Friday, December 12, 2014

Essential Opioid Package


So, your loved one is under palliative care due to a chronic condition or because he/she is dying. You look at the spot in the house (or spots) where the medications are kept and wonder: Does everyone else also takes these same medications? What if we lived in another country, would the prescriptions be the same? Would we be able to afford them? 

Eduardo Bruera along with Ernesto Vignaroli, M.D. Michael I. Bennett, M.B., Ch.B., M.D., FRCP, FFPMRCA,Cheryl Nekolaichuk, Ph.D., RPsych, Liliana De Lima, M.S., M.H.A., Roberto Wenk, M.D., andCarla I. Ripamonti, M.D., have written a protocol to address just that. 

In "Strategic Pain Management: The Identification and Development of the IAHPC Opioid
Essential Prescription Package" the authors surveyed doctors around the world to find out which pain prescription protocol they were using and favoring.

Here is the link to the study:
http://online.liebertpub.com/doi/pdfplus/10.1089/jpm.2011.0296

Thursday, December 11, 2014

Here is a shorter version of "Our Glorious Future" by Stanley Clark

Feel free to print this out!
Thank you Stan for writing this and sharing it.

What Happens When We Depart This Life?



John 14:1 – 2 Jesus has gone ahead of us to prepare a place for us

Do not let your hearts be troubled. You believe in God; believe also in me. My Father’s house has many rooms; if that were not so, would I have told you that I am going there to prepare a place for you? And if I go and prepare a place for you, I will come back and take you to be with me that where I am you may be also.



Luke 16:19 - 22 There is reason to believe angels will escort us to heaven

In the story of the rich man and Lazarus “It came about that the poor man died and was carried away by the angels to Abraham’s bosom”1



II Corinthians 5:6 – 8 We will be with Jesus Himself

We know that as long as we are in our earthly bodies we are absent from the Lord . . . But we would prefer to be absent from the body and to be at home with the Lord.2



Luke 23:42 - 43 We will be in His presence immediately

When the thief hanging on the cross next to Jesus said, "Jesus, remember me when You come in Your kingdom!" Jesus replied, "Truly I say to you, today you shall be with Me in Paradise."



Philippians 3:20 - 21 Jesus will give us new, glorious bodies

Our citizenship is (actually) in heaven. We eagerly await a Savior (to come) from there, the Lord Jesus Christ who, by the power that enables him to bring everything under his control, will transform our lowly bodies so that they will be like his glorious body.3




Revelation 21:3 - 7 Heaven will fulfill our longing for a better world

I heard a loud voice from the throne saying, “Look! God’s dwelling place is among the people now and He will dwell with them. They will be His people. God himself will be with them and be their God. ‘He will wipe every tear from their eyes. There will be no more death, or mourning or crying or pain, for the old order of things has passed away.”

He who was seated on the throne said, “I am making everything new!” Furthermore, He said, “Write this down, for these words are trustworthy and true.”

“It is finished. I am the Alpha and the Omega, the Beginning and the End. To the thirsty I will give water without cost from the spring of the water of life. Those who are victorious will inherit all this, and I will be their God and they will be my children.



Revelation 22:3 – 5 All the effects of the fall will be gone


(In heaven there will) no longer be any curse. The throne of God and of the Lamb will be in the city, and His servants will serve him. They will see His face, and His name will be on their foreheads. There won’t be anymore night. His people will not need the light of a lamp or the light of the sun, for the Lord God will give them light. And they will reign for ever and ever.



I Thessalonians 4:13 – 18 Our Christian family and will friends join us later

Brothers and sisters, we do not want you to be uninformed about those who sleep in death, so that you won’t grieve like the rest of mankind, who have no hope. 14 For because we believe that Jesus died and rose again we also believe that God will bring with Jesus those who have fallen asleep in him. 15 According to the Lord’s word we tell you that we who are still alive, who are left until the coming of the Lord will certainly not precede those who have fallen asleep. 16 For the Lord himself will come down from heaven with a loud command, with the voice of the archangel and with the trumpet call of God, and the dead in Christ will rise first. 17 After that we who are still alive and are left will be caught up together with them in the clouds to meet the Lord in the air. And so we will be with the Lord forever. 18 Therefore encourage one another with these words.



