Posted by PS on March 28, 2005 at 11:27:40:
In Reply to: Re: Personal experience, ethical sensibilites, and the bias of medical science posted by cav on March 27, 2005 at 05:28:36:
::Namely, where do we draw the line? If it is playing God to disconnect a person from life support, then isn't it also playing God to connect them in the first place?
First, the distinction must be made between artificial respiration and providing food and water to those who cannot feed themselves. This is clear-cut. Feeding someone is not artificial life support. Hence, this complicated question (which I will address below) does not apply to the Terry Shiavo case.
::After all, couldn't one argue that if the person was wounded such that they would die without explicit mechanical equipment to sustain their vital functions artificially (I'm not talking about treating wounds, etc. I'm talking about actual mechanical life support.) that to prolong that life is to assume the responsibility that this person should live longer? I mean this is really dangerous territory regarding predestination and God's purpose in negative events. Everyone really has to form their own opinion in these matters. And I completely believe that it doesn't have to be an either/or position. In this case situationality is a vital consideration.
If we withheld artificial life support, MILLIONS of people would die every year who do in fact recover completely and lead meaningful and productive lives. This I am sure you recognize. To provide such aid is not playing God; rather, it is following God's precepts which direct us to do all we can to render assistance. This is an ethical issue of responsibility to deliver those we can. In this case it is providing aid to the extent of our ability to those who we believe have some hope of recovery (the issue of hope of recovery previously addressed). Our ability to provide such aid has increased substantially, of course, with the introduction of life support machinery. Does this prevent God from taking a life he wishes to? Of course not. More to the point here, does using a breathing machine rather than manual CPR cross the line from providing aid to playing God? I think not. To add some perspective, in a couple of hundred years from now our technology may be so far advanced that the measures we have today seem like ancient blood-letting. In that age, nobody would consider helping someone to breathe while their body heals to be playing God. (I shudder to imagine what the issues will be in that time.)
I must reiterate, however, this isuue is irrelevant to Terry Shiavo's situation. She is not on life-support machinery providing respiration, heart functions, or kidney or liver functions. She is just being fed and hydrated.
::Anyway, let's all just pray that we never have to make such decisions or be the ones that others must decide for. I think we can never judge what another person decides in such cases, either to condemn it or to support it. The best we can do is pray that they will do the right thing. And as always, let's remember that nothing can happen outside of God's allowance, so though the situation may look horrible, he is still in control. In these cases, I think we are best to simply pray that God's will be done...Of course at the same time, I think that if God lays something on our hearts so severely, as with PS's friend and PJ's burden, then maybe there is a reason for that as well, and who knows how God will demonstrate his power, both in the miraculous and the tragic.
I agree with your conclusion emphatically, with the possible exception of one line:
"I think we can never judge what another person decides in such cases, either to condemn it or to support it."
If you are defining judgment and condemnation as decreeing one's eternal destiny, which only God can, I do agree with you. But apart from that distinction, the Bible itself repeatedly commands us to judge ethical issues according to God's precepts, and to be a force condemning unethical and cruel treatment when we see it. Thus we can and should judge actions and decisions, and it is impossible to live ethically without doing so.
The problem, which you and I both recognize, is regarding difficult issues where Biblical ethics may be interpreted in different ways. If the decision is made as an act of faith, we certainly must not condemn the person becaus they understand God's directives differently. An example that comes close to the heart of the Terry Shiavo case is the precept of delivering the helpless. If one believes that she is alive by definition (another complex issue), perhaps partially responsive, and has any hope of recovery, deliverance can be construed as preserving that hope as a matter of principle. On the other hand, if one believes she is technically dead by definition, letting her go could be construed as deliverance.
However, the key here is that the decision is an act of faith. I do not accept as an act of faith the reasoning that since her quality of life is poor and she is suffering, we should let her die. This is euthanasia--mercy killing--and all such decisions are relative to what the judging party believes is an acceptable "quality" of life. To set such a precedent is to invite eventual justified extermination of the handicapped, elderly, etc.
I certainly do not accept withholding basic nutrition as an act of faith, when no other artificial life support is needed.
NEW SUB-TOPIC
What is extremely relevant to this case and has not been discussed at all is the issue of medical ethics regarding procedures that cause death. "First do no harm..." is a very, very complex issue at times. Often a presumed good benefit is obtained by means of causing a bad effect. Abortion is the prime example, and is inexcusable because of the fact that the procedure's primary intent was to cause a death.
Now an example of a complex issue would be uterine cancer in a pregant woman. In our hypothetical case, if the uterus is not removed quickly the mother will certainly die, but of course removing the uterus will of necessity kill the fetus. The baby probably would not survive due to the failing health of the mother anyway, because of her body's inability to produce a healthy child. Should we let the mother die to have a poor chance of saving the child? Don't answer--THIS IS NOT THE ISSUE! (I tricked you.) Unfortunately, this is the first logical question most would consider. It is like "lifeboat." Someone must die, so who will it be? Again, this is not the issue--this is playing God.
Let's start over. First we must note that if the doctor can almost certainly save the mother's life, not to provide treatment is a decision to effect her death. He cannot do this. However, the mother CAN make that decision to refuse medical treatment for the sake of the small chance that her baby may live, and the doctor must honor that decision, but the doctor has NO choice here.
THIS BRING US TO THE TRUE ETHICAL ISSUE: Is the primary prupose of the procedure to cause a death? In this case, in removing the uterus, the intent is to save the life of the mother. The death of the fetus is an unintended and unavoidable result, but it is NOT the intent. This is the foundation upon which the very complex ethical issues are built. I cannot go further now, or I will be late for USF.
"First do no harm." Terry's is a competely different case, but the qiestion intent is still the foundational issue. Suffice to say that the intent of denying basic nutrition to Terry Shiavo is to cause her death (regardless of whatever language is used, e.g. "letting her die with dignity," etc.) Here is the starting point for the debate regarding medical ethics among believers. And from here it gets really problematic...