In the Christian tradition, pastoral care to the dying has a long history. This tradition encompasses the medieval literary genre of self-help books known as the ars moriendi, or “art of dying.” Martin Luther contributed to this genre with his Sermon on Preparing to Die (1519); dozens of Lutheran pastors, among them Wenzeslaus Linck in Nuremberg and Martin Moller in Görlitz, followed in his footsteps. All of them offered spiritual comfort to the dying in ways that addressed contemporary concerns. The recently-published The Divine Art of Dying (2014) by Karen Speerstra and Herbert Anderson heralds a long-overdue renaissance of this genre.
 My task is to describe the beginnings of Lutheran pastoral care for the dying in the sixteenth century. I will do so, and I will also identify some theological and pastoral issues we might consider in our discussion of Lutheran approaches to caring for the dying in our own secularized, pluralistic, and medically advanced day and age. In order to better understand Martin Luther’s approach to this dimension of pastoral care, I will begin with a consideration of the type of ministry to the dying that Luther himself would have witnessed as a child and a young man.
 Preparing for a Christian Death in Late-Medieval Germany
 In the Middle Ages, it was more difficult to avoid contact with death and dying than it is in the twenty-first century. Repeated waves of the plague killed not only adults, but children as well; women often died in childbirth; the infection of a small wound could have deadly consequences. Most people sought to die at home; people who died surrounded by family and loved ones considered themselves blessed.
 Medieval priests taught dying persons to call for both medical and spiritual assistance. They considered spiritual assistance more important than medical, because they believed the eternal fate of the soul to be at stake at the moment of death. Surviving liturgical manuals, such as the Rituale of Bishop Henry I. of Breslau from the fourteenth century, show that sick persons were expected to confess their sins to their priest, who would then absolve them. Thereupon they received the sacraments of the eucharist, or communion, and the anointing of the sick. Psalms and prayers were spoken; the rituals were performed in Latin, the liturgical language of the medieval church. Confession was the most important aspect of medieval preparation for death, because only persons who had been reconciled with God by having confessed all of their mortal, that is, very serious sins, could hope to escape eternal damnation. Moreover, the church taught that dying persons could not be certain of their eternal salvation. Even if they had remembered and confessed all their mortal sins, they could not know whether God had elevated them to a state of grace. And even if they had attained a state of grace, they could not be certain they would succeed in remaining in this state until the moment they died.
 Because eternal salvation was at stake at the moment of death, it was considered necessary for people to prepare to die while they were still in good health. Clergy thought it wise to teach Christian laypersons to minister to the dying, given that, especially at times of plague, priests were either already dead, or so busy they were unable to attend every deathbed. To assist with this, theologians and clergy devised a variety of self-help books and handbooks known by the Latin term ars moriendi, or art of dying. One of the most widely-disseminated of these books was the anonymous Art of Dying Well (Speculum artis bene moriendi) (ca. 1414-18). Originally written in Latin, it circulated in manuscript before the invention of the printing press, and was translated into several languages, including English. This book consisted of a variety of sections: Instructions to caregivers in the form of exhortations to dying persons to confess their sins, questions to ask of dying persons to elicit a confession of faith, prayers to be said with and by the dying, instructions on how dying persons were to face the demonic temptations they could expect on their deathbed, and a series of concluding prayers. A condensed version of the Art of Dying Well, consisting of the exhortations, the demonic temptations illustrated with vivid woodcuts, and a series of concluding admonitions to prayer along with prayer texts was also published in a variety of languages, including German, but not English. The five demonic temptations it taught dying Christians to resist were: to doubt their faith, to despair of their salvation, to fail to be patient in suffering, to believe they deserved salvation on account of all their good works, and to regret leaving behind their material possessions. Thus the first devil tells the dying person that he has sinned so much it is impossible for God to forgive him. He even quotes Scripture: “[N]o one knows whether he is worthy of hate or love [Ecclesiastes 9:1].” Against the devil’s temptation to despair, an angel admonishes the dying person not to give in to despair, but rather to keep on hoping. It was important to learn to expect and resist these temptations, because the person who gave in to any one of them would face eternity in hell.