I Corinthians 3: 11 – 14 Rewards await those who have lived for Christ

No one can lay any foundation other than the one already laid, which is Jesus Christ. 12 If anyone builds on this foundation using gold, silver, costly stones, wood, hay or straw, 13 his work will be shown for what it is, because the Day will bring it to light. It will be revealed with fire, and the fire will test the quality of each person’s work. 14 If what has been built survives, the builder will receive a reward.4




All verses are from the NIV. Some have been paraphrased for the sake of clarity.
1 “Abraham’s bosom” was a Jewish term for the place of bliss and blessing in eternity.
2 Further, we will never be separated from Him; I Thessalonians 4:17c.
3 See also I Corinthians 15:49.
4 Part of this reward for faithfulness is to get to share in Christ’s reign! See Revelation 22:5c and 2:26-27.

Our Glorious Future by Stanley Clark: An essay about what happens after we die.

 
Our Glorious Future

To many people, the notion of “heaven” is wishful thinking. To the secular mind, people who believe in heaven are denying that this life is all there is, and that the grave is the end of our existence.

In Mere Christianity C. S. Lewis rebuts this outlook: “If I find in myself a desire which no experience in this world can satisfy, the most probable explanation is that I was made for another world.”1

God created people to enjoy eternal life.

To get to heaven though, we have to die. Death is a penalty for Adam’s sin, and our own. The good news is that for those who have come to God through the work of the cross, dying becomes the portal through which we enter into the eternal experience of what God originally intended for us. Eternity will be an uninterrupted life of joy in the presence of God, as well as a reunion with our family and dearest friends unhindered by the pain, conflict, and burden of sin of this life.

But what happens when we die?

The Bible says that when those who have trusted in Christ’s death as the substitute for their sins die, they are immediately transported to the presence of God. Christ told the thief on the cross: “Today you will be with Me in Paradise”2 (Luke 23:43). The Apostle Paul said that to be “absent from the body is to be home with the Lord” (that is, with Jesus himself, II Corinthians 5:8).

The frequent use of the term “sleep” in the New Testament to describe death3 and dying pictures this transition to Jesus’ presence as similar to falling asleep.4 The story of Lazarus gives us reason to believe that angels escort us to this spiritual realm5 (Luke 16:19-31). Eventually, at the rapture the body that is laid in the grave will be resurrected and transformed into a new glorious body. In II Corinthians 5:1-4 the apostle Paul describes our bodily condition until then.

In II Corinthians chapter 4 Paul is speaking of the hardships associated with his ministry. Besides his daily physical trials6 there is the very real prospect of being killed (4:11-12). But despite the bruising and battering his body incurs or the possibility of death itself, he keeps going because he knows that this life is not all there is. He is assured that when he dies a new, heavenly habitation awaits him.

1 Now we know that if the earthly tent which is our house is torn down, we have a building from God, a house not made with hands, eternal in the heavens. 2 For indeed in this house we groan, longing to be clothed with our dwelling from heaven, 3 inasmuch as we, having put it on (the same Greek word as “clothed” in vss. 2 and 4), will not be found naked. 4 For indeed while we are in this tent, we groan, being burdened, because we do not want to be unclothed but to be clothed, so that what is mortal will be swallowed up by life. 5 Now He who prepared us for this very purpose is God, who gave to us the Spirit as a pledge.” (II Corinthians 5:1-5).

Paul is saying that this “house” in which we live is more like a tent. Tents are temporary structures that are subject to wear and tear. Dying is like collapsing the tent so that it can be moved somewhere else. But in place of this body which is our “tent house,” we will have a new body that Paul characterizes as a “building.” Buildings are more substantial than tents. For example, Paul’s word for “building” is used in Matthew 24:1 for the massive temple in Jerusalem. Our new “building” though, will not be man-made. It will be eternal, and will never be collapsed or replaced.

The word translated “clothed” in verses 2, 3, 4 is better rendered “put on” or “overclothed.”7 Even though the redeemed do not receive their resurrection body until the rapture, until then, in some sense that we don’t fully understand, we will be “overclothed” with our glorious heavenly habitation. The fact that we will be “overclothed” is an indication that in heaven we will not be mere spirits. There will be some kind of substance to our existence such that it needs to be “overclothed.” Paul’s confidence that he will receive this “overclothing” is the source of his joyful anticipation.8

The New Testament then, likens dying to falling asleep. If we can take Jesus’ words in Luke 16 as literal and not figurative, we are transported by angels to the presence of Christ. Our earthly tent-body will remain in the grave until it is resurrected at the rapture.9 But we will not be disembodied spirits. Our immaterial part will be overclothed with a kind of glorious, eternal “building” that will later be joined to our resurrected body. This will not be a temporary body. Paul says clearly in 5:1 that it is “eternal in the heavens.”10

Those who have trusted in Christ will enjoy His presence in this habitation until the rapture. At that point the “tent” (the body that was laid in the grave) is resurrected in the same way that Jesus’ body was resurrected. It is then transformed so that all the effects of sin which effaced mankind’s original glory are removed and we will exhibit the same kind of glory as Christ himself.

