ’s Comfort for the Dying

The comfort Christians offer those who are at the end of their earthly pilgrimage begins not in the hospital or hospice
room, but at the cross.170 The root for the English “comfort” comes from the Latin com fortis, with strength. While the
farthest thing from the existential reality of a dying person may be said to be strength, that is exactly what Christian
caregiving offers. We strengthen them because our God is the ultimate strength. Paul declares to the Corinthians, “Blessed
be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our
affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are
comforted by God. For as we share abundantly in Christ’s sufferings, so through Christ we share abundantly in comfort
too” (2 COR. 1:3–5).
But since this is no “whistling past the graveyard” kind of comfort, it does not ignore the ugly realities of the actual
situation the person faces in the midst of suffering. Just as Jesus quoted the words of abandonment from Psalm 22 while
He suffered on the cross, sometimes we may expect to hear words of bitter loneliness and even abandonment from those
we minister to at their most dire moment. Our task does not involve looking the other way from their pain, their negative
emotions or even their real doubts no matter how uncomfortable it makes us. As ministers of Christ, we represent the
ultimate Suffering One. Hebrews reminds us that “we do not have a high priest who is unable to sympathize with our weaknesses, but one who in every respect has been tempted as we are, yet without sin. Let us then with confidence draw near to
the throne of grace, that we may receive mercy and find grace to help in time of need” (HEB. 4:15–16). As one veteran chaplain
put it after meeting with a struggling patient: “She was sustained by God and God’s care-giver. She was comforted with the
comfort of God.”171
This was Luther’s pastoral approach, pointing to Christ and His saving work and promises as our source of comfort in
the face of death. Luther rejected much of the ars moriendi (“the art of dying”) tradition of his times.172 Unlike those who
focused their attention on the works that a Christian should perform in order to ensure a “blessed death,” Luther steadfastly held forth the promises of God in the Gospel. Reflecting on the finished work of his catechism, he observed, “Now it
has come, praise God, to this: men and women, young and old, know the catechism. They know how to believe, live, pray,
suffer, and die.”173 Luther began a 1522 Invocavit Sunday sermon with these words:
The summons of death comes to us all, and no one can die for another. All must fight their own battle with death
by themselves, alone. We can shout into one another’s ears but everyone must individually be prepared for the
time of death, for I will not be with you then nor you with me. Therefore each person must personally know and
be armed with the chief things that concern a Christian.174

In the last century, Dietrich Bonhoeffer similarly comprehended the uncertainties that faced him living as a follower
of Christ, needing to learn the painful lessons of discipleship. For him those lessons came under the Nazi regime. Near the
end of the war, Bonhoeffer wrote:
“Having patience in days of trouble” — this has been the focus recently of nearly our entire inner concentration.
How do we accomplish it? By submitting to God’s blows and God’s law and saying, Happy are those who experience this! This is what those who call God “dear Father” must say. Those whom God disciplines through difficult life experiences, through war and deprivation, learn that they can insist on nothing from God; so they wait
patiently and humbly until God again turns toward them kindly, and they know that this hour is coming.169

165

LW 76: 288.

In May 1519, while Luther was engaged in preparing to debate John Eck, he received a request from Mark Schart, a
counselor in Elector Frederick’s court, to write on the topic of death and dying. Luther demurred due to the press of his
debate preparation and other duties. Within weeks, Luther relented and promised to produce something on the topic if
Schart would be patient. On Nov. 1, 1519, Luther’s “A Sermon on Preparing to Die” was published.175 He took aim against
170

Steinke, “Comfort in the Face of Death,” 126.

171

Steinke, 126.

172

Robert Kolb, “The Reformation of Dying and Burial: Preaching, Pastoral Care, and Ritual at Committal in Luther’s Reform,” Concordia Theological Quarterly 81 (2017): 77–93, especially
81–82.

“Luther’s Warning to His Dear German People,” LW 47:52; quoted in Robert Kolb, “Introduction,” A Booklet of Comfort for the Sick & On the Christian Knight by Johann Spangenberg, trans.
Robert Kolb (Milwaukee: Marquette University Press, 2007), 9. “In contrast to Jean Gerson’s ars moriendi and other forms of late-medieval death literature, Martin Luther found in his theological
breakthrough a means of approaching death through what Oswald Bayer called promissio,” Jones, Promissio and Death, ii.

173

166
Dennis Bielfeldt, “Heidelberg Disputation,” in The Roots of Reform, ed. Hans J. Hillerbrand, Kirsi I. Stjerna and Timothy J. Wengert, vol. 1, The Annotated Luther (Minneapolis: Fortress Press,
2015), 99–100.
167

Francis Pieper, Christian Dogmatics, vol. 1 (St. Louis: Concordia Publishing House, 1953), 138.

168

Samuel H. Nafzger et al., eds., Confessing the Gospel: A Lutheran Approach to Systematic Theology, vol. 1 (St. Louis: Concordia Publishing House, 2017), 182.

169

Dietrich Bonhoeffer, Conspiracy and Imprisonment: 1940–1945, ed. Jørgen Glenthøj et al., trans. Lisa E. Dahill and Douglas W. Stott, vol. 16 (Minneapolis: Fortress Press, 2006), 627–628.

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Martin J. Lohrmann, “The Invocavit Sermons,” in Pastoral Writings, ed. Hans J. Hillerbrand et al., vol. 4, The Annotated Luther (Minneapolis: Fortress Press, 1522), 14–15. The “chief things”
Luther has in mind are that we are “children of wrath” under God’s judgment, that God has given His Son so that whoever believes in Him is a child of God, and that we must love as God has
loved us since true faith results in love.

174

175

Martin Luther, “A Sermon on Preparing to Die,” LW 42.

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2026 Convention Workbook