 Martin Luther’s Sermon on Preparing to Die (1519)
 Commenting on these books on preparing to die, Luther once wrote: “Many books have been written . . . on how we are to prepare for death: nothing but error, and people have become more downcast.” His own Sermon on Preparing to Die (1519) became a bestseller, likely because Luther accurately diagnosed and addressed the overriding spiritual concern of devout persons of his day: despair of eternal salvation, and fear of hell.
 Martin Luther rejected the traditional teaching that Christians could not be certain of their eternal salvation. On the contrary, he taught that Christians could rest assured of their salvation, and that this assurance could be attained through faith in God’s gracious promise to forgive sins. This teaching, which came to be known as justification by faith, became the basis for Lutheran teaching on preparing for death.
 The title of Luther’s Sermon on Preparing to Die (1519) is a bit misleading, because Luther did not preach it from a pulpit, rather, he wrote and published it for devotional reading by all Christians, and especially those close to death. Following tradition, Luther taught that dying persons were to draw up a will, to seek reconciliation with loved ones and neighbors, and to receive the traditional deathbed sacraments. In his exhortation to confession, however, Luther broke with tradition; he instructed dying persons to confess not all of their sins, but only the serious sins which lay most heavily on their conscience. This was a radical break with tradition, because the church had taught for hundreds of years that even one unconfessed mortal sin would send a person to hell for eternity. The remainder of the sermon consisted of instruction on the meaning of the deathbed sacraments. These are best understood, Luther writes, when one recognizes that they help one overcome the demonic temptations. Luther speaks of these temptations as images of death, sin, and hell; they correspond to the late medieval temptation of despair of salvation. Luther teaches that the images or temptations can be overcome by meditating on Christ’s passion. When Christians are tempted to despair of salvation on account of the certainty of impending death, the gravity of their sins, or the fear of damnation, they are to contemplate the death of Christ on the cross, through which their own death and sin are defeated and eternal life is given to them. Thus, when the dying Christian contemplates the image of sin, the devil holds up to him all those who have sinned and who have been damned on account of fewer sins than his. This the Christian is not to do; instead, he is to contemplate the image of grace: Christ, Luther writes, “takes your sins upon himself and overcomes them for you with his righteousness out of sheer mercy, and if you believe that, your sins will never do you harm.” In conclusion, Luther encourages dying persons to receive the deathbed sacraments joyfully, and to trust in the certainty of salvation that is Christ’s gift. Luther concludes his sermon as follows:
Thus we read in Psalm 111 [:2], ‘Great are the works of the Lord, selected according to his pleasure.’ Therefore, we ought to thank him with a joyful heart for showing us such wonderful, rich, and immeasurable grace and mercy against death, hell, and sin, and to laud and love his grace rather than fearing death so greatly. Love and praise make dying very much easier, as God tells us through Isaiah, ‘I shall curb your mouth in its praise of me, so that you will not perish’ [Isaiah 48:9]. To that end may God help us. Amen.
Thus Luther draws on motifs found in traditional ars moriendi works, like the temptation to despair, but rejects their central teaching that dying Christians cannot be certain of their salvation.
 Wenzeslaus Linck’s (1482-1547) and Martin Moller’s (1547-1606) Approaches to Pastoral Care for the Dying
 Luther’s colleagues and successors followed in Luther’s footsteps, teaching and consoling the Christians entrusted to their spiritual care with numerous contributions to the ars moriendi genre. In the sixteenth century alone, they published over one hundred such booklets, among them Wenzeslaus Linck’s How One May Console the Sick in a Christian Manner (1529) and Martin Moller’s Manual for the Rightful Art of Dying (1593).