For our citizenship is in heaven, from which also we eagerly wait for a Savior, the Lord Jesus Christ who will transform the body of our humble state into conformity with the body of His glory, by the exertion of the power that He has even to subject all things to Himself.” Philippians 3:20-21

Beloved, now we are children of God, and it has not appeared as yet what we will be. We know that when He appears, we will be like Him, because we will see Him just as He is.”
1 John 3:2

In I Corinthians 15 Paul elaborates on the process of resurrection and its results.

The fact is that Christ has been raised from the dead. He has become the first of a great harvest of those will be raised to life again. Just as death came into the world through a man, Adam, now the resurrection from the dead has begun through another man, Christ. Everyone dies because all of us are related to Adam, the first man. But all who are related to Christ, the second “Adam,” will be given new life. There is an order to this resurrection: Christ was raised first; then when Christ comes back all of his people will be raised.” I Corinthians 15:20-23 New Living Translation

It is the same for the resurrection of the dead. Our earthly bodies, which die and decay, will be different when they are resurrected, for they will never die. Our bodies disappoint us now, but when they are raised they will be full of glory. They are weak now, but when they are raised, they will be full of power. They are natural human bodies now, but when they are raised, they will be spiritual bodies. For just as there are natural bodies, so also there are spiritual bodies.” I Corinthians 15:42-44 NLT

Adam, the first man, was made from the dust of the earth, while Christ, the second man, came from heaven. Every human being has an earthly body just like Adam’s but our heavenly bodies will be just like Christ’s. Just as we are now like Adam, the man of the earth, so we will someday be like Christ, the man from heaven.

What I am saying dear brothers and sisters, is that flesh and blood cannot inherit the Kingdom of God. These perishable bodies of ours are not able to live forever. But let me tell you a wonderful secret that God has revealed to us. 11 Not all of us will die, but we will all be transformed. It will happen in a moment, in the blinking of an eye when the last trumpet is blown. When the trumpet sounds the Christians who have died will be raised with transformed bodies. And then we who are living will be transformed so that we will never die.12 For our perishable earthly bodies must be transformed into heavenly bodies that will never die. When this happens—when our perishable earthly bodies have been transformed into heavenly bodies that will never die—then at last the Scriptures will come true: ‘Death is swallowed up in victory. O death, where is your victory? O death, where is your sting?’

For sin is the sting that results in death, and the law gives sin its power. Now we thank God who gives us victory over sin and death through Jesus Christ our Lord!” I Corinthians 15:47-57 NLT

So when we die we figuratively “go to sleep” and are transported, possibly by angels, from the realm of earthly things to the realm of an unseen, but equally real, spiritual dimension. There we will “put on” or be “overclothed” with a glorious eternal and imperishable tunic of sorts, until the day that the physical body that was laid in the grave is resurrected and rejoined to our immaterial part. At the moment the spirit leaves the body we are greeted by the Lord Jesus Christ Himself. In this resurrected and glorified body we shall always be with the Lord. At this point there is no more sin, or death, or things associated with sin and death.



Many Christians are confident of their eternal destiny and look forward to being with the Lord. But because death is still an enemy, the process of dying creates apprehension. Even in dying though, God is with us. Henry Lyte died of tuberculosis as a relatively young man. As he approached his own death he wrote about the peace that God’s presence brings:

1 Abide with me, fast falls the eventide. 3 I fear no foe, with thee at hand to bless;
The darkness deepens, Lord with me abide. Ills have no weight, and tears no bitterness.
When other helpers fail and comforts flee, Where is death’s sting? Where, grave thy victory?
Help of the helpless, oh abide with me. I triumph still, if thou abide with me.

2 Swift to its close ebbs out life’s little day; 4 Hold Thou thy cross before my closing eyes.
Earth’s joys grow dim, its glories pass away; Shine through the gloom, and point me to the skies;
Change and decay in all around I see; Heaven’s morning breaks and earth’s vain shadows flee;
O thou who changest not, abide with me. In life, in death, O Lord, abide with me.

Henry Lyte 1793-1847



Another apprehension that some people have about death is the prospect of eternity—time that never ends—or of being “swallowed up” in a vastness of never ending space. A. W. Tozer however, points out that it will take an eternity to become what God made us to be.

