From Reuters:
A terminal leukemia patient must have daily blood transfusions or die. A family begs doctors to do everything possible to keep their elderly mother alive. Parents cannot accept their newborn baby will not survive.
End-of-life issues top the list of ethical dilemmas hospitals face as medical progress enables doctors to extend an endangered life to the hard-to-determine point where they may actually only be dragging out death.
Private dramas like these play out in hospitals every day, rarely hitting the headlines as did the family feud over ending life support for Terri Schiavo in the United States in 2005 or a British couple’s fight to save their severely handicapped baby Charlotte Wyatt in 2003 when doctors wanted to give up on her.
The article ends
[blockquote] “Most Americans don’t really believe they’re going to die,” Lynch said. “This is where so many of the problems start. [/blockquote] I have often wondered what is going on in the families of patients who are well past the point of futility and are in the realm of ludicrous. When I read the quote, I realized that the family members are not concerned with the death of the patient but that the death will force them to deal with their own mortality, something the are desperately trying to avoid.
Oh, this really [i]is[/i] a medical discussion. I thought it was going to lead into a discussion of when do we accept the fact that in terms of their functional theology the Episcopal Church is no longer a living member of the Anglican Communion, or for that matter — by most definitions — even a Christian church in other than name.
So, okay, let’s look at a particular medical implication; both my in-laws are medical people and I have some training on the veterinary side of the equation.
Medicine already has a pretty good operational indication of “life,” in the form of the presence (or absence) of certain sorts of brain waves, to be considered heavily in “end of life” decisions. What if … yeah, what if that exact same criterion were applied to [b]beginning of life[/b] decisions?
Since some 75% of Americans approve of restrictions on abortion (Rasmussen and others), would this not be a medically sound basis for defining the beginning (as well as the end) of human life? The 3% of Americans in favor of near-prohibition would not be happy, and neither would the 22% supporting absolutely unrestricted abortion — any age of the female, and stage of the baby, any reason — but there is a [i]medically sound[/i] basis for some of these tricky “life” decisions; one that should not be dismissed casually by the extremists (on either end) merely because the true mainstream is not particularly boisterous.
The only reference I find in the Bible to the concept of “living” is breath. The question seems to be: “is it breathing?” Does it have “the breath of life?” God breathed life into the first man, and when that breath was gone, he turned into dust.
It is a difficult problem with no quick or easy answers. As a physician, I would never favor the active taking of life, such as euthanasia or abortion, but I have counseled patients and families not to artificially extend life when the chance of recovery is very slim. It’s not something that is easily legislated. Sometimes miracles do happen, but we have to trust that God will do the miracle and not demand that He act on our time.
Truly a vexing question. I think the Schiavo outcome was abominable but at the same time too many people are kept as living corpses just because the technology exists to do so. They are breeding grounds for superbugs and in such cases we should remember our obligations to the living. I also question the ethic of people consuming more privately and publicly socialized medical services in their last six months of life. Of course, I speak as somebody not at that age.
Just to clarify, I don’t question the [i]ethics[/i] of any particular geriatric patient. I simply say that if we are going to underwrite medical care through private insurance and public transfer payments, it is an unavoidable ethical question for us as a society.
Only God can create ( make the living live ) and only God can kill.
How cute it is for man to assume he is in charge.
bl
Bob,
Unfortunately man can kill, you have the creation part right.
This got my attention:
[i] “The two biggest manipulation tools that patients and family use are God and lawyers,” said Nneka Mokwunde, director of the Center for Ethics at Washington Hospital Center.[/i]
Am I getting the idea that Ms. Mokwunde objects to patients or families actually falling back on their religious beliefs to help with decision-making during what is probably the most stressful time in their lives? If so, it reinforces my rather jaundiced view of most “bioethics” panels and experts. As someone in the medical field, I see bioethics being used largely to champion “autonomy,” “responsible use of scarce resources,” and “death with dignity,” with little acknowledgment of the Judeochristian roots of Western morality and ethics. I speak with some personal experience in dealing with end-of-life situations, both with patients and in my own family.
Our technical ability has made what used to be absolutely futile situations a lot more iffy, and this makes MDs hesitant to throw in the towel too quickly. Sometimes, what one observer might consider “prolonging death” might be an opportunity for a family to get to a loved one’s bedside and come to grips with the situation, say their goodbyes, and pray over the dying. I think it’s critical in situations like this for MDs and nurses to be realistic in prognosis but sensitive and respectful of the beliefs of their patients and families.
I very much agree with WestJ (#5)–as a Christian MD, my job isn’t to play God; my role is to use my God-given talents, training, and skill to cure where possible, render comfort when needed, and provide Christian compassion always.