 Unlike Luther’s Sermon, Linck’s booklet, published in 1529, was a manual that caregivers could use in looking after the dying. Linck and Luther had been fellow-Augustinian monks in Wittenberg. In 1525, Linck became a preacher at the Spitalkirche (lit. Hospital Church) in what was now Lutheran Nuremberg. While serving in this capacity, he wrote his How One May Console the Sick. Interestingly, Linck’s manual is equally liturgical and catechetical in nature; it sees the hospital bed as a venue for both consolation and instruction. In this manual, each section of the catechism is explained in such a way as to existentially relate it to the situation of the dying individual. For example, the caregiver is to instruct the dying person to reflect on the Ten Commandments and “keep in mind God’s judgment, which he has spoken over all people on account of sin . . . (1 Peter 4[:5, 17]).” He is to encourage him to repent of his sins: “I confess that I am a sinner, worthy of death . . ..” Following the confession, the pastor (“der kirchendiener”) is to pronounce absolution; the persons attending the deathbed (“die vmbstehende(n)”) may join in: “Dear man, set your heart on God’s gracious promise, who promises you grace and forgiveness.” Then the sick person is to take courage in the Christian faith as communicated in the Apostles’ Creed: “[D]ear man, keep in mind what a God you have, who both knows how and wills to help you overcome your fear of sin, death, hell, etc.” For your sake, he sent his only son Jesus Christ. “Through his suffering, dying and descent into hell [Christ] redeemed you from sin, death and hell.” Furthermore, to dispel your doubts, “through the preaching of the gospel and the hearing of the faith [God] has given the Holy Spirit into your heart ([cf.] Galatians 3[:1-5]).” The sick person is to meditate on Christ’s passion, and to remember his own baptism, which will be “completed” (“volbracht”) in his death. He is to receive the Lord’s Supper, which Christ has given him “for [his] consolation, and to assure [him], that by its power [his] sins are forgiven.” Finally, he is to pray the Lord’s prayer, and to commit his spirit into God’s hands: “Into your hands I commit my spirit . . . [Psalm 31:5]. I pray you would lead it into eternal life . . ..”
 In essence, Linck’s booklet is a hybrid of a medieval liturgical manual and Luther’s Sermon on Preparing to Die. Like the medieval liturgical manuals, it leads the dying person through the traditional rituals of confession, absolution, the Lord’s Supper, meditation on Christ’s passion, and committing his soul into God’s hands. Unlike the traditional manuals, but like Luther’s Sermon, it provides extensive evangelical instruction which emphasizes God’s gracious will to forgive sins and to be reconciled to human beings.
 In contrast to Linck’s How One May Console the Sick and Luther’s Sermon on Preparing to Die, Martin Moller’s Manual for the Rightful Art of Dying (1593), written more than a half-century later, is essentially a devotional work on Christian living and dying. Born near Wittenberg the year after Luther’s death, Moller obtained his secondary education first in Wittenberg, and then in Görlitz (today on the border between Germany and Poland). A rural church near Görlitz called him as cantor, then as pastor; toward the end of his life he became principal pastor at the Church of Saints Peter and Paul in Görlitz. He also became known as the author of several bestselling devotional works, including his Manual for Dying.
 While Moller takes up a striking number of “old” themes from the late medieval Art of Dying Well, theologically he preserves Martin Luther’s theme of the joyful certainty of salvation. The nine chapters of Moller’s book treat, respectively, the topics of 1.Contemplating human mortality; 2.Preparing for a blessed death with daily confession of sins; 3.Leading a Christian life; 4.Conducting oneself appropriately when afflicted with illness; 5.Dealing with the traditional demonic temptations; 6.Surrendering to death joyfully; 7.Confronting the torment of dying and the ugliness of death; 8.Finding Scripture verses, prayers, hymns, and formulas for commending the dying person’s soul to God; 9.Knowing about the eternal bliss or eternal damnation that awaits those who have died.