The days of the years of our lives are few, and swifter than a weaver’s shuttle. Life is a short and fevered rehearsal for a concert we cannot stay to give. Just when we appear to have attained some proficiency we are forced to lay our instruments down. There is simply not time enough to think, to become, to perform what the constitution of our nature indicates we are capable of. How completely satisfying to turn from our limitations to a God who has none.

Eternal years lie in His heart. For Him time does not pass, it remains; and those who are in Christ share with Him all the riches of limitless time and endless years. God never hurries. There are no deadlines against which He must work. Only to know this is to quiet our spirits and relax our nerves. For those out of Christ, time is a devouring beast; (but) before the sons of the new creation time crouches and purrs and licks their hands. Knowledge of the Holy (New York: Harper, 1961), p. 86

Eternity then, will not be frightening or boring. Men and women were given work before the fall. Indeed, God created work for our fulfillment. In eternity we will get to do all the things that we never had time to do, and pursue the interests and develop the skills that the responsibilities of this life never afforded us.

For the Christian, heaven is home.

Background to II Corinthians 4:16-5:8

In the book of 2nd Corinthians the apostle Paul defends himself against criticisms of himself and his ministry.

Beginning at verse 1:12 1 he answers the charge that "Paul doesn't keep his word, he's not trustworthy, he cannot be depended on to do what he said he would do." This charge arose because Paul had written the Corinthians that he would be coming to see them and did not (1:15-17). As he explains in 1:23 however, he changed his plans and chose not to come to Corinth so that he would not have to confront the Corinthians until they had an opportunity to repent. Instead, (verse 12) he went directly to Macedonia where he found a fruitful ministry.

From there Paul transitions to responding to the second criticism in 2:7 that he was simply an opportunist who preached the gospel for personal gain. He answers this in chapter 3, especially 3:2, that the Corinthians themselves are evidence of the sincerity of his ministry and that it was empowered by the “Spirit of the living God.”

It is because he is confident that his enablement, or adequacy (2:16; 3:5-6) is from God that he boldly preaches the Gospel (3:12). It is true that because of spiritual opposition (4:3-4) not everyone responds. But despite opposition and frequent failure he does not get discouraged and quit (4:1).

That his ministry is a work of God is evident in that even though he is a frail individual (4:7) who constantly lives with "death" (afflictions, perplexity, persecution and beatings 4:8 – 9) the life of Jesus shines through him (4:10-11).

Paul is very aware that due to the hardships of ministry (I Corinthians 11:23 – 28) his body is taking a beating and his physical abilities are ebbing away. (4:16 – 18). But while his external body is decaying, the inner man is being made like the image of Christ (Colossians 3:10). He is not dismayed by the toll ministry takes on his body nor the prospect of death because (5:1 – 4) when he knows that when he dies he will get a new, eternal body.

The body we will receive however, is not an intermediate body. This is not soul sleep.

The "building from God" in verse 1 is the same as the "dwelling from heaven" in verse 2. The fact that one is from God and the other is from heaven implies they are the same body.

This is the issue Paul addresses: God created us to have a body. But this earthly body is a temporary habitation. When we die it is taken down and laid in the grave. We will not receive a resurrection body until the rapture. Since not to have a body is to be "naked," what happens until we are resurrected at the rapture and given our new eternal resurrection body?

Because this present body is temporary, beset with afflictions and destined to die, we "groan" or long to have a new, affliction free, permanent body. (Just ask any elderly person, someone with a terminal illness, or a paralyzed or wheelchair bound individual like Joni Eareckson Tada.)

One of the difficulties in understanding this passage is that the translations do not reflect the nuance of the term "clothed" in verse 2 and 4. A better translation would be "overclothed.”

Additional Material

Then long Eternity shall greet our bliss
With an individual kiss;
And Joy shall overtake us as a flood,
When every thing that is sincerely good
And perfectly divine,
With Truth, and Peace, and Love shall ever shine
About the supreme Throne
Of him, t’ whose happy-making sight alone,
When once our heav'nly-guided soul shall climb,
Then all this Earthy grossness quit,
Attir'd with Stars, we shall forever sit,
Triumphing over Death, and Chance, and thee O Time.

John Milton



I once scorned ev’ry fearful thought of death,
When it was but the end of pulse and breath,
But now my eyes have seen that past the pain
There is a world that’s waiting to be claimed.
Earthmaker, Holy, let me now depart,
For living’s such a temporary art
And dying is but getting dressed for God,
Our graves are merely doorways cut in sod.

