Why the Doctrine of Election matters in the face of Disease and Death

There is perhaps no teaching that is maligned as much as the Doctrine of Election. But there may not be a teaching that matters more when disease and death are on the line. In fact, as we will see when all else is failing, but more pointedly our health, the doctrine of election provides the only comfort and hope that our salvation rests in the hands of a sovereign God. Doctrine simply means teaching and as it relates to election it is the teaching that God has sovereignly chosen an unknown number of people from out of the world for eternal salvation. Said clearly, the ultimate foundation of our salvation is the free will of God, not the free will of man. Because of our innate desire to be the captain of our lives, including our afterlife, we kick and scream at any notion that someone else can or would control our destiny, especially if that someone is the Lord God. Even believers, who understand that God is sovereign, are unwilling to give away (apparent) control of their free choice of salvation.

Scripture most clearly defines and describes the doctrine of election in passages that mention the elect, election, God’s sovereign choosing, or an irresistible, divine and gracious calling, among others. One of the primary passages where this is evident and a number of these phrases are used comes to us from Paul’s letter to the believers are Ephesus. It’s remarkable that he, under divine inspiration of the Holy Spirit, opens up his letter to otherwise doctrinally immature believers, by modern standards, and begins unfolding the doctrine of election. Often election has been viewed as meat for believers rather than milk. But that is not the way that God has viewed it in His Word. Not only does Ephesians start with the doctrine of election and unfold it in great detail, but arguably 20 of the 27 New Testament books mention it in some way (though on a closer examination that number may be higher). Of those, about 6 of the letters start off with an introduction to the doctrine of election. In other words, it wasn’t considered a high-browed, off-limits, or hidden teaching. It was foundational.

Turning to Ephesians, we see the introduction to the doctrine of election following the opening salutation by Paul

³ Blessed be the God and Father of our Lord Jesus Christ, who has blessed us with every spiritual blessing in the heavenly places in Christ, ⁴ just as He chose us in Him before the foundation of the world, that we should be holy and without blame before Him in love, ⁵ having predestined us to adoption as sons by Jesus Christ to Himself, according to the good pleasure of His will, ⁶ to the praise of the glory of His grace, by which He made us accepted in the Beloved. Ephesians 1:3-6

In the passage above we find a blessing ascribed to God because of the blessing given to believers, in Christ. Used primarily in the New Testament with respect to God, the Greek word translated as blessing is where we get our English word eulogy, meaning to speak well of or worthy of praise. Such praise could only be worthy of God, the Father of our Lord Jesus Christ. It is in Him, that is Christ, that we have received every spiritual blessing. In other words, no good thing from God’s plan is withheld from those who have been called and chosen in Christ. These blessings begin to unfold for us in verse 4 with the statement that He, the Father, has chosen us, that is those who have or will genuinely believe, in Christ before the foundation of the world. The time scale here is critically important as it establishes a time period for election before anyone had even been born, or to use the language of election with respect to Jacob and Esau, before having done anything right or wrong (Romans 9:11). God chose His elect in Christ before time began.

The language of in Christ is important and I’ve written elsewhere on how it communicates a pre-time union with Christ. In that post, I mentioned how the Puritans referred to this as an “immanent union”, a pre-temporal union that is outside of time and space. This is clearly a work of God the Father who through His divine prerogative chooses whom He will (Romans 9:18). If you go back to that post you will see that there is also a transient union, or what the Puritans summarized as that which happened at the cross of Christ and then also that union which is applicatory as the Spirit applies the finished work of Christ in time and space through His regenerating work in the heart of God’s elect enabling them to repent and believe. The doctrine of election does not neglect this final union. It does not remove the human responsibility to repent of sin and place our God-given faith in Christ. Rather it is the foundation of it.

That in brief, very brief, is the doctrine of election, that our salvation, while again not denying our responsibility to repent and believe, has been sovereignly ordained before time began outside of any contributing influence from us. But why would I claim that a doctrine or teaching which has been so controversial and troubling to believers and non-believes alike throughout history be such a comfort in the face of disease and death? Because what are you going to rest your hope in when your body has so failed you that you can no longer think or even speak. When you’re watching the crippling effects of disease kill your loved one slowly, to where will you look for comfort?

The World Health Organization estimated that in 2021 there were 57 million people living with dementia worldwide. Pubmed estimates that the number of dementia persons across all ranges of the spectrum could be closer to 416 million. In the United States the number of deaths related to Alzheimer’s, a subcategory of dementia, doubled between 2020 and 2022. Alzheimer’s Disease International projects the number of people living with dementia to exceed 78 million by 2030. Think of that. A 37% increase in less than a decade is staggering. We can argue the causation, but the fact remains that an increasing number of people worldwide have or are going to have dementia – a brain disease that can cripple memory, communication, and the ability to care for oneself. If we think this will not touch believers in Christ, we’re foolish. If we’re unable to see the connection with the damage and toll that this disease takes on the brain with respect to salvation, then we need to pause and consider it. Should any of us get dementia, and the likelihood exists, our ability to reason, think, even read and talk greatly diminishes if not evaporates completely. If we are either relying on our own free will for salvation and depending on our ability to save ourselves or keep ourselves saved, we will come face to face with the reality that it rests solely in the hands of a sovereign God.

When dementia, and other mental health issues that we don’t want to dismiss, arise and accompanying thoughts or words of blasphemy spring out, actions and intentions that would have been unthinkable come forth, what or better Who else will we rely on but a sovereignly gracious God who has elected His own before the foundation of the world and His sovereign ability to keep them saved? I have personally known people with dementia that have shot and killed loved ones coming into their home, because they were confused and thought them to be an intruder. I have witnessed a sweet, elderly woman flip a switch and become filled with as much anger and hatred as a murderer try with all the strength she could muster to attack me because I was building a writer’s desk in her guest bedroom. And I’ve experienced firsthand loved ones living in fear of their lives because of the unpredictability of a dementia person, a long-time believer mind you, trying to hurt or kill them or their own self.

The doctrine of election matters because it’s true. It matters because the Sovereign God planned, accomplished, and applied (or will) His redemption in Christ to His elect. If we could save ourselves, even in the exercise of our own faith, we wouldn’t. If we could keep ourselves saved, through some kind of self-sustaining strength, we couldn’t. The doctrine of election matters because when disease and death come, especially when it destroys the mind, we can rest assured that it was the opening cover of our life’s book, filled with the pages of salvation through repentance from sin, faith in Christ, and a life lived not in our own strength but in that supplied by our loving God, and closing that book with the back cover of God’s preservation of His own. When you watch your family or friends who have lived a life loving and serving the Lord suffering at the crippling hands of dementia, take comfort in knowing that God the Father chose them in Christ before the foundation of the world and our Lord Jesus has yet to lose any of those whom the Father has given Him (John 17:1-26).