 In his introduction, Moller emphasizes that his intention is not only to provide his readers with good Christian teaching, but also to show them how to apply the teaching to their own lives to reap spiritual benefit. Such application takes place primarily by means of prayer. In the third section of his first chapter, for example, Moller asks: “What does it mean to die blessedly?” Alluding to several New Testament passages, he teaches: “To die blessedly means to conclude one’s life in the right and true faith, to commend one’s soul to the Lord Jesus Christ, and – with a heartfelt desire for eternal bliss – to fall asleep gently and joyously, and to depart from here (Luke 2[:29]; Philippians 1[:23]; 1 Timothy 4[:6]).” He then provides a prayer, likewise rooted in Scripture, which explicitly reinforces the preceding teaching: “LORD Jesus Christ! you alone know my hour: I pray [that] you . . . give me a blessed ending and thereupon take my soul into your hands. Amen!” (Matthew 6:[10, 33]; Acts 7[:59]). The historian Elke Axmacher writes that in contrast to the authors of the earliest Lutheran handbooks on dying, for Moller, Christian teaching, and the application of Christian teaching to the life of the individual believer through prayer, are two distinct, albeit closely related concerns.
 Axmacher has also observed that while Moller agreed with the biblical, medieval, and early Reformation understanding of death as God’s just punishment for human sin, a punishment which was to be obediently accepted in faith, his teaching on dying reflected a broader shift in cultural attitudes toward death that had taken place since the Reformation. To a greater extent than in the early Reformation, in Moller’s day, popular culture had come to place greater value on earthly life and its enjoyments, and had come to perceive death as unnatural, and therefore a threat to life. In the fifth chapter, Moller acknowledges such changed perceptions toward life and death, and treats them, if not as sins, nevertheless as temptations to be overcome. Speaking of the human tendency to fear death, he writes: “It is natural, dear soul, for our nature was created in the beginning not for death, but for life.” After all, as Moller points out, Jesus, too, feared death. In the prayer that reinforces this teaching, however, Moller brings together the theme of fear of natural death with the traditional teaching that death is a deserved punishment for sin: “I thank you, LORD Jesus Christ, that you created me not for death, but for life, and that you formed love of life in my heart. I ask you from the bottom of my heart, teach me to remember that death rules over me on account of sin, and finally will strangle me. . . . But help me, that I may firmly cling to you, my LORD, to you who are life itself, with true faith, [and thus] overcome all fear of death . . . (John 11[:25-26])”.
 Given that death is punishment for sin, forgiveness, that is, justification, is the ultimate spiritual comfort that Moller, like Luther, offers his readers. Also like Luther, Moller offers consolation that is permeated with the conviction that penitent sinners can be certain of divine forgiveness: “Yes, I know and I believe, I trust and I am certain, my Redeemer, . . . that your descent into hell is my rescue from the force of hell and of the devil; . . . and that your ascension to heaven is my assurance that I am a distinct heir of eternal life, and that through you I have heaven already within me.” Moller, however, goes a step beyond Luther in offering comfort in the promise of mystical union with God. This comfort is also expressed in a prayer: “You [Jesus] are within me, and I am within you; everything that is yours is also mine, namely, life, and eternal delight and joy. . . . When I have you, then I have everything that pleases me, here, temporally, and there, eternally.”
 Despite sharing many themes with Luther, Linck, and late medieval writers, Moller’s book differs somewhat from their writings in both content and form. In form, it is a devotional manual both for Christian living and for Christian dying, providing both Christian instruction and formulas for prayer. In content, it acknowledges and addresses changed cultural attitudes toward living and dying.
 The Future of the Lutheran Art of Dying?
 Without a doubt, one reason these Lutheran works on dying were helpful and successful was that they spoke to timely spiritual and practical concerns. Luther and Linck, writing in the early years of the Reformation, addressed the spiritual fear of dying induced by the Church’s teaching that the fate of one’s soul would depend on one’s spiritual “performance” on one’s deathbed. Knowing that devout Christians of their day doubted that their sins would be forgiven and feared eternal damnation, Luther and Linck emphasized God’s mercy and taught that salvation was certain. Writing much later, near the end of the sixteenth century, Moller, though he firmly embraced traditional Lutheran teaching, acknowledged and spoke to the new valuation in his day of life as positive and pleasurable, even as he held to the traditional theology of death as punishment for sin.