Calvin Miller page 139, The Divine Symphony, Bethany House, Minneapolis quoted page 447 Heaven, Randy Alcorn

"Some day you will read in the papers, 'D. L. Moody of East Northfield is dead.' Don't you believe a word of it! At that moment I shall be more alive than I am now; I shall have gone up higher, that is all, out of this old clay tenement into a house that is immortal—a body that death cannot touch, that sin cannot taint; a body fashioned like unto His glorious body. I was born of the flesh in 1837. I was born of the Spirit in 1856. That which is born of the flesh may die. That which is born of the Spirit will live forever.”



When Christ calls me Home I shall go with the gladness of a boy bounding away from school. Adoniram Judson (1788-1850, first American missionary to Burma. He died in India;) quoted page 278 Heaven, Randy Alcorn.


Precious in the sight of the Lord is the death of His godly ones. Psalm 116:15
Further study:

Psalm 90, 103

Stephen’s martyrdom

“Well done faithful servant” is what faithful people hear. Faithfulness is not fame. It is not success or never failing. God evaluates the course of a life, not earthly attainments. Faithfulness is made up of daily steadfastness.
1 C. S. Lewis, “The Weight of Glory,” preached June 8, 1942 at Church of St. Mary the Virgin, Oxford, England accessed October 25, 2014, http://www.verber.com/mark/xian/weight-of-glory.pdf.
2 “Paradise” is a term borrowed from ancient Persian and means a garden with a wall. It is used three times in the New Testament: Luke 23:43; II Corinthians 12:4 and Revelation 2:7. In Jesus’ day it was a popular term (which is likely why Jesus used it in Luke 23 with a man who was probably unsophisticated) for the place where souls go immediately after death, and conveyed a vision of heaven as a place of security, beauty and serenity.
3 The Bible also uses “sleep” to describe the state of the deceased. To our eyes death is final; the end of existence. But the characterization of dying as “falling sleep” is telling us that dying is no more final than dozing off. In the same way that in this life we awaken from slumber, when we die we “wake up” in our eternal, spiritual condition. For “sleep” verses see Matthew 27:52; Mark 5:39; Luke 8:52; John 11:11-12; Acts 7:60; 13:36; 1Corinthians 15:6; 15:18,20; 1Thessalonians 4:13-15; 5:10; II Peter 3:4.
4 The body “sleeps,” not the soul or the spirit. While the body “sleeps” in the earth until the rapture (I Thessalonians 4:16, our soul and spirit are in the presence of Christ.
5 “Abraham’s bosom” was a Jewish term for the place of bliss and blessing in eternity.
6 Paul lists the things he endured in II Corinthians 11:23b-28. At Lystra, Jews hostile to his message “stoned Paul and dragged him out of the city, supposing him to be dead” (Acts 14:19-20).
7 The verb Paul uses here appears as a noun in John 21:7 for the “tunic” that Peter put on before he dove out of his fishing boat in order to swim to shore and greet the resurrected Jesus. The tunic was a garment that was worn over one’s undergarments.
8 Randy Alcorn, pages 57-63 Heaven, supports this view. He points out that “ . . . human beings are by nature both spiritual and physical. God did not create Adam as a spirit and place it inside a body. Rather, he first created a body, then breathed into it a spirit. There never was a moment when a human being existed without a body. . . . We cannot be fully human without both a spirit and a body.” He goes on to point out “. . . the martyrs in Heaven are described as wearing clothes (Revelation 6:9-11). Disembodied spirits don’t wear clothes.” Further, “It appears that the apostle John had a body when he visited Heaven because he is said to have grasped, held, eaten, and tasted the scroll that contained revelation of things still to occur (e.g. Revelation 10:9-10).” (Emphasis in the original.) Alcorn cites other supporting passages as well.
9 At the rapture, Jesus returns from heaven to remove from the earth those who have trusted in Him for salvation so that they won’t experience the judgments God will bring on the world. I Thessalonians 4:13-18; I Cor. 15:51-52.
10 Note that in verse 5 above, Paul states that the indwelling presence of the Holy Spirit is God’s “pledge” of our new body. The word for pledge was used in first century secular Greek of a down payment “that pays a part of the purchase price in advance and so secures a legal claim to the article in question.” It also “obligates the contracting party to make further payments.” (Page 109, BAG, Greek-English Lexicon of the New Testament.) It is used in modern Greek of an engagement ring. (See also II Corinthians 1:22 and Ephesians 1:14.)
11 The “wonderful secret” that Paul speaks of refers to the “rapture” of the church. See I Thessalonians 4.
12 This is the same event that Paul describes in I Thessalonians 4:13-18.