 To conclude, what might a modern Lutheran Art of Dying look like? To be helpful and gracious and ultimately relevant, today’s and tomorrow’s Lutheran pastors will, like their forebears, have to bring together traditional Christian teaching with contemporary cultural assumptions and medical realities. Luther’s emphasis on a gracious God, and on a confident and joyful approach to Christian living and dying in the presence of God, is an emphasis we Lutherans will want keep in mind when considering the profound moral questions raised by modern medical technology. Surely there were times when Luther, too, doubted himself, and his own questioning of the teachings of his church. Who was he to teach that mortally ill Christians need only to confess those sins that lay most heavily on their conscience, and not all their sins, when the Church had taught for hundreds of years that the failure to confess even one serious sin would lead to eternal damnation? Would he, Luther, at the Last Judgment be found guilty of sending sinners to hell? I’m not aware that we have evidence that Luther committed these particular doubts to paper, but I do know that he often spoke of himself as being tempted by the devil.
 Second, having found and read not only prayers, but also extensive Christian instruction in the manuals written by sixteenth-century pastors, I think that we Lutherans might consider developing literature for the “spiritual guidance” of persons contemplating their own mortality, as well as for laypersons and pastors caring for the seriously ill.
 Finally, I think that when considering spiritual care to gravely ill persons, it will behoove us Lutherans to follow Moller in being attuned to cultural changes taking place around us. In particular, I think it will be helpful for us to keep in mind that today’s Lutheran Christians increasingly live in confessionally and religiously diverse environments, and are more and more coming to appreciate the positive value of the teachings of other religions, including Judaism, Buddhism and Native American spirituality, and their respective approaches to living and dying.
 The recently published The Divine Art of Dying by Herbert Anderson and Karen Speerstra is a welcome step in this direction. Diary entries by Speerstra, who herself is living with cancer and contemplating her own approaching death, comprise the core of this book. They are accompanied by Anderson’s reflections on topics such as “Facing finality,” and “How do we talk about death?” Although rooted in the Christian tradition, this book is an ecumenical, interreligious, and thus in the widest sense, “spiritual,” contribution to the literature of the art of dying. Luther, Linck, and Moller would likely have approved!
Adolf Franz, ed., Das Rituale des Bischofs Heinrich I. von Breslau (Freiburg im Breisgau: Herder, 1912) 32-39.
 On the doctrine of the uncertainty of salvation, see Sven Grosse, Heilsungewißheit und Scrupulositas im späten Mittelalter: Studien zu Johannes Gerson und Gattungen der Frömmigkeitstheologie seiner Zeit (Tübingen: J. C. B. Mohr (Paul Siebeck), 1994) 35-41.
 Mary Catharine O’Connor, The Art of Dying Well: The Development of the Ars moriendi (New York: AMS Press, 1966), 7-10; for an English translation of the text, see The boke of the craft of dying, in Yorkshire Writers: Richard Rolle of Hampole and his Followers, vol. 2, ed. C. Horstman (London: Swan Sonnenschein, 1896) 406-420.
 O’Connor, The Art of Dying Well, 9; for a reprint of a beautiful German woodcut edition see Ernst Weil, ed., Die deutsche Übersetzung der Ars moriendi des Meisters Ludwig von Ulm um 1470 (facsimile reprint, Munich-Pasing: Roland Verlag, 1922).
 All Scripture translations follow the NRSV, except where they have been adapted to reflect the original German or Latin meaning more accurately. “[Q]uia nullus scit an odio vel amore dignus est.” Ars moriendi, in Alberto Tenenti, La vie et la mort à travers l’art du XVe siècle (Paris: Librairie Armand Colin, 1952) 104.
 “Multi libri . . . scripti, quomodo ad mortem praeparare debeamus: merus error et homines bedrubter worden.” Luthers Werke, Kritische Gesamtausgabe, vol. 41, ed. J. F. K. Knaake et al. (Weimar: Böhlau, 1883-1999) 699.
 Austra Reinis, Reforming the Art of Dying: The ars moriendi in the German Reformation (1519-1528) (Aldershot, Great Britain: Ashgate, 2007) 50-52. For an English translation of Luther’s text, see Martin Luther, A Sermon on Preparing to Die (1519), in Luther’s Works, American Edition, vol. 42, ed. Jaroslav Pelikan et al. (St. Louis, MO and Philadelphia, PA: Concordia and Fortress, 1955-1986) (henceforth LW) 99-115.
 Reinis, Reforming the Art of Dying, 54-57.
 Translation adapted from LW 42:105.
 Translation adapted from LW 42:115.
11 For an extensive bibliography of sixteenth-century German Lutheran works in the ars moriendi genre, see Luise Schottroff, Die Bereitung zum Sterben: Studien zu den frühen reformatorischen Sterbebüchern (Göttingen: Vandenhoeck & Ruprecht, 2012) 107-134.
12 Seebaß, Gottfried, “Linck, Wenceslaus,” in Neue Deutsche Biographie 14 (1985) 571-572, http://www.deutsche-biographie.de/ppn118573063.html (accessed December 27, 2014). The Spitalkirche was part of the Spital, or Hospital, built 1332-1339, and dedicated to the care of the sick and the elderly. The preachers were charged with pastoral care of the sick, which included leading worship in the church and providing pastoral care to the dying; see Ulrich Knefelkamp, Das Heilig-Geist-Spital in Nürnberg vom 14.–17. Jahrhundert. Geschichte, Struktur, Alltag (Nürnberg: Verein für Geschichte der Stadt Nürnberg, 1989) 107-109.
13 “[G]edencke das gottes gerichte / welchs er vber alle menschen von der su(e)ndt wegenn / . . . außgossen hat.” Wentzeßlaus Linck, Wie man Christe(n)lich die krancken tro(e)sten mu(e)ge . . ., in Wenzeslaus Linck, Erbauungsschriften, ed. Helmich van der Kolk (Amsterdam: Rodopi, 1978) 119.
14 “[I]ch bekenne mich einen su(e)nder / des todtes wirdig.” Ibid., 121.
15 “Lieber mensch stelle dein hertz auff Gottes gnedige zusagunge / der dir gnade vnnd vergebung inn Christo verheysset.” Ibid., 123.
16 “[L]ieber mensch / gendencke was du fu(e)r einen Gott hast der dir auß aller angst der su(e)nden / todtes / hellen etc. kan / weyß vnd wil helffen.” Ibid.,123-124.
17 “Durch sein leyden / sterben/ vnd nidersteigen zur hellen / dich von su(e)nden / todt / vnd hellen erlo(e)sete.” Ibid., 124.
18 “dir durch die predig des Euangelij vnnd geho(e)re vom glauben / seinen heyligen geyst ins hertz geben / Gala. iij.” Ibid., 125.
19 Ibid., 126-128.
20 “dir . . . dises sacrament zu trost vnd versicherunge / das dir in krafft desselbigen deine su(e)ndt vergeben sein.” Ibid., 130.
21 “Meynen geyst befilch ich inn deine hende . . .. [D]u wo(e)llest sie geleyten biß ins ewige leben.” Ibid., 133.
22 Austra Reinis, “Introduction,” in Dear Soul: A Manual For the Rightful Art of Dying, by Martin Moller, trans. by Stephen Trobisch (Bolivar, MO: Quiet Waters Publications, 2014) 11-13.
23 Martin Moller, Dear Soul: A Manual For the Rightful Art of Dying, trans. by Stephen Trobisch (Bolivar, MO: Quiet Waters Publications, 2014) 32.
24 Elke Axmacher, Praxis Evangeliorum: Theologie und Frömmigkeit bei Martin Moller (1547-1606) (Göttingen: Vandenhoeck & Ruprecht, 1989) 203.
25 Ibid., 204.
26 Ibid., Praxis Evangeliorum, 204-205.
27 Moller, Dear Soul, 93-94.
28 Axmacher, Praxis Evangeliorum, 206.
29 Moller, Dear Soul, 37.
30 Axmacher, Praxis Evangeliorum, 207.
31 Moller, Dear Soul, 111.
32 Herbert E. Anderson and Karen Speerstra, The Divine Art of Dying: How to Live Well While Dying (Studio City CA: Divine Arts Publishing, 2014).